Quality Assurance Independence

Gao ID: HEHS-94-151R April 28, 1994

GAO reviewed the Social Security Administration's (SSA) regional structure for ensuring the quality of disability decisions made by state disability determination services (DDS). GAO found that: (1) each SSA region's Disability Quality Branch (DQB) works cooperatively with regional medical consultants (RMC) to review the accuracy of disability decisions; (2) based on DQB review, SSA assesses whether DDS comply with regulatory performance accuracy standards; (3) DQB and RMC organizational placement and Regional Disability Program Branches' technical assistance compromise DQB organizational independence; (4) in 1987, SSA transferred DQB responsibility from regional commissioners' offices to a nonrelated branch of SSA; and (5) although RMC are an integral part of the DDS quality assurance review function, they have remained under the management and supervision of the regional commissioners' offices.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

Director: Jane L. Ross Team: General Accounting Office: Health, Education, and Human Services Division Phone: (202) 512-7215


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