The FY 2004 Redetermination Change Rate Study (3/2/2005)
The redetermination workload
In FY 2004, the redetermination and limited issue workloads totaled over 2.5 million cases. About 1.9 million involved field office interviews with recipients and verifications of various eligibility factors. This was a decrease of about 5 percent (or 100,000 cases) compared to FY 2002. The Agency also reduced the number of limited issue reviews, by over 220,000 (or nearly 50 percent).
The reductions in these workloads resulted in an estimated $260 million decrease in overpayment “benefits” and an estimated $215 million decrease in underpayment “benefits.” (These benefits are the overpayments that would be collected or prevented and the underpayments that would be paid or prevented if redetermination had been done.) The reduction in administrative cost was about $40 million.
The benefits of redeterminations
SSA defines the benefits of a redetermination as any recoverable overpayments it detects and any future incorrect payment it prevents. SSA estimated the total overpayment benefits from all cases to be about $2.4 billion. Over $2.2 billion comes from field office redeterminations; the remaining $212 million comes from limited issue cases. The workload also produces underpayment benefits of over $1.3 billion, nearly three quarters of which are from unscheduled redeterminations.
Compared to FY 2003, the total FY 2004 redetermination and limited-issue overpayment benefits decreased by over $260 million. FO redetermination overpayment benefits decreased by almost $78 million, while limited-issue benefits decreased by over $168 million. Likewise, FO redetermination underpayment benefits decreased almost $179 million while limited issue underpayment benefits decreased by about $37 million.
And if everyone were redetermined
If sufficient resources had been available to allow all 6.5 million postentitlement cases to have been redetermined as HEPs, the total overpayment benefits would have been over $4.4 billion.