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FY 14-15: Agency Priority Goal
Reduce the improper payment rate made under the Supplemental Security Income (SSI) program.
Priority Goal
Goal Overview
SSI is a means-tested program designed to provide a monthly payment to aged, blind, or disabled people with limited income and resources. Adults, as well as children, can receive payments based on disability or blindness.
SSI payments are calculated using a statutory definition where payment levels for beneficiaries can change from month-to–month, which may result in an improper payment. Two factors used to determine an individual's monthly benefit are income and living arrangements. Income can be in cash or in-kind, and is usually anything that a person receives that can be used to obtain food or shelter. Cash income includes wages, Social Security and other pensions, and unemployment compensation. In-kind income is food and shelter or something someone can use to obtain those items.
Individuals' SSI benefit amounts also may change if they move in to a different “living arrangement”—whether a person lives alone or with others, or resides in a medical facility or other institution. For instance, when an individual moves into a nursing home, the person’s monthly payment may be reduced to as little as $30 per month. If the person moves from his or her own household into the household of another person, and that person provides food or shelter, the payment also may be reduced.
An individual’s resources also affect eligibility for the SSI program. An individual is not eligible for benefits if his or her countable resources exceed $2,000, and couples are not eligible if their countable resources exceed $3,000. In general, SSA counts as resources items individuals can convert to cash and use for their support and maintenance, such as bank accounts, stocks, and bonds.
The design of the SSI program requires that SSA adjust benefit payments to account for these factors. SSA explains to SSI recipients that they must report these changes to us when they occur. Absent their timely reporting, it is difficult to obtain information about these changes in a prompt fashion, resulting in some erroneous payments. Additionally, even if individuals report in a timely manner, SSA is required to first provide written notification of how the change affects their benefit amounts and provide due process protections. This process delays adjusting payments to the correct amount. Furthermore, SSA generally makes SSI payments on the first day of the month for eligibility in that month. Even if the payment is correct when paid, any changes that may occur during the month can affect the payment due, which can result in an overpayment or underpayment. Thus, the program requirements themselves sometimes cause erroneous payments.
SSA’s SSI improper payment accuracy reflects the complex nature of the SSI program. SSA is working on improving administration of the SSI program, focusing on how technology can make the agency more efficient. SSA is currently offering telephone wage reporting and a smart-phone application for reporting wages and is expanding our use of those technologies. SSA is also working on expanded use of Lexis-Nexis to verify real property, and numerous other projects designed to improve our service and ensure the integrity of our payments.
Strategies
To assist in debt reduction efforts and protect taxpayer dollars, SSA must implement projects that will reduce improper payments with minimal administrative cost. SSA is committed to reducing SSI overpayments and underpayments by increasing the volume of our program integrity workload, and pursuing new initiatives and program improvements to the extent funding is available.
Redeterminations are a process SSA uses to re-examine recipients’ income and resources to ensure that they are still eligible for monthly payments. Redeterminations are one of our most powerful program integrity tools. SSA estimates that every dollar spent on SSI redeterminations yields about $5 in program savings over 10 years, including Medicaid program effects.
Predictive modeling techniques have proven to be immensely helpful to ensure that we use our resources effectively and efficiently. SSA does not have the resources to conduct redeterminations on all 8.1 million SSI recipients every year. Using our SSI Redetermination Scoring Model, SSA targets the cases most likely to be overpaid. In FY 2012, SSA completed 2,624,170 SSI non-disability redeterminations, which resulted in the prevention and recovery of $2.85 billion in total lifetime SSI overpayments and prevented $1.27 billion in underpayments. If SSA had relied on random case selection rather than using a predictive model, $2.1 billion in total lifetime savings for SSA projects would have been prevented and recovered for the same period.
Access to Financial Institutions (AFI) is an electronic system that allows us to detect assets in undisclosed bank accounts. Detection of these assets prevents one of the most frequent causes of SSI erroneous payments. Use of AFI will achieve an estimated increase of about $432 million in annual program savings (i.e., reductions in overpayments). SSA recently integrated the AFI process into our SSI case processing system, which enables us to check for undisclosed accounts at randomly selected financial institutions located near the recipient’s address. In May 2013, SSA modified the agency’s policy, lowered the AFI threshold from $750 to $400, and increased the number of undisclosed bank account searches from five to ten. SSA will implement this new threshold and increase in bank account searches by the end of October 2013. SSA will evaluate the impact of lowering the threshold and increasing our bank searches and continue to make enhancements to the AFI initiative.
SSA is always looking for more effective and efficient ways to fulfill the agency’s mission. Building upon our AFI success, SSA is exploring the use of commercial databases to help SSA identify undisclosed non-home real property held by SSI applicants and recipients. This automated approach has the potential for helping us uncover unreported assets and improve the accuracy and integrity of the SSI program.
SSI Wage Reporting provides recipients with an easy way to report their wages to us that also saves resources by updating our records directly without requiring employee handling. Unreported and untimely reported wages continue to be a major source of payment error in the SSI program.
To facilitate timely reporting, we implemented the SSI Telephone Wage Reporting (SSITWR) system. Recipients, their spouses and parents, and their representative payees report monthly wages directly into the SSI system via a combination of touch-tone entry and voice-recognition software. SSITWR is more efficient because it reduces unnecessary visits to the field office, diminishes the opportunity for manual keying errors, and allows us to process wage reports early enough to adjust the next SSI payment, thereby preventing improper payments.
SSI Mobile Wage Reporting (SSIMWR) application is an extension of the SSITWR system, which provides SSI recipients the ability to submit their wages via their mobile smart phones. Like its telephone counterpart, the mobile application will automatically update the SSI record, correct the upcoming payment, if necessary, and issue a receipt to the individual. In FY 2013, as part of SSA’s online services initiatives, SSA began piloting the SSIMWR program in 50 field offices in December 2012 and expanded it nationally in September 2013. The SSIMWR allows mobile wage reporting on smartphones. Participants can download and use the free SSIMWR application to report wages. SSA also posted a webcast to promote the use of SSITWR and SSIMWR.
SSA will continue to recruit SSI recipients to use this application and track the increase in usage. In FY 2014, SSA will allow individuals to report at any time during the month rather than just the first six days of the month.
SSA will begin efforts to automate the use of monthly payroll provider information and integrate it into our internal SSI computer systems by adding a consent question into our SSI application. This question will allow SSA to automatically change payments to SSI recipients once the agency is able to automate the wage reporting from payroll providers.
SSA will also continue to explore opportunities with other Federal agencies to obtain information about SSI recipients who leave the country and fail to report their absence.
Transactional Accuracy- Each year SSA measures the compliance of field offices with the documentation and development requirements in our policy and procedures. SSA bases this accuracy on a monthly sample selection of completed field office transactions for the Supplemental Security Record. If the reviewed case does not meet the required evidentiary standards, SSA secures the necessary evidence. If this changes the payment in the original determination, we record a dollar error. SSA categorizes dollar errors as either underpayments or overpayments. In FY 2012, overall dollar accuracy was 98.9 percent for overpayments and 99.2 percent for underpayments.
Progress Update
We are actively engaged in a host of different efforts to improve Supplemental Security Income (SSI) payment accuracy and help ensure that we pay the right person, the right amount, at the right time. For example, in FY 2014, we completed a comprehensive study related to our use of commercial data to identify non-home real property in which SSI recipients have an ownership interest that may affect their eligibility for benefits. The study concluded that utilizing commercially available data in this manner would be cost beneficial to the agency. In FY 2015, we pursued changes to our systems and processes that would be required to efficiently use such information. On a concurrent track, we continue to realize increased usage of our automated wage reporting tools, both of which save agency administrative dollars while also improving SSI payment accuracy. We had an overall increase in the number of successful wage reports we processed using SSI Telephone Wage Reporting (SSITWR) and SSI Mobile Wage Reporting (SSIMWR).
In FY 2015, we continued to evaluate the results of conducting Access to Financial Institutions searches at periodic intervals (i.e. between redeterminations). In FY 2015, we completed 100 percent of our target, by conducting 2,266,993 redeterminations and limited issues. This goal will be assessed in April 2016 after the final data is available for all indicators.
FY 2015 Milestone Progress:
Q1 Milestone - Analyze the success of the mobile wage reporting application to determine the need for modifications. Determine agency decisions and next steps resulting from the non-home real property studies. Analyze the impact of lowering the AFI threshold to determine the additional number of bank accounts found that resulted in changes in or ineligibility for SSI payments.
- Mobile Wage Reporting - We continued to see positive growth in the use of mobile wage reporting and processed 13% more transactions via this modality than the volume processed in Q4 of FY 2014. We realized an overall increase of 19% in the number of combined telephone and mobile wage reports over Q1 in FY 2014.
- Non-home real property study - Based on the positive outcome of the studies, we began planning for systems integration of the non-home real property process.
- AFI - We finalized the protocol for an evaluation of the impact from lowering the AFI threshold and are gathering the data needed to complete the evaluation.
Q2 Milestone - Determine the feasibility of capturing optional electronic permission to obtain wage information from payroll providers in order to explore opportunities to integrate this information into our SSI systems. Develop an implementation plan for non-home real property to integrate it into the current SSI business process.
- We have allocated resources to integrate authorization for us to contact commercial entities for evidence related to SSI eligibility and payment amount. We developed the requirements to make these changes to our systems.
- We have also allocated resources to integrate the non-home real property process into our systems. We made significant progress in our effort to determine the business process for such integration and develop systems requirements.
Q3 Milestone - Increase our ability to detect improper payments by initiating the non-home real property implementation plan.
- In Q3, we will continue moving forward with our implementation plan and request agency resources to fully support the non-home real property initiative in FY 2016 and 2017. Internal project participants meet every two weeks and include the Offices of Budget, Finance, Quality & Management, Systems, Policy, and Operations.
Q4 Milestone – Explore opportunities with the Department of State to obtain passport information from SSI recipients who leave the United States and do not report their absence to prevent us from making improper payments to these individuals.
- We are no longer exploring this opportunity with the Department of State as we have determined that the Department of Homeland Security (DHS) possesses more comprehensive entry and exit data.
- We will continue to pursue our efforts to test a matching operations with DHS that would permit us to obtain information electronically regarding a recipient’s absence from the United States for a full calendar month or longer.
Next Steps
•We will continue to revise our current Supplemental Security Income (SSI) business process to use third party data to identify undisclosed real property ownership in order to detect and prevent improper payments. In addition, we will revise our systems planning template to expand the scope of the FY 2016 development.
•We will continue to pursue efforts to test a matching operation with DHS.
•We will continue to process redeterminations and limited issues to evaluate a recipient’s eligibility for SSI and benefit payment amount.
•We are moving forward with our implementation plan and requested agency resources to support fully the non-home real property (NHRP) initiatives in FYs 2016 and 2017.
Next Steps
No Data Available
Expand All
Performance Indicators
Report on the percentage of SSI payments free of overpayment error
Report on the percentage of SSI payments free of underpayment error
Increase SSI wage reporting via telephone and the mobile application
Other Indicators
Complete the budgeted number of SSI non-disability redeterminations
Supplemental Security Income (SSI) Payment Accuracy Rate
Contributing Programs & Other Factors
Supplemental Security Income Program
Office of Systems
Internal Revenue Service - We are starting a data exchange with the IRS so that we are informed when an eligible SSI couple receives an IRS Form 1099, which may indicate possible unreported resources.
External payroll providers - We are developing an initiative to integrate payroll provider information into our internal systems, where we can match wage amounts and reducs wage-related improper payments.
Office of Management and Budget (OMB) - We submitted to OMB a legislative proposal that would give us the authority to engage in matching operations with commercial entities, including payroll providers.
Department of Homeland Security - We are working to share data on exit and entry to the USA.
Expand All
Strategic Goals
Strategic Goal:
Strengthen the Integrity of Our Programs
Statement: No Data Available
Strategic Objectives
Statement:
Description:
We devote significant resources to making certain our earnings records are accurate and we credit the correct amount to the right person.
In FY 2013, we posted more than 251 million earnings reports to workers’ records. Although in calendar year 2013, employers electronically filed about 87 percent of Forms W-2, we still receive approximately 30 million items on paper Forms W-2. To improve earning records accuracy, we will work with the employer community to significantly reduce paper wage reports, moving toward an all-electronic earnings record process. We also will increase efforts to encourage the public to verify their earnings information on their Social Security Statement.
A multi-year earnings redesign initiative is underway to modernize our earnings reporting system to increase efficiency and accuracy. In addition, we are collaborating with the Internal Revenue Service (IRS) to enhance the earnings data exchanges to improve the wage reporting process with IRS.
Strategies:
- Modernize our earnings system;
- Encourage electronic wage reporting; and
- Encourage the public to review their Social Security Statement for earnings accuracy.
Statement:
Description:
Safeguarding the confidentiality and integrity of our customers’ personal information has always been and will continue to be a top priority for us. With the growing threat of identity theft in an increasingly electronic world, we are taking steps to enhance protection of our beneficiaries’ records.
If we are to achieve our goal to move more customers to our online services, it is critical they have confidence their personal information is well protected – we must ensure that our online services remain secure. To that end, we are boosting authentication requirements for our online services, including enhanced security measures in the my Social Security portal. These enhancements require users to authenticate their identity with specific information not readily available to others. We will continue to seek additional ways to make our online services more secure.
Strategies:
- Ensure strong authentication technologies and appropriate access to information and services;
- Ensure online services have appropriate security features; and
- Partner with other Federal agencies, such as the IRS, to aggressively combat identity theft to prevent unauthorized transactions.
Statement:
Description:
We must protect the programs we manage from waste, fraud, and abuse. Ensuring proper payment to eligible beneficiaries is critical to that objective. Ensuring proper payments means not only preventing overpayments, but also, just as importantly, preventing underpayments.
We work hard to ensure that all beneficiaries receive the correct amount. Our payment accuracy rate for retirement and survivors benefits is greater than 99 percent. However, our DI and SSI programs are more error prone due to the complexity of the laws for both programs and the variability of SSI payments from month to month based on a recipient’s changes in income, resources, and living arrangements. We rely on recipients to self-report this information, and their failure to report timely is a significant reason for the difficulty in our SSI payment accuracy rate.
We have identified several strategies to increase payment accuracy in our DI and SSI programs and will work diligently to realize improvements in these areas:
- We will collaborate with other Federal and State agencies that serve similar populations, so we can benefit from shared ideas and best practices in ensuring proper payment. Among the potential solutions is better use of data exchanges to produce a more efficient and accurate process for receiving payment-affecting information. For example, we exchange data with the Department of Defense to verify entitlement to Special Veterans’ Benefits. In addition, the IRS shares Form 1099 information to help us verify SSI eligibility and payment amounts.
- We also will increase our partnerships with financial institutions to build on the success of our Access to Financial Institutions (AFI) initiative to identify financial resources that can affect SSI eligibility and often go unreported. AFI allows us to check SSI recipient bank records to ensure that recipients remain eligible for benefits. Over the next decade, this initiative will save American taxpayers hundreds of millions of dollars.
- Even after we approve a person for benefits, we periodically review many of their cases to ensure that they continue to meet the eligibility requirements under each program. For example, we complete SSI redeterminations, which are periodic reviews of non-medical factors of SSI eligibility, such as income and resources. On average SSI non-medical redeterminations produce about $5 of net program savings per dollar spent, with savings from overpayments partly offset from the cost for underpayments.
- For many years, we have used predictive models (i.e., computer-based screening tools) and data analytics tools to improve the integrity of our programs. With data from other agencies and other sources in the private sector, we will explore additional uses of predictive models, data analytics, and automation tools to provide cost-effective means to increase payment accuracy.
- Our representative payee program historically has been vulnerable to fraud. Based on recommendations from oversight organizations, we have strengthened our policy, selection criteria, and review process. We are developing a long-term strategic approach to improving the program. Current efforts include using a predictive model that identifies cases with a higher probability of potential misuse and piloting a process for conducting criminal background checks on payee applicants during our selection process. We are also working with other agencies with similar programs to determine the potential for collaboration on payee activities.
Strategies:
- Collaborate with other Federal agencies, such as the Department of Veterans Affairs and Centers for Medicare and Medicaid Services within the Department of Health and Human Services, to find innovative ways to prevent and reduce improper payments;
- Increase efforts to recover overpayments;
- Enhance predictive models and automation tools to help identify error-prone aspects of benefit eligibility;
- Expand use of data analytics to reduce fraud and payment errors; and
- Streamline the Representative Payee Program to better identify potential misuse of benefits.
Agency Priority Goals
Statement:
Reduce the improper payment rate made under the Supplemental Security Income (SSI) program. By September 30, 2015*, we will reduce the improper payment rate made under the SSI program to no more than 6.2% of all payments made under the SSI program (i.e. overpayments and underpayments).
*Because of the difficulties in evaluating payment accuracy, there is a 7-month lag in obtaining end–of-year data. We will not have FY 2014 data available until April 2015. FY 2015 data will be available in April 2016.
Description:
SSI is a means-tested program designed to provide a monthly payment to aged, blind, or disabled people with limited income and resources. Adults, as well as children, can receive payments based on disability or blindness.
SSI payments are calculated using a statutory definition where payment levels for beneficiaries can change from month-to–month, which may result in an improper payment. Two factors used to determine an individual's monthly benefit are income and living arrangements. Income can be in cash or in-kind, and is usually anything that a person receives that can be used to obtain food or shelter. Cash income includes wages, Social Security and other pensions, and unemployment compensation. In-kind income is food and shelter or something someone can use to obtain those items.
Individuals' SSI benefit amounts also may change if they move in to a different “living arrangement”—whether a person lives alone or with others, or resides in a medical facility or other institution. For instance, when an individual moves into a nursing home, the person’s monthly payment may be reduced to as little as $30 per month. If the person moves from his or her own household into the household of another person, and that person provides food or shelter, the payment also may be reduced.
An individual’s resources also affect eligibility for the SSI program. An individual is not eligible for benefits if his or her countable resources exceed $2,000, and couples are not eligible if their countable resources exceed $3,000. In general, SSA counts as resources items individuals can convert to cash and use for their support and maintenance, such as bank accounts, stocks, and bonds.
The design of the SSI program requires that SSA adjust benefit payments to account for these factors. SSA explains to SSI recipients that they must report these changes to us when they occur. Absent their timely reporting, it is difficult to obtain information about these changes in a prompt fashion, resulting in some erroneous payments. Additionally, even if individuals report in a timely manner, SSA is required to first provide written notification of how the change affects their benefit amounts and provide due process protections. This process delays adjusting payments to the correct amount. Furthermore, SSA generally makes SSI payments on the first day of the month for eligibility in that month. Even if the payment is correct when paid, any changes that may occur during the month can affect the payment due, which can result in an overpayment or underpayment. Thus, the program requirements themselves sometimes cause erroneous payments.
SSA’s SSI improper payment accuracy reflects the complex nature of the SSI program. SSA is working on improving administration of the SSI program, focusing on how technology can make the agency more efficient. SSA is currently offering telephone wage reporting and a smart-phone application for reporting wages and is expanding our use of those technologies. SSA is also working on expanded use of Lexis-Nexis to verify real property, and numerous other projects designed to improve our service and ensure the integrity of our payments.
Strategic Objectives
Strategic Objective:
Statement:
Description:
We must protect the programs we manage from waste, fraud, and abuse. Ensuring proper payment to eligible beneficiaries is critical to that objective. Ensuring proper payments means not only preventing overpayments, but also, just as importantly, preventing underpayments.
We work hard to ensure that all beneficiaries receive the correct amount. Our payment accuracy rate for retirement and survivors benefits is greater than 99 percent. However, our DI and SSI programs are more error prone due to the complexity of the laws for both programs and the variability of SSI payments from month to month based on a recipient’s changes in income, resources, and living arrangements. We rely on recipients to self-report this information, and their failure to report timely is a significant reason for the difficulty in our SSI payment accuracy rate.
We have identified several strategies to increase payment accuracy in our DI and SSI programs and will work diligently to realize improvements in these areas:
- We will collaborate with other Federal and State agencies that serve similar populations, so we can benefit from shared ideas and best practices in ensuring proper payment. Among the potential solutions is better use of data exchanges to produce a more efficient and accurate process for receiving payment-affecting information. For example, we exchange data with the Department of Defense to verify entitlement to Special Veterans’ Benefits. In addition, the IRS shares Form 1099 information to help us verify SSI eligibility and payment amounts.
- We also will increase our partnerships with financial institutions to build on the success of our Access to Financial Institutions (AFI) initiative to identify financial resources that can affect SSI eligibility and often go unreported. AFI allows us to check SSI recipient bank records to ensure that recipients remain eligible for benefits. Over the next decade, this initiative will save American taxpayers hundreds of millions of dollars.
- Even after we approve a person for benefits, we periodically review many of their cases to ensure that they continue to meet the eligibility requirements under each program. For example, we complete SSI redeterminations, which are periodic reviews of non-medical factors of SSI eligibility, such as income and resources. On average SSI non-medical redeterminations produce about $5 of net program savings per dollar spent, with savings from overpayments partly offset from the cost for underpayments.
- For many years, we have used predictive models (i.e., computer-based screening tools) and data analytics tools to improve the integrity of our programs. With data from other agencies and other sources in the private sector, we will explore additional uses of predictive models, data analytics, and automation tools to provide cost-effective means to increase payment accuracy.
- Our representative payee program historically has been vulnerable to fraud. Based on recommendations from oversight organizations, we have strengthened our policy, selection criteria, and review process. We are developing a long-term strategic approach to improving the program. Current efforts include using a predictive model that identifies cases with a higher probability of potential misuse and piloting a process for conducting criminal background checks on payee applicants during our selection process. We are also working with other agencies with similar programs to determine the potential for collaboration on payee activities.
Strategies:
- Collaborate with other Federal agencies, such as the Department of Veterans Affairs and Centers for Medicare and Medicaid Services within the Department of Health and Human Services, to find innovative ways to prevent and reduce improper payments;
- Increase efforts to recover overpayments;
- Enhance predictive models and automation tools to help identify error-prone aspects of benefit eligibility;
- Expand use of data analytics to reduce fraud and payment errors; and
- Streamline the Representative Payee Program to better identify potential misuse of benefits.
Agency Priority Goals
Statement: Reduce the improper payment rate made under the Supplemental Security Income (SSI) program. By September 30, 2015*, we will reduce the improper payment rate made under the SSI program to no more than 6.2% of all payments made under the SSI program (i.e. overpayments and underpayments). *Because of the difficulties in evaluating payment accuracy, there is a 7-month lag in obtaining end–of-year data. We will not have FY 2014 data available until April 2015. FY 2015 data will be available in April 2016.
Description: SSI is a means-tested program designed to provide a monthly payment to aged, blind, or disabled people with limited income and resources. Adults, as well as children, can receive payments based on disability or blindness. SSI payments are calculated using a statutory definition where payment levels for beneficiaries can change from month-to–month, which may result in an improper payment. Two factors used to determine an individual's monthly benefit are income and living arrangements. Income can be in cash or in-kind, and is usually anything that a person receives that can be used to obtain food or shelter. Cash income includes wages, Social Security and other pensions, and unemployment compensation. In-kind income is food and shelter or something someone can use to obtain those items. Individuals' SSI benefit amounts also may change if they move in to a different “living arrangement”—whether a person lives alone or with others, or resides in a medical facility or other institution. For instance, when an individual moves into a nursing home, the person’s monthly payment may be reduced to as little as $30 per month. If the person moves from his or her own household into the household of another person, and that person provides food or shelter, the payment also may be reduced. An individual’s resources also affect eligibility for the SSI program. An individual is not eligible for benefits if his or her countable resources exceed $2,000, and couples are not eligible if their countable resources exceed $3,000. In general, SSA counts as resources items individuals can convert to cash and use for their support and maintenance, such as bank accounts, stocks, and bonds. The design of the SSI program requires that SSA adjust benefit payments to account for these factors. SSA explains to SSI recipients that they must report these changes to us when they occur. Absent their timely reporting, it is difficult to obtain information about these changes in a prompt fashion, resulting in some erroneous payments. Additionally, even if individuals report in a timely manner, SSA is required to first provide written notification of how the change affects their benefit amounts and provide due process protections. This process delays adjusting payments to the correct amount. Furthermore, SSA generally makes SSI payments on the first day of the month for eligibility in that month. Even if the payment is correct when paid, any changes that may occur during the month can affect the payment due, which can result in an overpayment or underpayment. Thus, the program requirements themselves sometimes cause erroneous payments. SSA’s SSI improper payment accuracy reflects the complex nature of the SSI program. SSA is working on improving administration of the SSI program, focusing on how technology can make the agency more efficient. SSA is currently offering telephone wage reporting and a smart-phone application for reporting wages and is expanding our use of those technologies. SSA is also working on expanded use of Lexis-Nexis to verify real property, and numerous other projects designed to improve our service and ensure the integrity of our payments.