State Payment Integr

Se
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New Data SourcesCAIAPortal and Bulk Record MatchingAnalyticsMedicaid Screening ServiceAPIFeedback Loop

Agenda
DNP Data S

Presenter: 
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L EAD ∙ T RANSFORM ∙ D ELIVER

Death Data

• Social Security Administration (SSA) 

Death Master File (DMF): Public Data Source

 Full DMF expected late 2023

• American InfoSource (AIS) Obituary 

and Probate Records: Commercial Data Source

• Department of Defense (DOD) 

Death: Public Data Source

• Department of State (DOS) Death: 

Public Data Source

• Electronic Verification of Vital Events 

Fact of Death (EVVE FOD): Public Data Source

Deba

• Department o

Services (HHIndividuals anPublic Data S

• General Serv

(GSA) System (SAM) ExclusSource

Barred 

Foreign Entities

• Department of Treasury (TREAS) 

Office of Foreign Asset Controls (OFAC): Public Data Source

Registered Entities/

Non-Profit

• General Services Administration 

(GSA) System for Award Management (SAM) Entity Registration Records: Public Data Source

• Internal Revenue Service (IRS)Tax 

Exemption Lists: Public Data Source

 990-N (e-postcard),  Publication 78 (Pub78),  Automatic Revocation of 

Exemption List

Current Data Sources Available for State Pro

New D

Com

• Department o

Disqualified L

• Health and H

Plan & Provid

• Bureau of Pri• DNP Adjudica
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So that you can

Focus on your mission

Do Not Pay has received designation for new data sources: • Department of Agriculture’s National Disqualified List (NDL): 

information on providers that are ineligible to receive federal fundprogram, including agencies, individuals, and institutions who hahave serious deficiencies in administration or documentation

• HHS National Plan & Provider Enumeration System (NPPES)

information on approved health care providers and health plans; National Provider Identifier which is unique to the business and is 

various government agencies

• Bureau of Prisons Data (BOP): Contains information on incarce

under the jurisdiction of the U.S. Attorney General Does not cont

local, or private incarceration records. Verifies eligibility for benefprohibited or adjusted for prisoners (Veterans’ Health Benefits, SMeans-Based benefits).

New Data Sources
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So that you can

Focus on your mission

EVVE Fact of Death (EVVE FOD) is a NAPHSIS death matching system that ma

death databases of 44/57 participating jurisdictions’ (states and territories) vital reFOD delivers death matches against databases from jurisdictions, indicating the certificate, and providing related information on the deceased status specific reco• Returned results indicate Match/No Match, State of Death, and Date of Death • Returned results may also provide additional identifiers, such as: First Name, M

Name, Date of Birth (Month, Day, Year), and State of Birth

New Data Sources – EVVE FOD
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So that you can

Focus on your mission

• NAPHSIS has unique access to the vital records databases of jurisdictions participating 

systems. The vital records databases for the participating jurisdictions contain informatiavailable by other data sources such as state reported deaths which are currently excluMaster File – Public database.

– EVVE is the sole source for this capability – no other private or federal database dir

records databases.

• EVVE FOD provides independent confirmation of death information received from othe

sources (e.g. DNP, Financial Institution, obituary, family member, etc.) - improving the crecords. 

• EVVE FOD matched records are based on existence of a death certificate. This informa

be used by agencies when investigating the eligibility of payees receiving benefit paymtermination and recovery of benefit payments to the deceased, these services could als

– Determine eligibility for survivor and burial benefits– Termination of benefit payments– Cancel scheduling of federally funded medical appointments and prescriptions 

New Data Sources – EVVE FOD
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So that you can

Focus on your mission

DNP has upcoming data pilots scheduled to be completed this fall to assess the vcommercial data services for potential future designation: • The Work Number (Equifax): Verification of income and employment informa

employers and payroll providers 

• Accurint (LexisNexis): Identity validation/confirmation of essential personal in

name, address and Social Security Number or Federal Identification number

Upcoming Data Pilots
Common Approach to Identity Assurance 

Prese
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The Common Approach to Identity Assurance pto establish a common approach for improving hregister and log into Fiscal Service’s external-faprograms.

Overview
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A service that programs can leverage, gbusiness of identity management and rebusiness with their customers.An enterprise-wide service that achieveand operational efficiency.

A solution that leverages up-to-date, comcredential service providers; No need to ensure that technical requirements are mAn online process, giving customers a mexperience and streamlining internal opTools that will more effectively manage ientitlements, ensuring greater security

Programs separately establish and manage identity solutions, resulting in duplicative efforts across the bureau.Programs are challenged with staying current with evolving security standards.Enrollment for business entities include manual processes, resulting in an inefficient customer experience and operationsLifecycle management of identities are inconsistently managed, resulting in security risks.

Vision
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The CAIA program delivers an enterprise-wide service that programs can leveragmanage digital identities via credential service providers.CAIA Program
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DNP Login Experience
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Until CAIA is implemented, users will have access to DNID and Password combination. No tokens are required.Tokens will be deactivated on October 1st, 2022. Please w

to convert to this solution before September 30th. 

User ID and Password Solution
Portal and Bulk Record M

Presenter: Jo
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Prior to awarding 

funds or 

determination of 

recipient

After award or 

determination, 

but prior to 

disbursement 

of funds

When payments 

are submitted for 

payment

After t

payment 

been disb

to the rec

DESCRIPTION PAYMENT CYCLE

1 2 3 4

DNP Bulk 

Record Matching

When Do Improper Payments Occur?
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 Check multiple data sources across a

payments/payees at once

 Consolidated match results prioritized 

match strength

 Ability to export match results for revi

phase

 Create API connection with your syste

and DNP for automation

Advantages of Bulk Record Matching
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DNP Portal Matching Options

Online SearchUser can search an individual or entity and view matching recoat the time of searchBatch MatchingOne-time bulk submission for screening grants or loan paymenspecified data sourcesContinuous MonitoringContinuous screening for eligibility verification against specified sources using a grantee or loan recipient listingWeb Service/APIA Web Service or Application Programming Interface (API) creaconnection with agency payment systems and the DNP Portal. integrates the functionalities of the Portal within agency interna
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Online Search
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• Legal Approval – Complete Initial Questions and be approved fo

data sources

• File Creation – Using a standard template guide, create file of yo

records 

• Secure Transfer – Establish a safe, secure method of sending fi

matching

• Results Review – Adjudicate matches and provide feedback to D

Legal Approval File Creation Secure Transfer Result

Review

Bulk File Process
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Matched File Summary
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Matched File Records
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Match Record Details
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File Creation

Da

Adjudication Match R

Feedback

State #1: Medicaid and SNAP

July 2021 158

August 2021 100

September 2021 29

October 2021 64

November 2021 73

~ ~

May 2022 171

June 2022 75

Total Confirmed Deaths: 1053

Cost Avoidance $2,230,844

Recovery $801,198 

Total $3,032,042 

Continuous Monitoring Snapshot
DNP Analytics Ov

Presen
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So that you can

Focus on your mission

The DNP Analytics Solutions Team is dedicated to delive

insights and innovative data solutions that help you imppayment integrity and meet your mission. 

Our team of professionals with extensive experience include: 

Analytics ConsultantsData ScientistsData Analysts 

Introducing DNP Analytics
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Federal and State Programs 

can take advantage

of the benefits!

that administer Federal funds 

WIC

Unemployment Insurance Medic

Federal Benefits

SNAP

Oversight Offices

Office 

SBP

TANF V

Foster & Child Care

Grants & Loan

Office of the Inspector General

Office of Audit General CARES Act 

Who can benefit from FREE DNP Services?
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So that you can

Focus on your mission

Analytic Solutions Team services range from consultation to fully-insolutions that can be customized to your business.

DNP Analytics Services 
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Support the Point-in-Time Prevention & Improper Payments

Verify Payee Eligibility Throughout Paym

Detect Fraudulent Activity Earlier

Identify Overpayment Risks Associated Payments

Ensure Screening Efficacy through the RQuality Gain Assurance of Internal Controls & SEffectivenessProvide Time, Resource, and Cost SavinTurnaround of Results & Access to Data 

How can DNP Analytics help unlock benefits using 
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So that you can

Focus on your mission

We employ advanced data analysis techniqu

Data Matching Data Modeling Risk Assessment A

Analytics Techniques
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The State of Oregon’s (OR) Audit 

Division partnered with DNP to test 

the cost benefit of using DNP 

services to support their efforts in the 

identification and prevention of 

improper payments. 

DNP analyzed over 1.4M records of 

OR providers and beneficiaries to 

verify eligibility.

Programs Reviewed• Medicaid, SNAP, TANF, and 

Unemployment Related Day Care

• DNP identified $790,000 in recou

avoidance, and improper paymen

• “Using Do Not Pay generated a r

of $286 in savings for every $1 - Oregon Secretary of State, Repo

• DNP identified 98 additional case

participants/providers

• DNP identified 2 records with a ty

coverage date field “2108”

- OR estimated this error had the 

$6M worth of improper paym

BACKGROUND IMPACT

FINDINGS

Success Story: Oregon Audits Division
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An oversight office partnereview of a Federal benethe value of using DNP their efforts in the identifiprevention of improper pDNP analyzed 10M beneverify their eligibility and fraudulent activity betweeincludes COVID-19 relief The analysis included daassessments, fraud rismatching to death data whether beneficiaries weeligible at the time of a p

Success Story: Background
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i

as

f

Five Primary Analyses

Findings identified through individual analysis may not always appear suspicious on their own until comand/or analyses which could indicate a fraud network. As such, DNP compared the findings from five 

whether there were unexpected associations between the PII of different beneficiaries which may be a 

1. Death Data Source Matching

Finding: $38.6M in benefits were awarded to 2.2K beneficiaries that appear to have been 

deceased before or on the payment or claim date.

2. Age Assessment

Finding: $26M in benefits were awarded to 1.6K beneficiaries that appeared older than 100 which is outside of the expected age range associated with this benefit.

3. Email Alias

$809M in benefits were awarded to 42K beneficiaries that shared an email username and/or 

alias with a significant number of other beneficiaries

4. Mailing Address

$6.8B in benefits were awarded to 386K beneficiaries that shared a mailing address with 10 or 

more additional beneficiaries

5. IP Address

1.4K distinct beneficiaries shared an IP address with at least 25 other beneficiaries on the same day

Success Story: Analyses & Findings
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An Example of a Suspicious Network of Claimants

sampleemail.@gmail.com

555 Street Ave.

1.11.111.1111

Individual #1

sampleemail.@gmail.com

555 Street Ave.

1.11.111.1111

Individual #2

sampleemail.@gmail.com

555 Street Ave.

1.11.111.1111

Individual #3

sampleemail.@gmail.com

555 Street Ave.

1.11.111.1111

Individual #4

sampleemail.@gmail.com

555 Street Ave.

1.11.111.1111

Individual #5

sampleemail.@gmail.com

1 Square Cir.

99.99.999.999

Individual #6

manypeople@aol.com

99 Hundred Blvd.

1.11.111.1111

Individual #7

555 Street Ave.

300.0.300.0

Individual #12

familiar@yahoo.com

123 Main St.

257.257.257.257

Individual #13

sampleemail@gmail.com

456 Center Rd.

2222.33.4.555

Individual #15

testing@gmail.com

111 Broadway St.

Individual #14

testing@gmail.com

1.11.111.1111

555 Street Ave.

2222.33.4.555

Individual #16

username@domain.com

555 Street Ave.

99.99.999.999

Individual #17

person@outlook.com

1 Square Cir.

0.0.0.888

Individual #18

nobody@yahoo.com

Fraud Network Example
Medicaid Screening S

Presenter: 
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So that you can

Focus on your mission

• According to Payment Accuracy.gov, improper payments within the 

program exceeded $97B in FY 2021

• To help address this significant amount of improper payments, DN

a new tool called the Medicaid Screening Service to aid program oidentifying potentially deceased individuals

• This is an eligibility verification tool that can be used to match a 

against DNP’s available death sources on a recurring basis to 

identity and inform state offices of decedents before improper disbursed

• Data quality and integrity checks will also be run against the b

determine potential issues 

What is the Medicaid Screening Service?
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BENEFICIARY 

SYSTEM

Program office has a 

system of 

beneficiaries currently 

on their rolls PAYEE 

DEATH

STATE 

PROCESS

• In this example, there are 

two improper payments that would be reclaimed and one improper payment that is prevented by removing the payee from the beneficiary system.

RESEARCH & 

VALIDATION

Program office has to 

research and validate 

suspected deceased 

payees through a manual 

and time intensive process

REMOVE PAYEE 

Payees validated a

deceased through 

research and adjudic

are taken off payee ro

prevent future impro

payments

If 

o

d

p

att

MATCH TO DEATH 

SOURCES

Program office matches 

their beneficiaries to 

available sources of death 

and find constructive 

knowledge of death on a 

recurring cadence 

Current Medicaid Adjudication Flow
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BENEFICIARY 

SYSTEM

Program office has 

a system of 

beneficiaries 

currently on their 

rolls 

STATE 

PROCESS WITH MSS • This concep

burden and payment. • In this exampayment thatwo impropeprevented by from the ben

p

t

REMOVE PAYEE 

Payees validated as 

deceased through 

research and adjudication 

are taken off payee rolls 

to prevent future improper 

payments 

RESEARCH & 

ADJUDICATION

Program office has to 

research and validate 

suspected deceased 

payees through a 

manual and time 

intensive process

PAYEE DEATH

PAYEE FILE

DNP would receive a 

file of all beneficiaries 

currently receiving 

payment 

MATCH TO DEATH 

SOURCES

Program office 

matches their 

beneficiaries to 

available sources of 

death and finds 

constructive 

knowledge of death 

DEATH MATCHING

The MSS tool can be 

utilized on a set cadence to 

determine the probability of 

a payee being deceased 

prior to the payee receiving 

further improper payments 

from the state

SECONDARY VALIDATION

Payees identified by the tool 

as believed to be deceased 

would be transmitted to EVVE 

FOD for secondary validation 

of death, mitigating the 

program office’s need for 

manual research 

Proposed Medicaid Adjudication Flow
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So that you can

Focus on your mission

State Medicaid beneficiary files will be screened against aavailable death data sources, including: • Death Master File – Public• American InfoSource- Probate• America InfoSource – Obituary• Department of Defense Death Data• Department of State Death Data• Electronic Verification of Vital Events Fact of Death syste

Sources included in the Medicaid Screening 
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So that you can

Focus on your mission

The Medicaid Screening Service analyzes your client data program efforts to prevent and recover improper paymentsSome benefits of using the Medicaid Screening Service include: • Identification of deceased clients and those who are ineligible to 

Care payments 

• Identification of any quality or integrity issues within customer da

duplicate or invalid Social Security Numbers 

• Continuous screening of clients at a frequency that suits custome

timely case development 

• Prioritization of payments/payees based on the likelihood of the r

deceased and the suggested urgency of adjudication 

Benefits of the Medicaid Screening Service
Application Programming Interfac

Presenter: 
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What is an API?
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A machine-to-machine interaction that takes place network, typically using the Hypertext Transfer Proused on the web• An API is a software intermediary that allows two applications to • In this case, your organization’s software system would be the co

information and would be accessing information from DNP’s datawould be the provider

• Essentially, the consumer is integrating DNP data into their own s

What is an API?
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Legal 

Analysis/Approval Technical Set Up QA Tes

Produc

Verifica

Go Live! Outcome Feedback

Process – High Level
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• With the API, the consumer is integrating DNP data into their own • DNP would assess the needs of your organization to help you ma

on API vs. Portal

– Does the program need real time results or are daily results sufficient?

• Using the DNP Portal is a manual process of searching of DNP d• Portal requires people to log in and retrieve results• API does not require onboarding to the DNP Portal• API can be an automated process• API returns results without you having to navigate to the approprAPI vs. Do Not Pay Portal
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• Single API call contains the search criteria of one 

matched against your agency’s approved data soDNP response will include data source match resthat single entity.

Query Options: Option 1 – Single Record
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• Multiple API call contains the search criteria of up 

entities to be matched against your agency’s appsource(s). The DNP response will include data soresult(s) for the searched entities.

Query Options: Option 2 – Multiple Record
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• Initial meeting to discuss expectations• Initial Questions document and Legal Questionna

agency

• Garner legal approval• Assist agency with technical questions during sys

buildout

• Issue client certificates (QA and Production)• QA Testing• Assist with go-liveWhat Does DNP Do to Set Up?
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• Initial Meeting to discuss expectations• Complete the Initial Questions document and Leg

Approval forms (DNP will guide you through the p

• Once legal approval is given, the agency will be 

responsible for developing or installing their softwsolution

• Test with DNP• Go live and give feedback on decision made (fun

can be built into your software)

What Will You Do to Set Up?
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• The API team can meet with Agency Outreach an

how agencies are using API to better serve the a

• Technical team can watch for hiccups• This helps your organization and DNP uncover o• Testimonials are good for businessWhat Will DNP Do With Your Feedback?
Establishing a Feedback 

Presenter: Jo
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“Continuous improvement is better than delaperfection” – Mark Twain
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Quantifies goal of payment integrity effortsIdentifies opportunities to refine DNP systems/soDiscovers unknown agency needsProvides insight into the value DNP is bringing to 

agency

Why provide feedback on DNP matches?
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Agency 

submits DNP 

Bulk 

Matching 

File

DNP 

provides 

summary 

email of 

matches to 

Agency

Agency provides 

DNP number and 

$ amount of 

identified 

Improper 

Payments

Agency file is 

matched to 

DNP data 

sources 

through 

overnight 

process

Agency 

extracts 

match 

results and 

begins 

investigation

Procesmonth providvalue fand DN

Feedback Loop Example
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Process ImprovementsTime/Resources savingsCost RecoveryFuture Cost AvoidanceAgency Needs from DNP

What feedback can be shared?
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Any feedback provided to DNP is never shawith any other party.Custom reports on improper payments identcan be provided to your agency upon reques

Mum’s the word...
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• • 

• 

• Meet with DNP 

Schedule an Overview discussion

• Initiate Request 

Let DNP know that you are interested in an engagement Portal  Analytics Project

• Consultation/Scope

DNP will coordinate discussions to learn more about your eligibility requirements and data

INITIATION

• Formal Request

Execution of:

Initial Questions Document 

(Portal)

Customer Acknowledgment 

Form (Analytics)

• Legal Approval

Review and approval by DNP 

and Fiscal Service Legal

• Secure Connection 

Establish and test secure 

connection

Securely transfer customer 

data

PLANNING & INTAKE

• Kick-Off Discussions

Portal OverviewMeet the Analytics team 

• Portal Engagement

Online SearchEstablish Bulk File submissionWeb Services/ Application 

Programing Interface (API)

• Perform Analytics

Analyses will be performed utilizing customer provided data

EXECUTION 

Let’s Get Started!
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 “Utilizing DNP’s risk scoring capabilities enhanced our planning activities and provided 

results.”--State Auditor’s Office of Massachusetts

 “Direct benefits include authoritative sourcing that increases LAD’s credibility with audit

alert agencies to data errors in their identification data. These skills and the DNP servicour growing data analytic toolbox.For LAD, personnel costs were saved by using a single source, rather than manually codo death records the state death records. This saved time both in compiling and performchecks. In addition, the DNP service provided a level of certainty about the death that tnot.”--Montana Legislative Audit Division

 “Our partnership with DNP has resulted in an increase in cost avoidance and recovery 

every month. Additionally, it provides a resource to identify our clients who may have paor out of country. We’ve had a positive experience working alongside the DNP team anexplore the benefits of this resource.” --Oregon Department of Human Services, Data Match Unit Managers

Customer Feedback
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Jon OrtizManagement & Program AnalystDo Not Pay Business Center202-874-9579Jon.Ortiz@fiscal.treasury.govVisit our website:https://www.fiscal.treasury.gov/dnp/states.htmlContact Us