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Oct 4, 2016

Are You Kidding Me? A 48% Error Rate?

     From a recent report by Social Security's Office of Inspector General (OIG):
Our objective was to determine whether the Social Security Administration (SSA) correctly completed manual actions to bill for Medicare premiums owed by beneficiaries whose monthly Social Security benefit was less than the monthly Medicare premium. 
When an individual entitled to Medicare Part B receives a monthly Social Security benefit, SSA deducts the monthly Medicare premium from the benefit . However, some individuals’ monthly Social Security benefit is lower than the monthly Medicare premium. SSA must bill these individuals for the remaining amount of the Medicare premium. ...
 SSA incorrectly calculated the Medicare premium owed for 120 (48 percent ) of the beneficiaries we reviewed who had a monthly Social Security benefit lower than their monthly Medicare premium. Based on these results, we project 33,092 beneficiaries paid incorrect amounts totaling almost $21.9 million for Medicare premiums because of SSA’s errors. These errors included miscalculations, erroneous system inputs, and failure to update beneficiary records correctly. As a result, some beneficiaries paid more than the correct amount for Medicare premiums, while others paid less ....

5 comments:

  1. They should have indicated the error magnitude in percentage terms. They give a total dollar value but not the time frame. In the report, they give one specific example: "he paid $1,122 more than he actually owed for his Medicare premiums from December 2002 through December 2015." So that's about $7 per month. And the average error was $662, so this case had a much higher total error than the average (although we don't know if that's because the monthly error was larger or the time period was longer). OK, Medicare Part B is about $120, so $7 is not a trivial mistake, but it's not a huge one either, and this might be the worst case they found.

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  2. Presuming a good majority of these folks are also receiving some sort of SSI without any deduction, their monthly benefit amount is $733.00. That works out to about 1% of their monthly cash. If an ALJ with the topped out salary was under paid $1,700.00 per anium I'm sure they'd think it is a big deal.

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  3. But if they are getting SSI then quite often their Medicare is paid by the state so this probably does not include SSI recipients. You wonder why the billing amount is not coordinated with CMS.

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  4. Class action suits have been successful against banks who have charged minuscule improper fees to thousands of customers. The damages to any one plaintiff may have be minor but the cumulative impact was catastrophic. The same argument can be put forth with SSA. Either because of gross incompetence, lack of institutional control, or specific intent, SSA has caused improper charges to individuals. Again, each single case many be insignificant, but the cumulative impact is not.

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  5. Anon 10:37. I assume you mean Medicare is paid by the state if they are on SSI AND SSDI. We call is Med-Medi in California. If only on SSI, MediCal in California has been horrendous ever since Obamacare was passed in 2014.

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