Since late last year, there have been innumerable news articles about the massive fraud involving pandemic relief funds. If you’re charged with managing or protecting a state government agency providing social services benefits, you’ve probably read many of these articles – and winced nervously.
Agencies like yours are dealing with all kinds of headaches when it comes to protecting your resources and making sure that the people who really need the services and benefits you provide are getting them. At the same time, bad actors are making it harder to detect fraud.
In May, state agencies faced yet another major challenge. With the ending of the pandemic, public health emergency (PHE), began falling off the Medicaid rolls. This comes as agencies struggle to hire enough employees to deal with the influx of people that will be interacting with their programs. With staffers overworked, agencies are detecting less fraud.
And if they don’t have solutions in place to detect, prevent, investigate, and mitigate fraud, the risks are even bigger. Fulfilling your agency’s mission starts with protecting your citizens’ data. Inaccurate data renders you vulnerable to fraudsters stealing benefits from the people who rightfully deserve them – and often desperately need them. So how can you and your agency respond? First, by fully understanding the nature of the identity verification challenges you’re facing. Second, by exploring how new technologies can help solve those challenges through front-end prevention.
New stresses for government agencies
Your agency had to work extra-hard to keep up with record participation in pandemic-related benefit programs. You struggled to balance the volume of claimants while also preventing massive fraudulent activity. One of the problems here, of course, is that your agency’s mission isn’t stopping fraud. It’s getting benefits to the right people in a timely manner.
Proposed federal programs to beef up fraud prevention and prosecution will require states to be more rigorous in their anti-fraud efforts. (These proposals also would offer funds to help states recoup improper payments.) With fraudulent benefits claims costing the government billions, the need for such efforts has never been greater. That means state agencies will have to focus both on front-end prevention and detecting fraudulent activity within their programs. But with resources limited, few agencies are fiscally able to introduce in-house solutions that can efficiently and accurately uncover identity discrepancies, many of which are difficult to ascertain.
If this describes most or all of what your agency is facing, what you’re probably seeking is a cost-effective digital identity solution for each step of your due diligence workflow. For instance, your staffers need to detect and prioritize higher-risk fraud indicators that require further investigation. This approach shouldn’t delay payment of critical benefits to those truly qualified for them. You require real-time data sources that will quickly determine whether someone is using a false or stolen ID – or if the “applicant” is in fact a bot that’s searching for a weak spot in the system. Numerous fraudsters are hacking databases or using dark web sources to create so-called synthetic identities. Tearing off the masks of these false identities requires more than basic detective work.
Are you ready?
To achieve consistent, successful fraud detection and prevention, your agency’s staffers need a process that will provide long-term identity checks at the front end to immediately detect fraudulent activity before any money is disbursed. This toolkit should be able to automatically update when it uncovers new identity information tied to a particular individual. And it should immediately flag possible fraudulent IDs and be able to determine whether identity documents are legitimate and accurate.
Such a process should also be able to operate very quickly and efficiently. It should be capable of combing through all public records and other relevant data so that your investigators can do a rapid analysis of information on anyone interacting with government benefit agencies. This will allow your agency to review for potential fraud without requiring deserving applicants to jump through another hoop. That way, they won’t have to wait for benefits that they probably need right away.
Here you can learn more about how you can protect your agency’s program from fraud and fulfill its mission to serve citizens who are truly in need.
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