August 14, 2015—Seven programs administered by the Georgia Department of Health and Human Services (DHHS), the LIHEAP grantee, will soon be using Pondera Solution's "Fraud Detection as a Service" (FDaaS) to combat fraudulent program applications. LIHEAP is one of the programs that will use the new system.
Pondera's cloud-based service boasts access to Google's datacenters and advanced analytics tools. It claims to be able to provide "a 360 degree view of program transactions, an analysis of the identity of the person applying for benefits, the device used to apply for benefits (if processed online) and the claim itself." Pondera also touts its ability to process billions of transactions in a matter of minutes. Intake workers using the cloud service access it via an online dashboard, eliminating the need to purchase and install separate software. Thus, Pondera states the service can be developed and up and running quickly often in less than 90 days.
The FDaaS works by combining third-party data sets—such as checking Social Security Numbers, addresses, and other types of information against data collected from private business and consumer sources—with information provided by those applying for assistance programs. It also searches multiple sources looking for multiple people sharing one bank account, and it examines behavioral issues that might indicate potentially fictitious identities. The four-year contract between Pondera and Georgia's DHHS is set to begin in January 2016. The programs that will be utilizing this service will include Georgia's Medicaid; Children's Health Insurance Program; Supplemental Nutrition Assistance Program; Women, Infants and Children; Temporary Assistance for Needy Families; Childcare and Parent Services; in addition to LIHEAP.
The use of this service will help enable Georgia's LIHEAP to better comply with the U.S. Department of Health and Human Service's 2010 Action Transmittal that required all states to report on their systems for ensuring program integrity, including provisions to prevent waste, fraud and abuse. The 2010 Action Transmittal came soon after a Government Accountability Office (GAO) report entitled Low Income Home Energy Assistance Program: Greater Fraud Prevention Controls Are Needed was release that highlighted LIHEAP's risk for fraud and improper benefits in selected states. The GAO report set in motion a process that made program integrity a central focus of LIHEAP grantees. For more information about program integrity, see the LIHEAP Clearinghouse website.
Sources: Media Sources, LIHEAP Clearinghouse, Pondera Solutions