Each year the Social Security Administration issues billions of dollars in overpayments to recipients whose income or other qualifying criteria have changed, or as the result of agency miscalculations. Under federal law, the Social Security Administration is required to demand repayment of this money, treating it as debts to the federal government. These “clawbacks” can happen even decades after the initial overpayments occurred and even when they resulted from an agency mistake. In “Overpayment Outrage,” a collaboration that spanned a national nonprofit newsroom (KFF Health News) and Cox Media Group, a network of local TV news stations and their investigative and Washington, D.C. bureaus, the teamdug into the overpayment issue and the impacts of clawbacks on vulnerable people. They found that overpayments happen due to chronic understaffing at SSA, systemic delays in data tracking, and a process that made income changes and eligibility criteria invisible to those who were determining whether to issue a clawback demand. The reporting lays out potential solutions to address the legislative, funding, and process failures that cause this systemic problem. It reveals how Congress has demanded action to reduce excessive Social Security spending without adequately funding the agency that administers it, and examines the layers of complex policy, regulation, and procedural rules that employees and recipients of social security have to navigate to make the system work. The collaborative nature of the project and its publication in both print and TV outlets helped elevate the reach and impacts of the project.
For this impressive untangling of the root causes of problems in the functioning of government and the implementation of public policy, and explaining how this problem both impacted individuals and was not directly caused by them, “Overpayment Outrage” is the winner of the Goldsmith Awards’ inaugural Special Citation for Reporting on Government.
The Goldsmith Special Citation for Reporting on Government is intended to honor explanatory and/or investigative reporting that focuses on the functioning of government and the implementation of public policy. It aims to lift up reporting that illuminates the nitty gritty of governing – the people, systems, structures, and policies that layer together to make a government work, and, when it doesn’t, understanding why. The teams from Cox Media Group and KFF Health News are deserving of this special citation for their reporting on “Overpayment Outrage” because of the lengths they went to understand why failures happened, the impacts those failures have on individuals and communities, and the solutions suggested by their reporting – many of which were already being implemented in the weeks and months after the story came to light.
Denied by AI: How big insurers use algorithms to cut off care for Medicare Advantage patients
Following a tip from an employee at a small nursing home, STAT reporters Casey Ross and Bob Herman relied on internal sources, confidential company documents, and court records to reveal how UnitedHealth Group, the nation’s largest health insurer, was inappropriately using predictions from a flawed computer algorithm to deny care to seriously ill patients. Reducing older adults and people with disabilities to numbers, insurers used the predictions to deny or prematurely cut off rehab care of sick and injured Medicare Advantage beneficiaries and maximize the company’s profits. The publication of this four-part investigative series prompted federal regulators to issue new rules and launch their own investigations and triggered at least two class-action lawsuits.
With Every Breath: Millions of Breathing Machines. One Dangerous Defect.
After months of sorting through thousands of complaints submitted to the FDA, reporters revealed that Philips Respironics kept millions of dangerous breathing machines – used by COVID-19 patients, infants, the elderly, and veterans – on the market, despite warnings from their own experts that the devices posed serious health risks. The investigation also revealed that the FDA had received warnings about contaminants in the machines for years but repeatedly failed to warn the public. Their reporting prompted the Government Accountability Office (GAO) to launch an investigation of the FDA’s oversight of medical devices for the first time in a decade and led to calls by influential members of Congress for the Justice Department to open a criminal investigation into Philips Respironics.
Unresponsive
In this months-long investigation into Sedwick County EMS – the lone ambulance provider for more than half a million people – reporters at The Wichita Eagle uncovered a public safety crisis that put an entire community at risk. Through open records, leaked documents, interviews, and direct research, the reporters built a database of response times, and direct testimony to back it up, that showed the department had dangerously slow response times and staffing shortages driven by mismanagement. While under the EMS director’s leadership, the department had fallen from one of the best in the Midwest to one that showed up late for over 11,000 potentially fatal emergency calls in two years. The series led to the prompt ousting of the EMS director, an apology by the county manager for his slow response to the crisis, and most importantly – a massive overhaul of the county’s EMS service.
In reporting “Pain and Profit” the Dallas Morning News found that thousands of sick and disabled Texans were being denied life-sustaining drugs and treatments by the private health insurance companies hired by the state to manage their care. While these private contractors made billions of dollars from the corporate management of taxpayer-funded Medicaid, some of the most vulnerable Texans were denied critical services, equipment and treatments, often with profoundly life-altering results. As a result of the investigation the Texas legislature pledged millions of dollars to more closely regulate the system, monitor instances of denials of care, and reform the appeals process.
Learn more about how McSwane, Chavez, and the Dallas Morning News team found, investigated, and reported the story in a “how they did it” piece in The Journalist’s Resource, and a podcast interview with the reporters.
Rezulin: A Billion-Dollar Killer
An exposé of seven unsafe prescription drugs that had been approved by the Food and Drug Administration, and an analysis of the policy reforms that had reduced the agency’s effectiveness.
Doing Harm: Research on the Mentally Ill
A four-part series by Robert Whitaker and Dolores Kong shed light on the abusive research parameters of non-therapeutic experiments conducted on mentally incapacitated individuals. They focused on several victims who had suffered and were harmed by experiments that violated medical ethics standards.
Deadly Alliance
The series exposed a 50-year pattern of misconduct by the U.S. government and the American beryllium industry – wrongdoing that caused a chronic lung disease in dozens of workers producing the strategic metal. The articles sparked major safety reforms, numerous lawsuits, and two congressional investigations.
Population Bomb
An account of how two American contraceptive researchers arranged for the chemical sterilization of more than 100,000 women in developing nations. The story led the U.S. Food and Drug Administration to halt distribution of quinacrine, the potentially carcinogenic contraceptive.
Health Care Behind Bars
Reporters William Allen and Kim Bell of the St. Louis Post-Dispatch asked Skolnick to assist them in completing a special report on prison healthcare. Skolnick, along with Allen and Bell, wrote or contributed to three articles that were published in the September 27, 1998 edition of the paper: “Physicians with troubled pasts have found work behind bars;” “Two key posts in Alabama were filled by doctors with checkered histories;” and “Prisoner, doctor who treated him, both had drug arrests”.
