House Ways and Means Subcommittee on Social Security Hearing
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Chairman Johnson, Ranking Member Becerra, and Members of the Subcommittee:
Thank you for this opportunity to continue discussing our anti-fraud efforts and our partnership with the
At our last hearing on this topic, you asked us to review and report on our practices in light of the recent fraud cases in
Our Anti-Fraud Efforts
We are committed to preserving the public's trust in our programs. We have no tolerance for fraud, and I reiterate to those who would defraud
It is regrettable that people will try to take advantage of our programs; however, that is the reality. Thus, we have developed expertise on fraud identification and referral through comprehensive training. All SSA field office and DDS employees receive extensive training on fraud detection. This training includes identifying fraud scenarios--including "middleman fraud" such as what allegedly occurred in
We work closely with the
Our most successful collaboration with the
We have established procedures to handle cases if we have reason to believe that fraud was involved in obtaining benefits. Upon indictment, we immediately suspend benefit payments to indicted beneficiaries (or auxiliaries collecting on the beneficiaries' earnings records). In
Each of these activities played a critical role in support of the
Our Planned Immediate Enhancements to Our Anti-Fraud Efforts
Fighting fraud is an ongoing and evolving process. We use fraud cases to identify ways to combat fraud more successfully, and continually strive to build upon our successful anti-fraud efforts. I want to share with you several activities that we will implement immediately or in the very near future.
Working with the
As I mentioned earlier, all SSA field office and DDS employees receive fraud detection training. They remain our first and best line of defense against those seeking to cheat the system. We will expand training to all SSA employees during FY 2014 with specific focus on lessons learned from
We are establishing a central, specialized fraud unit comprised of disability examiners dedicated to reviewing and acting on potential fraud cases. This unit will be located in the
We are also establishing a National Anti-Fraud Committee, which will be co-chaired by the Inspector General and our Deputy Commissioner for Budget, Finance, Quality, and Management. Building off the model of our successful Regional Anti-Fraud Committees, the National Anti-Fraud Committee will lead and support enterprise-wide strategies to combat fraud, waste, and abuse. It will also collaborate with private insurers and other Federal agencies to learn new ways to combat complex and sophisticated fraud schemes.
In addition, we will expand our Fraud Prosecution project. For more than a decade, in partnership with the DOJ, we have placed a number of attorneys from our
There has been concern expressed that claimants withhold medical evidence that could be unfavorable to their claims. This withholding of evidence could result in improper findings of disability. We engaged with the
We are undertaking similar efforts with outside experts to update some of our policies in the disability determination process. While these efforts are primarily designed to improve the consistency of our disability determinations, they also may help deter fraud. For example, we have contracted with the
Lastly, with the FY 2014 appropriations,
While we recognize the importance of combatting fraud wherever we can, we are only too aware that all of these enhancements require substantial resources. Without adequate, sustained funding, we will not be able to achieve all that we can in our anti-fraud activities. Due to budgetary constraints, we have been unable to replace nearly 11,000 employees who retired or left our agency for other reasons from FY 2011 through FY 2013. The New York DDS, which identified the
Data Analytics
We fully appreciate that criminals continually look for an edge against potential victims. They are likely to devise more complex and sophisticated methods in their efforts to defraud
In the anti-fraud arena, we are undertaking a special initiative to expand our use of data analytics to enhance our ability to detect possible fraud. We will apply logical analysis to determine common characteristics and patterns of fraud based on data from past allegations and known cases of fraud. We will apply these tools to look for potential fraud or other suspicious behavior when we review initial applications or existing data on beneficiaries. With these diagnostic tools, we anticipate increasing our ability to identify questionable patterns of activity in disability claims and prevent fraudulent applications from being processed. During the remainder of FY 2014, we will develop and begin testing some of these tools.
We have invited the
Other Anti-Fraud Initiatives
Our anti-fraud efforts have not been limited to
We are also working with other Federal agencies. The Bipartisan Budget Act of 2013 includes another Administration proposal to expand both the data we collect from correctional facilities about incarcerated individuals, and the entities with which we can share that information. We are working with the
There has also been some Member interest relating to a former situation in our
We would emphasize, however, that we have taken significant actions to strengthen our hearings process. Over the last three years, we have implemented procedural changes, implemented new controls, implemented electronic system changes, implemented new management practices, improved data collection, and improved data analysis. While these improvements are paying off, we remain vigilant and continue to review national data for trends and fact patterns that suggest policy non-compliance or fraud.
Conclusion
In short, we have long been committed to combating fraud in our programs. Although there is a low level of fraud in our disability programs, no amount of fraud is tolerable. Fighting fraud is an ongoing and evolving process. Therefore, in collaboration with the
Alleged criminal conspiracies like those in
We appreciate this Committee's assistance in these efforts and stand ready to work with
Rooting out a fraud is a team effort. We need people who suspect something to say something. If you suspect that someone is trying to cheat us, please contact
n1 See www.ssa.gov/legislation/other.html#a0=2.
n2 See Inspector General Act of 1978, Pub. L. 95-452, [Sec.] 2.
n3 See OIG, Overpayments in the
n4 For a general discussion of SSA's improvements in its hearing process, and our specific actions resulting from the
Read this original document at: http://waysandmeans.house.gov/UploadedFiles/2_26_14_SS_Testimony_Carolyn_Colvin.pdf
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House Ways and Means Subcommittee on Social Security Hearing
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