[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3070 Reported in House (RH)]





                                                 Union Calendar No. 232

106th CONGRESS

  1st Session

                               H. R. 3070

                      [Report No. 106-393, Part I]

_______________________________________________________________________

                                 A BILL

  To amend the Social Security Act to establish a Ticket to Work and 
   Self-Sufficiency Program in the Social Security Administration to 
  provide beneficiaries with disabilities meaningful opportunities to 
  work, to extend health care coverage for such beneficiaries, and to 
 make additional miscellaneous amendments relating to Social Security.

_______________________________________________________________________

                            October 19, 1999

  Committee on Commerce discharged; committed to the Committee of the 
    Whole House on the State of the Union and ordered to be printed





                                                 Union Calendar No. 232
106th CONGRESS
  1st Session
                                H. R. 3070

                      [Report No. 106-393, Part I]

  To amend the Social Security Act to establish a Ticket to Work and 
   Self-Sufficiency Program in the Social Security Administration to 
  provide beneficiaries with disabilities meaningful opportunities to 
  work, to extend health care coverage for such beneficiaries, and to 
 make additional miscellaneous amendments relating to Social Security.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 13, 1999

Mr. Hulshof (for himself, Mr. Archer, Mr. Shaw, Mr. Camp, Ms. Dunn, Mr. 
    English, Mr. Foley, Mr. Hayworth, Mr. Herger, Mr. Houghton, Mr. 
  Ramstad, Mr. Thomas, and Mr. Weller) introduced the following bill; 
which was referred to the Committee on Ways and Means, and in addition 
     to the Committee on Commerce, for a period to be subsequently 
   determined by the Speaker, in each case for consideration of such 
 provisions as fall within the jurisdiction of the committee concerned

                            October 18, 1999

    Reported from the Committee on Ways and Means with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

                            October 18, 1999

Referral to the Committee on Commerce extended for a period ending not 
                      later than October 19, 1999

                            October 19, 1999

             Additional sponsors: Mr. Crane and Mr. Isakson

                            October 19, 1999

  Committee on Commerce discharged; committed to the Committee of the 
    Whole House on the State of the Union and ordered to be printed
[For text of introduced bill, see copy of bill as introduced on October 
                               13, 1999]

_______________________________________________________________________

                                 A BILL


 
  To amend the Social Security Act to establish a Ticket to Work and 
   Self-Sufficiency Program in the Social Security Administration to 
  provide beneficiaries with disabilities meaningful opportunities to 
  work, to extend health care coverage for such beneficiaries, and to 
 make additional miscellaneous amendments relating to Social Security.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Ticket to Work and 
Work Incentives Improvement Act of 1999''.
    (b) Table of Contents.--The table of contents is as follows:

Sec. 1. Short title; table of contents.

  TITLE I--TICKET TO WORK AND SELF-SUFFICIENCY AND RELATED PROVISIONS

            Subtitle A--Ticket to Work and Self-Sufficiency

Sec. 101. Establishment of the Ticket to Work and Self-Sufficiency 
                            Program.

             Subtitle B--Elimination of Work Disincentives

Sec. 111. Work activity standard as a basis for review of an 
                            individual's disabled status.
Sec. 112. Expedited reinstatement of disability benefits.

     Subtitle C--Work Incentives Planning, Assistance, and Outreach

Sec. 121. Work incentives outreach program.
Sec. 122. State grants for work incentives assistance to disabled 
                            beneficiaries.

        TITLE II--EXPANDED AVAILABILITY OF HEALTH CARE SERVICES

Sec. 201. Expanding State options under the medicaid program for 
                            workers with disabilities.
Sec. 202. Extending medicare coverage for OASDI disability benefit 
                            recipients.
Sec. 203. Grants to develop and establish State infrastructures to 
                            support working individuals with 
                            disabilities.
Sec. 204. Demonstration of coverage under the medicaid program of 
                            workers with potentially severe 
                            disabilities.
Sec. 205. Election by disabled beneficiaries to suspend medigap 
                            insurance when covered under a group health 
                            plan.

             TITLE III--DEMONSTRATION PROJECTS AND STUDIES

Sec. 301. Extension of disability insurance program demonstration 
                            project authority.
Sec. 302. Demonstration projects providing for reductions in disability 
                            insurance benefits based on earnings.
Sec. 303. Studies and reports.

            TITLE IV--MISCELLANEOUS AND TECHNICAL AMENDMENTS

Sec. 401. Technical amendments relating to drug addicts and alcoholics.
Sec. 402. Treatment of prisoners.
Sec. 403. Revocation by members of the clergy of exemption from social 
                            security coverage.
Sec. 404. Additional technical amendment relating to cooperative 
                            research or demonstration projects under 
                            titles II and XVI.
Sec. 405. Authorization for State to permit annual wage reports.
Sec. 406. Assessment on attorneys who receive their fees via the Social 
                            Security Administration.
Sec. 407. Extension of authority of State medicaid fraud control units.
Sec. 408. Elimination of fraud and abuse associated with certain 
                            payments under the medicaid program.

  TITLE I--TICKET TO WORK AND SELF-SUFFICIENCY AND RELATED PROVISIONS

            Subtitle A--Ticket to Work and Self-Sufficiency

SEC. 101. ESTABLISHMENT OF THE TICKET TO WORK AND SELF-SUFFICIENCY 
              PROGRAM.

    (a) In General.--Part A of title XI of the Social Security Act (42 
U.S.C. 1301 et seq.) is amended by adding after section 1147 (as added 
by section 8 of the Noncitizen Benefit Clarification and Other 
Technical Amendments Act of 1998 (Public Law 105-306; 112 Stat. 2928) 
the following:

           ``the ticket to work and self-sufficiency program

    ``Sec. 1148. (a) In General.--The Commissioner of Social Security 
shall establish a Ticket to Work and Self-Sufficiency Program, under 
which a disabled beneficiary may use a ticket to work and self-
sufficiency issued by the Commissioner in accordance with this section 
to obtain employment services, vocational rehabilitation services, or 
other support services from an employment network which is of the 
beneficiary's choice and which is willing to provide such services to 
such beneficiary.
    ``(b) Ticket System.--
            ``(1) Distribution of tickets.--The Commissioner of Social 
        Security may issue a ticket to work and self-sufficiency to 
        disabled beneficiaries for participation in the Program.
            ``(2) Assignment of tickets.--A disabled beneficiary 
        holding a ticket to work and self-sufficiency may assign the 
        ticket to any employment network of the beneficiary's choice 
        which is serving under the Program and is willing to accept the 
        assignment.
            ``(3) Ticket terms.--A ticket issued under paragraph (1) 
        shall consist of a document which evidences the Commissioner's 
        agreement to pay (as provided in paragraph (4)) an employment 
        network, which is serving under the Program and to which such 
        ticket is assigned by the beneficiary, for such employment 
        services, vocational rehabilitation services, and other support 
        services as the employment network may provide to the 
        beneficiary.
            ``(4) Payments to employment networks.--The Commissioner 
        shall pay an employment network under the Program in accordance 
        with the outcome payment system under subsection (h)(2) or 
        under the outcome-milestone payment system under subsection 
        (h)(3) (whichever is elected pursuant to subsection (h)(1)). An 
        employment network may not request or receive compensation for 
        such services from the beneficiary.
    ``(c) State Participation.--
            ``(1) In general.--Each State agency administering or 
        supervising the administration of the State plan approved under 
        title I of the Rehabilitation Act of 1973 may elect to 
        participate in the Program as an employment network with 
        respect to a disabled beneficiary. If the State agency does 
        elect to participate in the Program, the State agency also 
        shall elect to be paid under the outcome payment system or the 
        outcome-milestone payment system in accordance with subsection 
        (h)(1). With respect to a disabled beneficiary that the State 
        agency does not elect to have participate in the Program, the 
        State agency shall be paid for services provided to that 
        beneficiary under the system for payment applicable under 
        section 222(d) and subsections (d) and (e) of section 1615. The 
        Commissioner shall provide for periodic opportunities for 
        exercising such elections.
            ``(2) Effect of participation by state agency.--
                    ``(A) State agencies participating.--In any case in 
                which a State agency described in paragraph (1) elects 
                under that paragraph to participate in the Program, the 
                employment services, vocational rehabilitation 
                services, and other support services which, upon 
                assignment of tickets to work and self-sufficiency, are 
                provided to disabled beneficiaries by the State agency 
                acting as an employment network shall be governed by 
                plans for vocational rehabilitation services approved 
                under title I of the Rehabilitation Act of 1973.
                    ``(B) State agencies administering maternal and 
                child health services programs.--Subparagraph (A) shall 
                not apply with respect to any State agency 
                administering a program under title V of this Act.
            ``(3) Agreements between state agencies and employment 
        networks.--State agencies and employment networks shall enter 
        into agreements regarding the conditions under which services 
        will be provided when an individual is referred by an 
employment network to a State agency for services. The Commissioner of 
Social Security shall establish by regulations the timeframe within 
which such agreements must be entered into and the mechanisms for 
dispute resolution between State agencies and employment networks with 
respect to such agreements.
    ``(d) Responsibilities of the Commissioner of Social Security.--
            ``(1) Selection and qualifications of program managers.--
        The Commissioner of Social Security shall enter into agreements 
        with 1 or more organizations in the private or public sector 
        for service as a program manager to assist the Commissioner in 
        administering the Program. Any such program manager shall be 
        selected by means of a competitive bidding process, from among 
        organizations in the private or public sector with available 
        expertise and experience in the field of vocational 
        rehabilitation or employment services.
            ``(2) Tenure, renewal, and early termination.--Each 
        agreement entered into under paragraph (1) shall provide for 
        early termination upon failure to meet performance standards 
        which shall be specified in the agreement and which shall be 
        weighted to take into account any performance in prior terms. 
        Such performance standards shall include--
                    ``(A) measures for ease of access by beneficiaries 
                to services; and
                    ``(B) measures for determining the extent to which 
                failures in obtaining services for beneficiaries fall 
                within acceptable parameters, as determined by the 
                Commissioner.
            ``(3) Preclusion from direct participation in delivery of 
        services in own service area.--Agreements under paragraph (1) 
        shall preclude--
                    ``(A) direct participation by a program manager in 
                the delivery of employment services, vocational 
                rehabilitation services, or other support services to 
                beneficiaries in the service area covered by the 
                program manager's agreement; and
                    ``(B) the holding by a program manager of a 
                financial interest in an employment network or service 
                provider which provides services in a geographic area 
                covered under the program manager's agreement.
            ``(4) Selection of employment networks.--
                    ``(A) In general.--The Commissioner shall select 
                and enter into agreements with employment networks for 
                service under the Program. Such employment networks 
                shall be in addition to State agencies serving as 
                employment networks pursuant to elections under 
                subsection (c).
                    ``(B) Alternate participants.--In any State where 
                the Program is being implemented, the Commissioner 
                shall enter into an agreement with any alternate 
                participant that is operating under the authority of 
                section 222(d)(2) in the State as of the date of 
                enactment of this section and chooses to serve as an 
                employment network under the Program.
            ``(5) Termination of agreements with employment networks.--
        The Commissioner shall terminate agreements with employment 
        networks for inadequate performance, as determined by the 
        Commissioner.
            ``(6) Quality assurance.--The Commissioner shall provide 
        for such periodic reviews as are necessary to provide for 
        effective quality assurance in the provision of services by 
        employment networks. The Commissioner shall solicit and 
        consider the views of consumers and the program manager under 
        which the employment networks serve and shall consult with 
        providers of services to develop performance measurements. The 
        Commissioner shall ensure that the results of the periodic 
        reviews are made available to beneficiaries who are prospective 
        service recipients as they select employment networks. The 
        Commissioner shall ensure that the periodic surveys of 
        beneficiaries receiving services under the Program are designed 
        to measure customer service satisfaction.
            ``(7) Dispute resolution.--The Commissioner shall provide 
        for a mechanism for resolving disputes between beneficiaries 
        and employment networks, between program managers and 
        employment networks, and between program managers and providers 
        of services. The Commissioner shall afford a party to such a 
        dispute a reasonable opportunity for a full and fair review of 
        the matter in dispute.
    ``(e) Program Managers.--
            ``(1) In general.--A program manager shall conduct tasks 
        appropriate to assist the Commissioner in carrying out the 
        Commissioner's duties in administering the Program.
            ``(2) Recruitment of employment networks.--A program 
        manager shall recruit, and recommend for selection by the 
        Commissioner, employment networks for service under the 
        Program. The program manager shall carry out such 
recruitment and provide such recommendations, and shall monitor all 
employment networks serving in the Program in the geographic area 
covered under the program manager's agreement, to the extent necessary 
and appropriate to ensure that adequate choices of services are made 
available to beneficiaries. Employment networks may serve under the 
Program only pursuant to an agreement entered into with the 
Commissioner under the Program incorporating the applicable provisions 
of this section and regulations thereunder, and the program manager 
shall provide and maintain assurances to the Commissioner that payment 
by the Commissioner to employment networks pursuant to this section is 
warranted based on compliance by such employment networks with the 
terms of such agreement and this section. The program manager shall not 
impose numerical limits on the number of employment networks to be 
recommended pursuant to this paragraph.
            ``(3) Facilitation of access by beneficiaries to employment 
        networks.--A program manager shall facilitate access by 
        beneficiaries to employment networks. The program manager shall 
        ensure that each beneficiary is allowed changes in employment 
        networks without being deemed to have rejected services under 
        the Program. When such a change occurs, the program manager 
        shall reassign the ticket based on the choice of the 
        beneficiary. Upon the request of the employment network, the 
        program manager shall make a determination of the allocation of 
        the outcome or milestone-outcome payments based on the services 
        provided by each employment network. The program manager shall 
        establish and maintain lists of employment networks available 
        to beneficiaries and shall make such lists generally available 
        to the public. The program manager shall ensure that all 
        information provided to disabled beneficiaries pursuant to this 
        paragraph is provided in accessible formats.
            ``(4) Ensuring availability of adequate services.--The 
        program manager shall ensure that employment services, 
        vocational rehabilitation services, and other support services 
        are provided to beneficiaries throughout the geographic area 
        covered under the program manager's agreement, including rural 
        areas.
            ``(5) Reasonable access to services.--The program manager 
        shall take such measures as are necessary to ensure that 
        sufficient employment networks are available and that each 
        beneficiary receiving services under the Program has reasonable 
        access to employment services, vocational rehabilitation 
        services, and other support services. Services provided under 
        the Program may include case management, work incentives 
        planning, supported employment, career planning, career plan 
        development, vocational assessment, job training, placement, 
        follow-up services, and such other services as may be specified 
        by the Commissioner under the Program. The program manager 
        shall ensure that such services are available in each service 
        area.
    ``(f) Employment Networks.--
            ``(1) Qualifications for employment networks.--
                    ``(A) In general.--Each employment network serving 
                under the Program shall consist of an agency or 
                instrumentality of a State (or a political subdivision 
                thereof) or a private entity, that assumes 
                responsibility for the coordination and delivery of 
                services under the Program to individuals assigning to 
                the employment network tickets to work and self-
                sufficiency issued under subsection (b).
                    ``(B) One-stop delivery systems.--An employment 
                network serving under the Program may consist of a one-
                stop delivery system established under subtitle B of 
                title I of the Workforce Investment Act of 1998.
                    ``(C) Compliance with selection criteria.--No 
                employment network may serve under the Program unless 
                it meets and maintains compliance with both general 
                selection criteria (such as professional and 
                educational qualifications, where applicable) and 
                specific selection criteria (such as substantial 
                expertise and experience in providing relevant 
                employment services and supports).
                    ``(D) Single or associated providers allowed.--An 
                employment network shall consist of either a single 
                provider of such services or of an association of such 
                providers organized so as to combine their resources 
                into a single entity. An employment network may meet 
                the requirements of subsection (e)(4) by providing 
                services directly, or by entering into agreements with 
                other individuals or entities providing appropriate 
                employment services, vocational rehabilitation 
                services, or other support services.
            ``(2) Requirements relating to provision of services.--Each 
        employment network serving under the Program shall be required 
under the terms of its agreement with the Commissioner to--
                    ``(A) serve prescribed service areas; and
                    ``(B) take such measures as are necessary to ensure 
                that employment services, vocational rehabilitation 
                services, and other support services provided under the 
                Program by, or under agreements entered into with, the 
                employment network are provided under appropriate 
                individual work plans meeting the requirements of 
                subsection (g).
            ``(3) Annual financial reporting.--Each employment network 
        shall meet financial reporting requirements as prescribed by 
        the Commissioner.
            ``(4) Periodic outcomes reporting.--Each employment network 
        shall prepare periodic reports, on at least an annual basis, 
        itemizing for the covered period specific outcomes achieved 
        with respect to specific services provided by the employment 
        network. Such reports shall conform to a national model 
        prescribed under this section. Each employment network shall 
        provide a copy of the latest report issued by the employment 
        network pursuant to this paragraph to each beneficiary upon 
        enrollment under the Program for services to be received 
        through such employment network. Upon issuance of each report 
        to each beneficiary, a copy of the report shall be maintained 
        in the files of the employment network. The program manager 
        shall ensure that copies of all such reports issued under this 
        paragraph are made available to the public under reasonable 
        terms.
    ``(g) Individual Work Plans.--
            ``(1) Requirements.--Each employment network shall--
                    ``(A) take such measures as are necessary to ensure 
                that employment services, vocational rehabilitation 
                services, and other support services provided under the 
                Program by, or under agreements entered into with, the 
                employment network are provided under appropriate 
                individual work plans that meet the requirements of 
                subparagraph (C);
                    ``(B) develop and implement each such individual 
                work plan, in partnership with each beneficiary 
                receiving such services, in a manner that affords such 
                beneficiary the opportunity to exercise informed choice 
                in selecting an employment goal and specific services 
                needed to achieve that employment goal;
                    ``(C) ensure that each individual work plan 
                includes at least--
                            ``(i) a statement of the vocational goal 
                        developed with the beneficiary, including, as 
                        appropriate, goals for earnings and job 
                        advancement;
                            ``(ii) a statement of the services and 
                        supports that have been deemed necessary for 
                        the beneficiary to accomplish that goal;
                            ``(iii) a statement of any terms and 
                        conditions related to the provision of such 
                        services and supports; and
                            ``(iv) a statement of understanding 
                        regarding the beneficiary's rights under the 
                        Program (such as the right to retrieve the 
                        ticket to work and self-sufficiency if the 
                        beneficiary is dissatisfied with the services 
                        being provided by the employment network) and 
                        remedies available to the individual, including 
                        information on the availability of advocacy 
                        services and assistance in resolving disputes 
                        through the State grant program authorized 
                        under section 1150;
                    ``(D) provide a beneficiary the opportunity to 
                amend the individual work plan if a change in 
                circumstances necessitates a change in the plan; and
                    ``(E) make each beneficiary's individual work plan 
                available to the beneficiary in, as appropriate, an 
                accessible format chosen by the beneficiary.
            ``(2) Effective upon written approval.--A beneficiary's 
        individual work plan shall take effect upon written approval by 
        the beneficiary or a representative of the beneficiary and a 
        representative of the employment network that, in providing 
        such written approval, acknowledges assignment of the 
        beneficiary's ticket to work and self-sufficiency.
    ``(h) Employment Network Payment Systems.--
            ``(1) Election of payment system by employment networks.--
                    ``(A) In general.--The Program shall provide for 
                payment authorized by the Commissioner to employment 
                networks under either an outcome payment system or an 
                outcome-milestone payment system. Each employment 
                network shall elect which payment system will be 
                utilized by the employment network, and, for such 
                period of time as such election remains in effect, the 
                payment system so elected shall be utilized exclusively 
                in connection with such employment network (except as 
                provided in subparagraph (B)).
                    ``(B) No change in method of payment for 
                beneficiaries with tickets already assigned to the 
                employment networks.--Any election of a payment system 
                by an employment network that would result in a change 
                in the method of payment to the employment network for 
                services provided to a beneficiary who is receiving 
                services from the employment network at the time of the 
                election shall not be effective with respect to payment 
                for services provided to that beneficiary and the 
                method of payment previously selected shall continue to 
                apply with respect to such services.
            ``(2) Outcome payment system.--
                    ``(A) In general.--The outcome payment system shall 
                consist of a payment structure governing employment 
                networks electing such system under paragraph (1)(A) 
                which meets the requirements of this paragraph.
                    ``(B) Payments made during outcome payment 
                period.--The outcome payment system shall provide for a 
                schedule of payments to an employment network, in 
                connection with each individual who is a beneficiary, 
for each month, during the individual's outcome payment period, for 
which benefits (described in paragraphs (3) and (4) of subsection (k)) 
are not payable to such individual because of work or earnings.
                    ``(C) Computation of payments to employment 
                network.--The payment schedule of the outcome payment 
                system shall be designed so that--
                            ``(i) the payment for each month during the 
                        outcome payment period for which benefits 
                        (described in paragraphs (3) and (4) of 
                        subsection (k)) are not payable is equal to a 
                        fixed percentage of the payment calculation 
                        base for the calendar year in which such month 
                        occurs; and
                            ``(ii) such fixed percentage is set at a 
                        percentage which does not exceed 40 percent.
            ``(3) Outcome-milestone payment system.--
                    ``(A) In general.--The outcome-milestone payment 
                system shall consist of a payment structure governing 
                employment networks electing such system under 
                paragraph (1)(A) which meets the requirements of this 
                paragraph.
                    ``(B) Early payments upon attainment of milestones 
                in advance of outcome payment periods.--The outcome-
                milestone payment system shall provide for 1 or more 
                milestones, with respect to beneficiaries receiving 
                services from an employment network under the Program, 
                that are directed toward the goal of permanent 
                employment. Such milestones shall form a part of a 
                payment structure that provides, in addition to 
                payments made during outcome payment periods, payments 
                made prior to outcome payment periods in amounts based 
                on the attainment of such milestones.
                    ``(C) Limitation on total payments to employment 
                network.--The payment schedule of the outcome milestone 
                payment system shall be designed so that the total of 
                the payments to the employment network with respect to 
                each beneficiary is less than, on a net present value 
                basis (using an interest rate determined by the 
                Commissioner that appropriately reflects the cost of 
                funds faced by providers), the total amount to which 
                payments to the employment network with respect to the 
                beneficiary would be limited if the employment network 
                were paid under the outcome payment system.
            ``(4) Definitions.--In this subsection:
                    ``(A) Payment calculation base.--The term `payment 
                calculation base' means, for any calendar year--
                            ``(i) in connection with a title II 
                        disability beneficiary, the average disability 
                        insurance benefit payable under section 223 for 
                        all beneficiaries for months during the 
                        preceding calendar year; and
                            ``(ii) in connection with a title XVI 
                        disability beneficiary (who is not concurrently 
                        a title II disability beneficiary), the average 
                        payment of supplemental security income 
                        benefits based on disability payable under 
                        title XVI (excluding State supplementation) for 
                        months during the preceding calendar year to 
                        all beneficiaries who have attained 18 years of 
                        age but have not attained 65 years of age.
                    ``(B) Outcome payment period.--The term `outcome 
                payment period' means, in connection with any 
                individual who had assigned a ticket to work and self-
                sufficiency to an employment network under the Program, 
                a period--
                            ``(i) beginning with the first month, 
                        ending after the date on which such ticket was 
                        assigned to the employment network, for which 
                        benefits (described in paragraphs (3) and (4) 
                        of subsection (k)) are not payable to such 
                        individual by reason of engagement in 
                        substantial gainful activity or by reason of 
                        earnings from work activity; and
                            ``(ii) ending with the 60th month 
                        (consecutive or otherwise), ending after such 
                        date, for which such benefits are not payable 
                        to such individual by reason of engagement in 
                        substantial gainful activity or by reason of 
                        earnings from work activity.
            ``(5) Periodic review and alterations of prescribed 
        schedules.--
                    ``(A) Percentages and periods.--The Commissioner 
                shall periodically review the percentage specified in 
                paragraph (2)(C), the total payments permissible under 
                paragraph (3)(C), and the period of time specified in 
                paragraph (4)(B) to determine whether such percentages, 
                such permissible payments, and such period provide an 
                adequate incentive for employment networks to assist 
                beneficiaries to enter the workforce, while providing 
                for appropriate economies. The Commissioner may alter 
                such percentage, such total permissible payments, or 
                such period of time to the extent that the Commissioner 
                determines, on the basis of the Commissioner's review 
                under this paragraph, that such an alteration would 
                better provide the incentive and economies described in 
                the preceding sentence.
                    ``(B) Number and amount of milestone payments.--The 
                Commissioner shall periodically review the number and 
                amounts of milestone payments established by the 
                Commissioner pursuant to this section to determine 
                whether they provide an adequate incentive for 
                employment networks to assist beneficiaries to enter 
                the workforce, taking into account information provided 
                to the Commissioner by program managers, the Ticket to 
                Work and Work Incentives Advisory Panel established by 
                section 101(f) of the Ticket to Work and Work 
                Incentives Improvement Act of 1999, and other reliable 
                sources. The Commissioner may from time to time alter 
                the number and amounts of milestone payments initially 
established by the Commissioner pursuant to this section to the extent 
that the Commissioner determines that such an alteration would allow an 
adequate incentive for employment networks to assist beneficiaries to 
enter the workforce. Such alteration shall be based on information 
provided to the Commissioner by program managers, the Ticket to Work 
and Work Incentives Advisory Panel established by section 101(f) of the 
Ticket to Work and Work Incentives Improvement Act of 1999, or other 
reliable sources.
                    ``(C) Report on the adequacy of incentives.--The 
                Commissioner shall submit to Congress not later than 36 
                months after the date of the enactment of the Ticket to 
                Work and Work Incentives Improvement Act of 1999 a 
                report with recommendations for a method or methods to 
                adjust payment rates under subparagraphs (A) and (B), 
                that would ensure adequate incentives for the provision 
                of services by employment networks of--
                            ``(i) individuals with a need for ongoing 
                        support and services;
                            ``(ii) individuals with a need for high-
                        cost accommodations;
                            ``(iii) individuals who earn a subminimum 
                        wage; and
                            ``(iv) individuals who work and receive 
                        partial cash benefits.
                The Commissioner shall consult with the Ticket to Work 
                and Work Incentives Advisory Panel established under 
                section 101(f) of the Ticket to Work and Work 
                Incentives Improvement Act of 1999 during the 
                development and evaluation of the study. The 
                Commissioner shall implement the necessary adjusted 
                payment rates prior to full implementation of the 
                Ticket to Work and Self-Sufficiency Program.
    ``(i) Suspension of Disability Reviews.--During any period for 
which an individual is using, as defined by the Commissioner, a ticket 
to work and self-sufficiency issued under this section, the 
Commissioner (and any applicable State agency) may not initiate a 
continuing disability review or other review under section 221 of 
whether the individual is or is not under a disability or a review 
under title XVI similar to any such review under section 221.
    ``(j) Authorizations.--
            ``(1) Payments to employment networks.--
                    ``(A) Title ii disability beneficiaries.--There are 
                authorized to be transferred from the Federal Old-Age 
                and Survivors Insurance Trust Fund and the Federal 
                Disability Insurance Trust Fund each fiscal year such 
                sums as may be necessary to make payments to employment 
                networks under this section. Money paid from the Trust 
                Funds under this section with respect to title II 
                disability beneficiaries who are entitled to benefits 
                under section 223 or who are entitled to benefits under 
                section 202(d) on the basis of the wages and self-
                employment income of such beneficiaries, shall be 
                charged to the Federal Disability Insurance Trust Fund, 
                and all other money paid from the Trust Funds under 
                this section shall be charged to the Federal Old-Age 
                and Survivors Insurance Trust Fund.
                    ``(B) Title xvi disability beneficiaries.--Amounts 
                authorized to be appropriated to the Social Security 
                Administration under section 1601 (as in effect 
                pursuant to the amendments made by section 301 of the 
                Social Security Amendments of 1972) shall include 
                amounts necessary to carry out the provisions of this 
                section with respect to title XVI disability 
                beneficiaries.
            ``(2) Administrative expenses.--The costs of administering 
        this section (other than payments to employment networks) shall 
        be paid from amounts made available for the administration of 
        title II and amounts made available for the administration of 
        title XVI, and shall be allocated among such amounts as 
        appropriate.
    ``(k) Definitions.--In this section:
            ``(1) Commissioner.--The term `Commissioner' means the 
        Commissioner of Social Security.
            ``(2) Disabled beneficiary.--The term `disabled 
        beneficiary' means a title II disability beneficiary or a title 
        XVI disability beneficiary.
            ``(3) Title ii disability beneficiary.--The term `title II 
        disability beneficiary' means an individual entitled to 
        disability insurance benefits under section 223 or to monthly 
        insurance benefits under section 202 based on such individual's 
        disability (as defined in section 223(d)). An individual is a 
        title II disability beneficiary for each month for which such 
        individual is entitled to such benefits.
            ``(4) Title xvi disability beneficiary.--The term `title 
        XVI disability beneficiary' means an individual eligible for 
        supplemental security income benefits under title XVI on the 
        basis of blindness (within the meaning of section 1614(a)(2)) 
        or disability (within the meaning of section 1614(a)(3)). An 
        individual is a title XVI disability beneficiary for each month 
        for which such individual is eligible for such benefits.
            ``(5) Supplemental security income benefit.--The term 
        `supplemental security income benefit under title XVI' means a 
        cash benefit under section 1611 or 1619(a), and does not 
        include a State supplementary payment, administered federally 
        or otherwise.
    ``(l) Regulations.--Not later than 1 year after the date of the 
enactment of the Ticket to Work and Work Incentives Improvement Act of 
1999, the Commissioner shall prescribe such regulations as are 
necessary to carry out the provisions of this section.''.
    (b) Conforming Amendments.--
            (1) Amendments to title ii.--
                    (A) Section 221(i) of the Social Security Act (42 
                U.S.C. 421(i)) is amended by adding at the end the 
                following:
    ``(5) For suspension of reviews under this subsection in the case 
of an individual using a ticket to work and self-sufficiency, see 
section 1148(i).''.
                    (B) Section 222(a) of such Act (42 U.S.C. 422(a)) 
                is repealed.
                    (C) Section 222(b) of such Act (42 U.S.C. 422(b)) 
                is repealed.
                    (D) Section 225(b)(1) of such Act (42 U.S.C. 
                425(b)(1)) is amended by striking ``a program of 
                vocational rehabilitation services'' and inserting ``a 
                program consisting of the Ticket to Work and Self-
                Sufficiency Program under section 1148 or another 
                program of vocational rehabilitation services, 
                employment services, or other support services''.
            (2) Amendments to title xvi.--
                    (A) Section 1615(a) of such Act (42 U.S.C. 
                1382d(a)) is amended to read as follows:
    ``Sec. 1615. (a) In the case of any blind or disabled individual 
who--
            ``(1) has not attained age 16; and
            ``(2) with respect to whom benefits are paid under this 
        title,
the Commissioner of Social Security shall make provision for referral 
of such individual to the appropriate State agency administering the 
State program under title V.''.
                    (B) Section 1615(c) of such Act (42 U.S.C. 
                1382d(c)) is repealed.
                    (C) Section 1631(a)(6)(A) of such Act (42 U.S.C. 
                1383(a)(6)(A)) is amended by striking ``a program of 
                vocational rehabilitation services'' and inserting ``a 
                program consisting of the Ticket to Work and Self-
                Sufficiency Program under section 1148 or another 
                program of vocational rehabilitation services, 
                employment services, or other support services''.
                    (D) Section 1633(c) of such Act (42 U.S.C. 
                1383b(c)) is amended--
                            (i) by inserting ``(1)'' after ``(c)''; and
                            (ii) by adding at the end the following:
    ``(2) For suspension of continuing disability reviews and other 
reviews under this title similar to reviews under section 221 in the 
case of an individual using a ticket to work and self-sufficiency, see 
section 1148(i).''.
    (c) Effective Date.--Subject to subsection (d), the amendments made 
by subsections (a) and (b) shall take effect with the first month 
following 1 year after the date of the enactment of this Act.
    (d) Graduated Implementation of Program.--
            (1) In general.--Not later than 1 year after the date of 
        the enactment of this Act, the Commissioner of Social Security 
        shall commence implementation of the amendments made by this 
        section (other than paragraphs (1)(C) and (2)(B) of subsection 
        (b)) in graduated phases at phase-in sites selected by the 
        Commissioner. Such phase-in sites shall be selected so as to 
        ensure, prior to full implementation of the Ticket to Work and 
        Self-Sufficiency Program, the development and refinement of 
        referral processes, payment systems, computer linkages, 
        management information systems, and administrative processes 
        necessary to provide for full implementation of such 
        amendments. Subsection (c) shall apply with respect to 
        paragraphs (1)(C) and (2)(B) of subsection (b) without regard 
        to this subsection.
            (2) Requirements.--Implementation of the Program at each 
        phase-in site shall be carried out on a wide enough scale to 
        permit a thorough evaluation of the alternative methods under 
        consideration, so as to ensure that the most efficacious 
        methods are determined and in place for full implementation of 
        the Program on a timely basis.
            (3) Full implementation.--The Commissioner shall ensure 
        that ability to provide tickets and services to individuals 
        under the Program exists in every State as soon as practicable 
        on or after the effective date specified in subsection (c) but 
        not later than 3 years after such date.
            (4) Ongoing evaluation of program.--
                    (A) In general.--The Commissioner shall design and 
                conduct a series of evaluations to assess the cost-
                effectiveness of activities carried out under this 
                section and the amendments made thereby, as well as the 
                effects of this section and the amendments made thereby 
                on work outcomes for beneficiaries receiving tickets to 
                work and self-sufficiency under the Program.
                    (B) Consultation.--The Commissioner shall design 
                and carry out the series of evaluations after receiving 
                relevant advice from experts in the fields of 
                disability, vocational rehabilitation, and program 
                evaluation and individuals using tickets to work and 
                self-sufficiency under the Program and consulting with 
                the Ticket to Work and Work Incentives Advisory Panel 
                established under section 101(f), the Comptroller 
                General of the United States, other agencies of 
the Federal Government, and private organizations with appropriate 
expertise.
                    (C) Methodology.--
                            (i) Implementation.--The Commissioner, in 
                        consultation with the Ticket to Work and Work 
                        Incentives Advisory Panel established under 
                        section 101(f), shall ensure that plans for 
                        evaluations and data collection methods under 
                        the Program are appropriately designed to 
                        obtain detailed employment information.
                            (ii) Specific matters to be addressed.--
                        Each such evaluation shall address (but is not 
                        limited to)--
                                    (I) the annual cost (including net 
                                cost) of the Program and the annual 
                                cost (including net cost) that would 
                                have been incurred in the absence of 
                                the Program;
                                    (II) the determinants of return to 
                                work, including the characteristics of 
                                beneficiaries in receipt of tickets 
                                under the Program;
                                    (III) the types of employment 
                                services, vocational rehabilitation 
                                services, and other support services 
                                furnished to beneficiaries in receipt 
                                of tickets under the Program who return 
                                to work and to those who do not return 
                                to work;
                                    (IV) the duration of employment 
                                services, vocational rehabilitation 
                                services, and other support services 
                                furnished to beneficiaries in receipt 
                                of tickets under the Program who return 
                                to work and the duration of such 
                                services furnished to those who do not 
                                return to work and the cost to 
                                employment networks of furnishing such 
                                services;
                                    (V) the employment outcomes, 
                                including wages, occupations, benefits, 
                                and hours worked, of beneficiaries who 
                                return to work after receiving tickets 
                                under the Program and those who return 
                                to work without receiving such tickets;
                                    (VI) the characteristics of 
                                individuals in possession of tickets 
                                under the Program who are not accepted 
                                for services and, to the extent 
                                reasonably determinable, the reasons 
                                for which such beneficiaries were not 
                                accepted for services;
                                    (VII) the characteristics of 
                                providers whose services are provided 
                                within an employment network under the 
                                Program;
                                    (VIII) the extent (if any) to which 
                                employment networks display a greater 
                                willingness to provide services to 
                                beneficiaries with a range of 
                                disabilities;
                                    (IX) the characteristics (including 
                                employment outcomes) of those 
                                beneficiaries who receive services 
                                under the outcome payment system and of 
                                those beneficiaries who receive 
                                services under the outcome-milestone 
                                payment system;
                                    (X) measures of satisfaction among 
                                beneficiaries in receipt of tickets 
                                under the Program; and
                                    (XI) reasons for (including 
                                comments solicited from beneficiaries 
                                regarding) their choice not to use 
                                their tickets or their inability to 
                                return to work despite the use of their 
                                tickets.
                    (D) Periodic evaluation reports.--Following the 
                close of the third and fifth fiscal years ending after 
                the effective date under subsection (c), and prior to 
                the close of the seventh fiscal year ending after such 
                date, the Commissioner shall transmit to the Committee 
                on Ways and Means of the House of Representatives and 
                the Committee on Finance of the Senate a report 
                containing the Commissioner's evaluation of the 
                progress of activities conducted under the provisions 
                of this section and the amendments made thereby. Each 
                such report shall set forth the Commissioner's 
                evaluation of the extent to which the Program has been 
                successful and the Commissioner's conclusions on 
                whether or how the Program should be modified. Each 
                such report shall include such data, findings, 
                materials, and recommendations as the Commissioner may 
                consider appropriate.
            (5) Extent of state's right of first refusal in advance of 
        full implementation of amendments in such state.--
                    (A) In general.--In the case of any State in which 
                the amendments made by subsection (a) have not been 
                fully implemented pursuant to this subsection, the 
                Commissioner shall determine by regulation the extent 
                to which--
                            (i) the requirement under section 222(a) 
                        for prompt referrals to a State agency; and
                            (ii) the authority of the Commissioner 
                        under section 222(d)(2) of the Social Security 
                        Act to provide vocational rehabilitation 
                        services in such State by agreement or contract 
                        with other public or private agencies, 
                        organizations, institutions, or individuals,
                shall apply in such State.
                    (B) Existing agreements.--Nothing in subparagraph 
                (A) or the amendments made by subsection (a) shall be 
                construed to limit, impede, or otherwise affect any 
                agreement entered into pursuant to section 222(d)(2) of 
                the Social Security Act before the date of the 
                enactment of this Act with respect to services provided 
                pursuant to such agreement to beneficiaries receiving 
                services under such agreement as of such date, except 
                with respect to services (if any) to be provided after 
                3 years after the effective date provided in subsection 
                (c).
    (e) Specific Regulations Required.--
            (1) In general.--The Commissioner of Social Security shall 
        prescribe such regulations as are necessary to implement the 
        amendments made by this section.
            (2) Specific matters to be included in regulations.--The 
        matters which shall be addressed in such regulations shall 
        include--
                    (A) the form and manner in which tickets to work 
                and self-sufficiency may be distributed to 
                beneficiaries pursuant to section 1148(b)(1) of the 
                Social Security Act;
                    (B) the format and wording of such tickets, which 
                shall incorporate by reference any contractual terms 
                governing service by employment networks under the 
                Program;
                    (C) the form and manner in which State agencies may 
                elect participation in the Ticket to Work and Self-
                Sufficiency Program pursuant to section 1148(c)(1) of 
                such Act and provision for periodic opportunities for 
                exercising such elections;
                    (D) the status of State agencies under section 
                1148(c)(1) of such Act at the time that State agencies 
                exercise elections under that section;
                    (E) the terms of agreements to be entered into with 
                program managers pursuant to section 1148(d) of such 
                Act, including--
                            (i) the terms by which program managers are 
                        precluded from direct participation in the 
                        delivery of services pursuant to section 
                        1148(d)(3) of such Act;
                            (ii) standards which must be met by quality 
                        assurance measures referred to in paragraph (6) 
                        of section 1148(d) of such Act and methods of 
                        recruitment of employment networks utilized 
                        pursuant to paragraph (2) of section 1148(e) of 
                        such Act; and
                            (iii) the format under which dispute 
                        resolution will operate under section 
                        1148(d)(7) of such Act;
                    (F) the terms of agreements to be entered into with 
                employment networks pursuant to section 1148(d)(4) of 
                such Act, including--
                            (i) the manner in which service areas are 
                        specified pursuant to section 1148(f)(2)(A) of 
                        such Act;
                            (ii) the general selection criteria and the 
                        specific selection criteria which are 
                        applicable to employment networks under section 
                        1148(f)(1)(C) of such Act in selecting service 
                        providers;
                            (iii) specific requirements relating to 
                        annual financial reporting by employment 
                        networks pursuant to section 1148(f)(3) of such 
                        Act; and
                            (iv) the national model to which periodic 
                        outcomes reporting by employment networks must 
                        conform under section 1148(f)(4) of such Act;
                    (G) standards which must be met by individual work 
                plans pursuant to section 1148(g) of such Act;
                    (H) standards which must be met by payment systems 
                required under section 1148(h) of such Act, including--
                            (i) the form and manner in which elections 
                        by employment networks of payment systems are 
                        to be exercised pursuant to section 
                        1148(h)(1)(A) of such Act;
                            (ii) the terms which must be met by an 
                        outcome payment system under section 1148(h)(2) 
                        of such Act;
                            (iii) the terms which must be met by an 
                        outcome-milestone payment system under section 
                        1148(h)(3) of such Act;
                            (iv) any revision of the percentage 
                        specified in paragraph (2)(C) of section 
                        1148(h) of such Act or the period of time 
                        specified in paragraph (4)(B) of such section 
                        1148(h) of such Act; and
                            (v) annual oversight procedures for such 
                        systems; and
                    (I) procedures for effective oversight of the 
                Program by the Commissioner of Social Security, 
                including periodic reviews and reporting requirements.
    (f) The Ticket to Work and Work Incentives Advisory Panel.--
            (1) Establishment.--There is established within the Social 
        Security Administration a panel to be known as the ``Ticket to 
        Work and Work Incentives Advisory Panel'' (in this subsection 
referred to as the ``Panel'').
            (2) Duties of panel.--It shall be the duty of the Panel 
        to--
                    (A) advise the President, the Congress, and the 
                Commissioner of Social Security on issues related to 
                work incentives programs, planning, and assistance for 
                individuals with disabilities, including work incentive 
                provisions under titles II, XI, XVI, XVIII, and XIX of 
                the Social Security Act (42 U.S.C. 401 et seq., 1301 et 
                seq., 1381 et seq., 1395 et seq., 1396 et seq.); and
                    (B) with respect to the Ticket to Work and Self-
                Sufficiency Program established under section 1148 of 
                such Act--
                            (i) advise the Commissioner of Social 
                        Security with respect to establishing phase-in 
                        sites for such Program and fully implementing 
                        the Program thereafter, the refinement of 
                        access of disabled beneficiaries to employment 
                        networks, payment systems, and management 
                        information systems, and advise the 
                        Commissioner whether such measures are being 
                        taken to the extent necessary to ensure the 
                        success of the Program;
                            (ii) advise the Commissioner regarding the 
                        most effective designs for research and 
                        demonstration projects associated with the 
                        Program or conducted pursuant to section 302 of 
                        this Act;
                            (iii) advise the Commissioner on the 
                        development of performance measurements 
                        relating to quality assurance under section 
                        1148(d)(6) of the Social Security Act; and
                            (iv) furnish progress reports on the 
                        Program to the Commissioner and each House of 
                        Congress.
            (3) Membership.--
                    (A) Number and appointment.--The Panel shall be 
                composed of 12 members as follows:
                            (i) 4 members appointed by the President, 
                        not more than 2 of whom may be of the same 
                        political party;
                            (ii) 2 members appointed by the Speaker of 
                        the House of Representatives, in consultation 
                        with the Chairman of the Committee on Ways and 
                        Means of the House of Representatives;
                            (iii) 2 members appointed by the minority 
                        leader of the House of Representatives, in 
                        consultation with the ranking member of the 
                        Committee on Ways and Means of the House of 
                        Representatives;
                            (iv) 2 members appointed by the majority 
                        leader of the Senate, in consultation with the 
                        Chairman of the Committee on Finance of the 
                        Senate; and
                            (v) 2 members appointed by the minority 
                        leader of the Senate, in consultation with the 
                        ranking member of the Committee on Finance of 
                        the Senate.
                    (B) Representation.--Of the members appointed under 
                subparagraph (A), at least 8 shall have experience or 
                expert knowledge as a recipient, provider, employer, or 
                employee in the fields of, or related to, employment 
                services, vocational rehabilitation services, and other 
                support services, of whom--
                            (i) at least 2 shall represent the 
                        interests of recipients of employment services, 
                        vocational rehabilitation services, and other 
                        support services;
                            (ii) at least 2 shall represent the 
                        interests of providers of employment services, 
                        vocational rehabilitation services, and other 
                        support services;
                            (iii) at least 2 shall represent the 
                        interests of private employers; and
                            (iv) at least 2 shall represent the 
                        interests of employees.
                At least \1/2\ of the members described in each clause 
                of subparagraph (A) shall be individuals with 
                disabilities, or representatives of individuals with 
                disabilities, with consideration to current or former 
                title II disability beneficiaries or title XVI 
                disability beneficiaries (as such terms are defined in 
                section 1148(k) of the Social Security Act (as added by 
                subsection (a)).
                    (C) Terms.--
                            (i) In general.--Each member shall be 
                        appointed for a term of 4 years (or, if less, 
                        for the remaining life of the Panel), except as 
                        provided in clauses (ii) and (iii). The initial 
                        members shall be appointed not later than 90 
                        days after the date of the enactment of this 
                        Act.
                            (ii) Terms of initial appointees.--As 
                        designated by the President at the time of 
                        appointment, of the members first appointed--
                                    (I) \1/2\ of the members appointed 
                                under subparagraph (A) shall be 
                                appointed for a term of 2 years; and
                                    (II) the remaining members 
                                appointed under subparagraph (A) shall 
                                be appointed for a term of 4 years.
                            (iii) Vacancies.--Any member appointed to 
                        fill a vacancy occurring before the expiration 
                        of the term for which the member's predecessor 
                        was appointed shall be appointed only for the 
                        remainder of that term. A member may serve 
                        after the expiration of that member's term 
                        until a successor has taken office. A vacancy 
                        in the Panel shall be filled in the manner in 
                        which the original appointment was made.
                    (D) Basic pay.--Members shall each be paid at a 
                rate, and in a manner, that is consistent with 
                guidelines established under section 7 of the Federal 
                Advisory Committee Act (5 U.S.C. App.).
                    (E) Travel expenses.--Each member shall receive 
                travel expenses, including per diem in lieu of 
                subsistence, in accordance with sections 5702 and 5703 
                of title 5, United States Code.
                    (F) Quorum.--8 members of the Panel shall 
                constitute a quorum but a lesser number may hold 
                hearings.
                    (G) Chairperson.--The Chairperson of the Panel 
                shall be designated by the President. The term of 
                office of the Chairperson shall be 4 years.
                    (H) Meetings.--The Panel shall meet at least 
                quarterly and at other times at the call of the 
                Chairperson or a majority of its members.
            (4) Director and staff of panel; experts and consultants.--
                    (A) Director.--The Panel shall have a Director who 
                shall be appointed by the Panel, and paid at a rate, 
                and in a manner, that is consistent with guidelines 
                established under section 7 of the Federal Advisory 
                Committee Act (5 U.S.C. App.).
                    (B) Staff.--Subject to rules prescribed by the 
                Commissioner of Social Security, the Director may 
                appoint and fix the pay of additional personnel as the 
                Director considers appropriate.
                    (C) Experts and consultants.--Subject to rules 
                prescribed by the Commissioner of Social Security, the 
                Director may procure temporary and intermittent 
                services under section 3109(b) of title 5, United 
                States Code.
                    (D) Staff of federal agencies.--Upon request of the 
                Panel, the head of any Federal department or agency may 
                detail, on a reimbursable basis, any of the personnel 
                of that department or agency to the Panel to assist it 
                in carrying out its duties under this Act.
            (5) Powers of panel.--
                    (A) Hearings and sessions.--The Panel may, for the 
                purpose of carrying out its duties under this 
                subsection, hold such hearings, sit and act at such 
                times and places, and take such testimony and evidence 
                as the Panel considers appropriate.
                    (B) Powers of members and agents.--Any member or 
                agent of the Panel may, if authorized by the Panel, 
                take any action which the Panel is authorized to take 
                by this section.
                    (C) Mails.--The Panel may use the United States 
                mails in the same manner and under the same conditions 
                as other departments and agencies of the United States.
            (6) Reports.--
                    (A) Interim reports.--The Panel shall submit to the 
                President and the Congress interim reports at least 
                annually.
                    (B) Final report.--The Panel shall transmit a final 
                report to the President and the Congress not later than 
                eight years after the date of the enactment of this 
                Act. The final report shall contain a detailed 
                statement of the findings and conclusions of the Panel, 
                together with its recommendations for legislation and 
                administrative actions which the Panel considers 
                appropriate.
            (7) Termination.--The Panel shall terminate 30 days after 
        the date of the submission of its final report under paragraph 
        (6)(B).
            (8) Authorization of appropriations.--There are authorized 
        to be appropriated from the Federal Old-Age and Survivors 
        Insurance Trust Fund, the Federal Disability Insurance Trust 
        Fund, and the general fund of the Treasury, as appropriate, 
        such sums as are necessary to carry out this subsection.

             Subtitle B--Elimination of Work Disincentives

SEC. 111. WORK ACTIVITY STANDARD AS A BASIS FOR REVIEW OF AN 
              INDIVIDUAL'S DISABLED STATUS.

    (a) In General.--Section 221 of the Social Security Act (42 U.S.C. 
421) is amended by adding at the end the following:
    ``(m)(1) In any case where an individual entitled to disability 
insurance benefits under section 223 or to monthly insurance benefits 
under section 202 based on such individual's disability (as defined in 
section 223(d)) has received such benefits for at least 24 months--
            ``(A) no continuing disability review conducted by the 
        Commissioner may be scheduled for the individual solely as a 
        result of the individual's work activity;
            ``(B) no work activity engaged in by the individual may be 
        used as evidence that the individual is no longer disabled; and
            ``(C) no cessation of work activity by the individual may 
        give rise to a presumption that the individual is unable to 
        engage in work.
    ``(2) An individual to which paragraph (1) applies shall continue 
to be subject to--
            ``(A) continuing disability reviews on a regularly 
        scheduled basis that is not triggered by work; and
            ``(B) termination of benefits under this title in the event 
        that the individual has earnings that exceed the level of 
        earnings established by the Commissioner to represent 
        substantial gainful activity.''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect on January 1, 2003.

SEC. 112. EXPEDITED REINSTATEMENT OF DISABILITY BENEFITS.

    (a) OASDI Benefits.--Section 223 of the Social Security Act (42 
U.S.C. 423) is amended--
            (1) by redesignating subsection (i) as subsection (j); and
            (2) by inserting after subsection (h) the following:

                     ``Reinstatement of Entitlement

    ``(i)(1)(A) Entitlement to benefits described in subparagraph 
(B)(i)(I) shall be reinstated in any case where the Commissioner 
determines that an individual described in subparagraph (B) has filed a 
request for reinstatement meeting the requirements of paragraph (2)(A) 
during the period prescribed in subparagraph (C). Reinstatement of such 
entitlement shall be in accordance with the terms of this subsection.
    ``(B) An individual is described in this subparagraph if--
            ``(i) prior to the month in which the individual files a 
        request for reinstatement--
                    ``(I) the individual was entitled to benefits under 
                this section or section 202 on the basis of disability 
                pursuant to an application filed therefor; and
                    ``(II) such entitlement terminated due to the 
                performance of substantial gainful activity;
            ``(ii) the individual is under a disability and the 
        physical or mental impairment that is the basis for the finding 
        of disability is the same as (or related to) the physical or 
        mental impairment that was the basis for the finding of 
        disability that gave rise to the entitlement described in 
        clause (i); and
            ``(iii) the individual's disability renders the individual 
        unable to perform substantial gainful activity.
    ``(C)(i) Except as provided in clause (ii), the period prescribed 
in this subparagraph with respect to an individual is 60 consecutive 
months beginning with the month following the most recent month for 
which the individual was entitled to a benefit described in 
subparagraph (B)(i)(I) prior to the entitlement termination described 
in subparagraph (B)(i)(II).
    ``(ii) In the case of an individual who fails to file a 
reinstatement request within the period prescribed in clause (i), the 
Commissioner may extend the period if the Commissioner determines that 
the individual had good cause for the failure to so file.
    ``(2)(A)(i) A request for reinstatement shall be filed in such 
form, and containing such information, as the Commissioner may 
prescribe.
    ``(ii) A request for reinstatement shall include express 
declarations by the individual that the individual meets the 
requirements specified in clauses (ii) and (iii) of paragraph (1)(B).
    ``(B) A request for reinstatement filed in accordance with 
subparagraph (A) may constitute an application for benefits in the case 
of any individual who the Commissioner determines is not entitled to 
reinstated benefits under this subsection.
    ``(3) In determining whether an individual meets the requirements 
of paragraph (1)(B)(ii), the provisions of subsection (f) shall apply.
    ``(4)(A)(i) Subject to clause (ii), entitlement to benefits 
reinstated under this subsection shall commence with the benefit 
payable for the month in which a request for reinstatement is filed.
    ``(ii) An individual whose entitlement to a benefit for any month 
would have been reinstated under this subsection had the individual 
filed a request for reinstatement before the end of such month shall be 
entitled to such benefit for such month if such request for 
reinstatement is filed before the end of the twelfth month immediately 
succeeding such month.
    ``(B)(i) Subject to clauses (ii) and (iii), the amount of the 
benefit payable for any month pursuant to the reinstatement of 
entitlement under this subsection shall be determined in accordance 
with the provisions of this title.
    ``(ii) For purposes of computing the primary insurance amount of an 
individual whose entitlement to benefits under this section is 
reinstated under this subsection, the date of onset of the individual's 
disability shall be the date of onset used in determining the 
individual's most recent period of disability arising in connection 
with such benefits payable on the basis of an application.
    ``(iii) Benefits under this section or section 202 payable for any 
month pursuant to a request for reinstatement filed in accordance with 
paragraph (2) shall be reduced by the amount of any provisional benefit 
paid to such individual for such month under paragraph (7).
    ``(C) No benefit shall be payable pursuant to an entitlement 
reinstated under this subsection to an individual for any month in 
which the individual engages in substantial gainful activity.
    ``(D) The entitlement of any individual that is reinstated under 
this subsection shall end with the benefits payable for the month 
preceding whichever of the following months is the earliest:
            ``(i) The month in which the individual dies.
            ``(ii) The month in which the individual attains retirement 
        age.
            ``(iii) The third month following the month in which the 
        individual's disability ceases.
    ``(5) Whenever an individual's entitlement to benefits under this 
section is reinstated under this subsection, entitlement to benefits 
payable on the basis of such individual's wages and self-employment 
income may be reinstated with respect to any person previously entitled 
to such benefits on the basis of an application if the Commissioner 
determines that such person satisfies all the requirements for 
entitlement to such benefits except requirements related to the filing 
of an application. The provisions of paragraph (4) shall apply to the 
reinstated entitlement of any such person to the same extent that they 
apply to the reinstated entitlement of such individual.
    ``(6) An individual to whom benefits are payable under this section 
or section 202 pursuant to a reinstatement of entitlement under this 
subsection for 24 months (whether or not consecutive) shall, with 
respect to benefits so payable after such twenty-fourth month, be 
deemed for purposes of paragraph (1)(B)(i)(I) and the determination, if 
appropriate, of the termination month in accordance with subsection 
(a)(1) of this section, or subsection (d)(1), (e)(1), or (f)(1) of 
section 202, to be entitled to such benefits on the basis of an 
application filed therefor.
    ``(7)(A) An individual described in paragraph (1)(B) who files a 
request for reinstatement in accordance with the provisions of 
paragraph (2)(A) shall be entitled to provisional benefits payable in 
accordance with this paragraph, unless the Commissioner determines that 
the individual does not meet the requirements of paragraph (1)(B)(i) or 
that the individual's declaration under paragraph (2)(A)(ii) is false. 
Any such determination by the Commissioner shall be final and not 
subject to review under subsection (b) or (g) of section 205.
    ``(B) The amount of a provisional benefit for a month shall equal 
the amount of the last monthly benefit payable to the individual under 
this title on the basis of an application increased by an amount equal 
to the amount, if any, by which such last monthly benefit would have 
been increased as a result of the operation of section 215(i).
    ``(C)(i) Provisional benefits shall begin with the month in which a 
request for reinstatement is filed in accordance with paragraph (2)(A).
    ``(ii) Provisional benefits shall end with the earliest of--
            ``(I) the month in which the Commissioner makes a 
        determination regarding the individual's entitlement to 
        reinstated benefits;
            ``(II) the fifth month following the month described in 
        clause (i);
            ``(III) the month in which the individual performs 
        substantial gainful activity; or
            ``(IV) the month in which the Commissioner determines that 
        the individual does not meet the requirements of paragraph 
        (1)(B)(i) or that the individual's declaration made in 
        accordance with paragraph (2)(A)(ii) is false.
    ``(D) In any case in which the Commissioner determines that an 
individual is not entitled to reinstated benefits, any provisional 
benefits paid to the individual under this paragraph shall not be 
subject to recovery as an overpayment unless the Commissioner 
determines that the individual knew or should have known that the 
individual did not meet the requirements of paragraph (1)(B).''.
    (b) SSI Benefits.--
            (1) In general.--Section 1631 of the Social Security Act 
        (42 U.S.C. 1383) is amended by adding at the end the following:

 ``Reinstatement of Eligibility on the Basis of Blindness or Disability

    ``(p)(1)(A) Eligibility for benefits under this title shall be 
reinstated in any case where the Commissioner determines that an 
individual described in subparagraph (B) has filed a request for 
reinstatement meeting the requirements of paragraph (2)(A) during the 
period prescribed in subparagraph (C). Reinstatement of eligibility 
shall be in accordance with the terms of this subsection.
    ``(B) An individual is described in this subparagraph if--
            ``(i) prior to the month in which the individual files a 
        request for reinstatement--
                    ``(I) the individual was eligible for benefits 
                under this title on the basis of blindness or 
                disability pursuant to an application filed therefor; 
                and
                    ``(II) the individual thereafter was ineligible for 
                such benefits due to earned income (or earned and 
                unearned income) for a period of 12 or more consecutive 
                months;
            ``(ii) the individual is blind or disabled and the physical 
        or mental impairment that is the basis for the finding of 
        blindness or disability is the same as (or related to) the 
        physical or mental impairment that was the basis for the 
        finding of blindness or disability that gave rise to the 
        eligibility described in clause (i);
            ``(iii) the individual's blindness or disability renders 
        the individual unable to perform substantial gainful activity; 
        and
            ``(iv) the individual satisfies the nonmedical requirements 
        for eligibility for benefits under this title.
    ``(C)(i) Except as provided in clause (ii), the period prescribed 
in this subparagraph with respect to an individual is 60 consecutive 
months beginning with the month following the most recent month for 
which the individual was eligible for a benefit under this title 
(including section 1619) prior to the period of ineligibility described 
in subparagraph (B)(i)(II).
    ``(ii) In the case of an individual who fails to file a 
reinstatement request within the period prescribed in clause (i), the 
Commissioner may extend the period if the Commissioner determines that 
the individual had good cause for the failure to so file.
    ``(2)(A)(i) A request for reinstatement shall be filed in such 
form, and containing such information, as the Commissioner may 
prescribe.
    ``(ii) A request for reinstatement shall include express 
declarations by the individual that the individual meets the 
requirements specified in clauses (ii) through (iv) of paragraph 
(1)(B).
    ``(B) A request for reinstatement filed in accordance with 
subparagraph (A) may constitute an application for benefits in the case 
of any individual who the Commissioner determines is not eligible for 
reinstated benefits under this subsection.
    ``(3) In determining whether an individual meets the requirements 
of paragraph (1)(B)(ii), the provisions of section 1614(a)(4) shall 
apply.
    ``(4)(A) Eligibility for benefits reinstated under this subsection 
shall commence with the benefit payable for the month following the 
month in which a request for reinstatement is filed.
    ``(B)(i) Subject to clause (ii), the amount of the benefit payable 
for any month pursuant to the reinstatement of eligibility under this 
subsection shall be determined in accordance with the provisions of 
this title.
    ``(ii) The benefit under this title payable for any month pursuant 
to a request for reinstatement filed in accordance with paragraph (2) 
shall be reduced by the amount of any provisional benefit paid to such 
individual for such month under paragraph (7).
    ``(C) Except as otherwise provided in this subsection, eligibility 
for benefits under this title reinstated pursuant to a request filed 
under paragraph (2) shall be subject to the same terms and conditions 
as eligibility established pursuant to an application filed therefor.
    ``(5) Whenever an individual's eligibility for benefits under this 
title is reinstated under this subsection, eligibility for such 
benefits shall be reinstated with respect to the individual's spouse if 
such spouse was previously an eligible spouse of the individual under 
this title and the Commissioner determines that such spouse satisfies 
all the requirements for eligibility for such benefits except 
requirements related to the filing of an application. The provisions of 
paragraph (4) shall apply to the reinstated eligibility of the spouse 
to the same extent that they apply to the reinstated eligibility of 
such individual.
    ``(6) An individual to whom benefits are payable under this title 
pursuant to a reinstatement of eligibility under this subsection for 
twenty-four months (whether or not consecutive) shall, with respect to 
benefits so payable after such twenty-fourth month, be deemed for 
purposes of paragraph (1)(B)(i)(I) to be eligible for such benefits on 
the basis of an application filed therefor.
    ``(7)(A) An individual described in paragraph (1)(B) who files a 
request for reinstatement in accordance with the provisions of 
paragraph (2)(A) shall be eligible for provisional benefits payable in 
accordance with this paragraph, unless the Commissioner determines that 
the individual does not meet the requirements of paragraph (1)(B)(i) or 
that the individual's declaration under paragraph (2)(A)(ii) is false. 
Any such determination by the Commissioner shall be final and not 
subject to review under paragraph (1) or (3) of subsection (c).
    ``(B)(i) Except as otherwise provided in clause (ii), the amount of 
a provisional benefit for a month shall equal the amount of the monthly 
benefit that would be payable to an eligible individual under this 
title with the same kind and amount of income.
    ``(ii) If the individual has a spouse who was previously an 
eligible spouse of the individual under this title and the Commissioner 
determines that such spouse satisfies all the requirements of section 
1614(b) except requirements related to the filing of an application, 
the amount of a provisional benefit for a month shall equal the amount 
of the monthly benefit that would be payable to an eligible individual 
and eligible spouse under this title with the same kind and amount of 
income.
    ``(C)(i) Provisional benefits shall begin with the month following 
the month in which a request for reinstatement is filed in accordance 
with paragraph (2)(A).
    ``(ii) Provisional benefits shall end with the earliest of--
            ``(I) the month in which the Commissioner makes a 
        determination regarding the individual's eligibility for 
        reinstated benefits;
            ``(II) the fifth month following the month for which 
        provisional benefits are first payable under clause (i); or
            ``(III) the month in which the Commissioner determines that 
        the individual does not meet the requirements of paragraph 
        (1)(B)(i) or that the individual's declaration made in 
        accordance with paragraph (2)(A)(ii) is false.
    ``(D) In any case in which the Commissioner determines that an 
individual is not eligible for reinstated benefits, any provisional 
benefits paid to the individual under this paragraph shall not be 
subject to recovery as an overpayment unless the Commissioner 
determines that the individual knew or should have known that the 
individual did not meet the requirements of paragraph (1)(B).
    ``(8) For purposes of this subsection other than paragraph (7), the 
term `benefits under this title' includes State supplementary payments 
made pursuant to an agreement under section 1616(a) of this Act or 
section 212(b) of Public Law 93-66.''.
            (2) Conforming amendments.--
                    (A) Section 1631(j)(1) of such Act (42 U.S.C. 
                1383(j)(1)) is amended by striking the period and 
                inserting ``, or has filed a request for reinstatement 
                of eligibility under subsection (p)(2) and been 
                determined to be eligible for reinstatement.''.
                    (B) Section 1631(j)(2)(A)(i)(I) of such Act (42 
                U.S.C. 1383(j)(2)(A)(i)(I)) is amended by inserting 
                ``(other than pursuant to a request for reinstatement 
                under subsection (p))'' after ``eligible''.
    (c) Effective Date.--
            (1) In general.--The amendments made by this section shall 
        take effect on the first day of the thirteenth month beginning 
        after the date of enactment of this Act.
            (2) Limitation.--No benefit shall be payable under title II 
        or XVI on the basis of a request for reinstatement filed under 
        section 223(i) or 1631(p) of the Social Security Act before the 
        effective date described in paragraph (1).

     Subtitle C--Work Incentives Planning, Assistance, and Outreach

SEC. 121. WORK INCENTIVES OUTREACH PROGRAM.

    Part A of title XI of the Social Security Act (42 U.S.C. 1301 et 
seq.), as amended by section 101, is amended by adding after section 
1148 the following:

                   ``work incentives outreach program

    ``Sec. 1149. (a) Establishment.--
            ``(1) In general.--The Commissioner, in consultation with 
        the Ticket to Work and Work Incentives Advisory Panel 
        established under section 101(f) of the Ticket to Work and Work 
        Incentives Improvement Act of 1999, shall establish a 
        community-based work incentives planning and assistance program 
        for the purpose of disseminating accurate information to 
        disabled beneficiaries on work incentives programs and issues 
        related to such programs.
            ``(2) Grants, cooperative agreements, contracts, and 
        outreach.--Under the program established under this section, 
        the Commissioner shall--
                    ``(A) establish a competitive program of grants, 
                cooperative agreements, or contracts to provide 
                benefits planning and assistance, including information 
                on the availability of protection and advocacy 
                services, to disabled beneficiaries, including 
                individuals participating in the Ticket to Work and 
                Self-Sufficiency Program established under section 
                1148, the program established under section 1619, and 
                other programs that are designed to encourage disabled 
                beneficiaries to work;
                    ``(B) conduct directly, or through grants, 
                cooperative agreements, or contracts, ongoing outreach 
                efforts to disabled beneficiaries (and to the families 
                of such beneficiaries) who are potentially eligible to 
                participate in Federal or State work incentive programs 
                that are designed to assist disabled beneficiaries to 
                work, including--
                            ``(i) preparing and disseminating 
                        information explaining such programs; and
                            ``(ii) working in cooperation with other 
                        Federal, State, and private agencies and 
                        nonprofit organizations that serve disabled 
                        beneficiaries, and with agencies and 
                        organizations that focus on vocational 
                        rehabilitation and work-related training and 
                        counseling;
                    ``(C) establish a corps of trained, accessible, and 
                responsive work incentives specialists within the 
Social Security Administration who will specialize in disability work 
incentives under titles II and XVI for the purpose of disseminating 
accurate information with respect to inquiries and issues relating to 
work incentives to--
                            ``(i) disabled beneficiaries;
                            ``(ii) benefit applicants under titles II 
                        and XVI; and
                            ``(iii) individuals or entities awarded 
                        grants under subparagraphs (A) or (B); and
                    ``(D) provide--
                            ``(i) training for work incentives 
                        specialists and individuals providing planning 
                        assistance described in subparagraph (C); and
                            ``(ii) technical assistance to 
                        organizations and entities that are designed to 
                        encourage disabled beneficiaries to return to 
                        work.
            ``(3) Coordination with other programs.--The 
        responsibilities of the Commissioner established under this 
        section shall be coordinated with other public and private 
        programs that provide information and assistance regarding 
        rehabilitation services and independent living supports and 
        benefits planning for disabled beneficiaries including the 
        program under section 1619, the plans for achieving self-
        support program (PASS), and any other Federal or State work 
        incentives programs that are designed to assist disabled 
        beneficiaries, including educational agencies that provide 
        information and assistance regarding rehabilitation, school-to-
        work programs, transition services (as defined in, and provided 
        in accordance with, the Individuals with Disabilities Education 
        Act (20 U.S.C. 1400 et seq.)), a one-stop delivery system 
        established under subtitle B of title I of the Workforce 
        Investment Act of 1998, and other services.
    ``(b) Conditions.--
            ``(1) Selection of entities.--
                    ``(A) Application.--An entity shall submit an 
                application for a grant, cooperative agreement, or 
                contract to provide benefits planning and assistance to 
                the Commissioner at such time, in such manner, and 
                containing such information as the Commissioner may 
                determine is necessary to meet the requirements of this 
                section.
                    ``(B) Statewideness.--The Commissioner shall ensure 
                that the planning, assistance, and information 
                described in paragraph (2) shall be available on a 
                statewide basis.
                    ``(C) Eligibility of states and private 
                organizations.--
                            ``(i) In general.--The Commissioner may 
                        award a grant, cooperative agreement, or 
                        contract under this section to a State or a 
                        private agency or organization (other than 
                        Social Security Administration Field Offices 
                        and the State agency administering the State 
                        medicaid program under title XIX, including any 
                        agency or entity described in clause (ii), that 
                        the Commissioner determines is qualified to 
                        provide the planning, assistance, and 
                        information described in paragraph (2)).
                            ``(ii) Agencies and entities described.--
                        The agencies and entities described in this 
                        clause are the following:
                                    ``(I) Any public or private agency 
                                or organization (including Centers for 
                                Independent Living established under 
                                title VII of the Rehabilitation Act of 
                                1973, protection and advocacy 
                                organizations, client assistance 
                                programs established in accordance with 
                                section 112 of the Rehabilitation Act 
                                of 1973, and State Developmental 
                                Disabilities Councils established in 
                                accordance with section 124 of the 
                                Developmental Disabilities Assistance 
                                and Bill of Rights Act (42 U.S.C. 
                                6024)) that the Commissioner determines 
                                satisfies the requirements of this 
                                section.
                                    ``(II) The State agency 
                                administering the State program funded 
                                under part A of title IV.
                    ``(D) Exclusion for conflict of interest.--The 
                Commissioner may not award a grant, cooperative 
                agreement, or contract under this section to any entity 
                that the Commissioner determines would have a conflict 
                of interest if the entity were to receive a grant, 
                cooperative agreement, or contract under this section.
            ``(2) Services provided.--A recipient of a grant, 
        cooperative agreement, or contract to provide benefits planning 
        and assistance shall select individuals who will act as 
        planners and provide information, guidance, and planning to 
        disabled beneficiaries on the--
                    ``(A) availability and interrelation of any Federal 
                or State work incentives programs designed to assist 
                disabled beneficiaries that the individual may be 
                eligible to participate in;
                    ``(B) adequacy of any health benefits coverage that 
                may be offered by an employer of the individual and the 
                extent to which other health benefits coverage may be 
                available to the individual; and
                    ``(C) availability of protection and advocacy 
                services for disabled beneficiaries and how to access 
                such services.
            ``(3) Amount of grants, cooperative agreements, or 
        contracts.--
                    ``(A) Based on population of disabled 
                beneficiaries.--Subject to subparagraph (B), the 
                Commissioner shall award a grant, cooperative 
                agreement, or contract under this section to an entity 
                based on the percentage of the population of the State 
                where the entity is located who are disabled 
                beneficiaries.
                    ``(B) Limitations.--
                            ``(i) Per grant.--No entity shall receive a 
                        grant, cooperative agreement, or contract under 
                        this section for a fiscal year that is less 
than $50,000 or more than $300,000.
                            ``(ii) Total amount for all grants, 
                        cooperative agreements, and contracts.--The 
                        total amount of all grants, cooperative 
                        agreements, and contracts awarded under this 
                        section for a fiscal year may not exceed 
                        $23,000,000.
            ``(4) Allocation of costs.--The costs of carrying out this 
        section shall be paid from amounts made available for the 
        administration of title II and amounts made available for the 
        administration of title XVI, and shall be allocated among those 
        amounts as appropriate.
    ``(c) Definitions.--In this section:
            ``(1) Commissioner.--The term `Commissioner' means the 
        Commissioner of Social Security.
            ``(2) Disabled beneficiary.--The term `disabled 
        beneficiary' has the meaning given that term in section 
        1148(k)(2).
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $23,000,000 for each of the 
fiscal years 2000 through 2004.''.

SEC. 122. STATE GRANTS FOR WORK INCENTIVES ASSISTANCE TO DISABLED 
              BENEFICIARIES.

    Part A of title XI of the Social Security Act (42 U.S.C. 1301 et 
seq.), as amended by section 121, is amended by adding after section 
1149 the following:

``state grants for work incentives assistance to disabled beneficiaries

    ``Sec. 1150. (a) In General.--Subject to subsection (c), the 
Commissioner may make payments in each State to the protection and 
advocacy system established pursuant to part C of title I of the 
Developmental Disabilities Assistance and Bill of Rights Act (42 U.S.C. 
6041 et seq.) for the purpose of providing services to disabled 
beneficiaries.
    ``(b) Services Provided.--Services provided to disabled 
beneficiaries pursuant to a payment made under this section may 
include--
            ``(1) information and advice about obtaining vocational 
        rehabilitation and employment services; and
            ``(2) advocacy or other services that a disabled 
        beneficiary may need to secure or regain gainful employment.
    ``(c) Application.--In order to receive payments under this 
section, a protection and advocacy system shall submit an application 
to the Commissioner, at such time, in such form and manner, and 
accompanied by such information and assurances as the Commissioner may 
require.
    ``(d) Amount of Payments.--
            ``(1) In general.--Subject to the amount appropriated for a 
        fiscal year for making payments under this section, a 
        protection and advocacy system shall not be paid an amount that 
        is less than--
                    ``(A) in the case of a protection and advocacy 
                system located in a State (including the District of 
                Columbia and Puerto Rico) other than Guam, American 
                Samoa, the United States Virgin Islands, and the 
                Commonwealth of the Northern Mariana Islands, the 
                greater of--
                            ``(i) $100,000; or
                            ``(ii) \1/3\ of 1 percent of the amount 
                        available for payments under this section; and
                    ``(B) in the case of a protection and advocacy 
                system located in Guam, American Samoa, the United 
                States Virgin Islands, and the Commonwealth of the 
                Northern Mariana Islands, $50,000.
            ``(2) Inflation adjustment.--For each fiscal year in which 
        the total amount appropriated to carry out this section exceeds 
        the total amount appropriated to carry out this section in the 
        preceding fiscal year, the Commissioner shall increase each 
        minimum payment under subparagraphs (A) and (B) of paragraph 
        (1) by a percentage equal to the percentage increase in the 
        total amount so appropriated to carry out this section.
    ``(e) Annual Report.--Each protection and advocacy system that 
receives a payment under this section shall submit an annual report to 
the Commissioner and the Ticket to Work and Work Incentives Advisory 
Panel established under section 101(f) of the Ticket to Work and Work 
Incentives Improvement Act of 1999 on the services provided to 
individuals by the system.
    ``(f) Funding.--
            ``(1) Allocation of payments.--Payments under this section 
        shall be made from amounts made available for the 
        administration of title II and amounts made available for the 
        administration of title XVI, and shall be allocated among those 
        amounts as appropriate.
            ``(2) Carryover.--Any amounts allotted for payment to a 
        protection and advocacy system under this section for a fiscal 
        year shall remain available for payment to or on behalf of the 
        protection and advocacy system until the end of the succeeding 
        fiscal year.
    ``(g) Definitions.--In this section:
            ``(1) Commissioner.--The term `Commissioner' means the 
        Commissioner of Social Security.
            ``(2) Disabled beneficiary.--The term `disabled 
        beneficiary' has the meaning given that term in section 
        1148(k)(2).
            ``(3) Protection and advocacy system.--The term `protection 
        and advocacy system' means a protection and advocacy system 
        established pursuant to part C of title I of the Developmental 
        Disabilities Assistance and Bill of Rights Act (42 U.S.C. 6041 
        et seq.).
    ``(h) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $7,000,000 for each of the 
fiscal years 2000 through 2004.''.

        TITLE II--EXPANDED AVAILABILITY OF HEALTH CARE SERVICES

SEC. 201. EXPANDING STATE OPTIONS UNDER THE MEDICAID PROGRAM FOR 
              WORKERS WITH DISABILITIES.

    (a) In General.--
            (1) State option to eliminate income, assets, and resource 
        limitations for workers with disabilities buying into 
        medicaid.--Section 1902(a)(10)(A)(ii) of the Social Security 
Act (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended--
                    (A) in subclause (XIII), by striking ``or'' at the 
                end;
                    (B) in subclause (XIV), by adding ``or'' at the 
                end; and
                    (C) by adding at the end the following:
                                    ``(XV) who, but for earnings in 
                                excess of the limit established under 
                                section 1905(q)(2)(B), would be 
                                considered to be receiving supplemental 
                                security income, who is at least 16, 
                                but less than 65, years of age, and 
                                whose assets, resources, and earned or 
                                unearned income (or both) do not exceed 
                                such limitations (if any) as the State 
                                may establish;''.
            (2) State option to provide opportunity for employed 
        individuals with a medically improved disability to buy into 
        medicaid.--
                    (A) Eligibility.--Section 1902(a)(10)(A)(ii) of the 
                Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)), as 
                amended by paragraph (1), is amended--
                            (i) in subclause (XIV), by striking ``or'' 
                        at the end;
                            (ii) in subclause (XV), by adding ``or'' at 
                        the end; and
                            (iii) by adding at the end the following:
                                    ``(XVI) who are employed 
                                individuals with a medically improved 
                                disability described in section 
                                1905(v)(1) and whose assets, resources, 
                                and earned or unearned income (or both) 
                                do not exceed such limitations (if any) 
                                as the State may establish, but only if 
                                the State provides medical assistance 
                                to individuals described in subclause 
                                (XV);''.
                    (B) Definition of employed individuals with a 
                medically improved disability.--Section 1905 of the 
                Social Security Act (42 U.S.C. 1396d) is amended by 
                adding at the end the following:
    ``(v)(1) The term `employed individual with a medically improved 
disability' means an individual who--
            ``(A) is at least 16, but less than 65, years of age;
            ``(B) is employed (as defined in paragraph (2));
            ``(C) ceases to be eligible for medical assistance under 
        section 1902(a)(10)(A)(ii)(XV) because the individual, by 
        reason of medical improvement, is determined at the time of a 
        regularly scheduled continuing disability review to no longer 
        be eligible for benefits under section 223(d) or 1614(a)(3); 
        and
            ``(D) continues to have a severe medically determinable 
        impairment, as determined under regulations of the Secretary.
    ``(2) For purposes of paragraph (1), an individual is considered to 
be `employed' if the individual--
            ``(A) is earning at least the applicable minimum wage 
        requirement under section 6 of the Fair Labor Standards Act (29 
        U.S.C. 206) and working at least 40 hours per month; or
            ``(B) is engaged in a work effort that meets substantial 
        and reasonable threshold criteria for hours of work, wages, or 
        other measures, as defined by the State and approved by the 
        Secretary.''.
                    (C) Conforming amendment.--Section 1905(a) of such 
                Act (42 U.S.C. 1396d(a)) is amended in the matter 
                preceding paragraph (1)--
                            (i) in clause (x), by striking ``or'' at 
                        the end;
                            (ii) in clause (xi), by adding ``or'' at 
                        the end; and
                            (iii) by inserting after clause (xi), the 
                        following:
            ``(xii) employed individuals with a medically improved 
        disability (as defined in subsection (v)),''.
            (3) State authority to impose income-related premiums and 
        cost-sharing.--Section 1916 of such Act (42 U.S.C. 1396o) is 
        amended--
                    (A) in subsection (a), by striking ``The State 
                plan'' and inserting ``Subject to subsection (g), the 
                State plan''; and
                    (B) by adding at the end the following:
    ``(g) With respect to individuals provided medical assistance only 
under subclause (XV) or (XVI) of section 1902(a)(10)(A)(ii)--
            ``(1) a State may (in a uniform manner for individuals 
        described in either such subclause)--
                    ``(A) require such individuals to pay premiums or 
                other cost-sharing charges set on a sliding scale based 
                on income that the State may determine; and
                    ``(B) require payment of 100 percent of such 
                premiums or charges for a year in the case of such an 
                individual who has income for such year that exceeds 
250 percent of the income official poverty line (referred to in 
subsection (c)(1)) applicable to a family of the size involved, except 
that, in the case of such an individual who has income for a year that 
does not exceed 450 percent of such poverty line, such requirement may 
apply only to the extent that such premiums do not exceed 7.5 percent 
of such income; and
            ``(2) a State shall require payment of 100 percent of such 
        premium for a year by such an individual whose adjusted gross 
        income (as defined in section 62 of the Internal Revenue Code 
        of 1986) for such year exceeds $75,000, except that a State may 
        choose to subsidize such premium by using State funds which may 
        not be federally matched under this title.
The Secretary shall adjust annually (after 2000) the dollar amount set 
forth in paragraph (2) under procedures providing for adjustments in 
the same manner and to the same extent as adjustments are provided for 
under the procedures used to adjust benefit amounts under section 
215(i)(2)(A), except that any amount so adjusted that is not a multiple 
of $1.00 shall be rounded to the nearest multiple of $1.00.''.
            (4) Prohibition against supplantation of state funds and 
        state failure to maintain effort.--Section 1903(i) of such Act 
        (42 U.S.C. 1396b(i)) is amended--
                    (A) by striking the period at the end of paragraph 
                (18) and inserting ``; or''; and
                    (B) by inserting after such paragraph the 
                following:
            ``(19) with respect to amounts expended for medical 
        assistance provided to an individual described in subclause 
        (XV) or (XVI) of section 1902(a)(10)(A)(ii) for a fiscal year 
        unless the State demonstrates to the satisfaction of the 
        Secretary that the level of State funds expended for such 
        fiscal year for programs to enable working individuals with 
        disabilities to work (other than for such medical assistance) 
        is not less than the level expended for such programs during 
        the most recent State fiscal year ending before the date of 
        enactment of this paragraph.''.
    (b) Conforming Amendments.--
            (1) Section 1903(f)(4) of the Social Security Act (42 
        U.S.C. 1396b(f)(4)) is amended in the matter preceding 
        subparagraph (A) by inserting ``1902(a)(10)(A)(ii)(XV), 
        1902(a)(10)(A)(ii)(XVI)'' after ``1902(a)(10)(A)(ii)(X),''.
            (2) Section 1903(f)(4) of such Act, as amended by paragraph 
        (1), is amended by inserting ``1902(a)(10)(A)(ii)(XIII),'' 
        before ``1902(a)(10)(A)(ii)(XV)''.
    (c) GAO Report.--Not later than 3 years after the date of enactment 
of this Act, the Comptroller General of the United States shall submit 
a report to Congress regarding the amendments made by this section that 
examines--
            (1) the extent to which higher health care costs for 
        individuals with disabilities at higher income levels deter 
        employment or progress with employment;
            (2) whether such individuals have health insurance coverage 
        or could benefit from the State option established under such 
        amendments to provide a medicaid buy-in; and
            (3) how the States are exercising such option, including--
                    (A) how such States are exercising the flexibility 
                afforded them with regard to income disregards;
                    (B) what income and premium levels have been set;
                    (C) the degree to which States are subsidizing 
                premiums above the dollar amount specified in section 
                1916(g)(2) of the Social Security Act (42 U.S.C. 
                1396o(g)(2)); and
                    (D) the extent to which there exists any crowd-out 
                effect.
    (d) Effective Date.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendments made by this section apply to medical assistance for 
        items and services furnished on or after October 1, 1999.
            (2) Retroactivity of conforming amendment.--The amendment 
        made by subsection (b)(2) takes effect as if included in the 
        enactment of the Balanced Budget Act of 1997.

SEC. 202. EXTENDING MEDICARE COVERAGE FOR OASDI DISABILITY BENEFIT 
              RECIPIENTS.

    (a) In General.--The next to last sentence of section 226(b) of the 
Social Security Act (42 U.S.C. 426) is amended by striking ``24'' and 
inserting ``96''.
    (b) Effective Date.--The amendment made by subsection (a) shall be 
effective on and after October 1, 2000.
    (c) GAO Report.--Not later than 5 years after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall submit a report to the Congress that--
            (1) examines the effectiveness and cost of the amendment 
        made by subsection (a);
            (2) examines the necessity and effectiveness of providing 
        continuation of medicare coverage under section 226(b) of the 
        Social Security Act to individuals whose annual income exceeds 
        the contribution and benefit base (as determined under section 
        230 of such Act);
            (3) examines the viability of providing the continuation of 
        medicare coverage under such section 226(b) based on a sliding 
        scale premium for individuals whose annual income exceeds such 
        contribution and benefit base;
            (4) examines the viability of providing the continuation of 
        medicare coverage under such section 226(b) based on a premium 
        buy-in by the beneficiary's employer in lieu of coverage under 
        private health insurance;
            (5) examines the interrelation between the use of the 
        continuation of medicare coverage under such section 226(b) and 
        the use of private health insurance coverage by individuals 
        during the extended period; and
            (6) recommends such legislative or administrative changes 
        relating to the continuation of medicare coverage for 
        recipients of social security disability benefits as the 
Comptroller General determines are appropriate.

SEC. 203. GRANTS TO DEVELOP AND ESTABLISH STATE INFRASTRUCTURES TO 
              SUPPORT WORKING INDIVIDUALS WITH DISABILITIES.

    (a) Establishment.--
            (1) In general.--The Secretary of Health and Human Services 
        (in this section referred to as the ``Secretary'') shall award 
        grants described in subsection (b) to States to support the 
        design, establishment, and operation of State infrastructures 
        that provide items and services to support working individuals 
        with disabilities.
            (2) Application.--In order to be eligible for an award of a 
        grant under this section, a State shall submit an application 
        to the Secretary at such time, in such manner, and containing 
        such information as the Secretary shall require.
            (3) Definition of state.--In this section, the term 
        ``State'' means each of the 50 States, the District of 
        Columbia, Puerto Rico, Guam, the United States Virgin Islands, 
        American Samoa, and the Commonwealth of the Northern Mariana 
        Islands.
    (b) Grants for Infrastructure and Outreach.--
            (1) In general.--Out of the funds appropriated under 
        subsection (e), the Secretary shall award grants to States to--
                    (A) support the establishment, implementation, and 
                operation of the State infrastructures described in 
                subsection (a); and
                    (B) conduct outreach campaigns regarding the 
                existence of such infrastructures.
            (2) Eligibility for grants.--
                    (A) In general.--No State may receive a grant under 
                this subsection unless the State--
                            (i) has an approved amendment to the State 
                        plan under title XIX of the Social Security Act 
                        (42 U.S.C. 1396 et seq.) that provides medical 
                        assistance under such plan to individuals 
                        described in section 1902(a)(10)(A)(ii)(XV) of 
                        the Social Security Act (42 U.S.C. 
                        1396a(a)(10)(A)(ii)(XV)); and
                            (ii) demonstrates to the satisfaction of 
                        the Secretary that the State makes personal 
                        assistance services available under the State 
                        plan under title XIX of the Social Security Act 
                        (42 U.S.C. 1396 et seq.) to the extent 
                        necessary to enable individuals described in 
                        clause (i) to remain employed (as determined 
                        under section 1905(v)(2) of the Social Security 
                        Act (42 U.S.C. 1396d(v)(2)).
                    (B) Definition of personal assistance services.--In 
                this paragraph, the term ``personal assistance 
                services'' means a range of services, provided by 1 or 
                more persons, designed to assist an individual with a 
                disability to perform daily activities on and off the 
                job that the individual would typically perform if the 
                individual did not have a disability. Such services 
                shall be designed to increase the individual's control 
                in life and ability to perform everyday activities on 
                or off the job.
            (3) Determination of awards.--
                    (A) In general.--Subject to subparagraph (B), the 
                Secretary shall determine a formula for awarding grants 
                to States under this section that provides special 
                consideration to States that provide medical assistance 
                under title XIX of the Social Security Act to 
                individuals described in section 
                1902(a)(10)(A)(ii)(XVI) of that Act (42 U.S.C. 
                1396a(a)(10)(A)(ii)(XVI)).
                    (B) Award limits.--
                            (i) Minimum awards.--
                                    (I) In general.--Subject to 
                                subclause (II), no State with an 
                                approved application under this section 
                                shall receive a grant for a fiscal year 
                                that is less than $500,000.
                                    (II) Pro rata reductions.--If the 
                                funds appropriated under subsection (e) 
                                for a fiscal year are not sufficient to 
                                pay each State with an application 
                                approved under this section the minimum 
                                amount described in subclause (I), the 
                                Secretary shall pay each such State an 
                                amount equal to the pro rata share of 
                                the amount made available.
                            (ii) Maximum awards.--No State with an 
                        application that has been approved under this 
                        section shall receive a grant for a fiscal year 
                        that exceeds 15 percent of the total 
                        expenditures by the State (including the 
                        reimbursed Federal share of such expenditures) 
                        for medical assistance for individuals eligible 
                        under subclause (XV) and (XVI) of section 
                        1902(a)(10)(A)(ii) of the Social Security Act 
                        (42 U.S.C. 1396a(a)(10)(A)(ii)), as estimated 
                        by the State and approved by the Secretary.
    (c) Availability of Funds.--
            (1) Funds awarded to states.--Funds awarded to a State 
        under a grant made under this section for a fiscal year shall 
        remain available until expended.
            (2) Funds not awarded to states.--Funds not awarded to 
        States in the fiscal year for which they are appropriated shall 
        remain available in succeeding fiscal years for awarding by the 
        Secretary.
    (d) Annual Report.--A State that is awarded a grant under this 
section shall submit an annual report to the Secretary on the use of 
funds provided under the grant. Each report shall include the 
percentage increase in the number of title II disability beneficiaries, 
as defined in section 1148(k)(3) of the Social Security Act (as amended 
by section 201) in the State, and title XVI disability beneficiaries, 
as defined in section 1148(k)(4) of the Social Security Act (as so 
amended) in the State who return to work.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section--
            (1) for fiscal year 2000, $20,000,000;
            (2) for fiscal year 2001, $25,000,000;
            (3) for fiscal year 2002, $30,000,000;
            (4) for fiscal year 2003, $35,000,000;
            (5) for fiscal year 2004, $40,000,000; and
            (6) for each of fiscal years 2005 through 2010, the amount 
        appropriated for the preceding fiscal year under this 
        subsection increased by the percentage increase (if any) in the 
        Consumer Price Index for All Urban Consumers (United States 
        city average) for the preceding fiscal year.
    (f) Recommendation.--Not later than October 1, 2009, the Secretary, 
in consultation with the Ticket to Work and Work Incentives Advisory 
Panel established under section 101(f), shall submit a recommendation 
to the Committee on Commerce of the House of Representatives and the 
Committee on Finance of the Senate regarding whether the grant program 
established under this section should be continued after fiscal year 
2010.

SEC. 204. DEMONSTRATION OF COVERAGE UNDER THE MEDICAID PROGRAM OF 
              WORKERS WITH POTENTIALLY SEVERE DISABILITIES.

    (a) State Application.--A State may apply to the Secretary of 
Health and Human Services (in this section referred to as the 
``Secretary'') for approval of a demonstration project (in this section 
referred to as a ``demonstration project'') under which up to a 
specified maximum number of individuals who are workers with a 
potentially severe disability (as defined in subsection (b)(1)) are 
provided medical assistance equal to that provided under section 
1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) to individuals 
described in section 1902(a)(10)(A)(ii)(XV) of that Act (42 U.S.C. 
1396a(a)(10)(A)(ii)(XV)).
    (b) Worker With a Potentially Severe Disability Defined.--For 
purposes of this section--
            (1) In general.--The term ``worker with a potentially 
        severe disability'' means, with respect to a demonstration 
        project, an individual who--
                    (A) is at least 16, but less than 65, years of age;
                    (B) has a specific physical or mental impairment 
                that, as defined by the State under the demonstration 
                project, is reasonably expected, but for the receipt of 
                items and services described in section 1905(a) of the 
                Social Security Act (42 U.S.C. 1396d(a)), to become 
                blind or disabled (as defined under section 1614(a) of 
                the Social Security Act (42 U.S.C. 1382c(a))); and
                    (C) is employed (as defined in paragraph (2)).
            (2) Definition of employed.--An individual is considered to 
        be ``employed'' if the individual--
                    (A) is earning at least the applicable minimum wage 
                requirement under section 6 of the Fair Labor Standards 
                Act (29 U.S.C. 206) and working at least 40 hours per 
                month; or
                    (B) is engaged in a work effort that meets 
                substantial and reasonable threshold criteria for hours 
                of work, wages, or other measures, as defined under the 
                demonstration project and approved by the Secretary.
    (c) Approval of Demonstration Projects.--
            (1) In general.--Subject to paragraph (3), the Secretary 
        shall approve applications under subsection (a) that meet the 
        requirements of paragraph (2) and such additional terms and 
        conditions as the Secretary may require. The Secretary may 
        waive the requirement of section 1902(a)(1) of the Social 
        Security Act (42 U.S.C. 1396a(a)(1)) to allow for sub-State 
        demonstrations.
            (2) Terms and conditions of demonstration projects.--The 
        Secretary may not approve a demonstration project under this 
        section unless the State provides assurances satisfactory to 
        the Secretary that the following conditions are or will be met:
                    (A) Election of optional category.--The State has 
                elected to provide coverage under its plan under title 
                XIX of the Social Security Act of individuals described 
                in section 1902(a)(10)(A)(ii)(XV) of the Social 
                Security Act (42 U.S.C. 1396a(a)(10)(A)(ii)(XV)).
                    (B) Maintenance of state effort.--Federal funds 
                paid to a State pursuant to this section must be used 
                to supplement, but not supplant, the level of State 
                funds expended for workers with potentially severe 
                disabilities under programs in effect for such 
                individuals at the time the demonstration project is 
                approved under this section.
                    (C) Independent evaluation.--The State provides for 
                an independent evaluation of the project.
            (3) Limitations on federal funding.--
                    (A) Authorization of appropriations.--There is 
                authorized to be appropriated to carry out this 
                section--
                            (i) for fiscal year 2000, $72,000,000;
                            (ii) for fiscal year 2001, $74,000,000;
                            (iii) for fiscal year 2002, $78,000,000; 
                        and
                            (iv) for fiscal year 2003, $81,000,000.
                    (B) Limitation on payments.--In no case may--
                            (i) the aggregate amount of payments made 
                        by the Secretary to States under this section, 
                        other than for administrative expenses 
                        described in clause (ii), exceed $300,000,000;
                            (ii) the aggregate amount of payments made 
                        by the Secretary to States for administrative 
                        expenses relating to annual reports required 
                        under subsection (d) exceed $5,000,000; or
                            (iii) payments be provided by the Secretary 
                        for a fiscal year after fiscal year 2005.
                    (C) Funds allocated to states.--The Secretary shall 
                allocate funds to States based on their applications 
                and the availability of funds. Funds allocated to a 
                State under a grant made under this section for a 
                fiscal year shall remain available until expended.
                    (D) Funds not allocated to states.--Funds not 
                allocated to States in the fiscal year for which they 
                are appropriated shall remain available in succeeding 
                fiscal years for allocation by the Secretary using the 
allocation formula established under this section.
                    (E) Payments to states.--The Secretary shall pay to 
                each State with a demonstration project approved under 
                this section, from its allocation under subparagraph 
                (C), an amount for each quarter equal to the Federal 
                medical assistance percentage (as defined in section 
                1905(b) of the Social Security Act (42 U.S.C. 1395d(b)) 
                of expenditures in the quarter for medical assistance 
                provided to workers with a potentially severe 
                disability.
    (d) Annual Report.--A State with a demonstration project approved 
under this section shall submit an annual report to the Secretary on 
the use of funds provided under the grant. Each report shall include 
enrollment and financial statistics on--
            (1) the total population of workers with potentially severe 
        disabilities served by the demonstration project; and
            (2) each population of such workers with a specific 
        physical or mental impairment described in subsection (b)(1)(B) 
        served by such project.
    (e) Recommendation.--Not later than October 1, 2002, the Secretary 
shall submit a recommendation to the Committee on Commerce of the House 
of Representatives and the Committee on Finance of the Senate regarding 
whether the demonstration project established under this section should 
be continued after fiscal year 2003.
    (f) State Defined.--In this section, the term ``State'' has the 
meaning given such term for purposes of title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.).

SEC. 205. ELECTION BY DISABLED BENEFICIARIES TO SUSPEND MEDIGAP 
              INSURANCE WHEN COVERED UNDER A GROUP HEALTH PLAN.

    (a) In General.--Section 1882(q) of the Social Security Act (42 
U.S.C. 1395ss(q)) is amended--
            (1) in paragraph (5)(C), by inserting ``or paragraph (6)'' 
        after ``this paragraph''; and
            (2) by adding at the end the following new paragraph:
            ``(6) Each medicare supplemental policy shall provide that 
        benefits and premiums under the policy shall be suspended at 
        the request of the policyholder if the policyholder is entitled 
        to benefits under section 226(b) and is covered under a group 
        health plan (as defined in section 1862(b)(1)(A)(v)). If such 
        suspension occurs and if the policyholder or certificate holder 
        loses coverage under the group health plan, such policy shall 
        be automatically reinstituted (effective as of the date of such 
        loss of coverage) under terms described in subsection 
        (n)(6)(A)(ii) as of the loss of such coverage if the 
        policyholder provides notice of loss of such coverage within 90 
        days after the date of such loss.''.
    (b) Effective Date.--The amendments made by subsection (a) apply 
with respect to requests made after the date of the enactment of this 
Act.

             TITLE III--DEMONSTRATION PROJECTS AND STUDIES

SEC. 301. EXTENSION OF DISABILITY INSURANCE PROGRAM DEMONSTRATION 
              PROJECT AUTHORITY.

    (a) Extension of Authority.--Title II of the Social Security Act 
(42 U.S.C. 401 et seq.) is amended by adding at the end the following:

                   ``demonstration project authority

    ``Sec. 234. (a) Authority.--
            ``(1) In general.--The Commissioner of Social Security (in 
        this section referred to as the `Commissioner') shall develop 
        and carry out experiments and demonstration projects designed 
        to determine the relative advantages and disadvantages of--
                    ``(A) various alternative methods of treating the 
                work activity of individuals entitled to disability 
                insurance benefits under section 223 or to monthly 
                insurance benefits under section 202 based on such 
                individual's disability (as defined in section 223(d)), 
                including such methods as a reduction in benefits based 
                on earnings, designed to encourage the return to work 
                of such individuals;
                    ``(B) altering other limitations and conditions 
                applicable to such individuals (including lengthening 
                the trial work period (as defined in section 222(c)), 
                altering the 24-month waiting period for hospital 
                insurance benefits under section 226, altering the 
                manner in which the program under this title is 
                administered, earlier referral of such individuals for 
                rehabilitation, and greater use of employers and others 
                to develop, perform, and otherwise stimulate new forms 
                of rehabilitation); and
                    ``(C) implementing sliding scale benefit offsets 
                using variations in--
                            ``(i) the amount of the offset as a 
                        proportion of earned income;
                            ``(ii) the duration of the offset period; 
                        and
                            ``(iii) the method of determining the 
                        amount of income earned by such individuals,
        to the end that savings will accrue to the Trust Funds, or to 
        otherwise promote the objectives or facilitate the 
        administration of this title.
            ``(2) Authority for expansion of scope.--The Commissioner 
        may expand the scope of any such experiment or demonstration 
        project to include any group of applicants for benefits under 
        the program established under this title with impairments that 
        reasonably may be presumed to be disabling for purposes of such 
        demonstration project, and may limit any such demonstration 
        project to any such group of applicants, subject to the terms 
        of such demonstration project which shall define the extent of 
        any such presumption.
    ``(b) Requirements.--The experiments and demonstration projects 
developed under subsection (a) shall be of sufficient scope and shall 
be carried out on a wide enough scale to permit a thorough evaluation 
of the alternative methods under consideration while giving assurance 
that the results derived from the experiments and projects will obtain 
generally in the operation of the disability insurance program under 
this title without committing such program to the adoption of any 
particular system either locally or nationally.
    ``(c) Authority To Waive Compliance With Benefits Requirements.--In 
the case of any experiment or demonstration project conducted under 
subsection (a), the Commissioner may waive compliance with the benefit 
requirements of this title and the requirements of section 1148 as they 
relate to the program established under this title, and the Secretary 
may (upon the request of the Commissioner) waive compliance with the 
benefits requirements of title XVIII, insofar as is necessary for a 
thorough evaluation of the alternative methods under consideration. No 
such experiment or project shall be actually placed in operation unless 
at least 90 days prior thereto a written report, prepared for purposes 
of notification and information only and containing a full and complete 
description thereof, has been transmitted by the Commissioner to the 
Committee on Ways and Means of the House of Representatives and to the 
Committee on Finance of the Senate. Periodic reports on the progress of 
such experiments and demonstration projects shall be submitted by the 
Commissioner to such committees. When appropriate, such reports shall 
include detailed recommendations for changes in administration or law, 
or both, to carry out the objectives stated in subsection (a).
    ``(d) Reports.--
            ``(1) Interim reports.--On or before June 9 of each year, 
        the Commissioner shall submit to the Committee on Ways and 
        Means of the House of Representatives and to the Committee on 
        Finance of the Senate an annual interim report on the progress 
        of the experiments and demonstration projects carried out under 
        this subsection together with any related data and materials 
        that the Commissioner may consider appropriate.
            ``(2) Termination and final report.--The authority under 
        the preceding provisions of this section (including any waiver 
        granted pursuant to subsection (c)) shall terminate 5 years 
        after the date of the enactment of this Act. Not later than 90 
        days after the termination of any experiment or demonstration 
        project carried out under this section, the Commissioner shall 
        submit to the Committee on Ways and Means of the House of 
        Representatives and to the Committee on Finance of the Senate a 
        final report with respect to that experiment or demonstration 
        project.''.
    (b) Conforming Amendments; Transfer of Prior Authority.--
            (1) Conforming amendments.--
                    (A) Repeal of prior authority.--Paragraphs (1) 
                through (4) of subsection (a) and subsection (c) of 
                section 505 of the Social Security Disability 
                Amendments of 1980 (42 U.S.C. 1310 note) are repealed.
                    (B) Conforming amendment regarding funding.--
                Section 201(k) of the Social Security Act (42 U.S.C. 
                401(k)) is amended by striking ``section 505(a) of the 
                Social Security Disability Amendments of 1980'' and 
                inserting ``section 234''.
            (2) Transfer of prior authority.--With respect to any 
        experiment or demonstration project being conducted under 
        section 505(a) of the Social Security Disability Amendments of 
        1980 (42 U.S.C. 1310 note) as of the date of enactment of this 
        Act, the authority to conduct such experiment or demonstration 
        project (including the terms and conditions applicable to the 
        experiment or demonstration project) shall be treated as if 
        that authority (and such terms and conditions) had been 
        established under section 234 of the Social Security Act, as 
        added by subsection (a).

SEC. 302. DEMONSTRATION PROJECTS PROVIDING FOR REDUCTIONS IN DISABILITY 
              INSURANCE BENEFITS BASED ON EARNINGS.

    (a) Authority.--The Commissioner of Social Security shall conduct 
demonstration projects for the purpose of evaluating, through the 
collection of data, a program for title II disability beneficiaries (as 
defined in section 1148(k)(3) of the Social Security Act) under which 
benefits payable under section 223 of such Act, or under section 202 of 
such Act based on the beneficiary's disability, are reduced by $1 for 
each $2 of the beneficiary's earnings that is above a level to be 
determined by the Commissioner. Such projects shall be conducted at a 
number of localities which the Commissioner shall determine is 
sufficient to adequately evaluate the appropriateness of national 
implementation of such a program. Such projects shall identify 
reductions in Federal expenditures that may result from the permanent 
implementation of such a program.
    (b) Scope and Scale and Matters To Be Determined.--
            (1) In general.--The demonstration projects developed under 
        subsection (a) shall be of sufficient duration, shall be of 
        sufficient scope, and shall be carried out on a wide enough 
        scale to permit a thorough evaluation of the project to 
        determine--
                    (A) the effects, if any, of induced entry into the 
                project and reduced exit from the project;
                    (B) the extent, if any, to which the project being 
                tested is affected by whether it is in operation in a 
                locality within an area under the administration of the 
                Ticket to Work and Self-Sufficiency Program established 
                under section 1148 of the Social Security Act; and
                    (C) the savings that accrue to the Federal Old-Age 
                and Survivors Insurance Trust Fund, the Federal 
                Disability Insurance Trust Fund, and other Federal 
                programs under the project being tested.
        The Commissioner shall take into account advice provided by the 
        Ticket to Work and Work Incentives Advisory Panel pursuant to 
        section 101(f)(2)(B)(ii) of this Act.
            (2) Additional matters.--The Commissioner shall also 
        determine with respect to each project--
                    (A) the annual cost (including net cost) of the 
                project and the annual cost (including net cost) that 
                would have been incurred in the absence of the project;
                    (B) the determinants of return to work, including 
                the characteristics of the beneficiaries who 
                participate in the project; and
                    (C) the employment outcomes, including wages, 
                occupations, benefits, and hours worked, of 
                beneficiaries who return to work as a result of 
                participation in the project.
        The Commissioner may include within the matters evaluated under 
        the project the merits of trial work periods and periods of 
        extended eligibility.
    (c) Waivers.--The Commissioner may waive compliance with the 
benefit provisions of title II of the Social Security Act, and the 
Secretary of Health and Human Services may waive compliance with the 
benefit requirements of title XVIII of such Act, insofar as is 
necessary for a thorough evaluation of the alternative methods under 
consideration. No such project shall be actually placed in operation 
unless at least 90 days prior thereto a written report, prepared for 
purposes of notification and information only and containing a full and 
complete description thereof, has been transmitted by the Commissioner 
to the Committee on Ways and Means of the House of Representatives and 
to the Committee on Finance of the Senate. Periodic reports on the 
progress of such projects shall be submitted by the Commissioner to 
such committees. When appropriate, such reports shall include detailed 
recommendations for changes in administration or law, or both, to carry 
out the objectives stated in subsection (a).
    (d) Interim Reports.--Not later than 2 years after the date of 
enactment of this Act, and annually thereafter, the Commissioner of 
Social Security shall submit to Congress an interim report on the 
progress of the demonstration projects carried out under this 
subsection together with any related data and materials that the 
Commissioner of Social Security may consider appropriate.
    (e) Final Report.--The Commissioner of Social Security shall submit 
to Congress a final report with respect to all demonstration projects 
carried out under this section not later than 1 year after their 
completion.
    (f) Expenditures.--Expenditures made for demonstration projects 
under this section shall be made from the Federal Disability Insurance 
Trust Fund and the Federal Old-Age and Survivors Insurance Trust Fund, 
as determined appropriate by the Commissioner of Social Security, and 
from the Federal Hospital Insurance Trust Fund and the Federal 
Supplementary Medical Insurance Trust Fund, as determined appropriate 
by the Secretary of Health and Human Services, to the extent provided 
in advance in appropriation Acts.

SEC. 303. STUDIES AND REPORTS.

    (a) Study by General Accounting Office of Existing Disability-
Related Employment Incentives.--
            (1) Study.--As soon as practicable after the date of 
        enactment of this Act, the Comptroller General of the United 
        States shall undertake a study to assess existing tax credits 
        and other disability-related employment incentives under the 
        Americans with Disabilities Act of 1990 and other Federal laws. 
        In such study, the Comptroller General shall specifically 
        address the extent to which such credits and other incentives 
        would encourage employers to hire and retain individuals with 
        disabilities.
            (2) Report.--Not later than 3 years after the date of 
        enactment of this Act, the Comptroller General shall transmit 
        to the Committee on Ways and Means of the House of 
        Representatives and the Committee on Finance of the Senate a 
        written report presenting the results of the Comptroller 
        General's study conducted pursuant to this subsection, together 
with such recommendations for legislative or administrative changes as 
the Comptroller General determines are appropriate.
    (b) Study by General Accounting Office of Existing Coordination of 
the DI and SSI Programs as They Relate to Individuals Entering or 
Leaving Concurrent Entitlement.--
            (1) Study.--As soon as practicable after the date of 
        enactment of this Act, the Comptroller General of the United 
        States shall undertake a study to evaluate the coordination 
        under current law of the disability insurance program under 
        title II of the Social Security Act and the supplemental 
        security income program under title XVI of such Act, as such 
        programs relate to individuals entering or leaving concurrent 
        entitlement under such programs. In such study, the Comptroller 
        General shall specifically address the effectiveness of work 
        incentives under such programs with respect to such individuals 
        and the effectiveness of coverage of such individuals under 
        titles XVIII and XIX of such Act.
            (2) Report.--Not later than 3 years after the date of 
        enactment of this Act, the Comptroller General shall transmit 
        to the Committee on Ways and Means of the House of 
        Representatives and the Committee on Finance of the Senate a 
        written report presenting the results of the Comptroller 
        General's study conducted pursuant to this subsection, together 
        with such recommendations for legislative or administrative 
        changes as the Comptroller General determines are appropriate.
    (c) Study by General Accounting Office of the Impact of the 
Substantial Gainful Activity Limit on Return to Work.--
            (1) Study.--As soon as practicable after the date of 
        enactment of this Act, the Comptroller General of the United 
        States shall undertake a study of the substantial gainful 
        activity level applicable as of that date to recipients of 
        benefits under section 223 of the Social Security Act (42 
        U.S.C. 423) and under section 202 of such Act (42 U.S.C. 402) 
        on the basis of a recipient having a disability, and the effect 
        of such level as a disincentive for those recipients to return 
        to work. In the study, the Comptroller General also shall 
        address the merits of increasing the substantial gainful 
        activity level applicable to such recipients of benefits and 
        the rationale for not yearly indexing that level to inflation.
            (2) Report.--Not later than 2 years after the date of 
        enactment of this Act, the Comptroller General shall transmit 
        to the Committee on Ways and Means of the House of 
        Representatives and the Committee on Finance of the Senate a 
        written report presenting the results of the Comptroller 
        General's study conducted pursuant to this subsection, together 
        with such recommendations for legislative or administrative 
        changes as the Comptroller General determines are appropriate.
    (d) Report on Disregards Under the DI and SSI Programs.--Not later 
than 90 days after the date of enactment of this Act, the Commissioner 
of Social Security shall submit to the Committee on Ways and Means of 
the House of Representatives and the Committee on Finance of the Senate 
a report that--
            (1) identifies all income, assets, and resource disregards 
        (imposed under statutory or regulatory authority) that are 
        applicable to individuals receiving benefits under title II or 
        XVI of the Social Security Act (42 U.S.C. 401 et seq., 1381 et 
        seq.);
            (2) with respect to each such disregard--
                    (A) specifies the most recent statutory or 
                regulatory modification of the disregard; and
                    (B) recommends whether further statutory or 
                regulatory modification of the disregard would be 
                appropriate; and
            (3) with respect to the disregard described in section 
        1612(b)(7) of such Act (42 U.S.C. 1382a(b)(7)) (relating to 
        grants, scholarships, or fellowships received for use in paying 
        the cost of tuition and fees at any educational (including 
        technical or vocational education) institution)--
                    (A) identifies the number of individuals receiving 
                benefits under title XVI of such Act (42 U.S.C. 1381 et 
                seq.) who have attained age 22 and have not had any 
                portion of any grant, scholarship, or fellowship 
                received for use in paying the cost of tuition and fees 
                at any educational (including technical or vocational 
                education) institution excluded from their income in 
                accordance with that section;
                    (B) recommends whether the age at which such 
                grants, scholarships, or fellowships are excluded from 
                income for purposes of determining eligibility under 
                title XVI of such Act should be increased to age 25; 
                and
                    (C) recommends whether such disregard should be 
                expanded to include any such grant, scholarship, or 
                fellowship received for use in paying the cost of room 
                and board at any such institution.
    (e) Study by the General Accounting Office of Social Security 
Administration's Disability Insurance Program Demonstration 
Authority.--
            (1) Study.--As soon as practicable after the date of the 
        enactment of this Act, the Comptroller General of the United 
        States shall undertake a study to assess the results of the 
        Social Security Administration's efforts to conduct disability 
        demonstrations authorized under prior law as well as under 
        section 301 of this Act.
            (2) Report.--Not later than 5 years after the date of the 
        enactment of this Act, the Comptroller General shall transmit 
        to the Committee on Ways and Means of the House of 
        Representatives and the Committee on Finance of the Senate a 
        written report presenting the results of the Comptroller 
        General's study conducted pursuant to this section, together 
        with a recommendation as to whether the demonstration authority 
        authorized under section 301 of this Act should be made 
        permanent.

            TITLE IV--MISCELLANEOUS AND TECHNICAL AMENDMENTS

SEC. 401. TECHNICAL AMENDMENTS RELATING TO DRUG ADDICTS AND ALCOHOLICS.

    (a) Clarification Relating to the Effective Date of the Denial of 
Social Security Disability Benefits to Drug Addicts and Alcoholics.--
Section 105(a)(5) of the Contract with America Advancement Act of 1996 
(42 U.S.C. 405 note) is amended--
            (1) in subparagraph (A), by striking ``by the Commissioner 
        of Social Security'' and ``by the Commissioner''; and
            (2) by adding at the end the following:
                    ``(D) For purposes of this paragraph, an 
                individual's claim, with respect to benefits under 
                title II based on disability, which has been denied in 
                whole before the date of the enactment of this Act, may 
                not be considered to be finally adjudicated before such 
                date if, on or after such date--
                            ``(i) there is pending a request for either 
                        administrative or judicial review with respect 
                        to such claim; or
                            ``(ii) there is pending, with respect to 
                        such claim, a readjudication by the 
                        Commissioner of Social Security pursuant to 
                        relief in a class action or implementation by 
                        the Commissioner of a court remand order.
                    ``(E) Notwithstanding the provisions of this 
                paragraph, with respect to any individual for whom the 
                Commissioner of Social Security does not perform the 
                entitlement redetermination before the date prescribed 
                in subparagraph (C), the Commissioner shall perform 
                such entitlement redetermination in lieu of a 
                continuing disability review whenever the Commissioner 
                determines that the individual's entitlement is subject 
                to redetermination based on the preceding provisions of 
                this paragraph, and the provisions of section 223(f) 
                shall not apply to such redetermination.''.
    (b) Correction to Effective Date of Provisions Concerning 
Representative Payees and Treatment Referrals of Social Security 
Beneficiaries Who Are Drug Addicts and Alcoholics.--Section 
105(a)(5)(B) of the Contract with America Advancement Act of 1996 (42 
U.S.C. 405 note) is amended to read as follows:
                    ``(B) The amendments made by paragraphs (2) and (3) 
                shall take effect on July 1, 1996, with respect to any 
                individual--
                            ``(i) whose claim for benefits is finally 
                        adjudicated on or after the date of the 
                        enactment of this Act; or
                            ``(ii) whose entitlement to benefits is 
                        based upon an entitlement redetermination made 
                        pursuant to subparagraph (C).''.
    (c) Effective Dates.--The amendments made by this section shall 
take effect as if included in the enactment of section 105 of the 
Contract with America Advancement Act of 1996 (Public Law 104-121; 110 
Stat. 852 et seq.).

SEC. 402. TREATMENT OF PRISONERS.

    (a) Implementation of Prohibition Against Payment of Title II 
Benefits to Prisoners.--
            (1) In general.--Section 202(x)(3) of the Social Security 
        Act (42 U.S.C. 402(x)(3)) is amended--
                    (A) by inserting ``(A)'' after ``(3)''; and
                    (B) by adding at the end the following:
    ``(B)(i) The Commissioner shall enter into an agreement under this 
subparagraph with any interested State or local institution comprising 
a jail, prison, penal institution, or correctional facility, or 
comprising any other institution a purpose of which is to confine 
individuals as described in paragraph (1)(A)(ii). Under such 
agreement--
            ``(I) the institution shall provide to the Commissioner, on 
        a monthly basis and in a manner specified by the Commissioner, 
        the names, Social Security account numbers, dates of birth, 
        confinement commencement dates, and, to the extent available to 
        the institution, such other identifying information concerning 
        the individuals confined in the institution as the Commissioner 
        may require for the purpose of carrying out paragraph (1) and 
        other provisions of this title; and
            ``(II) the Commissioner shall pay to the institution, with 
        respect to information described in subclause (I) concerning 
        each individual who is confined therein as described in 
        paragraph (1)(A), who receives a benefit under this title for 
        the month preceding the first month of such confinement, and 
        whose benefit under this title is determined by the 
        Commissioner to be not payable by reason of confinement based 
        on the information provided by the institution, $400 (subject 
        to reduction under clause (ii)) if the institution furnishes 
        the information to the Commissioner within 30 days after the 
        date such individual's confinement in such institution begins, 
        or $200 (subject to reduction under clause (ii)) if the 
        institution furnishes the information after 30 days after such 
        date but within 90 days after such date.
    ``(ii) The dollar amounts specified in clause (i)(II) shall be 
reduced by 50 percent if the Commissioner is also required to make a 
payment to the institution with respect to the same individual under an 
agreement entered into under section 1611(e)(1)(I).
    ``(iii) There are authorized to be transferred from the Federal 
Old-Age and Survivors Insurance Trust Fund and the Federal Disability 
Insurance Trust Fund, as appropriate, such sums as may be necessary to 
enable the Commissioner to make payments to institutions required by 
clause (i)(II).
    ``(iv) The Commissioner shall maintain, and shall provide on a 
reimbursable basis, information obtained pursuant to agreements entered 
into under this paragraph to any agency administering a Federal or 
federally-assisted cash, food, or medical assistance program for 
eligibility and other administrative purposes under such program.''.
            (2) Conforming amendments to the privacy act.--Section 
        552a(a)(8)(B) of title 5, United States Code, is amended--
                    (A) in clause (vi), by striking ``or'' at the end;
                    (B) in clause (vii), by adding ``or'' at the end; 
                and
                    (C) by adding at the end the following:
                            ``(viii) matches performed pursuant to 
                        section 202(x)(3) or 1611(e)(1) of the Social 
                        Security Act (42 U.S.C. 402(x)(3), 
                        1382(e)(1));''.
            (3) Conforming amendments to title xvi.--
                    (A) Section 1611(e)(1)(I)(i)(I) of the Social 
                Security Act (42 U.S.C. 1382(e)(1)(I)(i)(I)) is amended 
                by striking ``; and'' and inserting ``and the other 
                provisions of this title; and''.
                    (B) Section 1611(e)(1)(I)(ii)(II) of such Act (42 
                U.S.C. 1382(e)(1)(I)(ii)(II)) is amended by striking 
                ``is authorized to provide, on a reimbursable basis,'' 
                and inserting ``shall maintain, and shall provide on a 
                reimbursable basis,''.
                    (C) Section 1611(e)(1)(I)(ii)(II) of such Act (42 
                U.S.C. 1382(e)(1)(I)(ii)(II)) is amended by striking 
                ``eligibility purposes'' and inserting ``eligibility 
                and other administrative purposes under such program''.
            (4) Effective date.--The amendments made by this subsection 
        shall apply to individuals whose period of confinement in an 
        institution commences on or after the first day of the fourth 
        month beginning after the month in which this Act is enacted.
    (b) Elimination of Title II Requirement That Confinement Stem From 
Crime Punishable by Imprisonment for More Than 1 Year.--
            (1) In general.--Section 202(x)(1)(A) of the Social 
        Security Act (42 U.S.C. 402(x)(1)(A)) is amended--
                    (A) in the matter preceding clause (i), by striking 
                ``during which'' and inserting ``ending with or during 
                or beginning with or during a period of more than 30 
                days throughout all of which'';
                    (B) in clause (i), by striking ``an offense 
                punishable by imprisonment for more than 1 year 
                (regardless of the actual sentence imposed)'' and 
                inserting ``a criminal offense''; and
                    (C) in clause (ii)(I), by striking ``an offense 
                punishable by imprisonment for more than 1 year'' and 
                inserting ``a criminal offense''.
            (2) Effective date.--The amendments made by this subsection 
        shall apply to individuals whose period of confinement in an 
        institution commences on or after the first day of the fourth 
        month beginning after the month in which this Act is enacted.
    (c) Conforming Title XVI Amendments.--
            (1) 50 percent reduction in title xvi payment in case 
        involving comparable title ii payment.--Section 1611(e)(1)(I) 
        of the Social Security Act (42 U.S.C. 1382(e)(1)(I)) is 
        amended--
                    (A) in clause (i)(II), by inserting ``(subject to 
                reduction under clause (ii))'' after ``$400'' and after 
                ``$200'';
                    (B) by redesignating clauses (ii) and (iii) as 
                clauses (iii) and (iv) respectively; and
                    (C) by inserting after clause (i) the following:
    ``(ii) The dollar amounts specified in clause (i)(II) shall be 
reduced by 50 percent if the Commissioner is also required to make a 
payment to the institution with respect to the same individual under an 
agreement entered into under section 202(x)(3)(B).''.
            (2) Expansion of categories of institutions eligible to 
        enter into agreements with the commissioner.--Section 
        1611(e)(1)(I)(i) of such Act (42 U.S.C. 1382(e)(1)(I)(i)) is 
        amended in the matter preceding subclause (I) by striking 
        ``institution'' and all that follows through ``section 
        202(x)(1)(A),'' and inserting ``institution comprising a jail, 
        prison, penal institution, or correctional facility, or with 
        any other interested State or local institution a purpose of 
        which is to confine individuals as described in section 
        202(x)(1)(A)(ii),''.
            (3) Elimination of overly broad exemption.--Section 
        1611(e)(1)(I)(iii) of such Act (as redesignated by paragraph 
        (1)(B)) is amended further--
                    (A) by striking ``(I) The provisions'' and all that 
                follows through ``(II)''; and
                    (B) by striking ``eligibility purposes'' and 
                inserting ``eligibility and other administrative 
                purposes under such program''.
            (4) Effective date.--The amendments made by this subsection 
        shall take effect as if included in the enactment of section 
        203(a) of the Personal Responsibility and Work Opportunity 
        Reconciliation Act of 1996 (Public Law 104-193; 110 Stat. 
        2186). The reference to section 202(x)(1)(A)(ii) in section 
        1611(e)(1)(I)(i) of the Social Security Act as amended by 
        paragraph (2) shall be deemed a reference to such section 
        202(x)(1)(A)(ii) of such Act as amended by subsection 
        (b)(1)(C).
    (d) Continued Denial of Benefits to Sex Offenders Remaining 
Confined to Public Institutions Upon Completion of Prison Term.--
            (1) In general.--Section 202(x)(1)(A) of the Social 
        Security Act (42 U.S.C. 402(x)(1)(A)) is amended--
                    (A) in clause (i), by striking ``or'' at the end;
                    (B) in clause (ii)(IV), by striking the period and 
                inserting ``, or''; and
                    (C) by adding at the end the following new clause:
            ``(iii) immediately upon completion of confinement as 
        described in clause (i) pursuant to conviction of a criminal 
        offense an element of which is sexual activity, is confined by 
        court order in an institution at public expense pursuant to a 
        finding that the individual is a sexually dangerous person or a 
        sexual predator or a similar finding.''.
            (2) Conforming amendment.--Section 202(x)(1)(B)(ii) of such 
        Act (42 U.S.C. 402(x)(1)(B)(ii)) is amended by striking 
        ``clause (ii)'' and inserting ``clauses (ii) and (iii)''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply with respect to benefits for months ending after 
        the date of the enactment of this Act.

SEC. 403. REVOCATION BY MEMBERS OF THE CLERGY OF EXEMPTION FROM SOCIAL 
              SECURITY COVERAGE.

    (a) In General.--Notwithstanding section 1402(e)(4) of the Internal 
Revenue Code of 1986, any exemption which has been received under 
section 1402(e)(1) of such Code by a duly ordained, commissioned, or 
licensed minister of a church, a member of a religious order, or a 
Christian Science practitioner, and which is effective for the taxable 
year in which this Act is enacted, may be revoked by filing an 
application therefor (in such form and manner, and with such official, 
as may be prescribed by the Commissioner of Internal Revenue), if such 
application is filed no later than the due date of the Federal income 
tax return (including any extension thereof) for the applicant's second 
taxable year beginning after December 31, 1999. Any such revocation 
shall be effective (for purposes of chapter 2 of the Internal Revenue 
Code of 1986 and title II of the Social Security Act), as specified in 
the application, either with respect to the applicant's first taxable 
year beginning after December 31, 1999, or with respect to the 
applicant's second taxable year beginning after such date, and for all 
succeeding taxable years; and the applicant for any such revocation may 
not thereafter again file application for an exemption under such 
section 1402(e)(1). If the application is filed after the due date of 
the applicant's Federal income tax return for a taxable year and is 
effective with respect to that taxable year, it shall include or be 
accompanied by payment in full of an amount equal to the total of the 
taxes that would have been imposed by section 1401 of the Internal 
Revenue Code of 1986 with respect to all of the applicant's income 
derived in that taxable year which would have constituted net earnings 
from self-employment for purposes of chapter 2 of such Code 
(notwithstanding paragraphs (4) and (5) of section 1402(c)) except for 
the exemption under section 1402(e)(1) of such Code.
    (b) Effective Date.--Subsection (a) shall apply with respect to 
service performed (to the extent specified in such subsection) in 
taxable years beginning after December 31, 1999, and with respect to 
monthly insurance benefits payable under title II on the basis of the 
wages and self-employment income of any individual for months in or 
after the calendar year in which such individual's application for 
revocation (as described in such subsection) is effective (and lump-sum 
death payments payable under such title on the basis of such wages and 
self-employment income in the case of deaths occurring in or after such 
calendar year).

SEC. 404. ADDITIONAL TECHNICAL AMENDMENT RELATING TO COOPERATIVE 
              RESEARCH OR DEMONSTRATION PROJECTS UNDER TITLES II AND 
              XVI.

    (a) In General.--Section 1110(a)(3) of the Social Security Act (42 
U.S.C. 1310(a)(3)) is amended by striking ``title XVI'' and inserting 
``title II or XVI''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect as if included in the enactment of the Social Security 
Independence and Program Improvements Act of 1994 (Public Law 103-296; 
108 Stat. 1464).

SEC. 405. AUTHORIZATION FOR STATE TO PERMIT ANNUAL WAGE REPORTS.

    (a) In General.--Section 1137(a)(3) of the Social Security Act (42 
U.S.C. 1320b-7(a)(3)) is amended by inserting before the semicolon the 
following: ``, and except that in the case of wage reports with respect 
to domestic service employment, a State may permit employers (as so 
defined) that make returns with respect to such employment on a 
calendar year basis pursuant to section 3510 of the Internal Revenue 
Code of 1986 to make such reports on an annual basis''.
    (b) Technical Amendments.--Section 1137(a)(3) of the Social 
Security Act (42 U.S.C. 1320b-7(a)(3)) is amended--
            (1) by striking ``(as defined in section 
        453A(a)(2)(B)(iii))''; and
            (2) by inserting ``(as defined in section 453A(a)(2)(B))'' 
        after ``employers'' .
    (c) Effective Date.--The amendments made by this section shall 
apply to wage reports required to be submitted on and after the date of 
enactment of this Act.

SEC. 406. ASSESSMENT ON ATTORNEYS WHO RECEIVE THEIR FEES VIA THE SOCIAL 
              SECURITY ADMINISTRATION.

    (a) In General.--Section 206 of the Social Security Act (42 U.S.C. 
606) is amended by adding at the end the following:
    ``(d) Assessment on Attorneys.--
            ``(1) In general.--Whenever a fee for services is required 
        to be certified for payment to an attorney from a claimant's 
        past-due benefits pursuant to subsection (a)(4)(A) or 
        (b)(1)(A), the Commissioner shall impose on the attorney an 
        assessment calculated in accordance with paragraph (2).
            ``(2) Amount.--
                    ``(A) The amount of an assessment under paragraph 
                (1) shall be equal to the product obtained by 
                multiplying the amount of the representative's fee that 
                would be required to be so certified by subsection 
                (a)(4)(A) or (b)(1)(A) before the application of this 
                subsection, by the percentage specified in subparagraph 
                (B).
                    ``(B) The percentage specified in this subparagraph 
                is--
                            ``(i) for calendar years before 2001, 6.3 
                        percent, and
                            ``(ii) for calendar years after 2000, 6.3 
                        percent or such different percentage rate as 
                        the Commissioner determines is necessary in 
                        order to achieve full recovery of the costs of 
                        certifying fees to attorneys from the past-due 
                        benefits of claimants.
            ``(3) Collection.--The Commissioner may collect the 
        assessment imposed on an attorney under paragraph (1) by offset 
        from the amount of the fee otherwise required by subsection 
        (a)(4)(A) or (b)(1)(A) to be certified for payment to the 
        attorney from a claimant's past-due benefits.
            ``(4) Prohibition on claimant reimbursement.--An attorney 
        subject to an assessment under paragraph (1) may not, directly 
        or indirectly, request or otherwise obtain reimbursement for 
        such assessment from the claimant whose claim gave rise to the 
        assessment.
            ``(5) Disposition of assessments.--Assessments on attorneys 
        collected under this subsection shall be credited to the 
        Federal Old-Age and Survivors Insurance Trust Fund and the 
        Federal Disability Insurance Trust Fund, as appropriate.
            ``(6) Authorization of appropriations.--The assessments 
        authorized under this section shall be collected and available 
        for obligation only to the extent and in the amount provided in 
        advance in appropriations Acts. Amounts so appropriated are 
        authorized to remain available until expended, for 
        administrative expenses in carrying out title II of the Social 
        Security Act and related laws.''.
    (b) Conforming Amendments.--
            (1) Section 206(a)(4)(A) of such Act (42 U.S.C. 
        606(a)(4)(A)) is amended by inserting ``and subsection (d)'' 
        after ``subparagraph (B)''.
            (2) Section 206(b)(1)(A) of such Act (42 U.S.C. 
        606(b)(1)(A)) is amended by inserting ``, but subject to 
        subsection (d) of this section'' after ``section 205(i)''.
    (c) Effective Date.--The amendments made by this section shall 
apply in the case of any attorney with respect to whom a fee for 
services is required to be certified for payment from a claimant's 
past-due benefits pursuant to subsection (a)(4)(A) or (b)(4)(A) of 
section 206 of the Social Security Act after--
            (1) December 31, 1999, or
            (2) the last day of the first month beginning after the 
        month in which this Act is enacted.

SEC. 407. EXTENSION OF AUTHORITY OF STATE MEDICAID FRAUD CONTROL UNITS.

    (a) Extension of Concurrent Authority To Investigate and Prosecute 
Fraud in Other Federal Health Care Programs.--Section 1903(q)(3) of the 
Social Security Act (42 U.S.C. 1396b(q)(3)) is amended--
            (1) by inserting ``(A)'' after ``in connection with''; and
            (2) by striking ``title.'' and inserting ``title; and (B) 
        upon the approval of the Inspector General of the relevant 
        Federal agency in a particular case or investigation, any 
        aspect of the provision of health care services and activities 
        of providers of such services under any Federal health care 
        program (as defined in section 1128B(f)(1)), if (i) the 
        suspected fraud or violation of law in such case or 
        investigation is primarily related to the State plan under this 
        title, and (ii) when such approval is granted, the Inspector 
        General of the relevant Federal agency retains the continuing 
        authority to join the case or investigation, or after 
        consultation with the entity, to replace the entity as the 
        primary agency assigned to the case or investigation.''.
    (b) Recoupment of Funds.--Section 1903(q)(5) of such Act (42 U.S.C. 
1396b(q)(5)) is amended--
            (1) by inserting ``or under any Federal health care program 
        (as so defined)'' after ``plan''; and
            (2) by adding at the end the following: ``All funds 
        collected in accordance with this paragraph shall be credited 
        exclusively to, and available for expenditure under, the 
        Federal health care program (including the State plan under 
        this title) that was subject to the activity that was the basis 
        for the collection.''.
    (c) Extension of Authority To Investigate and Prosecute Resident 
Abuse in Non-Medicaid Board and Care Facilities.--Section 1903(q)(4) of 
such Act (42 U.S.C. 1396b(q)(4)) is amended to read as follows:
            ``(4)(A) The entity has--
                    ``(i) procedures for reviewing complaints of abuse 
                or neglect of patients in health care facilities which 
                receive payments under the State plan under this title;
                    ``(ii) at the option of the entity, procedures for 
                reviewing complaints of abuse or neglect of patients 
                residing in board and care facilities; and
                    ``(iii) procedures for acting upon such complaints 
                under the criminal laws of the State or for referring 
                such complaints to other State agencies for action.
            ``(B) For purposes of this paragraph, the term `board and 
        care facility' means a residential setting which receives 
        payment (regardless of whether such payment is made under the 
        State plan under this title) from or on behalf of two or more 
        unrelated adults who reside in such facility, and for whom one 
        or both of the following is provided:
                    ``(i) Nursing care services provided by, or under 
                the supervision of, a registered nurse, licensed 
                practical nurse, or licensed nursing assistant.
                    ``(ii) A substantial amount of personal care 
                services that assist residents with the activities of 
                daily living, including personal hygiene, dressing, 
                bathing, eating, toileting, ambulation, transfer, 
                positioning, self-medication, body care, travel to 
                medical services, essential shopping, meal preparation, 
                laundry, and housework.''.
    (d) Effective Date.--The amendments made by this section take 
effect on the date of enactment of this Act.

SEC. 408. ELIMINATION OF FRAUD AND ABUSE ASSOCIATED WITH CERTAIN 
              PAYMENTS UNDER THE MEDICAID PROGRAM.

    (a) Requirements for Payments.--Section 1903(i) of the Social 
Security Act (42 U.S.C. 1396b(i)) is amended--
            (1) in paragraph (19), by striking the period at the end 
        and inserting ``; or'';
            (2) by inserting after paragraph (19) the following:
            ``(20) with respect to any amount expended for an item or 
        service provided under the plan, or for any administrative 
        expense incurred to carry out the plan, which is provided or 
        incurred by, or on behalf of, a local educational agency or 
        school district--
                    ``(A) for which payment is made for a bundled group 
                of individual items, services, and administrative 
                expenses, unless payment for the grouped items, 
                services, and administrative expenses is made in 
                accordance with a system that is approved by the 
                Secretary and that--
                            ``(i) provides for an itemization to the 
                        Secretary for assuring accountability of cost 
                        of the grouped items, services, and 
                        administrative expenses and includes payment 
                        rates and the methodologies underlying the 
                        establishment of such rates;
                            ``(ii) has an actuarially sound basis for 
                        determining the payment rates and the 
                        methodologies; and
                            ``(iii) reconciles payments for the grouped 
                        items and services provided and administrative 
                        expenses incurred under this title with their 
                        cost; or
                    ``(B) for which payment is otherwise made using a 
                fee-for-service methodology, unless payment for the 
                item, service, or administrative expense is made in 
                accordance with a system that is approved by the 
                Secretary and that reimburses only for the cost of an 
                item or service provided and an administrative expense 
                incurred that is reasonable and related to the cost of 
                providing or incurring such item, service, or 
                administrative expense or that is based on such other 
                tests of reasonableness as the Secretary prescribes in 
                regulations; or
            ``(21) with respect to any transportation service provided 
        by, or on behalf of, a local educational agency or school 
        district for a child unless--
                    ``(A) a medical need for transportation is noted in 
                the individual education plan of the child, including a 
                child residing in a geographic area within which school 
                bus transportation is otherwise not provided;
                    ``(B) the vehicle used to furnish such 
                transportation service is specially equipped to 
                accommodate individuals with special medical needs; and
                    ``(C) the payment for such service--
                            ``(i) is made only with respect to costs 
                        associated with transporting individuals whose 
                        medical needs require transport in such a 
                        vehicle; and
                            ``(ii) reflects only the proportion of the 
                        transportation costs equal to--
                                    ``(I) the proportion of time spent 
                                by such individuals at such location in 
                                activities relating to the receipt of 
                                covered services under this title; or
                                    ``(II) such other proportion based 
                                on an allocation method that the 
                                Secretary finds reasonable in light of 
                                the benefit to the program under this 
                                title and consistent with the cost 
principles contained in OMB Circular A-87; or
            ``(22) with respect to any amount expended for an item or 
        service under the plan or for any administrative expense to 
        carry out the plan provided by a public agency that enters into 
        a contract with an entity for the development and operation of 
        submitting claims for such amount unless the agency--
                    ``(A) uses a competitive bidding process or 
                otherwise to contract with such entity at a reasonable 
                rate commensurate with the services performed by such 
                entity; and
                    ``(B) requires that any fees (including any 
                administrative fees) to be paid to the entity for the 
                development of the claims procedure are identified as a 
                non-contingent, specified dollar amount in the 
                contract.''; and
            (3) in the third sentence, by striking ``(17), and (18)'' 
        and inserting ``(17), (18), (19), (20), and (21)''.
    (b) Provision of Items and Services Through Medicaid Managed Care 
Organizations.--Section 1903(m)(2)(A) of the Social Security Act (42 
U.S.C. 1396b(m)(2)(A)) is amended by redesignating clause (xi) (as 
added by section 4701(c)(3) of the Balanced Budget Act of 1997) as 
clause (xiii), by striking ``and'' at the end of clause (xi), and by 
inserting after clause (xi) the following:
            ``(xii) such contract provides that with respect to payment 
        for, and coverage of, such services in any case in which--
                    ``(I) a medicaid managed care organization is 
                responsible for providing such services to a child 
                eligible for benefits under this title but coverage of 
                services required under the child's individual 
                education plan is not included in the managed care 
                contract but is the responsibility of the local 
                educational agency or school district in the State; or
                    ``(II) acute care services are available in the 
                schools to children enrolled under such contract,
        that there are assurances in the State plan and in the managed 
        care contract that coordination exists between the local 
        educational agency or school district and the managed care plan 
        to prevent duplication of services or duplication of payments 
        under this title for such services.''
    (c) Allowable Share of FFP With Respect to Payment for Services 
Furnished in School Setting.--Section 1903 of the Social Security Act 
(42 U.S.C. 1396b) is amended by adding at the end the following:
    ``(x) In the case of any Federal financial participation amount 
determined under subsection (a) with respect to any expenditure for an 
item or service under the plan, or for any administrative expense to 
carry out the plan, which is furnished by a local educational agency or 
school district, the State shall provide that--
            ``(1) 100 percent of such amount be paid to such agency or 
        district, or
            ``(2) a percentage of such amount be retained by the State, 
        but only to the extent such percentage does not exceed the 
        percentage of such expenditure funded by State general revenue 
        sources dedicated for such purpose.''
    (d) Uniform Methodology for School-Based Claims.--Not later than 90 
days after the date of enactment of this Act, the Administrator of the 
Health Care Financing Administration, in consultation with State 
medicaid and educational agencies and local school systems, shall 
develop and implement a uniform methodology for claims for payment of 
medical assistance and related administrative expenses furnished under 
title XIX of the Social Security Act by schools. Such methodology for 
administrative expenses shall be based on standards related to time 
studies and population estimates and a national standard for 
determining payment for such administrative expenses.
    (e) Effective Date.--The amendments made by this section shall 
apply to items and services provided on and after the date of enactment 
of this Act, without regard to whether implementing regulations are in 
effect. The Secretary of Health and Human Services shall promulgate 
such final regulations as are necessary to carry out such amendments 
not later than 1 year after such date of enactment.