Supplemental Security Income:

SSA Could Enhance Its Ability to Detect Residency Violations

GAO-03-724: Published: Jul 29, 2003. Publicly Released: Jul 29, 2003.

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The Supplemental Security Income (SSI) program paid about $35 million recipients in 2002. In recent years, the Social Security Administration (SSA) has identified a general increase in the amount of annual overpayments made to (1) individuals who are found to have violated program residency requirements or (2) recipients who leave the United States and live outside the country for more than 30 consecutive days without informing SSA. This problem has caused concern among both program administrators and policy makers. As such, GAO was asked to determine what is known about the extent to which SSI benefits are improperly paid to individuals who are not present in the United States and to identify any weaknesses in SSA's processes and policies that impede the agency's ability to detect and deter residency violations.

Overpayments resulting from residency violations totaled about $118 million between 1997 and 2001. However, this figure, which represents only violations detected by SSA, likely understates the true level of the problem. Additionally, the extent of violations appears to vary by geographic region, with overpayments being more prevalent in several large metropolitan areas. GAO found that 54 percent of all overpayments detected by SSA during this period occurred in just 15 counties. In addition, GAO found that recipients born outside the United States accounted for at least 87 percent of all residency overpayments. SSA's ability to detect and deter residency violations is impeded by three kinds of weaknesses. First, the agency relies heavily on self-reported information from recipients to determine domestic residency, often without independently verifying such information. Second, SSA makes insufficient use of existing tools to detect violations, such as its "risk analysis" system, redeterminations, and home visits. Finally, the agency has not adequately pursued independent sources of information from other federal agencies or private organizations to detect nonresidency of SSI recipients. GAO recognizes that the SSI program is complex to administer, and residency requirements are particularly difficult to enforce because they can necessitate time-consuming, labor-intensive verification checks, such as home visits. However, SSA has not employed a systematic, comprehensive approach to this problem that would allow the agency to use its available systems and procedures more efficiently and reduce the program's exposure to additional violations.

Status Legend:

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  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendations for Executive Action

    Recommendation: In order to further strengthen and increase SSA's ability to detect SSI residency violations and reduce resulting overpayments due to recipient absences from the United States, the Commissioner of Social Security should study the feasibiliy of expanding the type of information SSA obtains from financial institutions as authorized by the Foster Care Independence Act of 1999 (Pub. L. No. 106-169). Additional information to help identify violators could include bank and ATM withdrawal records to help identify SSI recipients who may be accessing their SSI benefits outside the United States for extended periods of time.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: SSA agreed that accessing financial information is a valid method to help prevent overpayments and followed GAO's recommendation to study its feasibility. SSA's Office of Inspector General is conducting an evaluation to determine the types of financial information that could be useful in detecting residency violations.

    Recommendation: In order to further strengtben and increase SSA's ability to detect SSI residency violations and reduce resulting overpayments due to recipient absences from the United States, the Commissioner of Social Security should consider expanding the use of unannounced home visits in some areas as a way of verifying the residency of recipients whom the agency identifies as potentially being at high risk for violations. To ensure that only cases with a high potential for success are selected, any potential profile of high-risk recipients that SSA develops could be a primary source of referrals. To maximize limited staff resources, SSA should apply a strategic approach to this problem, recognizing that violations are not equally prevalent in all areas of the country.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: SSA agreed with this recommendation. The agency contacted the remaining states whose Medicaid agencies generally conduct the visits for both SSI residency and Medicaid purposes to determine their willingness to enter into similar agreements. Although 27 additional states and the District Columbia initially expressed interest, SSA entered into agreements with an additional 7 states, for a current total of 10 states (at the time of our report, 3 states had entered into agreements).

    Recommendation: In order to further stengthen and increase SSA's ability to detect SSI residency violations and reduce resulting overpayments due to recipient absences from the United States, the Commissioner of Social Security should consider reengineering the agency's risk analysis system to more specifically target potential residency violators. The list of potentially high-risk characteristics we have developed and tested could provide a startint point for such refinements. To accomplish this, SSA may wish to test the idea on a one-time basis methods the agency deems appropriate to assess its effectiveness.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: SSA agreed with the recommendation and examined and tested a number of risk factors to more specifically target residency violators, including the factors GAO identified in its report. SSA is working on a continuing basis to identify and utilize risk factors that will allow it to target residency violators more effectively.

    Recommendation: In order to further strengthen and increase SSA's ability to detect SSI residency violations and reduce resulting overpayments due to recipient absences from the United States, the Commissioner of Social Security should investigate the potential for obtaining access to emerging third-party data sources such as entry/exit databases being developed by DHS to help field staff more accurately verify whether SSI recipients are violating program regulations.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: SSA agrees that there are potential benefits to using external data sources to detect SSI residency requirement violations, such as the Department of Homeland Security's (DHS) records. As a result of its investigation into the potential for obtaining access to third party databases, SSA began two data exchanges with DHS. In July 2004, SSA began obtaining DHS's deportation file to identify individuals deported from the United States who may be receiving SSI benefits. In July 2005, the agency began obtaining DHS's voluntary departure file. This file is based on individual's notification to DHS that they will be out of the country for an extended period and are therefore not eligible for benefits. These matches have resulted in over 2,000 alerts to SSA field offices.

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