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Articles from prior issues of The Advocate
September/October, 2000
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Secret Agent Man by Tamara Kastanas MO Disability Determinations John Outtz, St. Louis DDS Hearing Officer, updated the conference on the pilot project, which was formed two years ago in an effort to combat fraud and abuse in the disability system. The Office of the Inspector General chose Missouri as one of the seven test sites and a team was in operation as of October of 1999. The CDI Unit, as it is called, stands for “Cooperative Disability Investigations” and is composed of a DDS Liaison (John Outtz), an Investigative Technician from the SSA Office, a Special Agent from the OIG, and two St. Louis County Policemen. The team relies on the combined skills and specialized knowledge of their members to combat fraudulent claims in their respective areas. They also target doctors, lawyers, interpreters and service providers who facilitate and promote disability fraud. A DDS Counselor who suspects that a case is one of fraud or “similar fault” (making false statements or false presentations) refers the case to CDI Unit for review. If selected, the CDI team then investigates and determines if there is evidence of fraud or similar fault. The St. Louis CDI team has a van specially equipped with inconspicuous telescopic lenses, hidden cameras and microphones to collect evidence. |
A report is then written up and given
to the counselor, who upon closing the case, writes up a report stating
the effect of the CDI’s investigation, flags the case and puts in a special
code for future reference. The pilot program does add time to a claimant’s
case, it takes 25-30 days average to investigate and to write up a report.
Since October of 1999, 122 cases have been referred to the St. Louis CDI
Unit. Of these, 120 were opened, 78 closed and 42 cases are still in development.
Since October of 1999, close to four million dollars in savings ($3,783,592)
has been realized by the St. Louis CDI Unit alone. In just two years, the
Social Security Administration has realized nearly fifty million dollars
in SSA program savings nationwide. Fifteen million dollars has been saved
in non-SSA savings (Medicaid and supplements). Taped and recorded evidence
has been revealed to ALJs, but prosecution must wait until the appeals
process is exhausted. A civil penalty can be levied against the person
in the amount of $5,000, if found guilty of fraud of similar fault. Ultimately,
the goal is to have a unit in every state by the year 2003.
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