Aug 9, 2009

SSAB Releases Report On SSI Payment Accuracy

The Social Security Advisory Board (SSAB) has just released a May 2009 report it prepared on payment accuracy in the Supplemental Security Income (SSI) program. I have no idea why this report is just now showing up on the SSAB website.

The report shows a dramatic decline in SSI redeterminations between 2003 and 2007. The effect has been a dramatic increase in SSI overpayments.

The report also shows a dramatic increase in the backlog of SSI cases awaiting continuing disability reviews. When cases were reviewed, most of the time the only "review" was a mailing to the claimant asking some questions. Unless the claimant reported that he or she was improved or had gone back to work, there was little chance of the "review" leading to the termination of benefits.

This has been caused by budget problems at Social Security. While Republicans controlled Congress, Social Security was given such inadequate operating funds that the agency had to cut back on anything not immediately necessary. The result was poorer service to the public and poor stewardship of public funds. Things are getting better now, but only very slowly.

Putting Things In Perspective

The Congressional Budget Office (CBO) has released updated long term projections for the Social Security trust funds. Here is an excerpt:
CBO estimates that if the Social Security payroll tax rate was increased immediately and permanently by 1.3 percentage points—from the current rate of 12.4 percent to 13.7 percent—the trust funds’ balance at the end of 2083 would equal projected outlays for the subsequent year.
When you put it that way, Social Security's financing problems sound like something easily solved.

Updated Fee Payment Information

Fee Payments

Month/Year Volume Amount
Jan-09
28,423
$101,128,880.69
Feb-09
31,352
$112,791,207.17
Mar-09
29,199
$104,155,187.96
Apr-09
30,963
$110,133,425.19
May-09
36,603
$126,725,262.45
June-09
31,799
$113,962,564.84
July-09
34,802
$124,621,068.71

Aug 8, 2009

E-Pulling Finally Killed Off

The Social Security Administration has finally decided to kill off the e-pulling experiment. Before being heard by Social Security's Administrative Law Judges (ALJs), the files of disability claimants are normally put into some semblance of order by staff at hearing offices. This "pulling" of exhibits can be a time consuming business. Lisa DeSoto, the former head of Social Security's Office of Disability Adjudication and Review (ODAR), thought that a computer program could do this. A lot of people, including me, kept saying that e-pulling would never work. We were right. Too much judgment is involved in pulling exhibits to allow a computer program to perform this vital task. I wonder how much money was wasted.

Number Of ALJs To Increase

There is a report on the ALJ Discussion Forum from an anonymous but previously reliable source that Social Security Commissioner Michael Astrue has decided to increase the number of Administrative Law Judges (ALJs) at his agency from 1,450 to 1,600 in fiscal year (FY) 2011 and FY 2012 and to open 15 additional hearing offices in FY 2011.

No Progress On Earnings Enforcement

From a recent report by Social Security's Office of Inspector General:
...[I]n some cases, retired beneficiaries may continue to work while receiving Social Security benefits. In those instances, Title II of the Social Security Act (Act) requires that SSA use an Annual Earnings Test (AET) to measure the extent of beneficiaries' retirement and determine the amount, if any, to be deducted from their monthly benefits. The Act provides for a two tier earnings test: one for beneficiaries under full retirement age and another for beneficiaries in the year they attain full retirement age. ...

To ensure compliance with the AET provisions, SSA compares beneficiaries’ reported earnings that are recorded on SSA’s Master Beneficiary Record (MBR) with earnings that were reported by employers that are recorded on SSA’s Master Earnings File (MEF). This process, called the Earnings Enforcement Operation (EEO), is designed to detect over- or underpayments that may have occurred during the year.

Our 2007 audit of the AET disclosed SSA had not adjusted the benefit payments of all beneficiaries who were identified by the EEO. As a result, SSA overpaid about $313 million to 89,300 beneficiaries and underpaid about $35 million to 12,800 beneficiaries for Calendar Years (CY) 2002 through 2004. In addition, we found SSA had not processed approximately 2.1 million of the 2.5 million Earnings Enforcement selections for CYs 1996 through 2005. We made several recommendations to improve the EEO, including that SSA review and process, as appropriate, all Earnings Enforcement selections pending since 1996.

RESULTS OF REVIEW

SSA had not made significant progress to resolve the 2.5 million Earnings Enforcement selections. Of the approximately 2.1 million Earnings Enforcement selections that were pending at the time of our prior audit, we found SSA had only processed about 337,500 (16.1 percent). In addition, our review disclosed there was a substantial number of improper payments in the backlog for the affected beneficiaries.

Based on a random sample of 275 beneficiaries, we estimate SSA

• overpaid about $956 million to 616,459 beneficiaries and

• underpaid about $245 million to 181,312 beneficiaries

New Digs In PA

From the Daily Item of Sunbury, PA:
The Social Security office is moving from 300 Market St. to a larger office near the Susquehanna Valley Mall in Hummels Wharf at nearly triple the current rent. ...

But, according to Gina Blyther Gilliam, regonal public affairs officer for the mid-Atlantic region of the U.S. General Services Administration in Philadelphia, the Sunbury office rate was negotiated in 1997, and the space "no longer meets the requirements of the Social Security Administration."

The move is being made because of an increase in visitors, officials said.

The Sunbury office serves Northumberland, Snyder and Union counties. It saw 15,866 visits in 2008. So far this year, the office has received 13,759 visitors. ...

The new building contains 8,135 rentable square feet, priced at $38.63 per year. The current building has 6,874 rentable square feet, at a cost of $16.75 per square foot.

Aug 7, 2009

$24 Million For Electronic Medical Records

A press release from Social Security:

Michael J. Astrue, Commissioner of Social Security, today announced the availability of $24 million in contracts to provide the agency with electronic medical records to improve the efficiency of its disability programs. Through a Request for Proposals available on www.fedbizopps.gov, Social Security is looking for health care providers, provider networks, and health information exchanges to participate in its Medical Evidence Gathering and Analysis through Health Information Technology (IT) program.

“With these competitive contracts, Social Security continues to be a leader in the use of health IT to improve service to the American public,” Commissioner Astrue said. “This technology will greatly improve the speed and consistency of our disability decisions.”

The contract opportunities announced today are funded through the American Recovery and Reinvestment Act. They will require awardees, with a patient’s authorization, to send Social Security electronic medical records through the Nationwide Health Information Network (NHIN). The NHIN, a safe and secure method for receiving instantaneous access to electronic medical records, is an initiative of the Department of Health and Human Services and is supported by multiple government agencies and private sector entities.

Social Security is seeing a significant increase in disability applications as a result of the current recession. The agency expects to receive more than 3.3 million applications in fiscal year (FY) 2010, a 27 percent increase over FY 2008. To process these applications, the agency sends more than 15 million requests for medical records to health care providers. The use of health IT will vastly improve the efficiency of this process, which currently is largely paper-bound.

For nearly a year, Social Security has been successfully testing health IT to obtain electronic medical records. Disability applications processed with electronic medical records from the test sites in Massachusetts and Virginia have significantly reduced processing times.

More information on Social Security’s use of health IT is available at www.socialsecurity.gov/hit.