Algorithms make it possible for companies to fix prices without explicitly coordinating with one another, posing a new test for regulators policing the market, said Lina Khan, chair of the Federal Trade Commission, during a media event hosted by KFF.

“I think we could be entering a somewhat novel era of pricing,” Khan told reporters.

Khan is regarded as one of the most aggressive antitrust regulators in recent U.S. history, and she has paid particular attention to the harm that technological advances can pose to consumers. Antitrust regulators at the FTC and the Justice Department in the fiscal year that ended Sept. 30, 2022, according to Bloomberg News.

Last year, the FTC successfully blocked biotech company Illumina’s of cancer-screening company Grail. The FTC, Justice Department, and Health and Human Services Department launched a website on April 18, , to make it easier for people to report suspected anticompetitive behavior in the health care industry.

The American Hospital Association, the industry’s largest trade group, has often criticized the Biden administration’s approach to antitrust enforcement. In comments in September on proposed guidance the FTC and Justice Department published for companies, “the guidelines reflect a fundamental hostility to mergers.”

Price fixing removes competition from the market and generally makes goods and services more expensive. The agency has argued in court filings that price fixing “is still illegal even if you are achieving it through an algorithm,” Khan said. “There’s no kind of algorithmic exemption to the antitrust laws.”

By simply using the same algorithms to set prices, companies can effectively charge the same “even if they’re not, you know, getting in a back room and kind of shaking hands and setting a price,” Khan said, using the example of residential property managers.

Khan said the commission is also scrutinizing the use of artificial intelligence and algorithms to set prices for individual consumers “based on all of this particular behavioral data about you: the websites you visited, you know, who you had lunch with, where you live.”

And as health care companies change the way they structure their businesses to maximize profits, the FTC is changing the way it analyzes behavior that could hurt consumers, Khan said.

Hiring people who can “help us look under the hood” of some inscrutable algorithms was a priority, Khan said. She said it’s already paid off in the form of legal actions “that are only possible because we had technologists on the team helping us figure out what are these algorithms doing.”

Traditionally, the FTC has policed health care by challenging local or regional hospital mergers that have the potential to reduce competition and raise prices. But consolidation in health care has evolved, Khan said.

Mergers of systems that don’t overlap geographically are increasing, she said. In addition, hospitals now often buy doctor practices, while pharmacy benefit managers start their own insurance companies or mail-order pharmacies 鈥� or vice versa 鈥� pursuing “vertical integration” that can hurt consumers, she said.

The FTC is hearing increasing complaints “about how these firms are using their monopoly power” and “exercising it in ways that’s resulting in higher prices for patients, less service, as well as worse conditions for health care workers,” Khan said.

Policing Noncompetes

Khan said she was surprised at how many health care workers responded to the commission’s recent proposal to ban “noncompete” clauses 鈥� agreements that can prevent employees from moving to new jobs. The FTC issued its final rule banning the practice on Tuesday. She said the ban was aimed at low-wage industries like fast food but that many of the comments in favor of the FTC’s plan came from health professions.

Health workers say noncompete agreements are “both personally devastating and also impeded patient care,” Khan said.

In some cases, doctors wrote that their patients “got really upset because they wanted to stick with me, but my hospital was saying I couldn’t,” Khan said. Some doctors ended up commuting long distances to prevent the rest of their families from having to move after they changed jobs, she said.

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One member of the FDA advisory committee was linked to hundreds of payments from Abbott totaling almost $200,000, according to a database maintained by the Department of Health and Human Services. Another was connected to 100 payments totaling about $100,000 and conducted research supported by about $50,000 from Abbott. A third member of the committee worked on research supported by more than $180,000 from the company.

The government database, called “,” records financial relationships between doctors and certain other health care providers and the makers of drugs and medical devices. 素人色情片Health News found records of Abbott payments associated with 10 of the 14 voting members of the FDA advisory panel, which was weighing clinical evidence for a heart device called TriClip G4 System. The money, paid from 2016 through 2022 鈥� the most recent year for which the database shows payments 鈥� adds up to about $650,000.

The panel voted almost unanimously that the benefits of the device outweigh its risks. Abbott announced on April 2 that the FDA had approved TriClip, which is designed to treat leakage from the heart’s tricuspid valve.

The Abbott payments illustrate the reach of medical industry money and the limits of transparency at the FDA. They also shed light on how the agency weighs relationships between people who serve on its advisory panels and the makers of drugs and medical devices that those committees review as part of the regulatory approval process.

The payments do not reflect wrongdoing on the part of the agency, its outside experts, or the device manufacturer. The database does not show that any of the payments were related directly to the TriClip device.

But some familiar with the process, including people who have served on FDA advisory committees, said the payments should have been disclosed at the Feb. 13 meeting 鈥� if not as a regulatory requirement, then in the interest of transparency, because the money might call into question committee members’ objectivity.

“This is a problem,” Joel Perlmutter, a former FDA advisory committee member and a professor of neurology at Washington University School of Medicine in St. Louis, said by email. “They should or must disclose this due to bias.”

The records several kinds of payments from drug and device makers. One category, called “associated research funding,” supports research in which a physician is named a principal investigator in the database. Another category, called “general payments,” includes consulting fees, travel expenses and meals connected to physicians in the database. The money can flow from manufacturers to third parties, such as hospitals, universities, or other corporate entities, but the database explicitly connects doctors by name to the payments.

At the to consider the TriClip device, an FDA official announced that committee members had been screened for potential financial conflicts of interest and found in compliance with government requirements.

FDA spokesperson Audra Harrison said by email that the agency doesn’t comment on matters related to individual advisory committee members.

“The FDA followed all appropriate procedures and regulations in vetting these panel members and stands firmly by the integrity of the disclosure and vetting processes in place,” she said. “This includes ensuring advisory committee members do not have, or have the appearance of, a conflict of interest.”

Abbott “has no influence over who is selected to participate in FDA advisory committees,” a spokesperson for the company, Brent Tippen, said in a statement.

Diana Zuckerman, president of the National Center for Health Research, a think tank, said the FDA shouldn’t have allowed recipients of funding from Abbott in recent years to sit in judgment of the Abbott product. The agency takes too narrow a view of what should be disqualifying, she said.

One committee member was Craig Selzman, chief of the Division of Cardiothoracic Surgery at the University of Utah. The Open Payments database connects to Selzman about $181,000 in associated research funding from Abbott to the University of Utah Hospitals & Clinics.

Asked in an interview if a reasonable person could question the impartiality of committee members based on the Abbott payments, Selzman said: “People from the outside looking in would probably say yes.”

He noted that Abbott’s money went to the university, not to him personally. Participating in industry-funded clinical trials benefits doctors professionally, he said. He added: “There’s probably a better way to provide transparency.”

The FDA has a history of appointing people to advisory committees who had relationships with manufacturers of the products under review. For example, in 2020, the doctor who chaired an FDA advisory committee had been a Pfizer consultant.

Appearance Issues

FDA advisory committee candidates, selected to provide expert advice on often complicated drug and device applications, must complete a confidential disclosure report that asks about current and past financial interests as well as “anything that would give an 鈥榓ppearance’ of a conflict.”

The FDA has discretion to decide whether someone with an “appearance issue” can serve on a panel, according to a guidance document posted on the agency’s website. Relationships more than a year in the past generally don’t give rise to appearance problems, according to the document, unless they suggest close ties to a company or involvement with the product under review. The main question is whether financial interests would cause a reasonable person to question the member’s impartiality, the document says.

The FDA draws a distinction between appearance issues and financial conflicts of interest. Conflicts of interest occur when someone chosen to serve on an advisory committee has financial interests that “may be impacted” by their work on the committee, says.

If the FDA finds a conflict of interest but still wants the applicant on a panel, it can issue a public waiver. None of the panelists voting on TriClip received a waiver.

The FDA’s approach to disclosure contrasts with at which doctors earn credit for continuing medical education. For example, for a recent conference in Boston on technology for treatment of heart failure, including TriClip, the group holding the meeting directed speakers to include in their slide presentations disclosures .

Those disclosures 鈥� naming companies from which speakers had received consulting fees, grant support, travel expenses, and the like 鈥� also appeared on the conference website.

鈥�Unbridled Enthusiasm’

The FDA has designated TriClip a “breakthrough” device with “the potential to provide more effective treatment or diagnosis of a life-threatening or irreversibly debilitating disease” compared with current treatments, an agency official, Megan Naber, .

Naber said that for breakthrough devices, the “totality of data must still provide a reasonable assurance of safety and effectiveness” but the FDA “may be willing to accept greater uncertainty” about the balance of risks and benefits.

In a for the advisory committee, FDA staff pointed out findings from a clinical trial that didn’t reflect well on TriClip. For example, patients treated with TriClip had “numerically higher” mortality and heart failure hospitalization rates during the 12 months after the procedure compared with a control group, according to the report. Tippen, the Abbott spokesperson, didn’t respond to a request for comment on those findings.

The committee voted 14-0 that TriClip was safe for its intended use. The panel voted 12-2 that the device was effective, and it voted 13-1 that the benefits of TriClip outweighed the risks.

The committee member to whom the database attributes the most money from Abbott, Paul Hauptman, cast one of the votes against the device on effectiveness and the sole vote against the device on the bottom-line question of its risks versus benefits.

Hauptman said during the meeting that the question of safety was “very, very clear” but added: “I just felt the need to pull back a little bit on unbridled enthusiasm.” Who will benefit from the device, he said, “needs better definition.”

Hauptman, dean of the University of Nevada-Reno School of Medicine, is connected to 268 general payments from Abbott in the Open Payments database. Some payments are listed as going to an entity called Keswick Cardiovascular.

Hauptman said in an email that he followed FDA guidance and added, “My impartiality speaks for itself based on my vote and critical comments.”

Some committee members voted in favor of the device despite concerns.

Marc Katz, chief of the Division of Cardiothoracic Surgery at the Medical University of South Carolina, is linked to 77 general about $53,000 from Abbott and worked on research supported by about $10,000 from the company, according to Open Payments.

“I voted yes for safety, no for effectiveness, but then caved and voted yes for the benefits outweighing the risks,” he said in the meeting.

In an email, he said of his Abbott payments: “All was disclosed and reviewed by the FDA.” He said that he “can be impartial” and that he “openly expressed 鈥� concerns about the treatment.”

Mitchell Krucoff, a professor at Duke University School of Medicine, is connected to 100 general about $105,000. Some went to a third party, HPIC Consulting. He also worked on research supported by about $51,000 from Abbott, according to Open Payments.

He said during the meeting that he voted in favor of the device on all three questions and added that doctors have “a lot to learn” once it’s on the market. For instance: By using the device to treat patients now, “do we set people up for catastrophes later?”

In an email, Krucoff said he completed a “very thorough conflict of interest screening by FDA for this panel,” which focused not only on Abbott but also on “any work done/payments received from any other manufacturer with devices in this space.”

John Hirshfeld Jr., an emeritus professor of medicine at the University of Pennsylvania, is linked by the database to six general payments from Abbott . Two of the payments linked to him went to a nonprofit, the Cardiovascular Research Foundation, according to the database. He voted yes on all three questions about TriClip but said at the meeting that he “would have liked to have seen more rigorous data to support efficacy.”

In an email, Hirshfeld said he disclosed the payments to the FDA. The agency did not deem him to have a conflict because he had no stake in Abbott’s success and his involvement with the company had ended, he said. Through the conflict-of-interest screening process, he said, he had been excluded from prior advisory panels.

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As a joint investigation by 素人色情片Health News and Cox Media Group television stations reported in September, the agency has harmed people it is supposed to help by reducing or halting benefit checks to recoup billions of dollars in payments it sent them but later said they should never have received.

Testifying at two Senate hearings on March 20, Social Security Commissioner Martin O’Malley said he is to address the problem.

Starting next week, O’Malley said, the agency will stop “that clawback cruelty” of intercepting 100% of a beneficiary’s monthly Social Security check if they fail to respond to a demand for repayment.

Instead, the agency will default to withholding 10% of the recipient’s monthly benefits to recoup the debt, he said.

That would have helped Denise Woods, a Savannah, Georgia, woman who ended up living in her car after the SSA clawed back her entire monthly benefit to recoup a $58,000 overpayment. The agency restored some of her benefits after 素人色情片Health News-CMG reported her story in December.

“People like Denise and others shouldn’t be penalized for situations they did not create,” Sen. Raphael Warnock (D-Ga.) said during one of the hearings. “I think it’s always important that we center the people as we discuss policy, remember the human face of the issues we talk about.”

On the question of who caused an overpayment 鈥� the beneficiary or someone at the agency 鈥� the burden of proof will shift from the beneficiary to the agency, O’Malley said.

The agency will make it much easier for people who believe they weren’t at fault or can’t repay the debt to seek a waiver, O’Malley said, which he later clarified means simplifying the form people must submit.

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O’Malley’s plan also includes making notices to beneficiaries easier to understand. Now, they’re “like Mad Libs designed by mad lawyers,” he testified.

In addition, the agency recently changed a policy to allow most beneficiaries to arrange repayment plans of as long as five years, up from three years, he said.

Millions of people a year have been hit with clawbacks, including retirees, people receiving Social Security disability benefits, and the poorest of the poor. The alleged debts can stretch back years or decades and reach tens of thousands of dollars or more.

At the end of the last fiscal year, uncollected overpayments totaled $23 billion.

In December, 素人色情片Health News and Cox Media Group television stations obtained an internal agency document showing that more than 2 million Americans each year are subjected to overpayment demands, out of about 70 million beneficiaries.

O’Malley, a former Maryland governor who was sworn in as commissioner in December, had previewed his planned changes in a recent interview with 素人色情片Health News.

On Wednesday, he appeared before the Senate Special Committee on Aging in the morning and the Finance Committee in the afternoon.

In hours of testimony, O’Malley said nothing about one of the reforms he heralded in the interview: limiting how far back in time the agency can reach to recover overpayments.

In an interview between the hearings, O’Malley said, “That’s still being unpacked and may well require a change in regulation.” He said he expected an announcement within a few months.

O’Malley said he didn’t know how far back the limit would go but noted that other agencies tend to have a look-back period of four years.

Establishing a statute of limitations is one of the most important steps the government can take to address overpayments, Boston University economist Laurence Kotlikoff, who has studied and written about clawbacks, said in an interview.

“If Social Security can’t figure out its mistakes within 18 months, it should be on them,” Kotlikoff said.

Having to repay a year and a half of benefits could cost people their homes, Kotlikoff said.

Rebecca Vallas, who has helped beneficiaries navigate overpayments as a legal aid attorney and has called for reform of clawbacks, said the steps O’Malley announced “are nothing short of historic.”

Shifting the burden of proof “is a dramatic change,” said David Camp, chief executive of the National Organization of Social Security Claimants’ Representatives. While a lot is riding on the details and how O’Malley’s plans are implemented, that change alone should lead to “a very different experience” for anyone challenging a clawback, Camp added.

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In the past, there has been a gap between what the agency says and what it does. O’Malley said 10% has been the default withholding rate in one of the Social Security programs, Supplemental Security Income. But 素人色情片Health News and Cox Media Group have found people whose entire SSI benefit checks were suspended on account of alleged overpayments.

The changes announced won’t apply automatically to people already on a repayment plan or whose monthly benefits are already being docked, O’Malley said outside the hearings. To take advantage of the new terms, beneficiaries would have to contact the agency and request relief, he said. The agency will notify people that they have that option, he added.

O’Malley implored lawmakers to increase funding for the agency. On average, customers trying to reach the agency by phone wait 38 minutes, he said. Most who call the 800 number “hang up in disgust after waiting far too long,” he said in written testimony.

Trouble getting through to anyone at the agency can contribute to overpayments and make it harder for recipients to resolve them.

Sen. Bob Casey (D-Pa.), chair of the Special Committee on Aging, said that unless Congress provides adequate funding for the agency, fixing problems “will be really difficult.”

Sen. Mike Braun of Indiana, the top Republican on that committee, called for looking at how the agency is run “before we throw more money at it.” He suggested focusing on what can be done to prevent overpayments “rather than forgiving them once they occur” or trying to claw them back, “which is insult on top of injury.”

O’Malley noted that the Social Security Administration recently on a long-delayed plan to reduce overpayments by automatically obtaining monthly wage and employment data on beneficiaries.

Finance Committee Chairman Ron Wyden (D-Ore.) praised O’Malley for tackling what Wyden called “the scourge of overpayments.”

“I think you’re really off to a strong start in terms of righting wrongs,” Wyden said.

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Do you have experience with the federal executive medicine program, either as an employee or a patient, you’d like to share? to contact our reporting team.

White House officials, senior military and other national security leaders, retired military officers, and family members have all benefited. The Washington elite could jump the line when filling prescriptions, book appointments through special call centers, and receive choice parking spots and escorts at military hospitals and other facilities, including Walter Reed National Military Medical Center in Bethesda, Maryland, according to the Pentagon’s inspector general.

Through a unit at the White House, government personnel were routinely allowed to receive treatment under aliases, providing no home address or insurance information. For some of them, the care was free, as Walter Reed had no way to bill for it or waived charges.

The so-called executive medicine program was described in a report the Pentagon’s inspector general released in January. The investigation drew extensive media attention for spotlighting a history of loose prescribing practices and poor controls of powerful drugs including opioids in the White House Medical Unit, a military outfit that attends to the president, vice president, and others in the White House compound.

But the White House Medical Unit is just the tip of the broader executive medicine program, intended to provide VIP treatment to senior government and military officials. Though the program is meant largely to accommodate top officials’ busy schedules, the privileges have followed many patients into retirement. According to data from late 2019 and early 2020, the IG’s report said, 80% of the executive medicine population in the national capital region were military retirees and members of their families.

Some facilities “provided access to care for executive medicine patients over active-duty military patients that had acute needs,” according to the report, which added that prioritizing medical care by seniority rather than medical need “increased the risk to the health and safety of non鈥慹xecutive general patient population.”

Much of the report was written in past tense, leaving unclear whether all the practices it described continue. Before the report was made public, a draft was under review by the White House Medical Unit for more than three years 鈥� from May 2020, when Donald Trump was in office, to last July. The delay isn’t explained in the report, and White House spokespeople didn’t respond to questions for this article.

A spokesperson for the inspector general’s office, Deputy Assistant Inspector General Reishia Kelsey, declined to elaborate on the report. A spokesperson for the Pentagon, James P. Adams, also declined to comment.

In a response included in the inspector general’s report, a Pentagon official said there were “new procedures already put in place by the White House Medical Unit.” The report didn’t detail those changes.

At Walter Reed, the program is available to Cabinet members; members of Congress; Supreme Court justices; active-duty and retired generals and flag officers and their beneficiaries; members of the Senior Executive Service who retired from the military; secretaries, deputy secretaries, and assistant secretaries of the Department of Defense and military departments; certain foreign military officers; and Medal of Honor recipients.

caters to the “time, privacy, and security demands” of leaders’ jobs, the hospital says on its website. The IG report makes clear that the program has, at times, provided extraordinary privileges to the government’s most elite officials.

For example, one unnamed executive medicine patient asked to have a prescription for an unspecified “controlled medication” refilled two weeks early 鈥� and complained when pharmacy staff at Fort Belvoir Community Hospital said that wasn’t allowed.

Hospital leaders told hospital staff to fill the prescription as requested. According to the report, the staff said the task required an estimated 30 hours of extra work.

Controlled medications are subject to abuse, and some, such as opioids, can be addictive. Defense Department health policy calls for minimizing the use of opioids and prescribing them only when indicated.

A spokesperson for the Fort Belvoir hospital, now known as Alexander T. Augusta Military Medical Center, said every patient is seen through the same lens and treated with the care they deserve.

The spokesperson, Reese Brown, said the facility shows military deference to top officers on account of their rank. For example, they don’t have to sit with the general population of patients.

The facility’s website mentions an “” for authorized patients, including eligible family members.

Brown said he was unaware of the inspector general’s account of the prescription refill and had no information about it.

The report said that at one unidentified pharmacy site, “all pharmacy staff members expressed frustration about the prioritization and filling of executive medicine prescriptions. This prioritization of executive medicine prescriptions diverted the pharmacist from filling prescriptions for patients diagnosed with conditions that are more urgent.”

Executive medicine services are also provided at the DiLorenzo Tricare Health Clinic at the Pentagon, Fort McNair Army Health Clinic, and Andrew Rader U.S. Army Health Clinic, the report said.

The inspector general recommended the Department of Defense take steps such as establishing controls for billing nonmilitary senior officials for outpatient services. The assistant secretary of defense for health affairs agreed but said the department would consider “the historical practices of the White House Medical Unit, the DoD’s health care support for non鈥憁ilitary U.S. Government senior officials, and the need for strict security protocols to protect the health and safety of White House principals.”

Chaseedaw Giles, 素人色情片Health News’ digital strategy & audience engagement editor, contributed to this report.

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“I want to apologize for any confusion or misunderstanding during the October hearing,” acting Commissioner Kilolo Kijakazi wrote in a letter dated Dec. 11.

Kijakazi sent the letter days after 素人色情片Health News and Cox Media Group reported that the agency has been demanding money back from more than 2 million people a year 鈥� more than twice as many as Kijakazi disclosed to a House panel at an Oct. 18 hearing.

The report was based on a Social Security document the news organizations obtained through a records request under the Freedom of Information Act.

“In my effort to be responsive to Committee questions on overpayment numbers, I provided a preliminary, unvetted and partial answer,” Kijakazi said in her apology letter.

“My goal 鈥� and SSA’s goal 鈥� is always to provide Congress with the most complete, accurate, and responsive information possible,” Kijakazi said. “We did not do that in this case and will use this experience to improve our communications with Congress going forward.”

In an interview before she sent the apology, Rep. Greg Steube (R-Fla.) said Kijakazi “wasn’t being completely upfront” at the hearing, and he wondered whether the agency had “intentionally deflated the numbers.”

Meanwhile, in a Dec. 12 interview, the chairman of the Senate Finance Committee, Ron Wyden (D-Ore.), said the agency had damaged its credibility by “not telling the truth.”

The hearing of the House Ways and Means Committee’s Subcommittee on Social Security focused on the agency’s record of sending out billions of dollars of benefit payments that it later concludes it never should have paid 鈥� and then, sometimes years later, demanding the recipients pay the money back.

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The unexpected bills, which can total tens of thousands of dollars or more, can be devastating for the recipients. Many are disabled and struggling to get by on minimal incomes.

Until the hearing, the agency had not disclosed the number of people affected, making it harder for policymakers to assess the seriousness of the problem and what to do about it.

At the hearing, Rep. Mike Carey (R-Ohio) asked how many people a year are receiving overpayment notices.

Reading from a piece of paper, Kijakazi gave two precise numbers: 1,028,389 for the 2022 fiscal year and 986,912 for the 2023 fiscal year.

Under further questioning, she repeated the numbers.

She also said they were “under Social Security” and “for Social Security.”

After the hearing, 素人色情片Health News and Cox Media Group sent the Social Security press office several emails over a period of weeks asking for clarification: Did the numbers Kijakazi gave at the hearing represent all programs administered by the Social Security Administration, or just a subset?

SSA spokesperson Nicole Tiggemann did not give a direct answer.

The news organizations filed the FOIA request for a copy of the document from which Kijakazi read the numbers at the hearing.

The document showed that Kijakazi did not tell House members the whole story.

She read numbers that included two benefit programs, but she repeatedly omitted numbers for a third program her agency administers under the Social Security Act. The numbers she omitted were bigger than the numbers she disclosed, and, on the piece of paper, they appeared directly below the numbers she disclosed.

She left out more than a million people a year.

More than seven weeks passed before she sent Congress the apology.

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“We should have followed up with additional context following the hearing,” she said in her letter. “I take seriously the commitment that all Federal officials make to provide the Congress with accurate information and I very much regret not contacting you with more information right away.”

素人色情片Health News and Cox Media Group obtained a copy of the letter addressed to Rep. Drew Ferguson (R-Ga.), chair of the Ways and Means’ Subcommittee on Social Security, and a copy sent to a Democratic member of the committee.

Asked which members of Congress were sent the letter, Tiggemann said in an email, “The correspondence was between Acting Commissioner Kijakazi and members of the committee.”

Tiggemann did not respond to a request for an interview with Kijakazi.

In her letter, Kijakazi essentially disavowed the numbers she gave the committee. She said the agency is trying to make sure it has “the right data to make meaningful improvements.”

“We are committed to sharing this data with the Committee and the public,” she wrote, “as soon as it is fully vetted.”

Addressing overpayment problems 鈥� and communicating with Congress about them 鈥� will soon be someone else’s responsibility.

The evening of Dec. 18, the Senate voted 50 to 11 to confirm former Maryland Gov. Martin O’Malley (D) as commissioner of Social Security.

At his confirmation hearing in November, O’Malley said he would “absolutely prioritize” reducing overpayments and overhauling the appeals process for people asked to repay money.

“It’s been heartbreaking reading some of these stories” of people who face government collection efforts “through no fault of their own” and “without regard” for their circumstances, O’Malley said.

“We have to do a better job of recognizing the justice at stake in each of these individual cases,” O’Malley, a former presidential candidate, said at the hearing.

O’Malley said he would emphasize improving customer service, measuring results, and disclosing data.

Instead of hoarding information, he said, “you need to share information openly and transparently.”

Do you have an experience with Social Security overpayments you’d like to share? to contact our reporting team.

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The Social Security Administration assured lawmakers in the past that it had been addressed, but “what you all found in your reporting is that the problem hadn’t been fixed,” Finance Committee Chair Ron Wyden (D-Ore.) said in an interview.

Wyden was referring to an ongoing investigation by 素人色情片Health News and Cox Media Group television stations reporting how the agency has been issuing billions of dollars in overpayments 鈥� benefits it claims people never should have received 鈥� and then, sometimes years later, demanding they pay the money back.

“Millions of these individuals are walking an economic tightrope, balancing their food bill against the fuel bill, the fuel bill against the rent bill,” Wyden said. “And they have one of these overpayments and it just hits them like a wrecking ball.”

Meanwhile, congressional legislation that would raise asset limits for millions of Social Security recipients for the first time in decades has been gaining support.

The amounts the agency alleges people owe the government often total tens of thousands of dollars. The recipients include many of the nation’s most vulnerable 鈥� people who are disabled and have minimal savings and incomes. Often the overpayments result from errors or lapses on the part of the Social Security Administration.

The agency has been sending overpayment notices to more than 2 million people a year, according to a government document 素人色情片Health News and CMG obtained through a request under the Freedom of Information Act. The notices typically ask recipients to repay the government within 30 days. They also explain how to appeal or request that the government waive the debt.

The Finance Committee oversees Social Security. Wyden spoke with 素人色情片Health News and CMG on Dec. 12 in his first interview with the news organizations since they began reporting on Social Security overpayments and clawbacks months ago. He was elaborating on a statement the committee posted last week.

“As the point person for getting this fixed, I’m committing to getting this turned around,” Wyden said.

“Your reporting has just been invaluable in terms of kind of opening up a lot of visibility and awareness to something that needs to be fixed.”

Wyden is co-sponsor of a Senate bill that would address one of the root causes of overpayments.

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In the Supplemental Security Income program, which provides monthly checks to people who have little or no income or assets and are over 65 or disabled, asset limits for beneficiaries haven’t been adjusted since the 1980s. Those limits stand at $2,000 for individuals and $3,000 for couples.

The bill, spearheaded by Sens. Sherrod Brown (D-Ohio) and Bill Cassidy (R-La.), to $10,000 and $20,000, respectively, and adjust them for inflation in the future.

The bill has seven other , including recent additions Lisa Murkowski (R-Alaska) and Sen. Patty Murray (D-Wash.), chair of the Appropriations Committee.

Chief executives of several major Wall Street firms, including Bank of America, Citigroup, Goldman Sachs, and Morgan Stanley, expressed support for the bill at a recent hearing, .

At a September news conference on Capitol Hill, a representative of JPMorgan Chase, which also backs the proposal, said the asset limits often prevent employees from participating in a 401(k) retirement plan to which the firm makes matching contributions.

A in the House of Representatives has 10 lawmakers behind it.

“With growing bipartisan support in Congress and among the business and faith communities, we have a good chance to finally get this done,” Brown said in a statement for this article.

Legislation to raise the asset limits could be included in a government funding bill early next year, Brown spokesperson Kevin Donohoe said.

Wyden said he hopes the legislation becomes a campaign issue in the election year and that candidates are asked whether they support it.

The monthly meetings with the Social Security Administration will begin when a new commissioner is in place, Wyden said. President Joe Biden’s nominee to head the agency, former Maryland Gov. Martin O’Malley (D), cleared the Finance Committee and is awaiting a confirmation vote by the full Senate.

In a recent hearing, O’Malley said accounts of people facing clawbacks were “heartbreaking” and promised to make the issue a priority.

Wyden said he expects the oversight meetings will include the top Republican on the Finance Committee, Sen. Mike Crapo of Idaho.

A spokesperson for Crapo, Mandi Critchfield, said he “is committed to addressing the overpayments issue, and looks forward to working with Senator Wyden to conduct proper oversight.”

One of the goals for those meetings, Wyden said, is to find out whether the agency can do more about overpayments using the legal powers it already has, including the authority to waive debts.

Wyden said he has discussed Social Security overpayments and clawbacks with officials at the White House.

In the interview, Wyden also addressed a recent report by 素人色情片Health News and CMG that, according to the results of a public records request, the SSA has been sending overpayment notices to over a million more people a year than the agency’s acting commissioner, Kilolo Kijakazi, disclosed at an October House hearing.

“When you have Social Security officials not telling the truth 鈥� and that’s how I would characterize that report on the number of people for whom there was actually a problem 鈥� it really damages this incredibly important program’s credibility,” Wyden said.

The news organizations obtained a copy of a piece of paper from which Kijakazi read aloud some numbers but not others at the October hearing.

SSA spokesperson Nicole Tiggemann said last week the agency could not confirm the accuracy of the counts 鈥� those Kijakazi presented at the hearing and those she left out.

Meanwhile, senior Democrats on the House Ways and Means Committee issued a statement this week on overpayments and clawbacks.

“Recent news reports have highlighted that the harm and unfairness Social Security beneficiaries experience after unknowingly being overpaid is more widespread than previously thought,” Reps. John B. Larson of Connecticut and Danny K. Davis of Illinois said.

Larson is the ranking Democrat on the Ways and Means Subcommittee on Social Security, and Davis is the ranking Democrat on the Subcommittee on Work and Welfare.

“The need for action is clear,” they said. “There must be a fundamental overhaul of Social Security’s overpayment process – one that puts seniors and Americans with severe disabilities first.”

While the government is at fault for some overpayments, others result from beneficiaries failing to comply with requirements, intentionally or otherwise. That can include failing to keep the SSA updated about items such as earnings, assets, and in-kind support 鈥� for example, whether family members are giving the beneficiary food or a place to stay.

Systemic problems also contribute.

The SSA has relied on manual systems, and those are subject to human error.

Rules are complex and difficult for SSA staff and beneficiaries alike to follow.

People who receive yet try to work can easily run afoul of restrictions not only on how much they are allowed to save but also on how much they are allowed to earn. For individuals who aren’t blind, the is $1,470.

The SSA relies heavily on beneficiaries to report changes in income, assets, and the like. For instance, the agency has been slow to implement systems that would automatically tap payroll data from outside sources.

Beneficiaries and advocates for Social Security recipients say the agency frequently loses information they submit. Getting through to humans at the agency can be extremely difficult, they say. Wait times are long, and calls get dropped.

O’Malley, the nominee for commissioner, recently told the Senate Finance Committee that the agency has a “.”

“The current wait times, backlogs, and delays are simply unacceptable,” O’Malley wrote.

The agency has cited staffing and funding. In the 2023 fiscal year, “we began to rebuild our workforce after ending FY 2022 with the lowest staffing level in 25 years,” the acting commissioner said in an October statement to a congressional subcommittee.

The agency closed field offices during the pandemic. That made it more difficult for beneficiaries to communicate with the SSA, and it caused problems to pile up.

The agency checks benefits retrospectively, which , researchers at the Urban Institute have said.

Regardless of who was originally at fault, by the time the SSA issues an overpayment notice, years can pass and the alleged overpayment total can balloon.

Under federal law, the agency must try to recover overpaid amounts, Kijakazi said in her October statement, and there is no statute of limitations. To collect debts, the SSA can reach back decades and across generations.

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That’s according to a document 素人色情片Health News and Cox Media Group obtained through a Freedom of Information Act request.

Acting Commissioner of the Social Security Administration Kilolo Kijakazi read aloud from the document during the hearing but repeatedly left out an entire category of beneficiaries displayed on the paper as well.

The document indicates the fallout from Social Security overpayments and clawbacks is much wider than Kijakazi acknowledged under direct questioning from a House Ways and Means subcommittee that oversees the federal agency.

In a statement for this article, SSA spokesperson Nicole Tiggemann described the numbers of people Kijakazi provided in her testimony and those she left out as “unverified.”

“We cannot confirm the accuracy of the information, and we have informed the committee,” Tiggemann said.

The numbers “were gathered quickly,” the spokesperson said. Social Security systems “were not designed to easily determine this information,” she said.

After the October hearing, 素人色情片Health News and Cox Media Group sent Tiggemann several emails asking her to clarify whether the annual numbers Kijakazi gave to Congress included all Social Security programs or just a subset. She would not say.

For answers, the news organizations several weeks ago filed a FOIA request.

Rep. Greg Steube (R-Fla.), a member of the subcommittee, said in an interview that he wondered if the agency “intentionally deflated the numbers to not make it look as bad as it is.”

“Maybe we should have her come back in for another hearing, put her under oath,” and ask her “why she wasn’t being completely upfront about the numbers,” Steube said.

Steube said that, when he heard Kijakazi’s testimony, he thought she was giving the subcommittee the complete numbers.

At issue is the scope of a problem that has terrified many Social Security beneficiaries and plunged them into financial distress.

As 素人色情片Health News and Cox Media Group television stations jointly reported in September, the government has been trying to recover billions of dollars from beneficiaries it says it overpaid. In many cases, the overpayments were the government’s fault.

But, even in cases where the beneficiary failed to comply with requirements, years can pass before the government catches the mistake and sends a notice demanding repayment, often within 30 days. In the meantime, the amount the beneficiary owes the government can grow to tens of thousands of dollars or more 鈥� far more than people living month to month could likely repay.

The people affected may be retired, disabled, or struggling to get by on only minimal income.

The number of people experiencing overpayments is important to know because overpayments can cause a lot of harm, said Kathleen Romig of the , who worked in research at the Social Security Administration and has since spent 20 years in the field of Social Security policy.

“It should be a very high priority at the agency to produce more reliable numbers,” Romig said.

The Social Security Administration has long quantified overpayments in dollars rather than numbers of people affected. For example, the agency’s latest says it recovered more than $4.9 billion in overpayments in the fiscal year that ended Sept. 30 and ended that period with a cumulative uncollected overpayment balance of $23 billion.

In September, SSA’s Tiggemann said, “We do not report on the number of debtors.”

In subsequent interviews with the news organizations, some lawmakers said the agency owed the public that information. “If they’re not telling you, I can assure you that’s a question that I’m going to ask in a hearing,” said Rep. Mike Carey of Ohio, the No. 2 Republican on the subcommittee.

At an , Carey brought up the number of debtors and told Kijakazi, “I think it’s something that we really need to get to the bottom of.”

Then he asked, “Do we have a number of how many people have been impacted by these overpayments?”

“We do,” Kijakazi replied. “And I’m, I looked at that before I came. I’m, I’m sorry. I’m not thinking of the number right now. But I can provide that.”

Carey pressed further.

“How many people are receiving overpayment notices in a year?” he asked.

At that point, Tom Klouda, a deputy SSA commissioner, got up from his seat behind Kijakazi and handed her a piece of paper.

Reading from the page, she gave two precise numbers: 1,028,389 for the 2022 fiscal year and 986,912 for the 2023 fiscal year.

When Carey asked if 986,912 “individuals were getting these letters in the mail saying that there was an overpayment and that they needed to contact you guys and set up a payment plan,” Kijakazi said, “That’s right.”

“Seems like an awful lot,” Carey said.

Under further questioning from Carey, Kijakazi repeated the numbers. She said they were “under Social Security” and “for Social Security.”

Subsequently, the agency declined to clarify what Kijakazi meant by that. Replying to a series of emails, Tiggemann would not say whether the numbers included all the Social Security programs.

Instead, she implied the agency didn’t know.

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“Again, our overpayment systems were not designed to easily determine the information you’re requesting,” she wrote on Nov. 29.

The document obtained via FOIA shows that the numbers Kijakazi gave at the hearing covered only two of the three Social Security benefit programs. They did not cover Supplemental Security Income, or SSI, which provides financial support for people who have little or no income or assets and are blind, otherwise disabled, or at least 65 years old.

On the paper that the deputy commissioner handed Kijakazi, overpayment counts for SSI appeared directly below the numbers she read aloud, and they were bigger: 1,118,648 people in fiscal 2022 and 1,189,642 in fiscal 2023.

The document is titled in part, “Overpayment Basic Facts.”

In the document, the numbers Kijakazi read at the hearing, which round to about 1 million people a year, are labeled “T2.” Title II of the Social Security Act covers two programs: Disability Insurance, or DI, and Old-Age and Survivors Insurance, or OASI.

The numbers Kijakazi omitted are labeled “T16.” Title XVI of the Social Security Act covers SSI.

Within the Social Security Administration, personnel use the term T16 when referring to SSI and T2 when referring to OASI and DI combined, said Romig, the former agency researcher.

It’s possible that some people who received overpayment notices through SSI also received notices through the other programs, leading to overlap between the numbers Kijakazi read at the hearing and those she didn’t provide, Romig said.

In the 2023 fiscal year, the agency paid SSI benefits to an average of 7.5 million recipients a month. Measured in dollars, the overpayment rate in SSI has been running about 8%, according to the agency’s latest annual financial report. That’s much higher than the half a percent overpayment rate for OASI and DI combined.

A written statement Kijakazi submitted to the House subcommittee included a clue that the numbers of people she gave the committee didn’t provide a complete picture. In the statement, dated Oct. 18, Kijakazi used the term “the Social Security program itself” to describe Disability Insurance and Old-Age and Survivors Insurance 鈥� but not SSI.

A the Ways and Means Committee issued after the hearing made no such distinction. “One Million Americans a Year Affected by Social Security’s Improper Payment Highlights Need for Reform,” it said.

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The document obtained via FOIA included other new information. It showed that relatively few beneficiaries contest overpayment notices and that many appeals or requests for waivers fail.

Weeks after 素人色情片Health News and CMG television stations published and broadcast the first stories in their series, the Social Security chief ordered a review of overpayments.

In her statement Dec. 5, the agency spokesperson said that, as part of the review, the Social Security Administration is “looking at how best to inform the Agency, the public, and Congress about this workload.”

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Two members of a Senate panel that oversees Social Security to the agency’s acting commissioner, Kilolo Kijakazi, urging her to do more to prevent overpayments and “limit harm to vulnerable beneficiaries” when trying to recover the money.

As 素人色情片Health News and Cox Media Group television stations jointly reported in September, the Social Security Administration routinely sends notices to beneficiaries saying they received benefits to which they weren’t entitled 鈥� and demanding they pay the government back, often within 30 days.

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In the 2022 federal fiscal year, for example, the agency sent overpayment notices to more than 1 million people, Kijakazi told Congress in mid-October.

Alleged overpayments can continue for years before the government notifies a recipient and seeks repayment. By then, the amount a beneficiary allegedly owes the government can reach tens of thousands of dollars or more. People living check to check likely would have spent the money.

To recoup money owed, the government can reduce or stop people’s monthly benefit checks.

“[W]e have been deeply concerned by stories from our constituents and recent reports of the extreme financial hardship placed upon beneficiaries who are asked to quickly repay in full or whose payments are halted, reduced, or reclaimed as the agency attempts to correct improper payments, many of which occurred due to agency error,” Sens. Maggie Hassan (D-N.H.) and Bill Cassidy (R-La.) wrote in a Nov. 28 letter to Kijakazi.

Citing the news organizations’ reporting, the senators asked what Kijakazi is doing to prevent harm to beneficiaries and what Congress can do.

Hassan and Cassidy are on the Senate Finance Committee’s Subcommittee on Social Security, Pensions, and Family Policy.

Meanwhile, Sen. Rick Scott (R-Fla.) sent Kijakazi a letter on Nov. 17 calling the

“If anyone intentionally defrauded the system or lied to receive payments at other taxpayers’ expense, they should absolutely be held accountable and repay this debt to taxpayers,” Scott wrote. “But it’s completely wrong for the federal government to go after well-intentioned Americans who did all the right things and trusted that their government was doing the right thing, too.”

Many of the people affected are disabled, low-income, or both and are enrolled in the Social Security Administration’s Disability Insurance or Supplemental Security Income programs.

In the 2022 fiscal year, the agency issued an estimated $4.6 billion in SSI overpayments, which represented 8% of payments in that program, according to the agency’s latest .

Kijakazi recently told a House subcommittee the 8% was “a small percentage.”

In other programs administered by the agency, there were an estimated $6.5 billion in overpayments in fiscal 2022, which amounted to one-half of 1%. Kijakazi called that overpayment rate “extremely low.”

During the 2023 fiscal year, which ended on Sept. 30, the agency recovered $4.9 billion in overpayments, according to a by Social Security’s inspector general. At the end of that period, an additional $23 billion of accumulated overpayments remained uncollected, the statement said.

Since 素人色情片Health News and Cox Media Group TV stations published and broadcast news reports on overpayment clawbacks in September, several members of the House and Senate have written to the Social Security Administration calling for change or answers.

“Many of these overpayment notices come as a complete surprise to SSA beneficiaries, leaving them confused, shocked, and scared that they cannot pay what SSA says they owe,” Rep. Ruben Gallego, an Arizona Democrat and Senate candidate, said in . “And, because of an indefinite 鈥榣ook-back period’, SSA can collect funds from a recipient for an error going back decades,” he added.

Asked about the latest letters from lawmakers, Social Security spokesperson Nicole Tiggemann said the agency “will respond directly to the requestors.”

Kijakazi said in October that she ordered a “top-to-bottom” review of how the agency handles overpayments.

Under federal law, the agency must seek recovery of overpaid amounts unless circumstances warrant waiving the debts, Kijakazi said in to Congress. There’s no time limit on efforts to collect the debts, she said.

In their letter to the acting commissioner, Cassidy and Hassan asked what the agency is doing to make it less burdensome for beneficiaries to appeal or seek a waiver when an overpayment is the government’s fault.

In response to questions for this article, Tiggemann, the Social Security spokesperson, said, “We will examine our policies and procedures 鈥� including our regulations 鈥� to determine where administrative updates to the overpayment recovery and waiver process may reduce the complexity and burden for the people we serve.”

Scott, the Florida Republican, asked if the review Kijakazi announced in October would be disclosed to the public. In a written response to questions for this article, the Social Security spokesperson didn’t say.

Samantha Manning of CMG’s Washington news bureau contributed to this report.

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At his confirmation hearing on Thursday, Democratic former Maryland Gov. Martin O’Malley said he would “absolutely prioritize” reducing overpayments and improving the appeals process for millions of people asked to repay money, often years later.

At least seven senators identified overpayments as a key concern during hours of questioning at Thursday’s hearing and asked O’Malley about how he would address the issue. Several committee members have cited joint investigations by 素人色情片Health News and Cox Media Group television stations, which reported the scope of the overpayment problem; how retired, disabled, and low-income beneficiaries have been affected; and the broad range of issues that can cause overpayments.

“It’s been heartbreaking reading some of these stories” of people who face government collection efforts “through no fault of their own” and “without regard” for their circumstances, O’Malley said.

“I am deeply concerned about the burden placed on individuals when the Social Security Administration works to recoup payments that the agency made because of its own errors,” Sen. Maggie Hassan (D-N.H.) told O’Malley. “We have constituents who are reaching out all the time to share that they’re struggling to make ends meet because SSA has unexpectedly and drastically reduced their benefits.”

Beneficiaries routinely receive demands for repayment long after they have spent the money.

Many of the overpayments are the result of beneficiaries’ failure to comply with federal requirements. But others are the result of errors by the Social Security Administration. Complex, hard-to-follow rules contribute to the problem. And beneficiaries often struggle to respond to overpayment notices because they have trouble reaching Social Security employees by phone.

“We need to correct that,” said Sen. Bob Casey (D-Pa.), who raised the issue during the hearing.

O’Malley added that Social Security’s attempts to claw back overpayments that were the result of covid relief payments were “an outrage,” and he pledged to correct it.

The agency frequently overpays people for months or years before catching the mistake. By then the amount to repay can balloon into tens of thousands of dollars. To recoup alleged overpayments, the Social Security Administration often reduces or suspends beneficiaries’ monthly benefits.

“We have to do a better job of recognizing the justice at stake in each of these individual cases,” O’Malley said.

Finance Committee Chair Ron Wyden (D-Ore.) told of a severely disabled constituent who is unable to work, lives with her parents, and pays them half of her benefits from the Supplemental Security Income (SSI) program each month as rent. The constituent was recently notified that she owes the government more than $9,000, Wyden said, because she still received a rental subsidy from her parents.

Wyden said he and other senators have proposed legislation “to friggin’ simplify the program and reduce these overpayments.”

Under questioning by Sen. Sherrod Brown (D-Ohio), O’Malley agreed that limits on the amount of assets beneficiaries are allowed to hold are root causes of overpayments. The limits, which haven’t been increased for inflation since the 1980s, stand at $2,000 for individuals and $3,000 for couples.

“It’s a leading cause and it’s a huge administrative burden,” O’Malley said.

Legislation proposed by Brown and others to raise the asset limits “would absolutely not only be the right thing to do for the recipients, the right policy,” O’Malley said, “but would also reduce the huge administrative burden that Social Security has to go through.”

Samantha Manning of CMG’s Washington news bureau contributed to this report.

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The lawmakers, who include Senate Finance Committee Chairman Ron Wyden (D-Ore.), sent a letter to acting SSA Commissioner Kilolo Kijakazi on Wednesday saying they were “deeply concerned” and wanted answers to a list of questions within 30 days.

In 2020 and 2021, to counter the economic fallout of the covid pandemic, the government distributed relief payments to eligible Americans totaling as much as $3,200 per person. The payments typically arrived automatically in mailboxes or bank accounts.

But, as 素人色情片Health News and Cox Media Group reported this week, some recipients say the payments had an unintended consequence: They led the Social Security Administration to claw back other federal benefits, including monthly support payments for people who are poor and either disabled or at least 65.

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The covid relief, known as stimulus or economic impact payments, left some recipients with more money in the bank than the $2,000 asset limit for individuals receiving benefits through a Social Security program called Supplemental Security Income. As a result, the Social Security Administration has sent some people notices alleging they were overpaid and demanding they repay the government, according to people affected.

In some cases, the agency has cut off SSI payments.

That wasn’t supposed to happen. According to the agency’s rules, the covid payments, also known as EIPs, do not count toward the asset limit.

“[W]e are concerned by recent reporting that SSI beneficiaries have received overpayment notices because of the EIPs, even though SSA determined that EIPs would never be counted toward eligibility for SSI,” the senators wrote to Kijakazi.

The letter cited the news report by CMG and 素人色情片Health News.

Signing along with Wyden were Democrats Sherrod Brown of Ohio, who chairs the Senate Subcommittee on Social Security, Pensions, and Family Policy, and Bob Casey of Pennsylvania, a member of that subcommittee and chair of the Senate Special Committee on Aging.

“We sent it because 鈥� it’s not right that Social Security made a mistake, and the beneficiary shouldn’t have to pay for that mistake,” Brown said Thursday in an interview with CMG’s WHIO-TV in Dayton.

“We’re not going to drop this until they back off,” Brown said, referring to the agency.

The senators asked Kijakazi about the scope of the problem, including the number of people who had benefits reduced or suspended because of covid payments, the number who had benefits reinstated with or without an appeal, and the outcomes of appeals. They also asked what the agency has been doing about the issue.

“As you know, SSI benefits, while modest, have a substantial impact in the lives of the people who rely on them,” the senators wrote. “Benefit suspensions and overpayment notices 鈥� regardless of the cause 鈥� can have a profound negative impact in their lives.”

“Further,” they wrote, “losing SSI eligibility risks a lengthy and bureaucratic process to restore eligibility and also risks beneficiaries’ access to Medicaid coverage.”

Nicole Tiggemann, a spokesperson for the Social Security Administration, did not respond to a request for comment.

The covid-related Social Security clawbacks are part of a larger picture. As 素人色情片Health News and CMG reported last month, many Americans have been struggling with demands that they repay benefits the Social Security Administration says they never should have received. The collection efforts can cover years of payments and reach tens of thousands of dollars or more.

In some cases, the alleged overpayments are the result of beneficiaries failing to comply with requirements. In others, they are the result of errors by the government.

The same day the senators sent their letter to Kijakazi, the agency chief was being questioned on overpayments at a hearing convened by a House panel.

Kijakazi revealed that about 1 million people have received overpayment notices from the agency in each of the last two fiscal years.

She told the panel that Social Security employees “work assiduously to pay the right person the right amount at the right time,” and that the agency was conducting a “top-to-bottom” review of its handling of overpayments.

“If we determine that a beneficiary has been paid more than they should have received, we are required by law to seek recovery of the overpayment amounts,” Kijakazi testified during the hearing.

Solving the larger problem may require legislation, Brown said, adding he would try to change the law this year “if that’s what’s necessary to get Social Security to do it right.”

John Bedell of CMG’s WHIO-TV in Dayton, Ohio, contributed to this report.

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