Special Disability Workload

Center developing national estimate for states in Medicaid overpayments issue

The Center for Health Care Financing became involved in the complex “Special Disability Workload” issue in 2004; five years after the Social Security Administration identified a system-wide error through which hundreds of thousands of Supplemental Security Income recipients missed out on eligibility for Social Security Disability Insurance and Medicare benefits. SSA began reviewing cases in 1999 and grouped them under the term Special Disability Workload.

Since then, the Center for Health Care Financing has been working to measure the breadth of the problem nationally and assess the financial harm to states.

The Center’s SDW methodology has been recognized in key Congressional hearings on the issue. Its role has included:

  • Developing for all states a national estimate of the Medicaid overpayments
  • Using  its expertise to help states understand and apply data sets
  • Leading research to identify and quantify impacts on state Medicaid programs
  • Keeping states apprised of other potential ramifications

The Center’s assessment

The Center's own study suggests the gross Medicare liability is more than $10 billion, with a net Medicare payment due to states of at least $4.3 billion after adjustments for Federal Medical Assistance Percentage.

For the past several years, the Center’s research and technical assistance has been used by a coalition of states that has been working with Congress and federal agencies to develop a remedy to the problem. The SSA has said that 273,000 people nationwide may have missed SSDI and Medicare eligibility ­­-- some for more than 30 years. Some estimates are higher.