With any earned benefit program like food stamps, or Medicaid, fraud is a problem. Individuals often use the identity of those who are dead or missing, to qualify for services they otherwise wouldn’t. In a large state like Florida, where populations shift, and immigrant or low-income individuals often have hard-to-verify personal histories, detecting fraud is an uphill battle. Now, with a first of its type pilot program, the Florida Department of Children and Families (DCF) has enlisted LexisNexis to help stop public assistance fraud before it happens.
LexisNexis Risk Solutions help private sector companies and financial services firms manage identity verification when an individual applies for a credit card, or a personal loan. Think of the security questions we must all set up and answer for online banking – solutions like this are created by LexisNexis.
Now, when Florida residents go to apply for earned benefit programs, they too will be asked to verify parts of their history in an effort to help the state make sure that applicants are who they say they are. The solution will work with the Automated Community Connection to Economic Self Sufficiency (ACCESS) Florida program.
“We have to do a verification anytime someone applies, and to this point most of those verifications have been done manually,” explains Suzanne Vitale, Deputy Secretary, Florida DCF, in an interview with CivSource. “Florida is in a unique situation because 90% of our applications come over the web. In most states, web applications barely make up 70%. Because of this, we had to start thinking differently about verification and how to make it faster, and better.”
Under the contract, LexisNexis processes requests of current DCF ACCESS Florida customers to verify and authenticate the identities of individuals seeking benefits from its Food Assistance, Temporary Cash Assistance and Medicaid programs. This process is handled through a set of questions that only an individual will know. “We didn’t want them to be ‘out of the wallet’ questions, what if someone has stolen your wallet and applies?” Vitale says. If a customer’s identity cannot be verified and authenticated using the LexisNexis technology, DCF will further investigate.
Nationwide, verification processes for earned benefit programs are mostly a manual process. State governments have long lagged federal and private organizations in technology, but part of it is also by design – the federal government supports manual verification. Through the pilot program, LexisNexis will bring verification online.
“We started thinking, if financial firms can do this, why can’t we do this? The federal government wasn’t fully convinced, but they gave us a waiver to test this out and make sure there weren’t any inadvertent access issues.”
The potential for access issues with these programs is significant. In a state like Florida populations, languages, education, income, physical and mental ability, can all be barriers to the system. Say someone just came to Florida from another country, completely legitimately, but couldn’t answer questions about that move due to a language barrier, they could be wrongly denied services. In human services, manual verification has been the cornerstone principle in an effort to mitigate these challenges.
According to Vitale to roll out the pilot, Florida DCF did needs assessment of all of the counties they serve to determine which county would provide the most representative sample of the rest of the state. From there, officials planned a phased in deployment of the technology, at a rate of a new county every two weeks.
On the backend, LexisNexis was making its own modifications to the identity management solutions it offers. “We added multiple language translations, and modified some of our modules to ensure access,” Clint Fuhrman, National Director of Government Health Care Programs, LexisNexis Risk Solutions, explains. “Accuracy rates for Medicaid verifications are going to be different from those for say, credit card verifications. We had to adapt those pieces to meet populations that have different histories.”
Fuhrman previously served as Deputy Secretary to the Florida Agency for Healthcare Administration from 2007-2008, and brought his knowledge of the state’s business processes to the pilot.
Working with DCF, LexisNexis created a feature that deals with people who don’t answer verification questions correctly. Initially, the system won’t tell them that they’ve answered incorrectly, they will go through the remaining application process, and DCF officials will follow-up with them directly for a manual verification process. Vitale says that the feature will help cut fraud while providing a safety net for people who may have just misunderstood the question. “We’re trying to move past the pay-and-chase model of assistance. We want to stop fraud at the front door.”
Now that the pilot has been announced, states like Michigan, Wisconsin, Pennsylvania, and Texas have indicated they are interested in implementing a system like this should the pilot be successful. Fuhrman notes that LexisNexis has already provided some advisory outreach to interested states on the initial technology deployment.
“We have exceeded our cost savings expectations by three times so far,” Vitale says. “This is a 105 day pilot and we are about midway through. The bottom line here is that we need to modernize the business practices of government, and we think this pilot will help us do that.”