BDP and R Industry Day PowerPoint.pptx

Welcome!

VBA Fraud, Waste, and Abuse Prevention Services Industry Engagement Day Date 6/9/2025

The meeting will begin soon!

VBA Benefits, Delivery, Protection, and Remediation

Mick Worstell Director, Benefits Delivery Protection & Remediation Office of Financial Management

Gregory J. Stevens Contract Specialist Office of Mission Support

Linda Rutland Senior Advisor Office of Financial Management

Jill K. Mengel Supervisory Program Analyst Office of Financial Management

Agenda and Housekeeping Contract Officer Opening Remarks Director Opening Remarks Rules of Engagement Contract and Service Category Overview Technical and Requirements Q&A Key RFI Information

Contracting Officer Opening Remarks Today’s Industry Day is for the purpose of sharing VBA’s mission and requirements for FWA prevention and sharing answers to some of the questions submitted in your RFI responses The Government is currently in the requirements development phase, which may inform market research Thank you for your responses from the Request for Information (RFI) announcement Subsequent collection of the RFI response and today’s Industry Day may inform the Government’s acquisition strategy Single Award Subcontracting Opportunities The VA’s obligation to examine small business participation is critical, consistent with FAR guidance as well as VA’s commitment to the small business community Additional Industry Day exchanges are anticipated with the vendor community Any prospective solicitation and award would likely occur next fiscal year

BDP&R Overview:

As VBA transitioned from paper to the electronic or digital environment, the need for VBA to have an organization dedicated to security for delivery of benefits was identified.

BDP&R was formed in part due to a need for VA to troubleshoot Veterans or beneficiaries who experienced fraud or had problems with receiving their regular benefits.

Efforts to fully stand-up BDP&R as an organization followed thereafter with additional staff allocations for The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2022 hiring. PACT Act hiring requires additional measures of reporting and work produced be properly accounted.

BDP&R is now considered a risk management entity within VBA – hence the current positioning under the Chief Risk Officer.

Date 6/9/2025

Director Opening Remarks

BDP&R Mission and Vision:

Mission: Safeguard the delivery of hard-earned benefits for Veterans and their families through prevention, early detection, and timely mitigation of Fraud, Waste and Abuse (FWA).

Vision: To be the Center of Excellence and premier service provider of FWA risk management services and innovative solutions that ensure the safe delivery of Veterans’ benefits while protecting taxpayer dollars.

BDP&R collaborates and partners with VBA Lines of Business (LoBs) to identify fraud, waste, and abuse within programs and to develop and implement solutions.

Collaborates with LoBs to assess Program Operations Leverages Interviews and Data Analysis to unveil Risks Develops detection, prevention, and mitigation solutions to assist LoBs

CS

MDEO

VR&E

LGY

P&FS

OTED

OAR

EDU

Ins

Vision for Future BDP&R Efforts:

Data Analytics Research and Innovation Center (DARIC)

Research workgroup for the development of solutioning and controls for current and future initiatives

Ideas come from referrals, case work, ongoing research, and interactions with government teams

Connect Accounts Script Detects any bank account shared by two or more unconnected beneficiaries Has caught hundreds of cases of fraud and employee error

Rules of Engagement The chat function is enabled throughout the session for submitting questions.

A portion of previously submitted technical questions will be answered during this presentation.

Any remaining technical questions previously submitted, as well as any submitted today, will be answered post-Industry Day unless the question is specific to the conduct of today’s meeting (e.g., is my audio on…?).

Industry Day questions and answers will be posted to SAM.gov.

Contract ProJecT management and Task Coordination The Contractor is responsible for all internal task management and oversight to ensure timely service delivery and to demonstrate agility in responding to changing Government priorities, with a single management focal point.

FWA Risk Management The objective of the FWA risk management activity is to mature and improve the current proactive processes that identify, analyze, mitigate, monitor, and resolve risks impacting the delivery of Veterans’ benefits.

FWA Incident and Case Management Support of FWA incident management is the monitoring of potential referral intake of cases to include reviewing and confirming referral data and information and maintaining an efficient intake process. Case management in the conduct of case investigations for fraud includes (1) assessing incidents and (2) data collection and analysis.

FWA Research and Development The FWA R&D activity seeks to employ and apply private sector tools and modern technology, computer, and traditional forensic capabilities to support (1) identifying and assessing FWA threats, (2) developing and testing FWA risk solutions, and (3) the preparation of suspected fraud evidence packages.

Sample VBA Statement of Work (SOO) Service Categories The descriptions below are intended to provide insight and depth into the SOO categories.

FWA DATA ANALYSIS

The support of FWA Data Analysis includes (1) growing and enhancing detection capabilities, (2) expanding the use of multiple government databases and public data to identify threats and vulnerabilities, and (3) developing solutions for detection, avoidance, and mitigation, including integrating emerging technology trends (e.g., AI, LLMs, LAMs). The activity includes examining and using data, conducting data mining, ad hoc data/research requests, environmental scans, and basic data/comparative analysis to enhance decision making.

FWA Education, Outreach, and Communications The objective is to provide services that promote broad FWA awareness and education to increase stakeholder interest in and ownership of addressing FWA issues. This activity includes providing research and analysis on the effectiveness and breadth of communications and outreach activities to specified audience demographics and supporting the communications strategy with innovative approaches in, e.g., content creation, graphic design, and advertising.

FWA Performance Reporting The objective of performance reporting is to report on metrics that include, at a minimum, fraud instances, the results of fraud investigations, monitoring plans, resolution time, investigation cost, repeat incidents, incident location, value of losses recovered and future losses prevented, corrective actions, and analytic agility.

Data Scripts and Models Transition-In The Contractor shall transition-in all risk assessments, outreach and education campaigns, data scripts and models, and any and all other ongoing efforts as required from the incumbent contractor, Data Scripts and Models Transition-OUT The incumbent Contractor shall develop a Transition-out plan to effect a smooth and orderly transfer of contract responsibility to a successor team.

Technical and Requirements Questions and Answers (1/5)

1. Can the government clarify BDP&R’s role in VA’s overall fraud risk governance?

The Government's role in fraud risk governance is currently collaborative - it is not an oversight and compliance role. Instead, it is a partnership for proactive risk management, to include development and enhancement of controls, and measuring effectiveness of controls.

2. Can the government provide VA’s Fraud Risk Management Strategy and Guidance?

VBA uses the GAO framework and leading practices to guide its risk management strategy. The Government maintains a high-level enterprise level risk register with high-level overarching and similar risks/response plans and measures that affect the enterprise, while each LoB and Staff Office (SO) maintains granular level risk registers with response plans and measures.

3. Can the government describe how confirmed cases of Fraud are being leveraged today to enhance preventative tactics?

The Government is in early stages of building its fraud repository and has not documented/counted all types of fraud. VBA has focused efforts on payment redirection - which impacts Veterans directly. Confirmed fraudulent activity in this space is currently focused on historical factors such as known bank accounts where payments have been fraudulently redirected, known phone numbers used to call and make fraudulent changes, known IP addresses etc.

Technical and Requirements Questions and Answers (2/5)

4. Does BDP&R already directly support VBA Compensation and Pension programs in improper payment mitigation efforts?

Yes, the Government currently supports Compensation, Pension, Insurance Service, Education Service, and Veteran Readiness and Employment with improper payment and/or fraud prevention. Our service is not limited to fraud, and we are looking to expand our capabilities to find and prevent more improper payments, identify and help solution operational waste, and system and process deficits that lead to waste.

5. Will the contractor have access to external data feeds to support fraud pattern correlation and risk modeling, or will all detection logic be based on internal VA data?

The Government welcomes the recommendations for approval of using of any external data the vendor deems relevant to execute the mission.

6. Are there existing performance dashboards, fraud KPIs, or risk management systems that the proposed solution must integrate with—or is the contractor expected to design and deliver these analytics from the ground up?

Yes, there are existing performance dashboards that require additional measures and enhancements. The Government also welcomes recommendations for new performance dashboards.

Technical and Requirements Questions and Answers (3/5)

7. Can the Government elaborate on the number and types of VA data sources targeted for integration?

The Government currently has 3 Oracle Databases, 1 Salesforce Platform, and 1 Microsoft Azure Workspace.

8. What are the functions of each of the BDP&R systems that the new vendor will be required to maintain?

The vendor will be required to support and maintain case management, data management, and data analysis.

9. Will the contractor have access to external data feeds to support fraud pattern correlation and risk modeling, or will all detection logic be based on internal VA data?

The Government welcomes the recommendations for approval of using any external data the vendor deems relevant to execute the mission.

10. Does the VA anticipate that AI/ML models will be deployed within its existing cloud infrastructure, or is the contractor expected to host and operate the solution in a secure, VA-compliant enclave (e.g., FedRAMP High, GovCloud)?

Yes- AI/ML models will be deployed into the secure, VA compliant enclave. The contractor will operate within that same enclave.

Technical and Requirements Questions and Answers (4/5)

11. For deliverables related to AI models and data scripts, will the VA require the delivery of source code, or will compiled/executable models be acceptable?

All source code created under this work shall be delivered to the Government.

12. Can you tell us what the current tool is used for Machine Learning in operations today? Are there preferred analytics platforms or tools (e.g., Python, R, SAS), or is there flexibility for contractors to propose modern cloud-based environments?

All machine learning is coded in Python using standard packages such as scikit-learn with some data preparation being done in R. The Government is open to the use of other recommended packages for approval such as PyTorch or other tools, as well as proposed modern cloud-based environments.

13. Has BDP&R identified which FedRamp solution(s) it will use to analyze data? If so, which one(s)?

The Government is migrating to the FedRamp approved VA cloud for its future implementation.

Technical and Requirements Questions and Answers (5/5)

14. Can you describe how your data science team collaborates cross-functionally with other departments to improve the accuracy, relevance, and impact of your predictive models?

The Government is in the early stages of collaboration with the business lines to conduct analysis (and validation) of data to size and scope risks. The Government also works with external stakeholders such as the Office of the Inspector General (OIG), Office of Information Technology (OIT), and the Social Security Administration to share data and to validate results. Ongoing work with the VBA Chief AI Officer is intended to ensure best practices and compliance with all regulations regarding AI implementations.

15. Can the Government elaborate on the size and composition of stakeholders in scope for FWA Education, Outreach, and Communication efforts?

The Government currently collaborates with multiple federal agencies and service organizations to reach the primary stakeholder of 7 million Veterans and beneficiaries receiving 194 billion dollars in benefits and services (FY24). The Government is looking to expand on these partnerships while also educating Veterans, the public and over 20,000 VBA employees on a wide array of topics centered on fraud prevention and awareness.

16. Can the Government elaborate on the technology tools currently employed in support of FWA Education, Outreach, and Communication efforts? Is the Government open to considering new tools to augment or replace existing tools?

The Government currently uses SharePoint and is open to new tools for replacement.

Key RFI Information See SAM.gov for any additional information RFI Announcement # 36C10D25Q0058

Thank you for joining the Industry Engagement Day

Backup Slides – Additional Questions/Answers (1/4)

17. Can the government provide VA’s existing Fraud Risk Governance model key and stakeholders?

The VBA Principal Deputy Under Secretary is the Chair of the Enterprise Risk Council (ERC), the Co-Chair is VBA Chief of Staff. VBA's Executive Director and Chief Financial Officer, Office of Financial Management serves as the Chief Risk Officer/Advisor to the Council Chair. Key stakeholders are the VBA Lines of Business (LoB) and Staff Office (SO) responsible for the delivery of benefits and services delivered under the VBA mission, the Senior Executive of each LoB sits on the Enterprise Risk Council and comprises the following: Compensation Service; Education Service; Insurance Service; Loan Guaranty Service; Pension and Fiduciary Service; and Veteran Readiness and Employment - and the Staff Offices that provide support to the LoBs: Medical Disability Examination Office (support to Disability Claims) Office of Administrative Review; Outreach, Transition and Economic Development; Strategic Program Management Office. Governance model includes Senior Executives from each LoB and Staff Office, with mandatory designees for each LoB and SO assigned to a Risk Management Committee workgroup.

18. Is the government considering starting a centralized fraud data warehouse to complement and power the Fraud Center of Excellence?

Yes.

Backup Slides – Additional Questions/Answers (2/4)

19. What are the Government’s expectations regarding the identification of fraud vs. prevention of improper payments due to administrative error or unintentional misrepresentation? Are both equally prioritized under this requirement?

Equally prioritized.

20. Does the Government maintain a standardized fraud risk framework or scoring methodology that the solution must align with (e.g., OMB A-123 guidance, GAO Fraud Risk Framework), or may respondents propose their own?

While our risk scoring framework does align with the GAO framework, and OMB A-123, the Government would welcome a new/additional scoring methodology for consideration for use within VBA.

21. What level of visibility will the contractor have into VBA policy, legislative, or regulatory changes that may affect fraud detection thresholds, scoring logic, or benefits eligibility rules?

The expectation of the Government is to have full visibility. To be effective with risk management activities, it will be imperative for the contractor to have high visibility into VBA policy, legislative, and regulatory changes.

Backup Slides – Additional Questions/Answers (3/4)

22. Will the Government provide access to existing structured and unstructured data sources (e.g., claims forms, scanned records, call transcripts, historical case files) to enable end-to-end ingestion, analysis, and fraud detection workflows?

Yes.

23. Will the Government clarify whether bundled fraud case data packages must follow a specific federal format or schema?

VBA currently has a template for bundling fraud packages but is open to enhancements and/or new templates.

24. Will the FWA contractor have the ability to access and analyze VA IT system logs that may contain data indicative of FWA?

Yes.

25. To what degree are the current reporting systems automated and/or integrated with up and downstream stakeholders, and if this is not currently the case, is this part of a modernization roadmap?

The Government currently has very limited integration/automation of reporting for stakeholders. Enhancements, additions, modifications, and/or a complete overhaul of dashboards and visualization are part of the modernization roadmap.

Backup Slides – Additional Questions/Answers (4/4)

26. What existing technology tools/solutions are currently being used by BDP&R to identify anomalies in data?

The Government has a catalogue of analytical jobs/scripts and machine learning models to include a neural network that carry out various jobs to identify anomalous data both as a predictor of potentially fraudulent activity and of data quality issues. These are primarily custom coded scripts and models in R and Python.

27. How is the government considering their current cloud migration strategy in connection to advanced technology approaches?

The Government seeks to expand its computational platform.

28. What specific challenges or recurring pain points have you faced so far during your AI/ML implementations?

The Government’s AI/ML implementations have faced the usual pain points that are faced by similar efforts such as sub-par data quality, limitations of compute resources, and lower than expected performance of models. The Government seeks to overcome these challenges and recurring pain points.

29. For “Risk Monitoring,” what tools or frameworks does VBA currently use, and is the Contractor expected to integrate with or replace them?

The GAO Framework and VA/VBA Enterprise Risk Management are the guiding principles. No, this contract does not replace enterprise risk management.

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