[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4419 Introduced in House (IH)]

103d CONGRESS
  2d Session
                                H. R. 4419

 To modify the supplemental security income program under title XVI of 
                        the Social Security Act.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 12, 1994

  Mr. Santorum (for himself, Mr. Archer, Mr. Gingrich, Mr. Thomas of 
 California, Mr. Shaw, Mr. Camp, Mr. Herger, Mr. McCrery, Mrs. Johnson 
 of Connecticut, Mr. Castle, Mr. Gekas, Mr. Smith of Michigan, and Mr. 
 Istook) introduced the following bill; which was referred jointly to 
        the Committees on Ways and Means and Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To modify the supplemental security income program under title XVI of 
                        the Social Security Act.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

                    TITLE I--RESTRICTIONS FOR ALIENS

SEC. 101. CERTAIN ALIENS INELIGIBLE FOR SUPPLEMENTAL SECURITY INCOME 
              BENEFITS.

    (a) In General.--Section 1614(a) of the Social Security Act (42 
U.S.C. 1382c(a)) is amended by adding at the end the following:
    ``(5)(A) An alien otherwise eligible for benefits under this title 
who has qualified for entry pursuant to section 207 of the Immigration 
and Nationality Act shall not be eligible for such benefits after the 
6-year period that begins with the date the alien arrives in the United 
States.
    ``(B) Subparagraph (A) shall not apply to an alien who--
            ``(i) has been lawfully admitted to the United States for 
        permanent residence;
            ``(ii) has attained 75 years of age; and
            ``(iii) has resided in the United States for at least 5 
        years.
    ``(C) Subparagraph (A) shall not apply to an alien who, on the date 
of the enactment of this paragraph, is residing in the United States 
and eligible for benefits under this title, until 1 year after such 
date of enactment.''.
    (b) Notification of Affected Aliens.--The Social Security 
Administration shall, directly or through the States, notify each alien 
receiving supplemental security income benefits under title XVI of the 
Social Security Act whose eligibility for such benefits is or will be 
terminated by reason of the amendment made by subsection (a).

SEC. 102. STATE AFDC AGENCIES REQUIRED TO PROVIDE INFORMATION ON 
              ILLEGAL ALIENS TO THE IMMIGRATION AND NATURALIZATION 
              SERVICE.

    Section 402(a) of the Social Security Act (42 U.S.C. 602(a)) is 
amended--
            (1) by striking ``and'' at the end of paragraph (44);
            (2) by striking the period at the end of paragraph (45) and 
        inserting ``; and''; and
            (3) by inserting after paragraph (45) the following:
            ``(46) require the State agency to provide to the 
        Immigration and Naturalization Service the name, address, and 
        other identifying information that the agency has with respect 
        to any individual unlawfully in the United States any of whose 
        children is a citizen of the United States.''.

         TITLE II--RESTRICTIONS FOR DRUG ADDICTS AND ALCOHOLICS

SEC. 201. TIME-LIMITED BENEFITS.

    (a) In General.--Section 1614(a) of the Social Security Act (42 
U.S.C. 1382c(a)) is amended by adding at the end the following:
    ``(5)(A) The Secretary shall identify all recipients of benefits 
under this title by reason of disability whose disability is a result 
of addiction to illegal drugs.
    ``(B) The Secretary shall periodically, on a random basis, test 
each recipient identified under subparagraph (A) (including any 
recipient who had become temporarily ineligible for benefits by reason 
of subparagraph (C)) to determine whether the recipient is using 
illegal drugs.
    ``(C)(i) Notwithstanding any other provision of this title, any 
individual who is determined under subparagraph (B) to be using illegal 
drugs, or who refuses to submit to testing as provided for under 
subparagraph (B), shall not be eligible for benefits under this title 
during the period described in clause (ii).
    ``(ii) The period described in this clause begins with the date of 
the determination referred to in clause (i) and ends with the passage 
by the individual of 2 tests administered by the Secretary (and paid 
for by the individual) to determine whether the individual is using 
illegal drugs, which tests occur--
            ``(I) at least 2 months apart; and
            ``(II) after the 1-year period that begins with the date of 
        the determination.
    ``(6)(A) The Secretary shall identify all recipients of benefits 
under this title by reason of disability whose disability is a result 
of addiction to alcohol.
    ``(B) The Secretary shall periodically, on a random basis, test 
each recipient identified under subparagraph (A) (including any 
recipient who had become temporarily ineligible for benefits by reason 
of subparagraph (C)) to determine whether the recipient is using 
alcohol.
    ``(C)(i) Notwithstanding any other provision of this title, any 
individual who is determined under subparagraph (B) to be using 
alcohol, or who refuses to submit to testing as provided for under 
subparagraph (B), shall not be eligible for benefits under this title 
during the period described in clause (ii).
    ``(ii) The period described in this clause begins with the date of 
the determination referred to in clause (i) and ends with the passage 
by the individual of 2 tests administered by the Secretary (and paid 
for by the individual) to determine whether the individual is using 
alcohol, which tests occur--
            ``(I) at least 2 months apart; and
            ``(II) after the 6-month period that begins with the date 
        of the determination.''.
    (b) Preservation of Eligibility for Medicaid Benefits.--Section 
1634 of the Social Security Act (42 U.S.C. 1383c) is amended by adding 
at the end the following:
    ``(e) For purposes of title XIX, an individual is deemed to be 
receiving benefits under this title if the individual is ineligible for 
such benefits solely by reason of paragraph (5) or (6) of section 
1614(a).''.

SEC. 202. RESTRICTIONS ON PAYMENT OF BENEFITS BASED ON DISABILITY TO 
              SUBSTANCE ABUSERS.

    (a) Required Payment of Benefits to Representative Payees.--
            (1) In general.--Section 1631(a)(2)(A) of the Social 
        Security Act (42 U.S.C. 1383(a)(2)(A)) is amended--
                    (A) in clause (ii), by adding at the end the 
                following: ``In the case of an individual entitled to 
                benefits under this title by reason of disability, if 
                alcoholism or drug addiction is a contributing factor 
                material to the Secretary's determination that the 
                individual is disabled, the payment of such benefits to 
                a representative payee shall be deemed to serve the 
                interest of such individual under this title.''; and
                    (B) in clause (iii), by striking ``to the 
                individual or eligible spouse or to an alternative 
                representative payee of the individual or eligible 
                spouse'' and inserting ``to an alternative 
                representative payee of the individual or eligible 
                spouse or, if the interest of the individual under this 
                title would be served thereby, to the individual or 
                eligible spouse''.
            (2) Conforming amendment.--Section 1631(a)(2)(B)(viii)(II) 
        of such Act (42 U.S.C. 1383(a)(2)(B)(viii)(II)) is amended by 
        striking ``15 years'' and all that follows and inserting ``of 
        15 years, or (if alcoholism or drug addition is a contributing 
        factor material to the Secretary's determination that the 
        individual is disabled) is entitled to benefits under this 
        title by reason of disability.''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply with respect to benefits for months beginning after 
        180 days after the date of the enactment of this Act.
    (b) Increased Reliance on Professional Representative Payees.--
            (1) Preference required for organizational representative 
        payees.--Section 1631(a)(2)(B) of such Act (42 U.S.C. 
        1383(a)(2)(B)) is amended--
                    (A) by redesignating clauses (vii) through (xii) as 
                clauses (viii) through (xiii), respectively;
                    (B) by inserting after clause (vi) the following:
    ``(vii) In the case of an individual entitled to benefits under 
this title by reason of disability, if alcoholism or drug addiction is 
a contributing factor material to the Secretary's determination that 
the individual is disabled, when selecting such individual's 
representative payee, preference shall be given to a--
            ``(I) community-based nonprofit social service agency 
        licensed or bonded by the State;
            ``(II) State or local government agency whose mission is to 
        carry out income maintenance, social service, or health care-
        related activities; or
            ``(III) State or local government agency with fiduciary 
        responsibilities,
(or a designee of such an agency if the Secretary deems it 
appropriate), unless the Secretary determines that selection of such an 
agency would not be appropriate.'';
                    (C) in clause (viii) (as so redesignated), by 
                striking ``clause (viii)'' and inserting ``clause 
                (ix)'';
                    (D) in clause (ix) (as so redesignated), by 
                striking ``(vii)'' and inserting ``(viii)'';
                    (E) in clause (xiii) (as so redesignated)--
                            (i) by striking ``(xi)'' and inserting 
                        ``(xii)''; and
                            (ii) by striking ``(x)'' and inserting 
                        ``(xi)''.
            (2) Availability of public agencies and other qualified 
        organizations to serve as representative payees.--Section 
        1631(a)(2)(D) of such Act (42 U.S.C. 1383(a)(2)(D)) is 
        amended--
                    (A) in clause (i)--
                            (i) by striking ``exceed the lesser of--'' 
                        and inserting ``exceed--''; and
                            (ii) by striking subclauses (I) and (II) 
                        and inserting the following:
            ``(I) in any case in which an individual is entitled to 
        benefits under this title by reason of disability and 
        alcoholism or drug addiction is a contributing factor material 
        to the Secretary's determination that the individual is 
        disabled, 10 percent of the monthly benefit involved, or
            ``(II) in any other case, the lesser of--
                    ``(aa) 10 percent of the monthly benefit involved, 
                or
                    ``(bb) $25.00 per month.'';
                    (B) in clause (ii)--
                            (i) by inserting ``State or local 
                        government agency whose mission is to carry out 
                        income maintenance, social service, or health 
                        care-related activities, any State or local 
                        government agency with fiduciary 
                        responsibilities, or any'' after ``means any'';
                            (ii) by inserting a comma after ``service 
                        agency'';
                            (iii) by adding ``and'' at the end of 
                        subclause (I); and
                            (iv) in subclause (II)--
                                    (I) by adding ``and'' at the end of 
                                item (aa);
                                    (II) by striking ``; and'' at the 
                                end of item (bb) and inserting a 
                                period; and
                                    (III) by striking item (cc); and
                    (C) by striking clause (iv), effective July 1, 
                1994.
    (c) Nonpayment or Termination of Benefits.--
            (1) In general.--Section 1611(e)(3) of such Act (42 U.S.C. 
        1382(e)(3)), is amended by redesignating subparagraph (B) as 
        subparagraph (C) and by inserting after subparagraph (A) the 
        following:
    ``(B)(i) Notwithstanding any other provision of this title, in the 
case of any individual entitled to benefits under this title solely by 
reason of disability, if alcoholism or drug addiction is a contributing 
factor material to the Secretary's determination that such individual 
is disabled and such individual is determined by the Secretary not to 
be in compliance with the requirements of this subparagraph for a 
month, such benefits shall be suspended for a period commencing with 
such month and ending with the month preceding the first month, after 
the determination of noncompliance, in which such individual 
demonstrates that he or she has reestablished and maintained compliance 
with such requirements for the applicable period specified in clause 
(iii).
    ``(ii)(I) An individual described in clause (i) is in compliance 
with the requirements of this subparagraph for a month if the 
individual in such month undergoes any medical or psychological 
treatment that may be appropriate, for the individual's condition 
diagnosed as substance abuse or alcohol abuse and for the stage of the 
individual's rehabilitation, at an institution or facility approved for 
purposes of this subparagraph by the Secretary, and complies in such 
month with the terms, conditions, and requirements of such treatment 
and with requirements imposed by the Secretary under subparagraph (C).
    ``(II) An individual described in clause (i) shall not be 
determined to be not in compliance with the requirements of this 
subparagraph for a month if access by such individual to such treatment 
is not reasonably available for the month, as determined under 
regulations of the Secretary.
    ``(iii) The applicable period specified in this clause is--
            ``(I) 2 consecutive months, in the case of a 1st 
        determination that an individual is not in compliance with the 
        requirements of this subparagraph;
            ``(II) 3 consecutive months, in the case of the 2nd such 
        determination with respect to the individual; or
            ``(III) 6 consecutive months, in the case of the 3rd or 
        subsequent such determination with respect to the individual.
    ``(iv) An individual shall not be an eligible individual for 
purposes of this title for the 12-month period that begins with the end 
of any period of 12 consecutive months for which the benefits of the 
individual under this title have been suspended by reason of this 
subparagraph.
    ``(v) In the case of any individual entitled to benefits under this 
title by reason of disability, if alcoholism or drug addiction is a 
contributing factor material to the Secretary's determination that such 
individual is disabled, such individual may not be entitled to such 
benefits by reason of disability (or any past-due benefits under such 
entitlement) for any month after the 36-month period beginning with 
such individual's first month of such entitlement, notwithstanding 
section 1619(a).
    ``(vi)(I) The Secretary shall not, in a month, pay to an individual 
described in clause (i) benefits under this title the payment of which 
is past due, in an amount that exceeds the amount of benefits under 
this title which are payable to the individual for the month and the 
payment of which is not past due.
    ``(II) As used in subclause (I) of this clause, the term `benefits 
under this title' includes supplementary payments of the type described 
in section 1616(a) and payments pursuant to an agreement entered into 
under section 212(a) of Public Law 93-66.''.
            (2) Referral, monitoring, and treatment.--Section 
        1611(e)(3)(C) of such Act (42 U.S.C. 1382(e)(3)(C)), as so 
        designated by the amendment made by paragraph (1) of this 
        subsection, is amended--
                    (A) by adding at the end the following: ``Each such 
                annual report shall include the number and percentage 
                of such individuals who did not receive regular drug 
                testing during the year covered by the report.'';
                    (B) by inserting ``(i)'' after ``(C)''; and
                    (C) by adding after and below the end following:
    ``(ii) The Secretary, in consultation with drug and alcohol 
treatment professionals, shall issue regulations--
            ``(I) defining appropriate treatment for alcoholics and 
        drug addicts who are subject to required medical or 
        psychological treatment under this subparagraph; and
            ``(II) establishing guidelines to be used to review and 
        evaluate their compliance, including measures of the progress 
        of participants in such programs.
    ``(iii)(I) For purposes of carrying out the requirements of clauses 
(i) and (ii), the Secretary shall establish in each State a referral 
and monitoring agency for the State.
    ``(II) Each referral and monitoring agency for a State shall--
            ``(aa) identify appropriate placements, for individuals 
        residing in the State who are entitled to benefits under this 
        title by reason of disability and with respect to whom 
        alcoholism or drug addiction is a contributing factor material 
        to the Secretary's determination that they are disabled, where 
        they may obtain treatment described in subparagraph (B)(ii)(I);
            ``(bb) refer such individuals to such placements for such 
        treatment; and
            ``(cc) monitor compliance with the requirements of 
        subparagraph (B) by individuals who are referred by the agency 
        to such placements, and promptly report to the Secretary any 
        failure to comply with such requirements.''.
            (3) Preservation of medicaid benefits.--Section 1634 of 
        such Act (42 U.S.C. 13283c) is amended by adding at the end the 
        following:
    ``(e) Each person to whom benefits under this title by reason of 
disability are not payable for any month solely by reason of section 
1611(e)(3)(B) shall be treated, for purposes of title XIX, as receiving 
benefits under this title for such month.''.
            (4) Conforming amendments.--Section 1611(e)(3) of such Act 
        (42 U.S.C. 1382(e)(3)), as amended by paragraphs (1) and (2) of 
        this subsection, is amended--
                    (A) in subparagraph (A), by striking ``(B)'' and 
                inserting ``(C)''; and
                    (B) in subparagraph (C), by inserting ``or (B)'' 
                after ``(A)''.
            (5) Effective date.--
                    (A) In general.--Except as provided in 
                subparagraphs (B) and (C), the amendments made by this 
                subsection shall apply with respect to benefits for 
                months beginning after 180 days after the date of the 
                enactment of this Act.
                    (B) Time limitation on benefits.--Section 
                1611(e)(3)(B)(v) of the Social Security Act (as added 
                by the amendment made by paragraph (1) of this 
                subsection) shall apply with respect to benefits for 
                months ending after 180 days after the date of the 
                enactment of this Act, and, for purposes of such 
                section, in the case of any individual entitled to 
                benefits by reason of disability for the first month 
                ending after 180 days after the date of the enactment 
                of this Act, such month shall be treated as such 
                individual's first month of entitlement to such 
                benefits.
                    (C) Establishment of referral and monitoring 
                agencies.--Section 1611(e)(3)(C)(iii) of the Social 
                Security Act (as added by the amendment made by 
                paragraph (2)(C) of this subsection) shall take effect 
                180 days after the date of the enactment of this Act.
    (d) Irrelevance of Legality of Substantial Gainful Activity.--
            (1) In general.--Section 1614(a)(3)(D) of such Act (42 
        U.S.C. 1382c(a)(3)(D)) is amended by adding at the end the 
        following: ``The Secretary shall make determinations under this 
        title with respect to substantial gainful activity, without 
        regard to the legality of the activity.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall take effect on the date of the enactment of this Act.
    (e) Effective Date.--Except as otherwise provided in this section, 
the amendments made by this section shall apply to benefits payable for 
months beginning 180 or more days after the date of the enactment of 
this Act.

                    TITLE III--BENEFITS FOR CHILDREN

SEC. 301. REPLACEMENT OF CASH BENEFIT WITH MEDICAL VOUCHER.

    (a) In General.--Section 1611(b) of the Social Security Act (42 
U.S.C. 1382(b)) is amended by adding at the end the following:
    ``(3) Notwithstanding paragraphs (1) and (2), the benefit under 
this title for a child who has not attained 18 years of age shall be 
vouchers issued pursuant to subsection (j).''.
    (b) Issuance of Vouchers for Treatment of Disabling Conditions of 
Children Eligible for SSI Benefits.--Section 1611 of such Act (42 
U.S.C. 1382(b)) is amended by adding at the end the following:
    ``(j)(1) The Secretary of Health and Human Services shall issue to 
each child eligible for benefits under this title who has not attained 
18 years of age a voucher which may be used to cover the cost of any 
item--
            ``(A) that is associated with treating the blindness or 
        disability of the child;
            ``(B) for which a medical expense deduction may be claimed 
        under section 213 of the Internal Revenue Code of 1986 by the 
        child or any taxpayer who may claim the child as a dependent; 
        and
            ``(C) the cost of which is not covered by the program of 
        medical assistance approved under title XIX of the State in 
        which the child resides.
    ``(2) The face dollar amount of the voucher issued with respect to 
a child shall not exceed the amount of the cash benefit to which the 
child would (but for section 1611(b)(3)) have been entitled under this 
title.
    ``(3) The Secretary shall pay to each provider of health care goods 
or services that is licensed by a State, or by a professional health 
care organization approved by the Secretary, that submits to the 
Secretary a voucher issued under this subsection an amount equal to the 
face dollar amount of the voucher.''.

SEC. 302. DISABILITY REVIEW REQUIRED FOR SSI RECIPIENTS WHO ARE 18 
              YEARS OF AGE.

    (a) In General.--Section 1614(a)(3)(G) of the Social Security Act 
(42 U.S.C. 1382c(a)(3)(G)) is amended--
            (1) by inserting ``(i)'' after ``(G)''; and
            (2) by adding after and below the end the following:
    ``(ii)(I) During the 1-year period that begins on the date a 
recipient of benefits under this title by reason of disability attains 
18 years of age, the applicable State agency or the Secretary (as may 
be appropriate) shall redetermine the eligibility of the recipient for 
such benefits by reason of disability, by applying the criteria used in 
determining eligibility for such benefits of applicants who have 
attained 18 years of age.
    ``(II) A review under subclause (I) of this clause shall be 
considered a substitute for a review required under clause (i).''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to individuals who attain 18 years of age in or after the 9th 
month after the month in which this Act is enacted.

                            TITLE IV--FRAUD

SEC. 401. EXPANSION OF THE AUTHORITY OF THE SOCIAL SECURITY 
              ADMINISTRATION TO PREVENT, DETECT, AND TERMINATE 
              FRAUDULENT CLAIMS FOR SSI BENEFITS.

    (a) Prevention of Fraud in the SSI Program by Translators of 
Foreign Languages.--
            (1) In general.--Section 1631(e) of the Social Security Act 
        (42 U.S.C. 1383(e)) is amended by inserting after paragraph (3) 
        the following:
    ``(4) A translation into English by a third party of a statement 
made in a foreign language by an applicant for or recipient of benefits 
under this title shall not be regarded as reliable unless the third 
party, under penalty of perjury--
            ``(A) certifies that the translation is accurate; and
            ``(B) discloses the nature and scope of the relationship 
        between the third party and the applicant or recipient, as the 
        case may be.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall take effect on October 1, 1994.
    (b) Civil Monetary Penalties, Assessments, and Exclusions for Title 
XVI.--
            (1) In general.--Title XI of such Act (42 U.S.C. 1301-
        1320b-14) is amended by inserting after section 1128B the 
        following:

``SEC. 1129. CIVIL MONETARY PENALTIES AND ASSESSMENTS FOR TITLE XVI.

    ``(a) Any person (including an organization, agency, or other 
entity) who makes, or causes to be made, a statement or representation 
of a material fact for use in determining any initial or continuing 
right to benefits or payments under title XVI that the person knows or 
should know is false or misleading or knows or should know omits a 
material fact shall be subject to, in addition to any other penalties 
that may be prescribed by law, a civil money penalty of not more than 
$5,000 for each such statement or representation. Such person also 
shall be subject to an assessment, in lieu of damages sustained by the 
United States because of such statement or representation, of not more 
than twice the amount of benefits or payments paid as a result of such 
a statement or representation. In addition, the Secretary may make a 
determination in the same proceeding to exclude the person from 
participation in the programs under title XVIII and to direct the 
appropriate State agency to exclude the person from participation in 
any State health care program.
    ``(b)(1) The Secretary may initiate a proceeding to determine 
whether to impose a civil money penalty, assessment, or exclusion under 
subsection (a) only as authorized by the Attorney General pursuant to 
procedures agreed upon by the Secretary and the Attorney General. The 
Secretary may not initiate an action under this section with respect to 
any violation described in subsection (a) later than 6 years after the 
date the violation was committed. The Secretary may initiate an action 
under this section by serving notice of the action in any manner 
authorized by Rule 4 of the Federal Rules of Civil Procedure.
    ``(2) The Secretary shall not make a determination adverse to any 
person under this section until the person has been given written 
notice and an opportunity for the determination to be made on the 
record after a hearing at which the person is entitled to be 
represented by counsel, to present witnesses, and to cross-examine 
witnesses against the person.
    ``(3) In a proceeding under this section which--
            ``(A) is against a person who has been convicted (whether 
        upon a verdict after trial or upon a plea of guilty or nolo 
        contendere) of a Federal crime charging fraud or false 
        statements; and
            ``(B) involves the same transaction as in the criminal 
        action,
the person is estopped from denying the essential elements of the 
criminal offense.
    ``(4) The official conducting a hearing under this section may 
sanction a person, including any party or attorney, for failing to 
comply with an order or procedure, failing to defend an action, or 
other misconduct as would interfere with the speedy, orderly, or fair 
conduct of the hearing. Such sanction shall reasonably relate to the 
severity and nature of the failure or misconduct. Such sanction may 
include--
            ``(A) in the case of refusal to provide or permit 
        discovery, drawing negative factual inference or treating such 
        refusal as an admission by deeming the matter, or certain 
        facts, to be established;
            ``(B) prohibiting a party from introducing certain evidence 
        or otherwise supporting a particular claim or defense;
            ``(C) striking pleadings, in whole or in part;
            ``(D) staying the proceedings;
            ``(E) dismissal of the action;
            ``(F) entering a default judgment;
            ``(G) ordering the party or attorney to pay attorneys' fees 
        and other costs caused by the failure or misconduct; and
            ``(H) refusing to consider any motion or other action which 
        is not filed in a timely manner.
    ``(c) In determining the amount or scope of any penalty, 
assessment, or exclusion imposed pursuant to this section, the 
Secretary shall take into account--
            ``(1) the nature of the statements and representations 
        referred to in subsection (a) and the circumstances under which 
        they occurred;
            ``(2) the degree of culpability, history of prior offenses, 
        and financial condition of the person committing the offense; 
        and
            ``(3) such other matters as justice may require.
    ``(d)(1) Any person adversely affected by a determination of the 
Secretary under this section may obtain a review of such determination 
in the United States Court of Appeals for the circuit in which the 
person resides, or in which the statement or representation referred to 
in subsection (a) was made, by filing in such court (within 60 days 
following the date the person is notified of the Secretary's 
determination) a written petition requesting that the determination be 
modified or set aside. A copy of the petition shall be forthwith 
transmitted by the clerk of the court to the Secretary, and thereupon 
the Secretary shall file in the court the record in the proceeding as 
provided in section 2112 of title 28, United States Code. Upon such 
filing, the court shall have jurisdiction of the proceeding and of the 
question determined therein, and shall have the power to make and enter 
upon the pleadings, testimony, and proceedings set forth in such record 
a decree affirming, modifying, remanding for further consideration, or 
setting aside, in whole or in part, the determination of the Secretary 
and enforcing the same to the extent that such order is affirmed or 
modified. No objection that has not been urged before the Secretary 
shall be considered by the court, unless the failure or neglect to urge 
such objection shall be excused because of extraordinary circumstances.
    ``(2) The findings of the Secretary with respect to questions of 
fact, if supported by substantial evidence on the record considered as 
a whole, shall be conclusive in the review described in paragraph (1). 
If any party shall apply to the court for leave to adduce additional 
evidence and shall show to the satisfaction of the court that such 
additional evidence is material and that there were reasonable grounds 
for the failure to adduce such evidence in the hearing before the 
Secretary, the court may order such additional evidence to be taken 
before the Secretary and to be made a part of the record. The Secretary 
may modify its findings as to the facts, or make new findings, by 
reason of additional evidence so taken and filed, and the Secretary 
shall file with the court such modified or new findings, which findings 
with respect to questions of fact, if supported by substantial evidence 
on the record considered as a whole shall be conclusive, and his 
recommendations, if any, for the modification or setting aside of his 
original order.
    ``(3) Upon the filing of the record with the Secretary's original 
or modified order, the jurisdiction of the court shall be exclusive and 
its judgment and decree shall be final, except that the same shall be 
subject to review by the Supreme Court of the United States, as 
provided in section 1254 of title 28, United States Code.
    ``(e)(1) Civil money penalties and assessments imposed under this 
section may be compromised by the Secretary and may be recovered--
            ``(A) in a civil action in the name of the United States 
        brought in United States district court for the district where 
        the statement or representation referred to in subsection (a) 
        was made, or where the person resides, as determined by the 
        Secretary;
            ``(B) by means of reduction in tax refunds to which the 
        person is entitled, based on notice to the Secretary of the 
        Treasury as permitted under section 3720A of title 31, United 
        States Code;
            ``(C) by decrease of any payment under title XVI to which 
        the person is entitled, notwithstanding section 207 of this 
        Act, as made applicable to this title by reason of section 
        1631(d)(1);
            ``(D) by authorities provided under the Debt Collection Act 
        of 1982, as amended, to the extent applicable to debts arising 
        under the Social Security Act;
            ``(E) by deduction of the amount of such penalty or 
        assessment, when finally determined, or the amount agreed upon 
        in compromise, from any sum then or later owing by the United 
        States to the person against whom the penalty or assessment has 
        been assessed; or
            ``(F) by any combination of the foregoing.
    ``(f) A determination by the Secretary to impose a penalty, 
assessment, or exclusion under this section shall be final upon the 
expiration of the 60-day period referred to in subsection (d). Matters 
that were raised or that could have been raised in a hearing before the 
Secretary or in an appeal pursuant to subsection (d) may not be raised 
as a defense to a civil action by the United States to collect a 
penalty and assessment imposed under this section.
    ``(g) Whenever the Secretary's determination to impose a penalty, 
assessment, or exclusion under this section with respect to a medical 
provider or physician becomes final, the provisions of section 1128A(h) 
shall apply.
    ``(h) Whenever the Secretary has reason to believe that any person 
has engaged, is engaging, or is about to engage in any activity which 
makes the person subject to a civil monetary penalty under this 
section, the Secretary may bring an action in an appropriate district 
court of the United States (or, if applicable, a United States court of 
any territory) to enjoin such activity, or to enjoin the person from 
concealing, removing, encumbering, or disposing of assets which may be 
required in order to pay a civil monetary penalty and assessment if any 
such penalty were to be imposed or to seek other appropriate relief.
    ``(i)(1) The provisions of subsections (d) and (e) of section 205 
shall apply with respect to this section to the same extent as they are 
applicable with respect to title II. The Secretary may delegate the 
authority granted by section 205(d) (as made applicable to this 
section) to the Inspector General of the Department of Health and Human 
Services for purposes of any investigation under this section.
    ``(2) The Secretary may delegate authority granted under this 
section to the Inspector General of the Social Security Administration.
    ``(j) For purposes of this section, the term `State agency' shall 
have the same meaning as in section 1128A(i)(1).
    ``(k) A principal is liable for penalties, assessments, and 
exclusions under this section for the actions of the principal's agent 
acting within the scope of the agency.''.
            (2) Conforming amendments.--Section 1128 of such Act (42 
        U.S.C. 1320a-7) is amended--
                    (A) in subsection (b)(7), by striking ``or section 
                1128B'' and inserting ``, section 1128B, or section 
                1129'';
                    (B) in subsection (b)(8)(B)(ii), by inserting ``and 
                section 1129'' after ``section 1128A'';
                    (C) in subsection (c)(1), by striking ``or under 
                section 1128A'' and inserting ``, section 1128A, or 
                section 1129'';
                    (D) in subsection (c)(3)(A), by inserting ``or 
                section 1129'' after ``section 1128A'';
                    (E) in subsection (d)(1), by striking ``and section 
                1128A'' and inserting ``, section 1128A, and section 
                1129'';
                    (F) in subsection (d)(2)(A), by striking ``or 
                section 1128A'' and inserting ``, section 1128A, or 
                section 1129'';
                    (G) in subsection (e)(1), by striking ``or section 
                1128A'' and inserting ``, section 1128A, or section 
                1129'';
                    (H) in subsection (f)(3), by inserting ``, 1129,'' 
                after ``sections 1128A'';
                    (I) in subsection (g)(1), by striking ``or section 
                1128A'' each place such term appears and inserting ``, 
                section 1128A, or section 1129'';
                    (J) in subsection (g)(2)(A), by inserting ``and 
                section 1129(a)'' after ``section 1128A(a)''; and
                    (K) in subsection (h), by striking ``1128A and 
                1128B'' and inserting ``1128A, 1128B, and 1129''.
    (c) SSI Fraud Considered a Felony.--
            (1) In general.--Section 1632(a) of such Act (42 U.S.C. 
        1383a(a)) is amended by striking ``shall'' the 1st place such 
        term appears and all that follows and inserting ``shall be 
        fined under title 18, United States Code, imprisoned not more 
        than 5 years, or both.''.
            (2) Conforming amendment.--Section 1632(b) of such Act (42 
        U.S.C. 1383a(b)) is amended to read as follows:
    ``(b)(1) If a person or entity violates subsection (a) in the 
person's or entity's role as, or in applying to become, a payee under 
section 1631(a)(2) on behalf of another individual (other than the 
person's eligible spouse), and the violation includes a willful misuse 
of funds by the person or entity, the court may also require that full 
or partial restitution of funds be made to such other individual.
    ``(2) Any person or entity convicted of a violation of subsection 
(a) of this section or of section 208 may not be certified as a payee 
under section 1631(a)(2).''.
    (d) Authority to Redetermine Eligibility in Disability Cases if 
Fraud is Involved, and to Terminate Benefits if There is Insufficient 
Reliable Evidence of Disability.--
            (1) In general.--Section 1631(e) of such Act (42 U.S.C. 
        1383(e)) is amended by adding at the end the following:
    ``(6)(A) The Secretary shall immediately redetermine the 
eligibility of an individual for benefits under this title by reason of 
disability, disregarding any unreliable evidence of disability, if 
there is reason to believe that fraud was involved in the application 
of the individual for such benefits, unless a United States attorney, 
or equivalent State prosecutor, with jurisdiction over potential or 
actual related criminal cases, certifies, in writing, that there is a 
substantial risk that redetermining such eligibility would jeopardize 
the criminal prosecution of any person who is a subject of the 
investigation from which the information is derived.
    ``(B) If, after redetermining the eligibility of an individual for 
benefits under this title by reason of disability, the Secretary 
determines that there is insufficient reliable evidence of disability, 
the Secretary may terminate such eligibility.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall take effect on October 1, 1994, and shall apply to 
        eligibility determinations made before, on, or after such date.
    (e) Availability of Recipient Identifying Information From the 
Inspector General, Department of Health and Human Services.--
            (1) In general.--Section 1631(e) of such Act (42 U.S.C. 
        1383(e)), as amended by subsection (d) of this section, is 
        amended by adding at the end the following:
    ``(7) As soon as the Inspector General, Social Security 
Administration, has reason to believe that fraud was involved in the 
application of a recipient for benefits under this title, the Inspector 
General shall make available to the Secretary information identifying 
the recipient, unless a United States attorney, or equivalent State 
prosecutor, with jurisdiction over potential or actual related criminal 
cases, certifies, in writing, that there is a substantial risk that 
making the information so available or redetermining the eligibility of 
the recipient for such benefits would jeopardize the criminal 
prosecution of any person who is a subject of the investigation from 
which the information is derived.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall take effect on October 1, 1994.
    (f) Authority to use Available Preadmission Immigrant and Refugee 
Medical Information.--
            (1) In general.--Section 1631(e) of such Act (42 U.S.C. 
        1383(e)), as amended by the preceding provisions of this Act, 
        is amended by adding at the end the following:
    ``(8) The Secretary shall request the Immigration and 
Naturalization Service and the Centers for Diease Control to provide 
the Secretary with whatever medical information either such entity has 
with respect to any alien who has applied for benefits under this title 
to the extent that the information is relevant to any determination 
relating to such eligibility.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall take effect on October 1, 1994.
    (g) Annual Reports on Reviews of SSI Cases.--The Secretary 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 extent to which the Secretary has exercised its authority to review 
supplemental security income cases under title XVI of the Social 
Security Act, and the extent to which the cases reviewed were those 
that involved a high likelihood or probability of fraud.
    (h) Development of Profiles; Periodic Targeted Redeterminations.--
Part B of title XVI of such Act (42 U.S.C. 1383-1383d) is amended by 
adding at the end the following:

``SEC. 1636. DEVELOPMENT OF PROFILES; PERIODIC TARGETED 
              REDETERMINATIONS.

    ``The Social Security Administration shall develop profiles of the 
kinds of cases that have a high probability of fraud, and shall conduct 
periodic targeted redeterminations based on such profiles.''.

                                 <all>

HR 4419 IH----2
HR 4419 IH----3