I 111th CONGRESS 2d Session H. R. 5363 IN THE HOUSE OF REPRESENTATIVES May 20, 2010 Mr. Schrader (for himself, Mr. Arcuri, Mr. Boren, Mr. Boyd, Mr. Cardoza, Mr. Chandler, Mr. Childers, Mr. Cooper, Mr. Costa, Mr. Cuellar, Mr. Davis of Tennessee, Mr. Ellsworth, Ms. Giffords, Ms. Harman, Ms. Herseth Sandlin, Mr. Hill, Mr. Holden, Mr. Kagen, Mr. Kratovil, Ms. Markey of Colorado, Mr. Matheson, Mr. McIntyre, Mr. Melancon, Mr. Michaud, Mr. Minnick, Mr. Moore of Kansas, Mr. Murphy of New York, Mr. Nye, Mr. Ross, Ms. Loretta Sanchez of California, Mr. Schiff, Mr. Shuler, Mr. Tanner, and Mr. Wilson of Ohio) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committees on Energy and Commerce and Education and Labor, 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 A BILL To make funds available to increase program integrity efforts and reduce wasteful government spending of taxpayer’s dollars.

1.

Short title

This Act may be cited as the Preventing Waste, Fraud, and Abuse Act of 2010.

2.

Findings

The Congress finds the following: (1)To protect the taxpayer and the Treasury, it is the responsibility of the Congress to provide Federal agencies with the financial resources necessary to enforce the laws of the United States and to prevent waste, fraud, and abuse of taxpayer’s dollars. (2)For every $1 invested in the Department of Health and Human Services and the Department of Justice for program integrity efforts to prevent waste, fraud, and abuse of Medicare, Medicaid, and the Children’s Health Insurance Program, approximately $1.55 will be saved, according to a report issued by the Office of Management and Budget. (3)Increased program integrity efforts by the Department of Health and Human Services and the Department of Justice can provide an estimated savings of $4,470,000,000 on an investment of $3,100,000,000 in Medicare, Medicaid, and the Children’s Health Insurance Program over the next 5 fiscal years and an estimated savings of $9,870,000,000 on an investment of $6,753,000,000 over the next 10 fiscal years, according to a report issued by the Office of Management and Budget. (4)For every $1 invested in the Social Security Administration for program integrity efforts to increase the volume of continuing disability reviews conducted pursuant to section 221(i) of the Social Security Act (42 U.S.C. 421(i)) to determine whether a recipient of disability insurance benefits under section 223(a) of such Act (42 U.S.C. 423(a)) will continue to be eligible for such benefits, approximately $10 will be saved, according to a report issued by the Office of Management and Budget. (5)For every $1 invested in the Social Security Administration for program integrity efforts to increase the volume of continuing disability reviews conducted pursuant to section 1631(j) of Social Security Act (42 U.S.C. 1383(j)) to determine whether a recipient of supplemental security income benefits under section 1611 of such Act (42 U.S.C. 1382) will continue to be eligible for such benefits, approximately $8 will be saved, according to a report issued by the Office of Management and Budget. (6)Providing additional funding to the Social Security Administration to increase the volume of continuing disability reviews conducted pursuant to sections 221(i) and 1631(j) of Social Security Act (42 U.S.C. 421(i), 1383(j), respectively) can provide an estimated savings of $16,102,000,000 on an investment of $3,953,000,000 over the next 5 fiscal years and an estimated savings of $57,838,000,000 on an investment of $10,252,000,000 over the next 10 fiscal years, according to a report issued by the Office of Management and Budget. (7)The tax gap, the difference between the annual amount of Federal income taxes owed and the amount voluntarily paid on time, places an undue burden upon the overwhelming majority of taxpayers who fully and voluntarily pay their taxes on time. (8)In a report released in 2009 by the Internal Revenue Service, it was estimated that in 2005 (the most recent estimate available) the gross tax gap was $345,000,000,000 and the net tax gap (after the collection of late and enforced payments) was $290,000,000,000. (9)In 2009, for every $1 that was invested for the purposes of enforcing the tax code, the Internal Revenue Service returned an average of $4 to the Treasury, with some enforcement activities returning as much as $11 for every $1 invested, according to a report issued by the Office of Management and Budget. (10)By increasing overall tax enforcement efforts, the Internal Revenue Service can provide an estimated savings of $13,874,000,000 on an investment of $8,869,000,000 over the next 5 fiscal years and an estimated savings of $62,217,000,000 on an investment of $23,275,000,000 over the next 10 fiscal years, according to a report issued by the Office of Management and Budget. (11)For each $1 invested to increase the volume of in-person reemployment and eligibility assessments conducted by States for the Department of Labor’s unemployment insurance program, approximately $3.19 will be saved over the next 10 years, according to a report issued by the Office of Management and Budget. (12)States will save the Department of Labor’s unemployment insurance program an estimated $937,000,000 on an investment of $325,000,000 by increasing the volume of in-person reemployment and eligibility assessments over the next 5 fiscal years and an estimated savings of $2,296,000,000 on an investment of $720,000,000 over the next 10 fiscal years, according to a report issued by the Office of Management and Budget. (13)The investments described in the preceding paragraphs, if carried out, will save the taxpayers nearly $2,000,000,000 during fiscal year 2011, while laying the foundations for saving more than $35,000,000,000 over the next 5 fiscal years and more than $132,000,000,000 over the next 10 fiscal years.

3.

Definitions

In this Act: (1)

Agency head

The term agency head means— (A)the Attorney General; (B)the Commissioner of Social Security; (C)the Secretary of Health and Human Services; (D)the Secretary of Labor; and (E)the Secretary of the Treasury. (2)

Director

The term Director means the Director of the Office of Management and Budget.

4.

Increasing program integrity efforts

(a)

Program integrity efforts

(1)

In general

Each agency head, in consultation with the Director, shall— (A)identify existing Federal laws and regulations that may impede the ability to decrease waste, fraud, and abuse of funds appropriated to the agency head’s agency; and (B)develop appropriate performance metrics to measure such agency’s success in decreasing waste, fraud, and abuse. (2)

Development of metrics

In developing performance metrics referred to in paragraph (1)(B), each agency head shall— (A)ensure that such metrics accurately demonstrate the effectiveness of the programs and activities referred to in subsection (d) in decreasing waste, fraud, and abuse; (B)provide estimates for points of diminishing returns on the funds provided under this Act to increase program integrity efforts; (C)identify optimal baselines for each of the metrics developed under this subsection and appropriate methods to measure variations from such baselines; and (D)set performance targets for each of fiscal years 2012 through 2020. (b)

Innovation and development

Each agency head shall make appropriate accommodations for innovation and development to address the program integrity efforts for programs and activities referred to in subsection (d). (c)

Reports

(1)

In general

Each agency head shall submit to Congress— (A)not later than 6 months after the date of enactment of this Act, an interim report that includes a description of— (i)what the performance metrics developed under subsection (a) will be measuring; and (ii)how such metrics will measure and provide an accurate analysis of the performance of the applicable programs and activities referred to in subsection (d); and (B)not later than 1 year after the date of enactment of this Act, a final report that sets forth the performance metrics developed under subsection (a). (2)

Federal register; Web site

Each agency head shall publish in the Federal Register and make available on the agency Web site the performance metrics set forth in its final report submitted under paragraph (1)(B) not later than 30 days after such report is submitted. (3)

Modification of performance metrics

Not later than 30 days after the date on which any performance metrics developed under subsection (a) are modified by an agency head, such agency head shall submit to Congress a written notice describing such modifications. (4)

OMB annual report

Using the performance metrics developed under subsection (a), each year, beginning with the first fiscal year following the date on which the final reports are required to be submitted under paragraph (1)(B), on or after the first Monday in January but not later than the first Monday in February, the Director shall submit to Congress an annual report measuring the success of the agency head’s agency in decreasing waste, fraud, and abuse of funds appropriated to such agency. Each annual report shall include a summary of and justifications for any modified performance metrics submitted to Congress pursuant to paragraph (3). (5)

Referral of reports

Each report submitted pursuant to this subsection shall be referred to the Committee on Appropriations and the Committee on the Budget of the House of Representatives and the Committee on Appropriations and the Committee on the Budget of the Senate, and any other appropriate committee of jurisdiction. (d)

Authorization of appropriations

(1)

Department of Health and Human Services; Department of Justice

For the purposes of continuing and increasing program integrity efforts of the Department of Health and Human Services and the Department of Justice to prevent waste, fraud, and abuse of Medicare, Medicaid, and the Children’s Health Insurance Program, there are authorized to be appropriated the following sums: (A)$561,000,000 for fiscal year 2011, to remain available through September 30, 2012. (B)$589,000,000 for fiscal year 2012, to remain available through September 30, 2013. (C)$619,000,000 for fiscal year 2013, to remain available through September 30, 2014. (D)$649,000,000 for fiscal year 2014, to remain available through September 30, 2015. (E)$682,000,000 for fiscal year 2015, to remain available through September 30, 2016. (F)$3,653,000,000 for the period encompassing fiscal years 2016 through 2020. (2)

Social Security Administration

For the purposes of continuing and increasing program integrity efforts of the Social Security Administration by increasing the volume of continuing disability reviews conducted pursuant to sections 221(i) and 1631(j) of the Social Security Act (42 U.S.C. 421(i), 1383(j), respectively), there are authorized to be appropriated to the Commissioner of Social Security the following sums: (A)$513,000,000 for fiscal year 2011, to remain available through September 30, 2012. (B)$642,000,000 for fiscal year 2012, to remain available through September 30, 2013. (C)$751,000,000 for fiscal year 2013, to remain available through September 30, 2014. (D)$924,000,000 for fiscal year 2014, to remain available through September 30, 2015. (E)$1,123,000,000 for fiscal year 2015, to remain available through September 30, 2016. (F)$6,299,000,000 for the period encompassing fiscal years 2016 through 2020. (3)

Department of the Treasury

For purposes of continuing and increasing program integrity efforts of the Department of the Treasury by expanding tax enforcement activities, there are authorized to be appropriated to the Secretary of the Treasury the following sums: (A)$1,115,000,000 for fiscal year 2011, to remain available through September 30, 2012. (B)$1,357,000,000 for fiscal year 2012, to remain available through September 30, 2013. (C)$1,724,000,000 for fiscal year 2013, to remain available through September 30, 2014. (D)$2,105,000,000 for fiscal year 2014, to remain available through September 30, 2015. (E)$2,568,000,000 for fiscal year 2015, to remain available through September 30, 2016. (F)$14,406,000,000 for the period encompassing fiscal years 2016 through 2020. (4)

Department of Labor

For purposes of continuing and increasing program integrity efforts of the Department of Labor by increasing the volume of in-person reemployment and eligibility assessments of unemployment insurance beneficiaries conducted by States, there are authorized to be appropriated to the Secretary of Labor the following sums: (A)$55,000,000 for fiscal year 2011, to remain available through September 30, 2012. (B)$60,000,000 for fiscal year 2012, to remain available through September 30, 2013. (C)$65,000,000 for fiscal year 2013, to remain available through September 30, 2014. (D)$70,000,000 for fiscal year 2014, to remain available through September 30, 2015. (E)$75,000,000 for fiscal year 2015, to remain available through September 30, 2016. (F)$395,000,000 for the period encompassing fiscal years 2016 through 2020.