,i #aacth ,,congress #b;d ,session ,h4 ,r4 #djij ,,in ,,the ,,house ,,of ,,representatives ,february #bf1 #bjad ,mr4 ,becerra 7for himself1 ,mr4 ,levin1 ,mr4 ,rangel1 ,mr4 ,doggett1 ,mr4 ,thompson of ,california1 ,ms4 ,schwartz1 and ,mr4 ,crowley7 introduced the following bill2 which was referred to the ,committee on ,ways and ,means1 and in addition to the ,committee on the ,budget1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to amend title ,,ii of the ,social ,security ,act to improve the ,social ,security ,administration's ability to fight fraud1 prevent errors1 and protect the ,social ,security ,trust ,fund1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,social ,security ,fraud and ,error ,prevention ,act of #bjad4 #b4 ,fraud and error prevention 7a7 ,in general ,section #bja of the ,social ,security ,act 7#db ,u4,s4,c4 #dja et seq47 is amended by striking subsection 7n7 and inserting the following3 7n7 ,fraud and error prevention 7#a7 ,subject to paragraph 7#d71 there is hereby appropriated from any one or all of the ,trust ,funds to the ,social ,security ,administration for each fiscal year beginning with fiscal year #bjae for fraud and error prevention activities described in paragraph 7#c71 in addition to any other amounts otherwise appropriated for such fiscal year1 an amount equal to the sum of-- 7,a7 the applicable dollar amount 7determined under paragraph 7#b771 plus 7,b7 an amount equal to the sum of any fines or other monetary penalties recovered in the previous fiscal year pursuant to sections #bjh7;a71 #aabi7;a71 #aadj 7to the extent that such penalties are imposed for misuse of words1 letters1 symbols1 or emblems relating to the ,social ,security ,administration71 and #afcb7;a74 7#b7 ,the applicable dollar amount determined under this clause is-- 7,a7 for fiscal year #bjae1 #a1gej1jjj1jjj2 7,b7 for each of fiscal years #bjaf through #bjbj1 #a1hjj1jjj1jjj2 and 7,c7 for each fiscal year thereafter1 #a1hjj1jjj1jjj multiplied by the ratio 7not less than #a7 of-- 7i7 the ,consumer ,price ,index for all ,urban ,consumers 7,,cpi-,u1 published by the ,bureau of ,labor ,statistics of the ,department of ,labor7 for the #ast full calendar year preceding such fiscal year1 to 7ii7 the ,,cpi-,u for #bjah4 7#c7 ,the ,commissioner of ,social ,security may use funds appropriated under paragraph 7#a7 for the following purposes3 7,a7 ,medical continuing disability reviews conducted pursuant to section #bba7;i7 and section #afad7;a77#c77;,h74 7,b7 ,,ssi redeterminations conducted pursuant to section #afaa7;c74 7,c7 ,work-related continuing disability reviews conducted pursuant to section #bbc7;f74 7,d7 ,establishment or expansion of cooperative disability investigations 7,,cdi7 units4 7,e7 ,pre-effectuation reviews conducted pursuant to section #bba7;c7 and section #afcc7;e74 7,f7 ,quality reviews of decisions made by an administrative law judge under this title or title ,,xvi in accordance with section #bba7n74 7,g7 ,recovery of overpayments under sections #bjd and #afca7;b74 7,h7 ,recovery of civil penalties imposed under sections #aabi and #aadj4 7,i7 ,supporting prosecution of felonies under section #bjh4 7#d7 ,funds appropriated under paragraph 7#a7 for a fiscal year shall not be available for obligation until the report required to be submitted under paragraph 7#e7 #fj days prior to the beginning of such fiscal year has been submitted4 7#e7 ,not later than #fj days prior to the beginning of each fiscal year after #bjad1 the ,commissioner of ,social ,security shall submit a report to the ,committee on ,ways and ,means of the ,house of ,representatives1 the ,committee on ,finance of the ,senate1 and the ,office of ,management and ,budget that includes the following3 7,a7 ,a plan for conducting the fraud and error prevention activities described in paragraph 7#c7 in such fiscal year1 including-- 7i7 an itemized statement of the dollar amounts expected to be spent on each such activity during such fiscal year2 7ii7 an itemized statement of the estimated long-term savings to the ,trust ,funds and the ,treasury expected to be obtained as a result of each such activity1 and a statement of the estimated total value of benefits paid under this title solely as a result of such activities2 7iii7 performance targets for each such activity2 and 7iv7 a certification from the ,chief ,actuary of the ,social ,security ,administration that the plan will improve the actuarial status of the ,trust ,funds4 7,b7 ,an assessment of the fraud and error prevention activities described in paragraph 7#c7 conducted in the previous fiscal year1 including-- 7i7 an itemized statement of the dollar amounts spent on each such activity during such fiscal year2 7ii7 an itemized statement of the estimated long-term savings to the ,trust ,funds and the ,treasury obtained as a result of each such activity1 and a statement of the estimated total value of benefits paid under this title solely as a result of such activities2 7iii7 an assessment of the extent to which performance targets set in the applicable plan for such fiscal year were met2 7iv7 an explanation and a corrective action plan for any failure to meet such performance targets2 and 7v7 an assessment of whether funds made available under paragraph 7#a7 for such fiscal year were adequate to protect the ,trust ,funds from fraud and errors1 an explanation of any such funds that remained unobligated at the end of the fiscal year1 and recommendations for needed adjustments to future funding in order to protect the ,trust ,funds from fraud and errors and any additional cost-effective strategies for improving the actuarial status of the ,trust ,funds4 7#f7 ,of the discretionary amounts made available for ,social ,security ,administration--,limitation on ,administrative ,expenses for each fiscal year beginning with fiscal year #bjae1 the amount obligated for the activities described in paragraph 7#c7 shall be not less than the sum of-- 7,a7 #bgc1jjj1jjj2 plus 7,b7 the amount obligated from funds made available for ,social ,security ,administration--,limitation on ,administrative ,expenses for fiscal year #bjac for the activities described in subparagraphs 7,c7 through 7,i7 of paragraph 7#c74 4 #c4 ,expansion of cooperative disability investigations units ,not later than ,october #a1 #bjag1 the ,commissioner of ,social ,security shall take any necessary actions to ensure that cooperative disability investigations 7,,cdi7 units have been established for each of the #ej ,states1 the ,district of ,columbia1 ,puerto ,rico1 ,guam1 the ,northern ,mariana ,islands1 the ,virgin ,islands1 and ,american ,samoa4 #d4 ,codification of requirement to conduct quality reviews ,section #bba of the ,social ,security ,act is amended by adding at the end the following3 7n7 7#a7 ,the ,commissioner of ,social ,security shall conduct quality reviews in accordance with section #ifi of part #djd of title #bj1 ,code of ,federal ,regulations1 in cases described in section #igj7;a7 of such part 7as such sections were in effect on ,january #a1 #bjad7 with respect to decisions in connection with applications for benefits under this title and title ,,xvi1 in a sufficient number to ensure compliance with laws1 regulations1 and other guidance issued by the ,commissioner of ,social ,security4 7#b7 ,the ,commissioner of ,social ,security shall annually submit to the ,committee on ,ways and ,means of the ,house of ,representatives and the ,committee on ,finance of the ,senate a report that includes-- 7,a7 the total number of cases selected for a quality review as described in paragraph 7#a72 7,b7 the number of such cases in which a decision is remanded2 and 7,c7 the number of such cases in which a decision is modified or reversed4 4 #e4 ,report on work-related continuing disability reviews ,section #bbc of the ,social ,security ,act is amended by adding at the end the following3 7k7 ,report on work-,related continuing disability reviews ,the ,commissioner of ,social ,security shall annually submit to the ,committee on ,ways and ,means of the ,house of ,representatives and the ,committee on ,finance of the ,senate a report on the number of work-related continuing disability reviews conducted pursuant to subsection 7f74 ,such report shall include-- 7#a7 the total number of reports of earnings received by the ,commissioner in the previous calendar year from individuals receiving benefits on account of disability under this title or title ,,xvi2 7#b7 the number of such reports that resulted in a determination by the ,commissioner to conduct a work-related continuing disability review with respect to the beneficiary to whom such report pertains1 and the basis on which such determinations were made2 7#c7 in the case of a beneficiary selected for a work-related continuing disability review on the basis of a report of earnings-- 7,a7 the average number of days between the submission of the report and the initiation of the review1 and the average number of days between the initiation and the completion of the review2 7,b7 the number of such reviews completed during such calendar year1 and the number of such reviews that result in a suspension or termination of benefits2 and 7,c7 the number of such reviews that had not been completed as of the end of such calendar year2 7#d7 the total savings to the ,trust ,funds and the ,treasury generated from benefits terminated as a result of such reviews2 and 7#e7 with respect to individuals for whom a work-related continuing disability review was completed during such calendar year-- 7,a7 the number who participated in the ,ticket to ,work program under section #aadh during such calendar year2 7,b7 the number who used any program work incentives during such calendar year2 and 7,c7 the number who received vocational rehabilitation services during such calendar year with respect to which the ,commissioner of ,social ,security reimbursed a ,state agency under section #bbb7;d74 4 #f4 ,coordination of reports relating to disability benefits ,section #bba7;i77#c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #dba7;i77#c77 is amended by adding at the end the following3 ,to the extent the ,commissioner of ,social ,security determines to be necessary for maximum efficiency1 the ,commissioner may submit a combined report consisting of the information required to be submitted under this paragraph1 subsection 7c77#c77;,c71 subsection 7n77#b71 section #bja7n77#e71 and section #bbc7k744 #g4 ,increased penalties in certain cases of fraud 7a7 ,conspiracy ,to commit ,social ,security fraud ,section #bjh7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #djh7;a77 is amended-- 7#a7 in paragraph 7#g77;,c71 by striking or at the end2 7#b7 in paragraph 7#h71 by adding or at the end2 and 7#c7 by inserting after paragraph 7#h7 the following3 7#i7 conspires to commit any offense described in any of paragraphs 7#a7 through 7#d71 4 7b7 ,increased criminal penalties for certain individuals in positions of trust ,section #bjh7;a7 of such ,act 7#db ,u4,s4,c4 #djh7;a771 as amended by subsection 7a71 is further amended by striking the period at the end and inserting 1 except that in the case of a person who receives a fee or other income for services performed in connection with any determination with respect to benefits under this title1 or who is a physician or other health care provider who submits medical evidence in connection with any such determination1 such person shall be guilty of a felony and upon conviction thereof shall be fined under title #ah1 ,united ,states ,code1 or imprisoned for not more than ten years1 or both44 7c7 ,increased civil penalties for certain individuals in positions of trust ,section #aabi7;a77#a7 of such ,act 7#db ,u4,s4,c4 #acbj;a-#h7;a77#a77 is amended1 in the matter following subparagraph 7,c71 by inserting after withholding disclosure of such fact the following3 1 except that in the case of such a person who receives a fee or other income for services performed in connection with any such determination or who is a physician or other health care provider who submits medical evidence in connection with any such determination1 the amount of such penalty shall be not more than #g1ejj4 7d7 ,references to ,social ,security and ,medicare in electronic communications ,section #aadj7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#aj7;a77#a77 is amended by inserting 7including any electronic communication7 after or other communication4 7e7 ,inflation adjustment of certain civil penalties ,title ,,xi of the ,social ,security ,act is amended by inserting after section #aabi;,b the following3 #aabi;,c4 ,civil penalty inflation adjustment 7a7 ,adjustment by regulation ,the ,commissioner of ,social ,security shall1 not later than #ahj days after the date of enactment of the ,social ,security ,fraud and ,error ,prevention ,act of #bjad1 and at least once every #d years thereafter-- 7#a7 by regulation adjust the maximum amount of each civil monetary penalty by the inflation adjustment described under subsection 7b72 and 7#b7 publish each such regulation in the ,federal ,register4 7b7 ,amount of adjustment ,the inflation adjustment under subsection 7a7 shall be determined by increasing the maximum amount of each civil monetary penalty by the cost-of-living adjustment4 ,any increase determined under this subsection shall be rounded to the nearest-- 7#a7 multiple of #a1jjj in the case of penalties greater than #a1jjj but less than or equal to #aj1jjj2 and 7#b7 multiple of #e1jjj in the case of penalties greater than #aj1jjj but less than or equal to #ajj1jjj4 7c7 ,definitions ,for purposes of this section-- 7#a7 the term civil monetary penalty means-- 7,a7 a penalty imposed by paragraph 7#a7 or 7#c7 of section #aabi7;a72 and 7,b7 a penalty imposed by paragraph 7#a7 or 7#b7 of section #aadj7;b74 7#b7 the term cost-of-living adjustment means the percentage 7if any7 for each civil monetary penalty by which-- 7,a7 the ,consumer ,price ,index for the month of ,june of the calendar year preceding the adjustment1 exceeds 7,b7 the ,consumer ,price ,index for the month of ,june of the calendar year in which the amount of such civil monetary penalty was last set or adjusted pursuant to law4 7d7 ,application of increase ,any increase under this ,act in a civil monetary penalty shall apply only to violations which occur after the date the increase takes effect4 4 #h4 ,exclusion of certain medical evidence in disability cases 7a7 ,in general ,section #bbc7;d77#e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #dbc7;d77#e77 is amended by adding at the end the following3 7,c7 ,in making any determination with respect to whether an individual is under a disability or continues to be under a disability1 the ,commissioner of ,social ,security may not consider1 except for good cause as determined by the ,commissioner1 any evidence furnished by a physician or other health care provider who-- 7i7 has been barred from practice in any ,state2 or 7ii7 has been assessed a penalty under section #aabh or #aabi for the submission of false evidence4 4 7b7 ,regulations ,not later than #a year after the date of the enactment of this ,act1 the ,commissioner of ,social ,security shall issue regulations to carry out the amendment made by subsection 7a74 7c7 ,effective date ,the amendment made by subsection 7a7 shall apply with respect to determinations of disability made on or after the date that is #a year after the date of enactment of this ,act4 #i4 ,repeal of program integrity adjustments to discretionary spending limits ,section #bea7;b77#b77;,b77i7 of the ,balanced ,budget and ,emergency ,deficit ,control ,act of #aihe is amended-- 7#a7 in subclause 7,,ii71 by adding and at the end2 7#b7 in subclause 7,,iii71 by striking the semicolon at the end and inserting a period2 and 7#c7 by striking subclauses 7,,iv7 through 7,x74