ACCESS Florida System Replacement State of Florida, Department of Children and Families Office of Economic Self-Sufficiency Oral Presentation ITN# 03F12GC1 Xerox State & Local Solutions, Inc. October 17 – 18, 2012 Duplicate Copy Business Group Name Here
Agenda – Day 2 Topic Allotted Time Participants Mark Mayo Joel Schensul, Account Executive Bill Majorossy, Project Manager Functional Requirements Kim Shaver, Subject Matter Expert 9:00AM – 10:00AM (Information Verification and Jeff Valentine, Subject Matter Expert Eligibility Determination) Glenn Miller, Subject Matter Expert Dustin Nguyen, Subject Matter Expert Geoff Duckwall, Subject Matter Expert 10:00AM – 10:15AM Break 10:15AM – 11:15AM Functional Requirements 11:15AM – 12:15PM Functional Requirements 12:15PM – 1:15PM Lunch 1:15PM – 2:45PM Functional Requirements 2:45PM – 3:00PM Break 3:00PM – 4:15PM Cost Discussion 4:15PM – 5:00PM Question and Answer Page 2 October 18, 2012
Agenda – Day 2 Topic Allotted Time Participants 9:00AM – 10:00AM Functional Requirements 10:00AM – 10:15AM Break 10:15AM – 11:15AM Functional Requirements 11:15AM – 12:15PM Functional Requirements 12:15PM – 1:15PM Lunch 1:15PM – 2:45PM Functional Requirements 2:45PM – 3:00PM Break 3:00PM – 4:15PM Cost Discussion 4:15PM – 5:00PM Question and Answer Page 3 October 18, 2012
Agenda – Day 2 Topic Allotted Time Participants 9:00AM – 10:00AM Functional Requirements 10:00AM – 10:15AM Break Mark Mayo Joel Schensul, Account Executive Functional Requirements Bill Majorossy, Project Manager 10:15AM – 11:15AM (Financial Management and Kim Shaver, Subject Matter Expert Reporting and Analytics) Jeff Valentine, Subject Matter Expert Sarah Wilson, Subject Matter Expert William Rudolph, Subject Matter Expert 11:15AM – 12:15PM Functional Requirements 12:15PM – 1:15PM Lunch 1:15PM – 2:45PM Functional Requirements 2:45PM – 3:00PM Break 3:00PM – 4:15PM Cost Discussion 4:15PM – 5:00PM Question and Answer Page 4 October 18, 2012
Agenda – Day 2 Topic Allotted Time Participants 9:00AM – 10:00AM Functional Requirements 10:00AM – 10:15AM Break 10:15AM – 11:15AM Functional Requirements Mark Mayo Joel Schensul, Account Executive Bill Majorossy, Project Manager Functional Requirements Kim Shaver, Subject Matter Expert (Program Management and 11:15AM – 12:15PM Jeff Valentine, Subject Matter Expert Infrastructure and Support Shawn Dietrich, Subject Matter Expert Functions) Glenn Miller, Subject Matter Expert Dustin Nguyen, Subject Matter Expert Geoff Duckwall, Subject Matter Expert 12:15PM – 1:15PM Lunch 1:15PM – 2:45PM Functional Requirements 2:45PM – 3:00PM Break 3:00PM – 4:15PM Cost Discussion 4:15PM – 5:00PM Question and Answer Page 5 October 18, 2012
The Xerox Solution Advantages – Reusable Assets from Oracle Consulting Oracle Software + Oracle Services = Pre-built MAGI Eligibility Enabled Integration Rules Requirements CMS Gate Self-Service Federal Data Reviews Portal HUB Integration Page 6 March 4, 2013
Development Cycle Present Day Business Rules in code Page 7 October 18, 2012
A New Approach to Rules Oracle Policy Automation transforms policy documents … Page 8 March 4, 2013
Oracle Policy Automation Page 9 March 4, 2013
Agenda – Day 2 Topic Allotted Time Participants 9:00AM – 10:00AM Functional Requirements 10:00AM – 10:15AM Break 10:15AM – 11:15AM Functional Requirements 11:15AM – 12:15PM Functional Requirements 12:15PM – 1:15PM Lunch 1:15PM – 2:45PM Functional Requirements 2:45PM – 3:00PM Break 3:00PM – 4:15PM Cost Discussion 4:15PM – 5:00PM Question and Answer Page 10 October 18, 2012
Lunch
Agenda – Day 2 Topic Allotted Time Participants 9:00AM – 10:00AM Functional Requirements 10:00AM – 10:15AM Break 10:15AM – 11:15AM Functional Requirements 11:15AM – 12:15PM Functional Requirements 12:15PM – 1:15PM Lunch Mark Mayo Joel Schensul, Account Executive Functional Requirements Bill Majorossy, Project Manager (Case Management and Kim Shaver, Subject Matter Expert 1:15PM – 2:45PM Case Work and provider and Jeff Valentine, Subject Matter Expert Business Partner Glenn Miller, Subject Matter Expert Management) Dustin Nguyen, Subject Matter Expert Geoff Duckwall, Subject Matter Expert 2:45PM – 3:00PM Break 3:00PM – 4:15PM Cost Discussion 4:15PM – 5:00PM Question and Answer Page 12 October 18, 2012
Program Integrity – Reducing Fraud and Error Rates
KPMG’s Fraud Risk Management KPMG Forensic Practice in the United States • Established in 1987 (components date from 1800s) • 39 Partners • 572 Forensic professionals • Core Services offered include: Investigations; Compliance & Monitoring; Forensic Technology; Dispute Advisory Services, and Fraud Risk Management Page 14 October 18, 2012
Prevent, Detect, and Respond Page 15 October 18, 2012
Prevent Reduce the risk of fraud, waste, and misconduct Design program in collaboration with DCF – available activities and approaches include: • Database connectivity/data sharing across state systems • Identity verification technologies and services with the Xerox IES and specialty providers (real time) • Error prone profiling – identifying high risk applications • Process and data mapping across all eligibility programs • Fraud awareness and other training Page 16 March 4, 2013
Detect Discover fraud, waste, and abuse in its earliest stage • Analyze voluminous electronic information and data to identify trends • Determine appropriate areas for sampling or comprehensive follow up • On an ongoing basis, evaluate processes for possible improvements in the efficiency of programs, or in the quality of program delivery, and to look for and understand the root cause of problems identified Page 17 March 4, 2013
Respond Take corrective action and remediate the harm • Integrate with other recovery operations within the State of Florida • Investigate and conduct fact-finding in response to allegations of wrongdoing • Coordinate with federal or state law enforcement authorities or officials with audit responsibilities • Continue analysis and reporting on the effectiveness of fraud prevention programs Page 18 March 4, 2013
KPMG Fraud Risk Management Methodology Consistent with the Government Accountability Office’s (GAO) model for anti-fraud programs and controls Lessons learned influence future use of preventive controls Preventive Detection and Investigations controls monitoring and prosecutions Potential fraud, Potential fraud, Potential fraud waste, and abuse waste, and abuse Source: GAO Page 19 October 18, 2012
Data Analytics Data analytics procedures that can be used include: • Identify key data personnel for each respective program • Interview key data personnel to discuss data availability, location, and systems that are currently in place • Work with respective IT Team to obtain data access • Create queries to perform proactive forensic data analysis, such as identifying areas where key pieces of data are missing, incomplete, or erroneous • Cross-match information against program-related information, state/local government provided information, and third-party databases • Perform periodic cross validation against employees, applications, and contractors • Use fuzzy logic techniques to identify relationship not immediately apparent • Perform advanced analytical procedures to identify outliers Page 20 October 18, 2012
KPMG Data Analytics Tool (KDAT) • Enables global consistency in KPMG’s approach and design of analytical procedures • Designed to allow for flexibility and customization of client needs and their systems Identify Criteria Configure Analyze • Define criteria • Configure the • Proactively for each tool for the analyze data program criteria and • Refine the tool considering available data based on past experience experience and available data Page 21 October 18, 2012
Fraud Risk Management in Action Example 1 – Louisiana’s Road Home program • Housing recovery and rebuilding program following Hurricanes Katrina and Rita • Members of HUD Office of Inspector General’s Hurricane Katrina Fraud Task Force • Fully integrated solution, including policies and procedures, data analytics, investigations, training, and reporting • Helped identify and investigate more than 1,800 instances of benefit fraud Example 2 – Galveston and Harris County, Texas Example 3 – British Petroleum oil spill government claims Page 22 October 18, 2012
Louisiana’s Road Home Program Integrated and Comprehensive Solution • Bi-weekly forensic data analysis and data mining across the program’s 150,000+ applicants to identify possible anomalies, patterns, and instances of fraud, waste or abuse, and duplication of benefits • Scripting of custom-designed data analytics routines incorporating owner, occupancy, homestead, address, insurance, and damage assessment information for the purposes of identifying red flags which could indicate instances of potential fraud, waste, or abuse • Reporting on data mining and data analysis results to program management for review and follow-up • Investigating homeowner occupancy and eligibility when critical red flags were discovered through our data analytics routines or when tips were provided via the program’s fraud whistleblower hotline Page 23 October 18, 2012
Recommend
More recommend
