Government said lagging on anti-fraud technologies

Federal agencies should adopt forensics, analytics, open source and error triangulation tools

Agencies lag behind the private sector in deploying sophisticated analytical tools for identifying fraud and improper payments, according to Daniel Werfel, controller of the Office of Federal Financial Management in the Office of Management and Budget.

With respect to use of forensic technologies, analytics, open-source data, and triangulation techniques, government is still “in the embryonic stage,” Werfel said June 15 at the SAS Institute Inc. Government Leadership Summit.

“I feel this is an important moment, and deployment of these technologies will set government on a new path,” he said.

The Obama administration has estimated that in fiscal 2010 federal agencies made about $125 billion in improper payments, defined  as payments made to the wrong person, for the wrong amount, the wrong reason or with incomplete documentation. Some of the wrongful payments are due to fraud, while many are due to errors or incomplete data. The administration intends to reduce such payments by $50 billion by fiscal 2012.


Related stories:

Auditors estimate $2.8B in improper payments at SSA, FEMA

Administration uses IT to cut improper payments


Some of the errors are rooted in naming conventions, such as allowing a federal check to be sent to "John Smith," who is dead, but whose death is listed in an index as "John L. Smith." In those cases, triangulation techniques, where several independent sources of identifying data are used, should be used to confirm the identifies of people getting federal payments, he said.

Werfel said transparency and fraud detection have advanced tremendously by the oversight board for the American Recovery and Reinvestment Act of 2009. The board is headed by Earl Devaney, a former inspector general at the Interior Department.

Werfel said he was extremely impressed when he visited the Recovery Accountability and Transparency Board’s fraud detection operation for the first time last year. The investigators use analytic tools, software, mapping tools and business intelligence databases.

“I have been in government since the 1990s, and I had never seen anything like it in government,” Werfel said. “My jaw dropped.”

The board was able to demonstrate to Werfel how to quickly identify suspicious activities in several states, such as money going to debarred contractors or to contractors with felony convictions. The cases that raised red flags were either prosecuted or are undergoing further investigation.

Werfel said he encouraged the Centers for Medicare and Medicaid Services to try the recovery board’s analytical tools on a trial basis and it is experiencing good results. The new tools were used to help identify a fraud ring and several cases of identity theft in the Medicare files, he said.

“Medicare is very good about finding certain kinds of fraud,” Werfel. “The recovery board also found those frauds, as well as more errors…It turns out that [Medicare] was not as good at catching identity thefts.”

Werfel said his mission is to persuade other federal agencies to apply the forensic tools.

“Agencies are skeptical, but so far the experience has been eye opening,” Werfel said.

Although agencies should be aggressive in reducing improper payments, policy decisions will need to be made to balance the risk of wrongful payments against the risk of delaying a payment to a needy person who relies government benefits, Werfel said.

For example, a portion of the improper Social Security payments are made to dead people. The problem is that the Social Security Administration does not receive immediate notice of all deaths. The solution might involve delaying all payments to ensure that all beneficiaries are living, but that would have a negative effect on needy recipients who are dependent on receiving checks on a regular schedule, Werfel said.

“I had one [federal] executive say to me, ‘I would rather allow 100 payments to dead people than to hold up one payment to a living person,' ” Werfel said, adding that he questioned if that is a good business rule for governments that operate under budgetary constraints.

“The point is, there needs to be an equilibrium,” Werfel said. “The big elephant in the room is, ‘What business rules are we willing to live under?’ ”


Reader comments

Wed, Jun 22, 2011 Dave Dantus, principal of Government Solutions at Pegasystems

The massive and costly problem of improper payments goes beyond social security. It’s not something that will go away anytime soon, and I’m glad you’re covering it, as it’s very newsworthy. Whether it’s Medicare or unemployment insurance, federal agencies delivering citizen services are struggling with how to combat waste, fraud and abuse. They are under more pressure than ever to improve citizen satisfaction and decrease costly errors. This is in part due to changing programs and policies. Diminishing manpower and continually tightening agency budgets signal that the situation might only get worse.

Thu, Jun 16, 2011 Brand Niemann United States

Here is some real substance for this story: http://semanticommunity.info/Build_the_Health_Data_Infrastructure_in_the_Cloud/Announcement

Thu, Jun 16, 2011

QUOTE: "I had one [federal] executive say to me, 'I would rather allow 100 payments to dead people than to hold up one payment to a living person,' " Werfel said, adding that he questioned if that is a good business rule for governments that operate under budgetary constraints. :END QUOTE

While it is a waste, it is better that the 100 get paid than to have one life ruined by a bureaucracy. There are already too many stories of folks declared as 'dead' and cut off from all they had worked for at a time when they may not be able to cope with the stress. No, it is far better to let the 100 get unearned gain, and then do the research and go retrieve the money plus interest. Gives some jobs to some folks, as enforcers.....

In the 90's when I was living in Dallas, Texas, a co-worker told me of a certain prominent organization going around the country and teaching a certain class of folks (that he was a member of, which is how he knew of it) how to cheat the Gov and ways to have multiple identities set up to rack in multiple welfare and other handout checks. So it is a big problem

Please post your comments here. Comments are moderated, so they may not appear immediately after submitting. We will not post comments that we consider abusive or off-topic.

Please type the letters/numbers you see above