Payment Integrity-Disability Payment Integrity: Advancing Solutions Through Partnership-Highlights of Roundtables

January 2018
Topics: Payment Integrity, Improper Payments, Fraud, Government Agency Operations, Data Analytics, Computing Methodologies
Gordon C. Milbourn III, The MITRE Corporation
Alanna M. Lavelle, The MITRE Corporation
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In 1990, fewer than 2.5 percent of working-age Americans received disability benefits, but today, that number has grown to over 5 percent—representing more than 14 million people. Various federal agencies and insurance companies, as well as some states, provide direct disability benefits to individuals, payments to providers for disability-related medical treatments, and more. While the total dollar figure for all disability-related payments each year is not known, some perspective can be gained from the Social Security Administration’s (SSA) programs; for example, in the month of November 2017 the Disability Insurance program alone paid $10.83 billion to almost 10.43 million individuals. Where large sums of money are involved, fraud is almost always nearby; the SSA Office of Inspector General reported in 2013 that disability-related fraud investigations comprised 70 percent of their caseload, but by 2015 this had grown to 86 percent.

MITRE, which operates federally funded research and development centers (FFRDCs) on behalf of federal government sponsors, convened two roundtables on Disability Payment Integrity in conjunction with its charter to help address significant government-wide problems. The first Roundtable was comprised of experts from 11 government and law enforcement agencies, insurance companies, and professional associations, and the second of experts from the Government Accountability Office (GAO) and the OIGs from seven federal agencies. This report summarizes their findings.

 

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