Health Care:

CDR Process Could Be Enhanced

HEHS-94-212R: Published: Jul 29, 1994. Publicly Released: Jul 29, 1994.

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Pursuant to a congressional request, GAO reviewed the Social Security Administration's (SSA) new process for conducting continuing disability reviews (CDR). GAO found that: (1) SSA could reliably base its decisions on when to conduct full medical examinations on beneficiary self-reported data in combination with other key SSA information; (2) SSA has taken steps to assess the reliability of its self-reported data and plans to improve the use of computerized beneficiary data to better predict medical improvement and benefit terminations; (3) SSA believes that the mailer process has enabled it to make the CDR process more efficient and cost-effective; (4) the mailer process is substantially less costly than the full medical CDR process; (5) SSA has not completed the number of CDR required by law; (6) SSA needs to increase the number of mailers it sends to Disability Insurance (DI) and Supplemental Security Income (SSI) beneficiaries and adjust its priorities for determining which beneficiaries should receive mailers; (7) as SSA gains experience with the mailer process and improves its ability to accurately identify beneficiaries showing medical improvement, it should do more full medical CDR on those beneficiaries who need them; and (8) SSA could save taxpayers significant amounts each year and preserve the program's integrity by removing those beneficiaries who most likely have improved or are no longer disabled.

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