According to our own analysis of SSA’s data,  residency overpayments appear to vary by geographic region, with the  majority of overpayments having been detected in several large  metropolitan areas. Finally, we determined that most of the overpayments  detected during this period were attributable to recipients who were born  outside the U.S.

		Residency Violations May be More Prevalent than SSA Has Detected

SSA detected an average of about 46,000 recipient residency violations  annually between 1997 and 2001, resulting in $118 million in  overpayments. Overall, we found that just 15  counties in 5 states—California, Florida, Illinois, New Jersey, and New  York—accounted for 54 percent of all residency overpayments detected by  SSA during this period. Reliance on Self- Reported Information and Other Vulnerabilities Have Impeded SSA’s Ability to Detect and Deter Violations

SSA’s ability to detect and deter residency violations has been impeded by  three kinds of weaknesses. First, the agency has relied heavily on self- reported information from recipients to determine domestic residency,  often without independently verifying such information. Second, SSA has  made insufficient use of its existing tools for identifying potential  violations, such as its risk analysis system to screen for high-risk cases. Finally, the agency historically has not made adequate use of  independent data sources from other federal agencies or private  organizations to detect nonresidency of SSI recipients. Our prior  work has shown that about 77 percent of all payment errors in the SSI  program were attributable to recipients who do not comply with reporting  requirements. However, program guidelines do not require field staff to perform any  additional verification steps to establish recipients’ residency. Because Medicaid eligibility is often directly tied to SSI eligibility,  identifying residency violations may save funds from both programs. Major Management Challenges and Program Risks: Social Security  Administration. Supplemental Security Income: Additional Actions Needed to Reduce  Program Vulnerability to Fraud and Abuse. This is a work of the U.S. government and is not subject to copyright protection in the  United States.
Why GAO Did This Study

The Supplemental Security Income (SSI) program paid about $36 billion in benefits to about 6.9 million recipients in 2003. In recent years, the Social Security Administration (SSA) has identified a general increase in the amount of annual overpayments made to recipients who are not present in the U.S. as required by SSI program guidelines--a problem we refer as "residency violations." This problem has caused concern among both program administrators and policy makers. As such, GAO was asked to determine what is known about the extent to which SSI benefits are improperly paid to individuals who are not present in the United States and to identify any weaknesses in SSA's processes and policies that impede the agency's ability to detect and deter residency violations.

What GAO Found

Overpayments resulting from residency violations totaled about $118 million between 1997 and 2001. Additionally, the extent of violations appears to vary by geographic region, with overpayments being more prevalent in several large metropolitan areas. GAO found that 54 percent of all overpayments detected by SSA during this period occurred in just 15 counties. In addition, we found that recipients born outside the United States accounted for at least 87 percent of all residency overpayments. SSA's ability to detect and deter residency violations is impeded by three kinds of weaknesses. First, the agency relies heavily on self-reported information from recipients to determine domestic residency, often without independently verifying such information. Second, SSA makes insufficient use of existing tools to detect violations, such as its "risk analysis" system, redeterminations, and home visits. Finally, the agency has not adequately pursued independent sources of information from other federal agencies or private organizations to detect nonresidency of SSI recipients. GAO recognizes that the SSI program is complex to administer, and residency requirements are particularly difficult to enforce because they can necessitate time-consuming, labor-intensive verification checks, such as home visits. However, SSA has not employed a systematic, comprehensive approach to this problem that would allow the agency to use its available systems and procedures more efficiently and reduce the program's exposure to additional violations.