Summary

Pursuant to a congressional request, GAO reviewed selected issues concerning: (1) the administration of the Medicare part B program in Ohio; and (2) the time frames for paying beneficiaries whose social security disability claims were approved by either administrative law judges (ALJ) or federal courts.

GAO noted that: (1) the Social Security Administration (SSA) has implemented a number of procedures that, in general, have resulted in more timely payments to beneficiaries; (2) the average length of time for SSA to complete payment processing activities for court-approved claims decreased from 120 to 93 days; and (3) most claimants who are awarded disability benefits by ALJ should receive their first payment in about 2 months unless their case is selected for review. GAO found that: (1) the decrease in average processing time resulted from the increased use of a more sophisticated claims processing system; and (2) after SSA finishes processing a disability payment, another 7 to 15 days pass before the beneficiary receives a check. GAO also found that: (1) in 21 of the 22 cases it reviewed, claimants were entitled to retroactive benefits; (2) for claims involving only title II benefits, SSA generally completed the processing of retroactive benefits within the same time frame as current benefit payments, but the payment of claims involving concurrent title II and title XVI benefits was considerably delayed; (3) the amount of title XVI benefits owed is partially determined by the amount of title II benefits received, and adjustments must be made before SSA can pay the correct amount of retroactive benefits; (4) SSA samples ALJ-approved decisions for review to ensure that they conform to statutes, regulations, and policy; and (5) the Office of the General Counsel discontinued the policy of holding cases before sending them to SSA for payment processing.