1 The MITRE Challenge Strengthening Eligibility Verification for Federal Benefit Programs September 20, 2018
2 Important Dates Sept 30 Deadline for registration and package request Oct 1 Challenge begins at 12:00 p.m. ET Oct 3 Challenge Instructions Webinar, 4:00 p.m. ET Nov 30 Submissions due by 5:00 p.m. ET Dec 19 Announce teams moving intro phase 2 Jan 19 Announce winning teams Mar 15 Award presentations, McLean, VA
3 Welcome Prospective Teams! Today s Objectives: Introduce competition concepts and expectations Provide overview of Challenge resources and rules Review submission requirements Explain the judging process Explain notification of awards
4 Welcome MITRE Federal Partners U.S. Department of Agriculture U.S. Department of Health and Human Services, including the Centers for Medicare and Medicaid Services U.S. Department of Homeland Security/Federal Emergency Management Agency U.S. Department of Labor U.S. Department of Veterans Affairs U.S. Internal Revenue Service U.S. Office of Management and Budget
MITRE: Solving Problems for a Safer World We work across government agencies, solving critical established national problems and sharing knowledge and experiences 1958 As an objective, trusted partner, we work together with government, industry, academia, and other non-profit not-for-profit organizations to achieve the best solutions possible While we provide deep technical experience and innovation to conflict-free our government sponsors, we don t have all the answers or environment all the smart people! Like a bridge, we connect innovative ideas from all over the science world to & government problems/agencies technology Part of the ecosystem of federal research centers Public Interest, Excellence, Partnership, and Integrity
6 The Benefits of Holding Challenges Win-Win: The government gets new ideas for solving complex problems and challenge winners gain prize money, recognition, and connections MITRE helps connect government agencies with innovative ideas that could solve problems And helps innovators understand the government domain MITRE has experience in holding challenges and expertise in the area of payment integrity issues Which led to this MITRE Challenge
7 Objectives for This Challenge Payment Integrity affects many agencies and all tax payers Solving this problem is a White House Cross-Agency Priority Goal on the President s Management Agenda The government is looking for fresh ideas from a diverse group they will look at all submissions for new approaches An ideation challenge is a great way to entice innovators to work in the government space and provide creative solutions Generate new ideas Raise awareness of the problem Create partnerships and a broader community to continue to work this issue
Problem Description Improper Payments Payments that should not have been made or were made in the wrong amount Significant, and Climbing More than $1.2T since FY 2002 FY 2016 exceeded $141B for fewer than 125 federal programs Dollars and rate increased more than 33% over last 4 years Eligibility Is claimant truly eligible for the benefit applied for?
9 Eligibility Background How big is this problem? An estimated 25% of improper payments happen because federal agencies cannot validate with sufficient certainty that the people they pay are eligible; FY2016: 25% of $141 billion=$35 billion Why is this occurring? Legislation and program structure issues Eligibility rules across programs overlap but do not fully coincide: e.g., Medicaid and SSI; state to state Administration issues many programs are federally funded but state administered In most instances, federal agencies and states administer benefits through disparate systems that do not communicate well and can t leverage information from each other s systems (both open source and private systems) Historically, states have not exchanged information well among themselves, nor with the federal government, despite incentives and federal mandates
Eligibility Determination: Overview of Current Process
Challenge Problem Statement Each year tens of billions of dollars are lost due to improper payment of benefits across federal programs. Application processes for government benefits are fraught with paperwork, bureaucracy, duplicated burden of entry in multiple forms, and little sharing of information which often results in improperly granted benefits and payment errors. Benefit eligibility and enrollment determination processes need to be made less vulnerable to lost funds due to fraud, applicant error, and agency error while recognizing the need for efficiency, user friendliness, and privacy protection.
Desired Solution in an Ideation Challenge We re seeking ideas that are: Practical for government agencies, implementable Creative in that they ve never been done before (or tried in the way you imagine) Competition participants should provide a framework/concept for a comprehensive eligibility and enrollment monitoring system, with enough detail so we can assess if it s feasible and how much impact it might have on the problem The concept should address mechanisms to detect and prevent attempts to fraudulently gain or retain benefits in a variety of federal and federally funded, state-administered programs Think about ways to check on initial enrollments and continued benefits, in the event that the beneficiary s life changes, for example, work or marital status Solutions should offer the capability to detect unqualified applicants for benefits before payments are made (i.e., left of check)
13 Hypothetical Scenario The MITRE Challenge Team has created: A hypothetical government agency And a new hypothetical federal benefits program That requires improvement in its ability to verify eligibility Scenario will be provided to participating teams at noon on October 1 Scenario will be the subject of the next webinar on October 3 You must register as a participant to attend Scenario will have employees of 8 federal agencies describing their own real problems under the guise of a hypothetical benefit program
14 The Submission Template Submission template includes: A team s primary point of contact information and organizational affiliation List of team members Solution title and Team name A paper (up to 10 pages) that describes your idea/concept Upload paper to the Challenge website. Link will be provided after you are fully registered.
15 Competition Structure MITRE PROVIDES Hypothetical Agency, Program, Problem Submission Template Instruction Presentation References and resources Online environment for questions and clarifications Explain Solution Identify IP Identify Innovations TEAM Develop Implementation Strategy Recommendations Submit to MITRE Scoring TEAM Download the Hypothetical Scenario, review references, and develop models Perform research and analysis Challenge Collaboration Website Top Teams Advance to Final Judging
16 Challenge Collaboration Secure Website Announcements Calendar, discussions, blogs, and activities Recorded presentations Posted FAQs (all questions will be answered here) Files Hypothetical Scenario Submission Template Training Resources Links to references Relevant laws, regulations
Challenge Website (go to live demo of how to use) 17
18 Challenge Rules The Challenge participation agreement (PA) guides conduct during the competition All team members must sign the agreement prior to October 1 To add a team member email challenge@mitre.org, include your team name and an amended participation agreement Reminder: MITRE and federal employees and their family members may not participate or give help Challenge questions must be posted on the Challenge Collaboration website. MITRE will post a response and alert team captains when it has been posted. Your IP must be clearly identified in the submission. Guidelines for identification are included in the template instructions and PA Submissions must be received by 5:00 p.m. ET, November 30, 2018 Rules are covered in more detail in the PA and on the website
19 Judging Criteria Paper submitted will be evaluated against six scored categories: 1. How well does the solution address each of the six essential eligibility issues? 2. Does the solution provide a complete set of verification methods to address the eligibility issues? 3. Is the solution efficient, effective, user-friendly and protective of privacy? 4. Does the solution include originality/use of novel components? 5. Does the solution include a continuous improvement lifecycle process to stay ahead of the curve as fraud schemes evolve? 6. Is the solution feasible to implement?
Competition Awards Grand Prize* $50K $5K awards* for the following anticipated categories: Most cost-effective solution Most innovative solution Best approach to verifying income Best submission from an academic team Best submission from a start-up team * MITRE, in its sole discretion may determine if there are eligible prize winners for all categories. March, 2019, McLean, VA Selected teams will meet with government agencies to present their solutions and participate in discussions Recognition: Announcements, media outreach
Next Steps Register and Submit the Participation Agreement by midnight, September 30 Next Steps Team Captains will receive information via email on how to access the Challenge Collaboration Site Join the Team Instruction webinar on Wednesday, October 3 at 4 p.m. ET
22 Questions? If you think of questions after today, please email them to challenge@mitre.org