Reforms to Payment Integrity Information Act of 2019

(a)

Definitions

Section 3351 of title 31, United States Code, is amended— (1)in paragraph (2)— (A)in subparagraph (A)— (i)in clause (i)— (I)by inserting information on before improper payments; (II)by striking information with and inserting resulting in financial loss to the Government in the accompanying materials to; and (III)by striking and at the end; and (ii)by inserting after clause (ii) the following new clause:

(iii)published information on improper payments resulting in financial loss to the Government with the annual budget justification of the executive agency for the most recent fiscal year;

;

(B)by redesignating subparagraphs (B) and (C) as clauses (iv) and (v), respectively (and adjusting the margins accordingly); (C)by redesignating subparagraphs (D) through (F) as subparagraphs (B) through (D), respectively; (D)in subparagraph (A)(iv), as so redesignated— (i)by striking if required, has; and (ii)by inserting and after the semicolon at the end; (E)in subparagraph (A)(v), as so redesignated, by striking if required, publishes and inserting published; (F)by striking subparagraph (B), as so redesignated; and (G)by redesignating subparagraphs (C) and (D), as so redesignated, as subparagraphs (B) and (C); and (2)by adding at the end the following new paragraph:

(9)

Financial loss to the Government

The term financial loss to the Government— (A)means any payment or part of a payment made in excess of the correct amount authorized by law that results in a financial loss to the Federal Government; and (B)does not include any payment or part of a payment made to the correct person or entity for the correct amount authorized by law but not made in accordance with certain administrative procedures applicable to the executive agency (excluding any such procedure necessary to establish eligibility or to verify that any payment or part of a payment was made in such correct amount).

(b)

Estimates of improper payments resulting in financial loss to the government and reports on actions to reduce such payments

Section 3352 of title 31, United States Code, is amended— (1)in the heading— (A)by inserting

resulting in financial loss to the Government

before

and reports

(and by conforming the item relating to such section in the table of sections in chapter 33); and (B)by striking

reduce improper payments

and inserting

reduce such payments

(and by conforming the item relating to such section in the table of sections in chapter 33); (2)in subsection (a)— (A)in paragraph (1)— (i)in subparagraph (A), by striking periodically review all programs and activities and inserting submit annually a list of each program and activity required to be reported on the Program Inventory under section 1122; and (ii)in subparagraph (B)— (I)by striking all programs and activities and inserting each program and activity from each such list; and (II)by striking (3) and inserting (2); (B)by striking paragraph (2); (C)by redesignating paragraph (3) as paragraph (2); and (D)in paragraph (2), as so redesignated— (i)in subparagraph (A), by striking improper payments and payments whose propriety cannot be determined and inserting improper payments resulting in financial loss to the Government and payments lacking sufficient documentation to determine whether the payments result in financial loss to the Government; (ii)by redesignating subparagraphs (B) and (C) as subparagraphs (D) and (E), respectively; (iii)by inserting after subparagraph (A) the following new subparagraphs:

(B)

Development of risk assessment guidance

Not later than 1 year after the date of the enactment of this Act, the Secretary of the Treasury shall develop risk assessment guidance to assess the risk of improper payments resulting in financial loss to the Government that addresses the following: (i)The likelihood of payment errors and the magnitude of such errors that do not result in financial loss to the Government. (ii)The likelihood of payment errors and the magnitude of such errors that do result in financial loss to the Government. (iii)A formula for estimating financial loss to the Government. (iv)Relevant governmentwide documents and best practices for managing improper payments and mitigating fraud risks in Federal programs, such as the document of the Government Accountability Office entitled A Framework for Managing Fraud Risks in Federal Programs (or any successor document), as applicable and appropriate. (C)

Scope

In preparing a list under paragraph (1)(A), the head of each executive agency shall require, within 6 months after issuing the risk assessment guidance, a risk assessment using the guidance developed under subparagraph (B) for each program or activity listed under paragraph (1)(A) for each— (i)existing programs or activities prior to the next disbursement of Federal funds with respect to the program or activity; and (ii)newly authorized programs and activities prior to any disbursement of Federal funds with respect to the program or activity.

;

(iv)in subparagraph (D), as so redesignated— (I)in the heading, by striking

Scope

and inserting

Requirements

; (II)in the matter preceding clause (i)— (aa)by striking In conducting a review under paragraph (1), the head of each executive agency shall and inserting Risk assessments are to be conducted on an ongoing basis, but no less frequently than once every 3 years, and; and (bb)by inserting , including with respect to fraud in any program or activity listed under paragraph (1)(A) that causes improper payments resulting in financial loss to the Government before , such as; (III)in clause (x), by striking data systems and inserting data assets; and (IV)in clause (xi)— (aa)by inserting or improper payments before as assessed; and (bb)by inserting , or any successor document after (commonly known as the Green Book); and (v)in subparagraph (E), as so redesignated— (I)in the heading, by striking

Annual report

and inserting

Reports

; (II)in the matter preceding clause (i), by striking Each executive agency shall publish an annual report and inserting Not less than once every 3 years, the head of each executive agency shall publish a report, which may be included in a report required under subsection (b)(2)(F) by such head with respect to a high-priority Federal program or activity,; (III)in clause (i), by striking ; and and inserting a semicolon; (IV)in clause (ii), by striking the period at the end and inserting ; and; and (V)by adding at the end the following new clause:

(iii)a prioritized listing of risks identified in subparagraph (D) associated with each program and activity listed under paragraph (1)(A) and any corresponding financial and administrative control to mitigate any such risk, including the use of the Do Not Pay Initiative (or any successor system) and any other system or data asset maintained by the Secretary of the Treasury or the Inspector General of the executive agency to prevent fraud or improper payments resulting in financial loss to the Government prior to making an eligibility determination to receive Federal funds with respect to any such program or activity listed under paragraph (1)(A), issuing an award, or requesting a payment.

;

(3)in subsection (b)— (A)in the heading, by inserting

that result in financial loss to the Government

after

Improper payments

; (B)in paragraph (1)— (i)in subparagraph (A)— (I)by inserting and activities after high-priority Federal programs; and (II)by inserting that result in financial loss after improper payments each place it appears; and (ii)in subparagraph (B), by striking associated and inserting and financial loss associated; and (C)in paragraph (2)— (i)in the heading, by inserting

that result in financial loss to the Government

after

improper payments

; (ii)in subparagraph (A), by striking shall on an annual basis and inserting , not less frequently than once every 3 years, shall; (iii)in subparagraph (B)— (I)in clause (i)— (aa)in subclause (I)— (AA)by inserting that result in financial loss to the Government after improper payments; and (BB)by striking ; and and inserting a semicolon; (bb)in subclause (II), by inserting that result in financial loss to the Government, including by making it harder for fraudulent actors to exploit the program after improper payments; and (cc)by adding at the end the following new subclause:

(III)has taken or plans to take to reduce the percentage of improper payments that result in financial loss to the Government;

;

(II)by inserting after clause (i) the following new clause:

(ii)shall include— (I)an estimate of the total amount of the payments that result in financial loss to the Government; (II)an estimate of the total amount of the payments that do not result in financial loss to the Government; (III)the percentage of payments that result in financial loss to the Government; (IV)an assessment of the portion of the total amount of payments that result in financial loss to the Government that are due to fraudulent actions by the recipient of such payments; (V)the total amount of disbursed payments; and (VI)a description of resources or legislative changes proposed to improve or maintain the integrity of the relevant program or activity; and

;and

(III)by redesignating clause (iii) as clause (ii); (iv)in subparagraph (E)(i)— (I)in subclause (I)— (aa)by striking improper payment and inserting improper payments that result in financial loss; and (bb)by striking ; and and inserting a semicolon; (II)in subclause (II), by striking improper payments and inserting improper payments that result in financial loss; and (III)by adding at the end the following new subclause:

(III)each statistically valid estimate developed under subsection (c)(1)(A) and make a recommendation to the head of the executive agency on whether the agency estimate should be reassessed and reestablished; and

;

(v)by amending subparagraph (F) to read as follows:

(F)

Agency liaison designation and mandatory coordination meetings

Not less frequently than once every fiscal year, the head of each executive agency with a high-priority Federal program or activity identified under paragraph (1)(B) shall designate a senior official of the executive agency to serve as the liaison of the executive agency for work under this subchapter who shall meet for a non-audit or investigative purpose with the Director of the Office of Management and Budget (or a designee of the Director), the Commissioner of the Bureau of the Fiscal Service of the Department of the Treasury (or a designee of the Commissioner), the Inspector General of the executive agency (or a designee of the Inspector General), and the Pandemic Response Accountability Committee established under section 15010 of the CARES Act (Public Law 116–136; 134 Stat. 533) (or any successor organization) to report on any action taken during the preceding fiscal year and any planned action, including any reform to any financial or administrative control, to prevent improper payments (with a focus on improper payments that lead to financial loss to the Government) and mitigate fraud in such program or activity.

; and

(vi)by adding at the end the following new subparagraph:

(G)

Federal-State coordination meetings

Not less frequently than once every fiscal year, the Director of the Office of Management and Budget and the Secretary of the Treasury shall convene a meeting of State officials responsible for program and payment integrity in programs administered on behalf of the Federal Government by a State or local government to review fraud prevention performance, share best practices, and identify ongoing coordination challenges.

;

(4)in subsection (c)— (A)in the heading, by inserting

that result in financial loss to the Government

after

Improper payments

; (B)in paragraph (1)— (i)by amending subparagraph (A) to read as follows:

(A)develop a statistically valid estimate of improper payments that result in financial loss to the Government;

;

(ii)by striking subparagraph (B); and (iii)by adding at the end the following new subparagraphs:

(B)include such estimate in the annual budget justification of the executive agency; and (C)revise such estimate if the head of the executive agency determines, which may be based on a recommendation from the Director in consultation with the Secretary of the Treasury and the Inspector General of the executive agency, that there is a need to reestablish the estimate of improper payments that result in financial loss to the Government due to— (i)a significant change, as determined by the agency head, to the program or activity’s appropriation or authorization; (ii)newly establishing the program or activity; or (iii)a recommendation from the agency Inspector General in the annual compliance report issued under section 3353(a).

; and

(C)in paragraph (2)— (i)in subparagraph (A), by inserting resulting in financial loss to the Government after improper payment; and (ii)in subparagraph (B), by striking improper payments before estimate; (5)in subsection (d)— (A)in the heading— (i)by striking

Reduce

and inserting

Reduce and prevent

; and (ii)by inserting

that result in financial loss to the Government

after

Improper payments

; (B)in the matter preceding paragraph (1)— (i)by inserting that result in financial loss to the Government after estimated improper payments; and (ii)by striking reduce improper payments and inserting reduce and prevent such payments; (C)in paragraph (1), by inserting that result in financial loss to the Government (including actions used to commit fraud) after improper payments; (D)in paragraph (2)— (i)in the matter preceding subparagraph (A), by inserting that result in financial loss to the Government after in order to reduce improper payments; (ii)in subparagraph (B), by striking ; and and inserting a semicolon at the end; (iii)in subparagraph (C), by inserting and after the semicolon; and (iv)by adding at the end the following new subparagraph:

(D)access to appropriate records and data assets, whether maintained by an executive agency, a State or local government, or a private sector organization;

;

(E)in paragraph (4), by inserting that result in financial loss to the Government after improper payments; (F)in paragraph (5)— (i)by inserting that result in financial loss to the Government after improper payments each place it appears; and (ii)in subparagraph (B)(ii), by striking ; and and inserting a semicolon at the end; (G)by amending paragraph (6) to read as follows:

(6)a description of how the level of planned or completed actions by the executive agency to address the causes of the improper payments that result in financial loss to the Government matched the level of improper payments that resulted in financial loss to the Government, including a breakdown by category of such improper payments and specific timelines for completion of those actions; and

; and

(H)by adding at the end the following new paragraph:

(7)information on the progress of the executive agency with respect to— (A)implementing the financial and administrative controls required to be established under subsection (a)(2)(E)(iii); (B)implementing relevant governmentwide documents and best practices for managing improper payments and mitigating fraud risks in Federal programs, such as the document of the Government Accountability Office entitled A Framework for Managing Fraud Risks in Federal Programs (or any successor document), as applicable and appropriate, including with respect to the identification of— (i)any dedicated entity that leads the fraud risk management activity of the executive agency; (ii)responsibilities of such entity, including any program or operation for which the entity is responsible; (iii)capacity, including any limitations, to strategically manage fraud risks; (iv)any program or operation within the executive agency for which there is not a dedicated entity that leads fraud risk management, along with a detailed justification for not having such a dedicated entity; and (v)the status of implementing the overarching concepts with associated leading practices identified in such document entitled A Framework for Managing Fraud Risks in Federal Programs (or any such successor document), as applicable and appropriate; (C)implementing the Office of Management and Budget Circular A–123, or any successor policy, with respect to leading practices for managing fraud and improper payments risk; (D)identifying fraud risks and vulnerabilities, including but not limited to payroll, beneficiary payments, grants, large contracts, and purchase and travel cards; and (E)establishing strategies, procedures, and other steps to prevent, detect, and respond to fraud.

;

(6)in subsection (e)— (A)in the matter preceding paragraph (1)— (i)by inserting that result in financial loss to the Government, after With respect to improper payments; and (ii)by striking the improper payments and inserting such payments; (B)in paragraph (1), by inserting that result in financial loss to the Government after improper payments; and (C)in paragraph (2), by inserting that result in financial loss to the Government, after improper payments; (7)in subsection (f)— (A)in paragraph (1)— (i)in the matter preceding subparagraph (A)— (I)by inserting that result in financial loss to the Government after regarding improper payments; and (II)by inserting such after recover; (ii)in subparagraph (B)— (I)by inserting Government before Reform; and (II)by striking and at the end; (iii)by inserting after subparagraph (B) the following new subparagraphs:

(C)the Committee on the Budget of the Senate; (D)the Committee on the Budget of the House of Representatives; (E)the Committee on Appropriations of the Senate; (F)the Committee on Appropriations of the House of Representatives; and

; and

(iv)by redesignating subparagraph (C) as subparagraph (G); and (B)in paragraph (2)— (i)in subparagraph (A), by inserting that result in financial loss to the Government after improper payments; (ii)in subparagraph (C), by inserting that result in financial loss to the Government after improper payment; (iii)in subparagraph (D), by inserting that result in financial loss to the Government after improper payments; and (iv)in subparagraph (E), by inserting that result in financial loss to the Government after improper payment; (8)in subsection (g)— (A)in paragraph (1), by inserting and periodically thereafter, after Not later than 1 year after the date of enactment of this section,; and (B)in paragraph (2)(B), by striking prepayment and postpayment and inserting pre-award, pre-payment, and post-payment; and (9)in subsection (i)(2)— (A)in subparagraph (C), by striking 25 and inserting 10; and (B)in subparagraph (D), by striking 25 and inserting 75.