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At least 523 records · Page 29Linked to original sources
PubMed1991

The financial status of the Social Security and Medicare programs (1990).

To summarize the major points I have covered: The Social Security and Medicare trust funds are carefully held and monitored by three five member boards of trustees, and each board has two members who represent the public's interest. The combined Social Security trust funds are well financed for many years into the future; however, there is reason to monitor the financing for the disability insurance trust fund; and actions will in all likelihood ultimately be required to assure the long-term financial integrity of the combined OASDI programs over the next 75 years. The Medicare trust funds are adequately financed for the short term; however, the HI program faces serious mid- and long-range financing problems that must be addressed. As a result, there is a strong need for Congress to take remedial action to improve the financing and provide an adequate contingency reserve for the program.

Decision Making↗
PubMed1996

Medicare program; waiver of recovery of overpayments--HCFA. Final rule.

This final rule duplicates in HCFA's regulations the content of two sections of the Social Security Administration's regulations concerning waiver of recovery of overpayments. In the past, regulations in 20 CFR part 404 were applicable to both the Federal Old-Age, Survivors and Disability Insurance program (OASDI), which provides monthly Social Security checks directly to beneficiaries or their representatives, and the Medicare program. Since the Social Security Administration (SSA) is now independent of HHS, and SSA is restructuring its regulations to apply only to the OASDI program, we are establishing the content of these sections in 42 CFR part 405 to preserve provisions that are applicable to the Medicare program.

Aged↗
PubMed1987

Practitioner fraud and abuse: a public policy status report.

In summary, a public policy to get rid of practitioner fraud and abuse has been established. It resulted initially from the changing attitude of the electorate on spending for social as well as health service programs. It is reflected by the congressional enactment of new laws against practitioner fraud and abuse, i.e., the Medicare-Medicaid Anti-Fraud and Abuse Amendments of 1977 and the Civil Money Penalties Law of 1981. It has been implemented through the prosecution of numerous practitioners involved in fraudulent activities and abuses using the new laws as well as many others, including the False Claims Act of 1963 and the fraud penalties codes recognized under the Federal Old Age, Survivors and Disability Insurance Act. The ultimate success of this public policy, however, will certainly depend, at least in part, on our ability to obtain an objective and realistic analysis of the degree of fraud and abuse in these programs, as well as to define the characteristics of "Medical Mills" and to determine to what extent they still exist. Finally, if this public policy is to mature, it must follow a path that assures that we do not disrupt or hamper the delivery of health care services to our poor and elderly populations through the needless introduction of regulatory requirements or legal excesses.

Crime↗
PubMed1989

Public emergency shelters for the homeless, exclusion of underpayments, increase in benefit rate for individuals in medical care facilities--SSA. Interim rules with request for comments.

These interim rules reflect sections 9113, 9114, and 9119 of Public Law (Pub. L.) 100-203, the Omnibus Budget Reconciliation Act of 1987, signed into law on December 22, 1987. They affect applicants for and recipients of Supplemental Security Income (SSI) payments. These regulations increase the number of months an individual who resides in a public emergency shelter for the homeless may be eligible for SSI payments, extend the time period during which certain retroactive benefit payments made under the Federal Old-Age, Survivors, and Disability Insurance (OASDI) or SSI programs will be excluded from resources, and increase the SSI Federal benefit rate for individuals in certain medical institutions where Medicaid pays more than half the cost of their care. These interim rules also provide that States making an optional supplementary payment to residents in these medical institutions on or after October 1, 1987, and before July 1, 1988, are required to continue making such payments. Thus, the increase in the Federal payment for individuals in these medical institutions is passed along to the recipients.

Ill-Housed Persons↗
PubMed1999

The development of the Project NetWork administrative records database for policy evaluation.

This article describes the development of SSA's administrative records database for the Project NetWork return-to-work experiment targeting persons with disabilities. The article is part of a series of papers on the evaluation of the Project NetWork demonstration. In addition to 8,248 Project NetWork participants randomly assigned to receive case management services and a control group, the simulation identified 138,613 eligible nonparticipants in the demonstration areas. The output data files contain detailed monthly information on Supplemental Security Income (SSI) and Disability Insurance (DI) benefits, annual earnings, and a set of demographic and diagnostic variables. The data allow for the measurement of net outcomes and the analysis of factors affecting participation. The results suggest that it is feasible to simulate complex eligibility rules using administrative records, and create a clean and edited data file for a comprehensive and credible evaluation. The study shows that it is feasible to use administrative records data for selecting control or comparison groups in future demonstration evaluations.

Adolescent↗