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Railroad Retirement Board: Internal Controls for Unemployment Program Improving, but Gaps Remain

HRD-90-42 Published: May 03, 1990. Publicly Released: May 03, 1990.
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Highlights

Pursuant to a legislative requirement, GAO reviewed the railroad unemployed-sickness benefits program's internal controls for safeguarding against fraud and payment error.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Railroad Retirement Board The Chairman, RRB, should alter procedures to ensure adequate separation of claims-processing and payment authorization activities.
Closed – Implemented
Procedures were implemented on October 1, 1991 to conduct quality control reviews of a statistically valid sample of unemployment and sickness insurance claims transactions resulting in benefit payments of less than $1,000. Procedures requiring separate authorization of payments of $1,000 or more were also implemented.
Railroad Retirement Board The Chairman, RRB, should provide better control for documents used to enter data so the documents cannot be lost or manipulated.
Closed – Implemented
RRB has developed procedures to improve control of original entry documents.
Railroad Retirement Board The Chairman, RRB, should strengthen controls to ensure that only properly authorized computer programs are used, the computer center is secure, and all computer personnel receive background security checks.
Closed – Implemented
RRB installed a software program that will automatically keep source and load modules in proper synchronization. The security access system for the computer facility is fully operational. RRB now conducts security investigations on all employees who are in sensitive positions.
Railroad Retirement Board The Chairman, RRB, should improve control for validity of physician certificates of sickness by implementing an earlier GAO recommendation that physicians: (1) provide their tax identification numbers with the certificates; and (2) deal directly with RRB, rather than through claimants.
Closed – Implemented
Use of revised medical information forms that require physicians to furnish tax identification numbers was implemented January 14, 1991. On January 31, 1991, an on-line comparison of the tax ID numbers furnished on medical statements with a database of valid numbers was initiated. Discrepancies are investigated through questionnaires sent directly to physicians.
Railroad Retirement Board The Chairman, RRB, should increase the: (1) priority for resolving discrepancies disclosed by computer matches of benefit payments with state employment records; and (2) number of manual matches in states in which computer match agreements have not been negotiated. A cost-benefit analysis should be carried out, however, to ensure that the benefits derived exceed the costs incurred.
Closed – Implemented
Guidance on resolving discrepancies from computer matches has been issued to responsible personnel. The number of computer matching programs with state agencies has been increased significantly, with agreements in place with 35 states, as of September 1, 1991. Efforts are on-going to secure agreements with all other states. Automated selection of cases is in place.

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Topics

Claims processingCompensation claimsComputer fraudComputer securityCost controlEmployee medical benefitsErroneous paymentsFraudInternal controlsRailroad employeesRetirementUnemployment insurance benefits