2017 Fraud and Abuse Forum: Requirements to Results, Where we are and What's Next

The American Council for Technology and Industry Advisory Council (ACT-IAC) invites you to the Fraud and Abuse Forum on Thursday, July 20, 2017 at the Renaissance Washington in Washington, DC.The theme, ‘Requirements to Results: Fraud and Abuse Where We Are and What’s Next’, will focus on challenges of the Fraud Reduction and Data Analytics Act of 2015 and look to the future of fraud and abuse.

In a report, issued on January 12, 2017, the GAO addressed the government wide improper payment amount which had risen to $ 144B in FY 16.“This increase between FY 2015 and FY 2016 can be attributed to percentage and dollar increases in the Medicaid Program, the Direct Loan Program, the Medicare Part C Program, the Pell Grant Program, the VA Community Care Program, and the Earned Income Tax Credit (EITC) Program.” They further stated, “For fiscal year 2016, federal entities reported improper payment error rates that exceeded 10 percent for 11 risk-susceptible programs, accounting for more than 70 percent of the government wide improper payment estimate.”

In response, Congress introduced the Fraud Reduction and Data Analytics Act of 2015. This Act would require every agency to establish financial and administrative controls to identify, assess, monitor, and report fraud risk. The purpose of the Act was to design and implement control activities to prevent, detect, and respond to fraud and abuse, including: improper payments that include the integration and adoption of appropriate risk management processes and systems to identify risks, challenges, and potential threats. This Act was signed into law by President Obama on June 30, 2016.

Identifying and reducing these erroneous payments at every level of government is critical not only from budgetary perspective; if left unchecked erroneous payments can result in an erosion of confidence by the public in the governments’ ability to properly administer programs.

Objectives of the Forum:

Federal and state employees are responsible for safeguarding federal and state assets in addition to efficient, effective, and timely delivery of services to the public.  To comply, each agency needs to understand the potential impact of fraud and abuse, identify risk profiles, design approaches for monitoring, prioritize risk impacts, and evaluate the effectiveness of these activities.  The government and industry panels will address the following items as they relate to existing and future changes associated with fraud and abuse.

• What are the current challenges/barriers to identifying and managing fraud and abuse?
• What is working and not working today?
• What does the Act and related OMB guidance require, what is the timeline, and how will it benefit the agencies?
• What will be the impact of the Fraud Reduction and Data Analytics Act be to agencies with implementation – is it doable?
• What is needed and what is necessary to achieve a reduction in risk associated to fraud and abuse cases?
• What analytics, audits, risk mitigation, compliance, and forensics need to be included?
• How is cybersecurity and identity management addressed in conjunction with fraud and abuse?
• Can analytics drive fraud identification processes?
• What does the future hold as it relates to new, unique, and complex fraud and abuse schemas?

Audience:

• The Federal and state government audience is any agency that detects, reviews, monitors, and assesses fraud, abuse, and improper payments.
• The industry audience are those firms that manage, review, audit, and track fraud, abuse and improper payments; develop tracking tools; assess and monitor potential or emerging risk situations; and are an insurer or provider.

ACT-IAC events are intended to provide an objective and vendor-neutral collaborative environment where government and industry can work together on issues of mutual interest and forge relationships based on trust.  Attendees are requested to avoid using this forum for business development purposes.