Supplemental Security Income:

SSA Has Taken Steps to Prevent and Detect Overpayments, but Additional Actions Could Be Taken to Improve Oversight

GAO-13-109: Published: Dec 14, 2012. Publicly Released: Dec 14, 2012.

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What GAO Found

On October 19, 2012, we briefed Congressional staff on the results of our study of the extent to which SSA makes overpayments to and recovers overpayments from SSI beneficiaries. In summary, we found that cumulative SSI overpayment debt nearly doubled from $3.8 billion in fiscal year 2002 to $7.3 billion in fiscal year 2011. SSI overpayment debt recovery also increased from $860 million to almost $1.2 billion during the same time period. For fiscal year 2011, the unreported value of recipients' financial institution accounts, such as checking and savings accounts, and unreported wages were the major factors associated with causes of overpayments, and were associated with about $1.7 billion (37 percent) of all SSI overpayments. SSA lacks comprehensive, timely information on SSI recipients' financial institution accounts and wages, but has developed new tools to improve its information in these areas: Access to Financial Institutions (AFI) and Telephone Wage Reporting (TWR). The AFI initiative conducts electronic searches of about 96 percent of the financial institutions where SSI recipients have a direct deposit account, and provides SSA with independent data on a recipient's financial institution accounts to use when periodically redetermining a recipient's eligibility for payments. The TWR system allows recipients to call into an automated telephone system to report their monthly wages. Agency officials reported that the TWR system should ease the burden of reporting wages for some recipients and save time for SSA staff since wage data will be input directly into SSA's computer system.

We also found that in fiscal year 2011, 75 percent of SSI overpayment debt that was recovered was obtained by withholding a portion of recipients' ongoing Title XVI (SSI) payments, or by withholding of Title II (Old-Age, Survivors, and Disability Insurance) payments. Recipients can request a waiver of repayment under certain circumstances. According to the standards for internal control in the federal government, agencies must have controls in place to ensure that no individual can control all key aspects of a transaction or event. SSA, however, does not require supervisory review or approval for overpayment waivers of $2,000 or less; and claims representatives, who are located in SSA's more than 1,260 field offices, have the authority to unilaterally approve such waivers. In fiscal year 2011, SSA approved about 76 percent of all SSI overpayment waivers requested by recipients. Management oversight of the SSI overpayment waiver decision process is limited. The agency does not routinely analyze collected SSI waiver data to identify potential negative trends in the implementation of SSA's waiver policies and procedures, such as the type, number, and dollar value of the waivers granted, including those waivers below the $2,000 approval threshold that SSA staff can unilaterally approve, and whether there are waiver patterns specific to SSA offices, regions, or individual staff.

Why GAO did this study

The Social Security Administration's (SSA) Supplemental Security Income program (SSI) provides cash assistance for eligible aged, blind, and disabled individuals with limited financial means. In fiscal year 2011, the SSI program paid about $46 billion in benefits to approximately 9 million beneficiaries. The program has grown substantially in recent years, and is expected to grow more in the near future, placing added pressure on already stretched federal budgets. Given the size of the SSI program, even small errors in benefit payments can result in a significant loss of taxpayer dollars, and financial hardships for individuals of limited means who have to repay the overpayment. In fiscal year 2010, SSA reported that overpayments to program recipients exceeded $3.3 billion. Agency data also showed that the amount of SSI debt recovered was less than half the amount of new debt detected.

To determine an individual's ongoing financial eligibility for SSI program payments, SSA conducts periodic "redeterminations." During a redetermination, field office staff perform a variety of activities to verify recipients' income, resources, living arrangements, and other factors to determine their continued SSI program eligibility. These activities may include querying internal and external databases, checking with employers and banks, and performing interviews with recipients to obtain current information. In fiscal year 2011, SSA conducted more than 2.4 million redeterminations--an increase of about 136 percent over the number conducted in fiscal year 2007--that it estimates will prevent or recover about $3.2 billion in lifetime overpayments.

In fiscal year 2012, recipients with countable income that exceeds $698 per month ($1,048 for couples) are generally ineligible for SSI payments. In addition, recipients who have countable assets of more than $2,000 ($3,000 for couples) are also ineligible for SSI payments. SSA may overpay beneficiaries if it does not obtain timely and accurate information regarding their earnings and assets, and act expeditiously to discontinue payments to recipients who exceed income or asset thresholds. These overpayments adversely impact program integrity, and may create economic hardship for beneficiaries who have to repay them. Moreover, the potential burden of having to repay SSI overpayments could create, for some, a disincentive to work.

Given the importance of verifying the continued eligibility of SSI recipients, and identifying and recovering potential SSI benefit overpayments, Congress asked us to study the extent to which SSA makes overpayments to and recovers overpayments from SSI beneficiaries. Specifically, we answered the following questions: (1) What are the major factors associated with SSI overpayments, and what actions has SSA taken to address them? and (2) What is known about SSA's recovery of overpayments from SSI recipients, including those not currently receiving SSI payments?

What GAO Recommends

To enhance SSA's ability to recover SSI overpayment debt, the Commissioner of Social Security should:
  • Review the agency's policy concerning the supervisory review and approval of overpayment waiver decisions of $2,000 or less, to determine if the policy is still appropriate given that federal agencies must have controls in place to ensure that no individual can control all key aspects of a transaction or event. Such a review should include collecting the information needed to determine the impact of this policy on the agency's financial stewardship of SSI program dollars.
  • Explore ways to strengthen the agency's oversight of the overpayment waiver process through the analysis of data to identify waiver trends, such as approval rates, amounts, and patterns specific to SSA offices, regions, or individual staff that the agency may wish to track more closely.
For more information, contact Daniel Bertoni, (202) 512-7215 or bertonid@gao.gov.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: SSA agreed with this recommendation. In FY 15, SSA reported that the agency convened an inter-component workgroup to evaluate the policy concerning the supervisory review and approval of overpayment waiver decisions of $2,000 or less. The workgroup conducted a study and reviewed a random sample of 503 SSI waiver determinations of $2,000 or less that occurred between November 22 and December 27, 2013. SSA found the dollar accuracy rate of these waiver transactions was 98.7 percent. The agency also found the case-dollar accuracy rate was 98.9 percent. Since the study did not detect any significant reason for us to change our current policy, SSA reported that it will continue to allow technicians to waive overpayments without supervisory review and approval when the overpayment waiver decision is $2,000 or less.

    Recommendation: To enhance SSA's ability to recover SSI overpayment debt, the Commissioner of Social Security should review the agency's policy concerning the supervisory review and approval of overpayment waiver decisions of $2,000 or less, to determine if the policy is still appropriate given that federal agencies must have controls in place to ensure that no individual can control all key aspects of a transaction or event. Such a review should include collecting the information needed to determine the impact of this policy on the agency's financial stewardship of SSI program dollars.

    Agency Affected: Social Security Administration

  2. Status: Closed - Implemented

    Comments: SSA reported in June 2017 that it had taken several actions to address this recommendation. First, SSA's Office of Quality Review conducted a waiver study. The study, entitled "Title XVI Overpayment Waivers of $2,000 or less," was published in November 2014. The study found that in 57 of the cases studied, the SSA Field Office should not have approved the overpayment waiver. Second, in fiscal year 2015, the agency conducted a Continuous Quality (CQ) Area Director review focused on reviews of overpayments and waiver processing. According to SSA, the review provided the agency with a national approach to improving and maintaining the accuracy and quality of work done in our field offices by pinpointing specific areas of concern. SSA reported that, as a result, a series of recommendations focused on policy clarifications, training augmentation, and systems enhancements were identified. In relation to this, SSA updated several overpayment procedural instructions, and created a series of mandatory videos on demand (VOD) related to overpayments. Third, in fiscal year 2016, a national SSA workgroup created Title II and Title XVI Overpayment and Waiver workflows to address common processing errors. The workflows are located in the Overpayment Clusters in SSA's PolicyNet so technicians can access these guides, as well as other overpayment guides, from one centralized location. Finally, SSA reported in June 2017 that the agency is in the process of requesting resources to create an electronic application to process waiver requests. The current waiver process is a manual multi-step process. According to SSA, an electronic application will strengthen the overpayment waiver process by ensuring the agency has automated methods in place to improve performance by addressing inefficiencies, errors, and timeliness. SSA is in the early stages of this request.

    Recommendation: To enhance SSA's ability to recover SSI overpayment debt, the Commissioner of Social Security should explore ways to strengthen the agency's oversight of the overpayment waiver process through the analysis of data to identify waiver trends, such as approval rates, amounts, and patterns specific to SSA offices, regions, or individual staff that the agency may wish to track more closely.

    Agency Affected: Social Security Administration

 

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