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Strategic Objective

Increase Payment Accuracy

Strategic Objective

Lead Office: Office of Systems

Themes:

Social Security

SSA.gov

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Overview
Progress Update

Overview

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.

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Progress Update

We took the following steps in FY 2015 to increase payment accuracy (see Key Initiatives and Performance Measures for more details):

Expanded the use of data analytics and improved technology to:
- Identify patterns of fraud in our programs; and
- Prevent payment errors by identifying missed entitlements to benefits.
Through data exchange partnerships with the Centers for Medicare and Medicaid Services, we have:
- Identified over $49 million in estimated incorrect payments;
- Referred 1,334 cases to the Office of Inspector General for investigation; and
- Uncovered 272 out-of-country cases.
Implemented improvements to the Pre-effectuation Review (PER) model to help identify the most error-prone adult SSI DDS allowances for review;
Identified 1,352 previously unreported deaths of U.S. beneficiaries abroad, resulting in potential overpayment savings of almost $7 million;
Implemented a change to our address verification business process, allowing us to notify more delinquent debtors of a potential offset; and
Expanded the payee monitoring program to better identify potential benefit misuse – expected to net an increase of 300 additional reviews over FY 2014.

Next Steps

Monitor PER workloads on a weekly basis to ensure models and associated business processes are working correctly and as intended;
Research the use of quarterly reported earnings data in the CDR predictive model to prioritize CDRs that are likely to result in suspension or termination;
Develop systems, policy, and training to support the non-home real property process;
Expand automated reciprocal death data exchanges to as many partner countries as possible; and
Publish agency operating instructions to improve the business process for transmitting information to and from the Department of Veterans Affairs.

Expand All

Strategic Goals

Strategic Goal:

Strengthen the Integrity of Our Programs

Statement: No Data Available

Strategic Objectives

Transform the Way We Record Earnings to Enhance Data Accuracy

Statement:No Data Available

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.

Learn More

Protect the Public’s Data and Provide Secure Online Services

Statement:No Data Available

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.

Learn More

Increase Payment Accuracy

Statement:No Data Available

Description:

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.

Learn More

FY 14-15 Priority Goal: Reduce the improper payment rate made under the Supplemental Security Income (SSI) program.

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.

Learn More