I Was Kind Of Expecting This

     Binder and Binder may be about to enter Chapter 11 bankruptcy.

Colvin Nomination May Soon Come Up For Vote In Senate

     There are signs that Carolyn Colvin's nomination for a term as Commissioner of Social Security is a matter of some priority with Senate Democrats. She is currently the Acting Commissioner. Her nomination is apparently considered as being on the same plateau as lifetime judicial nominations. There is a rumor that it may come up on the Senate floor as early as today but it's not on the calendar at this time.

GAO Report Urges More Efforts To Find Fraud To Satisfy GOP

     From a report by the Government Accountability Office done at the behest of the Chairman of the House Social Security Subcommittee and the Ranking Member of the Senate Finance Committee:

The Social Security Administration (SSA) has policies and procedures in place for detecting and preventing fraud with regard to disability benefit claims. However, GAO identified a number of areas that could leave the agency vulnerable to physician-assisted fraud and other fraudulent claims:

• SSA relies heavily on front-line staff in the offices of its disability determination services (DDS)—which have responsibility for reviewing medical evidence—to detect and prevent potential fraud. However, staff said it is difficult to detect suspicious patterns across claims, as directed by SSA policy, given the large number of claims and volume of medical information they review. Moreover, DDS offices generally assign claims randomly, so staff said it would only be by chance that they would review evidence from the same physician.

• SSA and, in turn, DDS performance measures that focus on prompt processing can create a disincentive for front-line staff to report potential fraud because of the time it requires to develop a fraud referral. Four of the five DDS offices GAO visited count time that staff spend on documenting potential fraud and developing fraud referrals against their processing time. Some staff at these DDS offices said this creates a reluctance to report potential fraud.

• The extent of anti-fraud training for staff varied among the five offices GAO visited and was often limited. SSA requires all DDSs to provide training to newly hired staff that includes general information on how to identify potential fraud, but does not require additional training. The five DDS offices GAO visited varied in whether staff received refresher training and its content—such as how to spot suspicious medical evidence from physicians—and staff at all levels said they needed more training on these issues.

• SSA has not fully evaluated the risk associated with accepting medical evidence from physicians who are barred from participating in federal health programs. Although information from these physicians is not necessarily fraudulent, it could be associated with questionable disability determinations.

SSA has launched several initiatives to detect and prevent potential fraud, but their success is hampered by a lack of planning, data, and coordination. For instance, SSA is developing computer models that can draw from recent fraud cases to anticipate potentially fraudulent claims going forward. This effort has the potential to address vulnerabilities with existing fraud detection practices by, for example, helping to identify suspicious patterns of medical evidence. However, SSA has not yet articulated a plan for implementation, assigned responsibility for this initiative within the agency, or identified how the agency will obtain key pieces of data to identify physicians who are currently not tracked in existing claims' management systems. Furthermore, SSA is developing other initiatives, such as a centralized fraud prevention unit and analysis to detect patterns in disability appeals cases that could indicate fraud. However, these initiatives are still in the early stages of development and it is not clear how they will be coordinated or work with existing detection activities.

     It could be that there really isn't much fraud and that extensive efforts to find it wouldn't be cost effective. 

Threat Of A Shutdown

     The federal government will shut down tomorrow if Congress cannot agree on a continuing resolution to fund the government. 

     The last time there was a shutdown, which was just last year, almost all Social Security employees were told to keep working. The major exceptions were employees of the Office of Disability Adjudication and Review (ODAR) other than the Administrative Law Judges (ALJs) and most of the Office of General Counsel (OGC). Even without passage of a funding bill almost all the ODAR employees were recalled. The OGC employees were recalled just before passage of the continuing resolution. Social Security asked the state Disability Determination Services (DDS) to stay open and they did for a time but some started closing down as the shutdown continued. 

     I expect that Social Security employees were told today whether they should come to work tomorrow if there's a shutdown. What's the plan this time in case there's a shutdown?

     By the way, when's the next federal payday? If the shutdown, if it happens, is still going on at that time, no paychecks can be issued even for employees who have been told to work.

OIG Report

     Social Security's Office of Inspector General (OIG) has released its Semiannual Report to Congress. In Fiscal Year 2014 OIG received 121,461 allegations, opened 8,335 cases and get 1,291 criminal convictions. This is for a program that pays benefits to 63.2 million people. Only 6% of the allegations had enough substance to be worthy of an investigation. Only about 1% of the allegations resulted in a conviction. Whatever fraud there is at Social Security should certainly be investigated and prosecuted but it's only a tiny, tiny part of Social Security.

Social Security Asks Permission To Publish Final Rule On Submission Of Evidence

     Social Security has asked the Office of Management and Budget (OMB) to approve a final rule on the submission of evidence in disability claims. If this has not been significantly altered since it was published as a proposed rule, it will be completely unworkable.

TV Station Reports On Hearing Backlogs

     A Nashville television station is reporting on the huge backlogs and long waiting times to get a hearing on a Social Security disability claim. Expect many more similar reports. The backlogs are approaching record levels.

Former Service Representative Pleads Guilty To Social Security Fraud

     From a press release issued by Social Security's Office of Inspector General:

A former employee of the Social Security Administration (SSA) appeared in federal court in Dallas this morning and pleaded guilty ... to one count of conspiracy to commit theft of government funds. He faces a maximum statutory penalty of five years in federal prison, a $250,000 fine and restitution. ...

In some instances, for example, [Carwin Shaw of Arlington, Texas, who was a Service Representative] manipulated the verified income attributed to Supplemental Security Income beneficiaries that resulted in the issuance of larger payments than authorized, the issuance of payments when none were due, and the removal of legitimate overpayments posted to beneficiary’s record. Shaw further admitted using the SSA’s electronic systems that interface with the U.S. Treasury Department to issue duplicate checks to beneficiaries when only one check was due. Shaw would cut additional checks to the co-conspirators by alleging their initial check had been lost or stolen, split the second check with the co-conspirator and then access the system and waive the overpayment so that it would not be recovered from any future benefits. Each co-conspirator was the representative payee for one minor or otherwise incompetent Social Security beneficiary.

The loss to the SSA as a result of all of Shaw’s relevant conduct is approximately $78,165. ...