II-B: Program Integrity
Ensure the integrity of benefit programs Other Information:
In fiscal year 2005, the RRB invested over 24 full-time equivalent staff years at a cost of approximately $1.93 million, in
program integrity efforts. This resulted in $9.1 million in recoveries, $770,000 in benefits denied, and the referral of 215
cases to the Office of Inspector General for investigation. We achieved approximately $5.11 in savings for each dollar invested
in these activities. As part of our fiduciary responsibilities to the rail community, we must ensure that the correct amount
of benefits is being paid to the right people. Through automation, we match our benefit payments against the Social Security
Administration’s earnings and benefits database, the Centers for Medicare & Medicaid Services’ utilization and death records,
the Office of Personnel Management’s benefit records, and State wage reports, and we administer other benefit monitoring programs
to identify and prevent erroneous payments. We also refer some cases to the RRB’s Office of Inspector General for investigation.
After investigation, the Inspector General may pursue more aggressive collection methods, which include civil and criminal
prosecution. We measure the effectiveness of the matching programs each year by comparing the dollars collected or saved through
these initiatives to their cost. To accomplish this objective, we will conduct comprehensive and integrated monitoring activities
to identify and prevent erroneous payments: Maintain established matching programs. Our plan is to continue our wage matches
with all 50 States, the District of Columbia and Puerto Rico to ensure that employees are not working while drawing unemployment
or sickness insurance benefits. During fiscal year 2005, the State wage match program identified nearly $1,180,814 in recoverable
benefits and effected recovery of $1,443,394 previously identified through the program. In addition, we will continue to coordinate
our benefit payments with the Social Security Administration’s Master Benefit Record to ensure the proper payment of benefits
under both programs. We will continue to monitor our benefit payments against social security wage reports to ensure that
our benefit payments are correctly adjusted for post-retirement earnings. We will also continue to compare our beneficiary
records with the Centers for Medicare & Medicaid Services’ files to prevent incorrect payment of benefits after an annuitant’s
death. Continue our program integrity reviews. We will continue to seek information from annuitants through questionnaires
and to conduct reviews to ensure correct payment of benefits. We will ensure that all annuitants continue to be entitled to
benefits, through programs such as continuing disability reviews and other entitlement-monitoring initiatives. These efforts,
consistent with the President’s Management Agenda, help us minimize the possibility of payments to ineligible beneficiaries.
Indicator(s):
|
