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Supplemental Security Income: Disability Program Vulnerable to Applicant Fraud When Middlemen Are Used

HEHS-95-116 Published: Aug 31, 1995. Publicly Released: Sep 05, 1995.
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Highlights

Pursuant to a congressional request, GAO reviewed fraudulent claims for disability benefits under the Supplemental Security Income (SSI) program, focusing on: (1) the extent of fraudulent applications submitted by non-English speaking immigrants using middlemen; (2) factors that contribute to SSI vulnerability to such fraudulent applications; and (3) government initiatives to combat such fraudulent activities.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Social Security Administration The Commissioner of Social Security should develop a more aggressive, programwide strategy for improving the quality of information obtained from applicants, maintaining and sharing data collected on interpreters and middlemen among field offices, and using information that results from the work of other local, state, and federal government agencies to pursue cases in which fraud is suspected. Such a strategy should include developing improved ways to more effectively manage SSA resources to further facilitate communications with applicants, possibly by requiring that SSA bilingual staff or SSA contracted staff conduct the interviews and by exploring videoconferencing technology. The strategy should also include instituting procedures for sharing, among field offices, the information SSA has already collected about interpreters and middlemen from its required forms and other sources, until the automated interpreter database is established, and establishing a mechanism to facilitate regular sharing of all state Medicaid agencies' investigative results with SSA.
Closed – Implemented
SSA has taken some actions to address the middleman fraud problem. For example, it has established pilot task forces to investigate cases of disability fraud that are referred by DDS examiners. It also issued new procedures that all DDSs are to follow in cases where examiners suspect fraud or abuse. While these actions are a step in the right direction, they are not fully responsive to GAO's recommendation. For example, pilot task forces in 5 DDSs do not constitute an aggressive, agencywide strategy to address middlemen fraud. Also, SSA has yet to develop such information sharing capabilities as an automated third party database that field staff nationwide could use to learn about and track suspected middlemen. GAO is closing out this recommendation because continued complaints about middlemen fraud in particular and service provider fraud in general have resulted in a second congressional request on this topic.

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Topics

BeneficiariesData collectionDatabasesDisability benefitsFraudImmigrantsIncome maintenance programsInternal controlsMedicaidProgram abusesSocial security benefitsSupplemental security incomeMedicare