Articles from prior issues of The Advocate

November/December, 1999

Acting Inspector General Huse Updates NADE On Fraud Initiatives
by Mabel A. Felix, Los Angeles Chapter

ACTING INSPECTOR GENERAL JIM HUSE, Jr. provided an interesting update on the achievements of his office during the last fiscal year on matters relevant to SSA and DDS. Among these are issues on disability, residency, and institutionalization. The most significant achievement of the Office of Inspector General (OIG ) is establishing the “Hotline”. Whereas in the past, it was nearly impossible to reach anyone in their offices, the OIG now has a hotline where live operators handle the calls. These operators actually know and understand the SSA program… and you don’t have to wait on hold forever!

The complaints and /or allegations received by the hotline have categorized as follows: T16-Disability=26.2%, T16-Aged=2.9%, T2-Disability=20.5&, T2-Retirement=6.8%, SSN related=40.2%, Employee related=0.8%, others=2.6%. As evidenced by the figures, the SSN related calls has the highest percentage of alleged fraud and/or misuse in order to obtain state and federal benefits.

OIG and SSA have started three investigative collaboration projects. These are: Cooperative Disability Investigations (CDI), Regional Antifraud Committees, and Fugitive Felon projects.

The strategies used for CDIs include investigation of suspicious initial claims, questionable CDR reentitlement reviews, and third party involvement ( including legal representatives, doctors, interpreters, etc.). For the first half of FY’99, these investigations have resulted in SSA savings of 9 million dollars , and over $100,000 in restitution and scheduled recoveries. Collateral savings have been shown to other programs like Medicaid, Food Stamps and other state supplemental benefits. On the other end of the spectrum, these investigations have also deterred false applications, and eliminated the perception of easy money. Unscrupulous individuals now need to think twice before applying for benefits because of the perceived stricter enforcement of controls in the SSA program.

Mr. Huse also emphasized the need for Regional Antifraud committees. A proposal has been sent out to include more DDS participation in the regions. This will ensure that more inputs are received, and that OIG receives feedback on the various programs and activities they are doing.

On the Fugitive Felon projects, massive database matching have been started. These databases include the prison systems and the INS. By doing regular matching, SSA is able to detect beneficiaries who are incarcerated, or have been convicted of felonies and are considered as fugitives. This enables SSA to cease benefits to these people as mandated. The INS database also provides SSA with lists of SSI beneficiaries who are out of the country but continues to receive benefits, or those who do not meet the residency requirements for benefits.

On our part, the DDSs can be proactive by assisting OIG in analyzing the alleged improprieties, providing technical assistance with audits, and reporting suspicions of fraudulent activities to the OIG. These reports may be sent via email, phone calls, or letters to:

Email address:

OIG.Hotline@SSA.GOV Phone: (800) 269-0271

Mailing address: SSA Fraud Hotline PO Box 17768 Baltimore, MD 21235 Fax: (410) 597-0118