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Congressional watchdog to investigate disability consultant doctors

  June 24, 2019 | By Mike Reicher, Tennessean

The Government Accountability Office plans to investigate the Social Security Administration’s use of consultant doctors to review claims, a congressman announced Monday.

The announcement follows a Tennessean report that found some doctors in Tennessee were denying a high rate of applicants while reaping large sums in fees.

In states across the country doctors also are paid on a per-case basis to review disability claims, providing a financial incentive that rewards speed. Facing Social Security’s case backlog, and pressure to protect taxpayer funds, some doctors wrongfully deny low-income people unable to work. The rejections also often lead to a loss of health insurance.

“Since learning about the Tennessean’s investigation, I have been very concerned about this,” U.S. Rep. John B. Larson, D-Connecticut, said in a statement. “Many states’ Disability Determination Service agencies contract to outside doctors to help make disability determinations and little is known about these practices.”

Social Security delegates the responsibility for determining eligibility to state offices.

Larson chairs the Ways and Means Social Security subcommittee. Earlier this month, he asked the GAO to examine the system of using contracted doctors, known as medical consultants.

The GAO responded June 19 by approving the request. It will take about six months until the appropriate experts are available to begin the investigation, according to a letter from Orice Brown, the GAO congressional liaison.

Larson asked the GAO, the congressional watchdog, to examine how widespread the practice of paying contract doctors is among states and report on how much doctors are compensated. He also requested the GAO report on what qualifications and performance measures are required of these physicians. Larson has also asked for an analysis of the quality of disability decisions.

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