**GAO-08-816R**                      Published: Jul 15, 2008. Publicly Released: Aug 13, 2008.                  

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## Highlights

The Social Security Administration (SSA) has been withholding Medicare premiums from beneficiaries' Social Security payments since the Supplementary Medical Insurance (Part B) program was first enacted in 1965. Beginning in 2006, premium withholding became a payment option for the Medicare Advantage program (Part C) and the new program for Prescription Drug Coverage (Part D). These changes were authorized by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). Two federal agencies play critical roles in the premium withholding process: the Centers for Medicare & Medicaid Services (CMS) and SSA. The Department of the Treasury (Treasury) also plays an important role by disbursing the adjusted Social Security payments to beneficiaries. Premium withholding can make paying premiums easier for both beneficiaries and the insurance plans. However, following implementation of the premium withholding provisions under MMA in 2006, there were numerous reports of beneficiaries not having the correct Parts C and D premiums withheld. Also, about 231,000 beneficiaries had their premiums refunded erroneously because they were mistakenly identified as having paid excess premiums. As a result, you requested that we review efforts to ensure that the correct Medicare premiums are being withheld from beneficiaries' Social Security payments. Specifically, we sought answers to the following key questions: 1. How do the processes for withholding premiums from Social Security payments compare for the various parts of Medicare? 2. What problems, if any, have been identified with the premium withholding process? 3. What steps have SSA and CMS taken to address these problems?

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## Topics

Health Care

BeneficiariesData collectionData integrityErroneous paymentsFederal social security programsInformation managementInstallment paymentsInsurance premiumsInternal controlsMedicarePaymentsRecords managementRetrospective paymentsSocial security benefits