Annual Performance Plan - 2014, Revised Final Performance Plan - 2013 Page 40
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89Strategic Objective 3.1
Increase Efforts To Accurately Pay Benefits
Ø Explore New Business Processes for Completing Our Program Integrity
Activities
Ø Develop New Tools and Automated Means for Beneficiaries to Report Changes
that May Affect Their Payment Amount
Ø Automate Internal Business Processes to Make It Easier for Our Employees to
Make Changes Quickly and Accurately
Ø Collaborate with Other Federal Agencies to Find Innovative Ways to Detect
STRATEGIES
Fraud
Ø Pursue Additional Data Sharing Agreements with Private Industry and
Government Agencies
Ø Enhance Predictive Models and Automation Tools to Help Identify Elements of
Benefit Eligibility
Ø Explore Innovative Methods to Communicate Reporting Responsibilities to
Beneficiaries
Our program integrity activities are critical to ensuring well-run programs and accurate payments.
Despite rising workloads, we have been steadily increasing our program integrity efforts. We intend to
continue our commitment to our program integrity efforts to minimize improper payments. Our
stewardship responsibilities include conducting periodic medical Continuing Disability Reviews (CDR)
and non-medical SSI redeterminations. These reviews save significant program dollars by avoiding
improper payments to beneficiaries. The FY 2014 President’s Budget includes a new legislative proposal
that would replace discretionary cap adjustments with a dependable source of mandatory funding to
significantly ramp up our program integrity work. In FY 2014, the proposed funding would allow us to
handle significantly more CDRs.
We will further increase our efforts to pay benefits accurately by:
Conducting Continuing Disability Reviews (CDR):
To ensure we pay disability benefits to only those
who continue to meet our medical requirements, we conduct CDRs periodically for both DI beneficiaries
and SSI recipients to determine if their disabling condition has improved and if they are still eligible for
benefits. We use statistical modeling to identify beneficiaries’ probability of medical improvement.
We conduct two types of medical CDRs: questionnaires (mailers) and full medical reviews. Generally,
we send mailers to beneficiaries and recipients who have a low probability of demonstrating medical
improvement. We schedule a full medical CDR for those beneficiaries with a higher probability of
medical improvement. Full medical CDRs require a new medical evaluation and disability determination
by our DDS examiners.
Although most CDRs do not result in a cessation of benefits, our medical CDR process is cost effective.
For FY 2014, we estimate that every dollar spent on CDRs will yield about $9 in program savings over
10 years, including Medicare and Medicaid program effects.
Conducting SSI Redeterminations:
Because SSI is a means-tested program, changes in recipients’
living arrangements or the amount of their income and resources can affect their eligibility or the
Annual Performance Plan for FY 2014 and Revised Final Performance Plan for FY 2013
Social Security Administration |
| 1-800-772-1213
40
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