[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1419 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 1419

  To amend title II of the Social Security Act to improve the Social 
 Security Administration's ability to fight fraud, prevent errors, and 
    protect the Social Security Trust Fund, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 18, 2015

    Mr. Becerra (for himself, Mr. Levin, Mr. Doggett, Mr. Larson of 
  Connecticut, Mr. Blumenauer, Mr. Rangel, Mr. Lewis, Mr. Thompson of 
 California, Mr. Crowley, Mr. Danny K. Davis of Illinois, Ms. Linda T. 
 Saanchez of California, Mr. Cummings, Mr. Cartwright, Ms. Schakowsky, 
Ms. Matsui, and Mr. Pierluisi) introduced the following bill; which was 
  referred to the Committee on Ways and Means, and in addition to the 
Committee on the Budget, 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 amend title II of the Social Security Act to improve the Social 
 Security Administration's ability to fight fraud, prevent errors, and 
    protect the Social Security Trust Fund, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Social Security Fraud and Error 
Prevention Act of 2015''.

SEC. 2. FRAUD AND ERROR PREVENTION.

    (a) In General.--Section 201 of the Social Security Act (42 U.S.C. 
401 et seq.) is amended by striking subsection (n) and inserting the 
following:
    ``(n) Fraud and Error Prevention.--
            ``(1) Subject to paragraph (4) and as authorized by 
        subparagraph (g)(1), there is hereby appropriated from any one 
        or all of the Trust Funds to the Social Security Administration 
        for each fiscal year beginning with fiscal year 2016 for fraud 
        and error prevention activities described in paragraph (3), in 
        addition to any other amounts otherwise appropriated for such 
        fiscal year, an amount equal to the sum of--
                    ``(A) the applicable dollar amount (determined 
                under paragraph (2)), plus
                    ``(B) an amount equal to the sum of any fines or 
                other monetary penalties recovered in the previous 
                fiscal year pursuant to sections 208(a), 1129(a), 1140 
                (to the extent that such penalties are imposed for 
                misuse or misrepresentation of words, letters, symbols, 
                or emblems relating to the Social Security 
                Administration), and 1632(a).
            ``(2) The applicable dollar amount determined under this 
        clause is--
                    ``(A) for fiscal year 2016, $1,750,000,000;
                    ``(B) for each of fiscal years 2017 through 2021, 
                $1,800,000,000; and
                    ``(C) for each fiscal year thereafter, 
                $1,800,000,000 multiplied by the ratio (not less than 
                1) of--
                            ``(i) the Consumer Price Index for Urban 
                        Wager Earners and Clerical Workers (CPI-W, as 
                        published by the Bureau of Labor Statistics of 
                        the Department of Labor) for the 1st full 
                        calendar year preceding such fiscal year, to
                            ``(ii) the CPI-W for 2019.
            ``(3) The Commissioner of Social Security may use funds 
        appropriated under paragraph (1) for the following purposes:
                    ``(A) Medical continuing disability reviews 
                conducted pursuant to section 221(i) and section 
                1614(a)(3)(H).
                    ``(B) SSI redeterminations conducted pursuant to 
                section 1611(c).
                    ``(C) Work-related continuing disability reviews 
                conducted pursuant to section 223(f).
                    ``(D) Establishment, support, or expansion of 
                cooperative disability investigations (CDI) units.
                    ``(E) Pre-effectuation reviews conducted pursuant 
                to section 221(c) and section 1633(e).
                    ``(F) Quality reviews of decisions made by an 
                administrative law judge under this title or title XVI 
                in accordance with section 221(n).
                    ``(G) Recovery of overpayments under sections 204 
                and 1631(b).
                    ``(H) Recovery of civil monetary penalties imposed 
                under sections 1129 and 1140.
                    ``(I) Supporting prosecution of felonies under 
                section 208.
            ``(4) Funds appropriated under paragraph (1) for a fiscal 
        year shall not be available for obligation until the report 
        required to be submitted under paragraph (5) 60 days prior to 
        the beginning of such fiscal year has been submitted.
            ``(5) Not later than 60 days prior to the beginning of each 
        fiscal year after 2015, the Commissioner of Social Security 
        shall submit a report to the Committee on Ways and Means of the 
        House of Representatives, the Committee on Finance of the 
        Senate, and the Office and Management and Budget that includes 
        the following:
                    ``(A) A plan for conducting the fraud and error 
                prevention activities described in paragraph (3) in 
                such fiscal year, including--
                            ``(i) an itemized statement of the dollar 
                        amounts expected to be spent on each such 
                        activity during such fiscal year;
                            ``(ii) an itemized statement of the 
                        estimated long-term savings to the Trust Funds 
                        and the Treasury expected to be obtained as a 
                        result of each such activity, and a statement 
                        of the estimated total value of benefits paid 
                        under this title solely as a result of such 
                        activities;
                            ``(iii) performance targets for each such 
                        activity; and
                            ``(iv) a certification from the Chief 
                        Actuary of the Social Security Administration 
                        that the plan will improve the actuarial status 
                        of the Trust Funds.
                    ``(B) An assessment of the fraud and error 
                prevention activities described in paragraph (3) 
                conducted in the previous fiscal year, including--
                            ``(i) an itemized statement of the dollar 
                        amounts spent on each such activity during such 
                        fiscal year;
                            ``(ii) an itemized statement of the 
                        estimated long-term savings to the Trust Funds 
                        and the Treasury obtained as a result of each 
                        such activity, and a statement of the estimated 
                        total value of benefits paid under this title 
                        solely as a result of such activities;
                            ``(iii) an assessment of the extent to 
                        which performance targets set in the applicable 
                        plan for such fiscal year were met;
                            ``(iv) an explanation and a corrective 
                        action plan for any failure to meet such 
                        performance targets;
                            ``(v) an assessment of whether funds made 
                        available under paragraph (1) for such fiscal 
                        year were adequate to protect the Trust Funds 
                        from fraud and errors, an explanation of any 
                        such funds that remained unobligated at the end 
                        of the fiscal year, and recommendations for 
                        needed adjustments to future funding in order 
                        to protect the Trust Funds from fraud and 
                        errors and any additional cost-effective 
                        strategies for improving the actuarial status 
                        of the Trust Funds; and
            ``(6) Of the discretionary amounts made available for 
        `Social Security Administration--Limitation on Administrative 
        Expenses' for each fiscal year beginning with fiscal year 2016, 
        the amount obligated for the activities described in paragraph 
        (3) shall be not less than the sum of--
                    ``(A) $273,000,000; plus
                    ``(B) the amount obligated from funds made 
                available for `Social Security Administration--
                Limitation on Administrative Expenses' for fiscal year 
                2014 for the activities described in subparagraphs (C) 
                through (I) of paragraph (3).''.
    (b) Office of Inspector General.--Section 201 of the Social 
Security Act (42 U.S.C. 401 et seq.), as amended by subsection (a), is 
further amended by adding at the end the following:
    ``(o) Office of Inspector General Fraud Investigations.--
            ``(1) As authorized by subparagraph (g)(1), there is hereby 
        appropriated from any one or all of the Trust Funds to the 
        Office of Inspector General of the Social Security 
        Administration for each fiscal year beginning with fiscal year 
        2016 for the Office of Investigations, in addition to any other 
        amounts otherwise appropriated for such fiscal year, an amount 
        equal to the applicable dollar amount (determined under 
        paragraph (2)).
            ``(2) The applicable dollar amount determined under this 
        clause is--
                    ``(A) for fiscal year 2016, $60,000,000;
                    ``(B) for each fiscal year thereafter, $60,000,000 
                multiplied by the ratio (not less than 1) of--
                            ``(i) the Consumer Price Index for Urban 
                        Wager Earners and Clerical Workers (CPI-W, as 
                        published by the Bureau of Labor Statistics of 
                        the Department of Labor) for the 1st full 
                        calendar year preceding such fiscal year, to
                            ``(ii) the CPI-W for 2014.''.

SEC. 3. EXPANSION OF COOPERATIVE DISABILITY INVESTIGATIONS UNITS.

    Not later than October 1, 2018, the Commissioner of Social Security 
shall take any necessary actions to ensure that cooperative disability 
investigations (CDI) units have been established to provide coverage 
for each of the 50 States, the District of Columbia, Puerto Rico, Guam, 
the Northern Mariana Islands, the Virgin Islands, and American Samoa.

SEC. 4. CODIFICATION OF REQUIREMENT TO CONDUCT QUALITY REVIEWS.

    Section 221 of the Social Security Act is amended by adding at the 
end the following:
    ``(n)(1) The Commissioner of Social Security shall conduct quality 
reviews in accordance with section 969 of part 404 of title 20, Code of 
Federal Regulations, in cases described in section 970(a) of such part 
(as such sections were in effect on January 1, 2015) with respect to 
decisions in connection with applications for benefits under this title 
and title XVI, in a sufficient number to ensure compliance with laws, 
regulations, and other guidance issued by the Commissioner of Social 
Security.
    ``(2) The Commissioner of Social Security shall annually submit to 
the Committee on Ways and Means of the House of Representatives and the 
Committee on Finance of the Senate a report that includes--
            ``(A) the total number of cases selected for a quality 
        review as described in paragraph (1);
            ``(B) the number of such cases in which a decision is 
        remanded; and
            ``(C) the number of such cases in which a decision is 
        modified or reversed.''.

SEC. 5. REPORT ON WORK-RELATED CONTINUING DISABILITY REVIEWS.

    Section 223 of the Social Security Act is amended by adding at the 
end the following:
    ``(k) Report on Work-Related Continuing Disability Reviews.--The 
Commissioner of Social Security shall annually submit to the Committee 
on Ways and Means of the House of Representatives and the Committee on 
Finance of the Senate a report on the number of work-related continuing 
disability reviews conducted pursuant to subsection (f). Such report 
shall include--
            ``(1) the total number of reports of earnings received by 
        the Commissioner in the previous calendar year from individuals 
        receiving benefits on account of disability under this title or 
        title XVI;
            ``(2) the number of such reports that resulted in a 
        determination by the Commissioner to conduct a work-related 
        continuing disability review with respect to the beneficiary to 
        whom such report pertains, and the basis on which such 
        determinations were made;
            ``(3) in the case of a beneficiary selected for a work-
        related continuing disability review on the basis of a report 
        of earnings--
                    ``(A) the average number of days between the 
                submission of the report and the initiation of the 
                review, and the average number of days between the 
                initiation and the completion of the review;
                    ``(B) the number of such reviews completed during 
                such calendar year, and the number of such reviews that 
                result in a suspension or termination of benefits;
                    ``(C) the number of such reviews that had not been 
                completed as of the end of such calendar year;
            ``(4) the total savings to the Trust Funds and the Treasury 
        generated from benefits terminated as a result of such reviews; 
        and
            ``(5) with respect to individuals for whom a work-related 
        continuing disability review was completed during such calendar 
        year--
                    ``(A) the number who participated in the Ticket to 
                Work program under section 1148 during such calendar 
                year;
                    ``(B) the number who used any program work 
                incentives during such calendar year; and
                    ``(C) the number who received vocational 
                rehabilitation services during such calendar year with 
                respect to which which the Commissioner of Social 
                Security reimbursed a State agency under section 
                222(d).''.

SEC. 6. COORDINATION OF REPORTS RELATING TO DISABILITY BENEFITS.

    Section 221(i)(3) of the Social Security Act (42 U.S.C. 421(i)(3)) 
is amended by adding at the end the following: ``To the extent the 
Commissioner of Social Security determines to be necessary for maximum 
efficiency, the Commissioner may submit a combined report consisting of 
the information required to be submitted under this paragraph, 
subsection (c)(3)(C), subsection (n)(2), section 201(n)(5), and section 
223(k).''.

SEC. 7. INCREASED PENALTIES IN CERTAIN CASES OF FRAUD.

    (a) Conspiracy To Commit Social Security Fraud.--Section 208(a) of 
the Social Security Act (42 U.S.C. 408(a)) is amended--
            (1) in paragraph (7)(C), by striking ``or'' at the end;
            (2) in paragraph (8), by adding ``or'' at the end; and
            (3) by inserting after paragraph (8) the following:
    ``(9) conspires to commit any offense described in any of 
paragraphs (1) through (4),''.
    (b) Increased Criminal Penalties for Certain Individuals in 
Positions of Trust.--Section 208(a) of such Act (42 U.S.C. 408(a)), as 
amended by subsection (a), is further amended by striking the period at 
the end and inserting ``, except that in the case of a person who 
receives a fee or other income for services performed in connection 
with any determination with respect to benefits under this title, or 
who is a physician or other health care provider who submits medical 
evidence in connection with any such determination, such person shall 
be guilty of a felony and upon conviction thereof shall be fined under 
title 18, United States Code, or imprisoned for not more than ten 
years, or both.''.
    (c) Increased Civil Monetary Penalties for Certain Individuals in 
Positions of Trust.--Section 1129(a)(1) of such Act (42 U.S.C. 1320a-
8(a)(1)) is amended, in the matter following subparagraph (C), by 
inserting after ``withholding disclosure of such fact'' the following: 
``, except that in the case of such a person who receives a fee or 
other income for services performed in connection with any such 
determination or who is a physician or other health care provider who 
submits medical evidence in connection with any such determination, the 
amount of such penalty shall be not more than $7,500''.
    (d) References to Social Security and Medicare in Electronic 
Communications.--
            (1) In general.--Section 1140(a)(1) of the Social Security 
        act (42 U.S.C. 1320b-10(a)(1)) is amended by inserting 
        ``(including any electronic or Internet-related 
        communication)'' after ``or other communication''.
            (2) Treatment as separate violations.--Section 1140(b) of 
        such Act (42 U.S.C. 1320b-10(b)) is amended by adding at the 
        end the following: ``In the case of any items referred to in 
        subsection (a)(1) consisting of an electronic or Internet-
        related communication, each dissemination, viewing, or 
        accessing of the electronic or Internet-related communication 
        which contains one or more words, letters, symbols, or emblems 
        in violation of subsection (a) shall represent a separate 
        violation.''.
    (e) Inflation Adjustment of Certain Civil Monetary Penalties.--
Title XI of the Social Security Act is amended by inserting after 
section 1129B the following:

``SEC. 1129C. CIVIL MONETARY PENALTY INFLATION ADJUSTMENT.

    ``(a) Adjustment by Regulation.--The Commissioner of Social 
Security shall, not later than 180 days after the date of enactment of 
the Social Security Fraud and Error Prevention Act of 2015, and at 
least once every 4 years thereafter--
            ``(1) by regulation adjust the maximum amount of each civil 
        monetary penalty by the inflation adjustment described under 
        subsection (b); and
            ``(2) publish each such regulation in the Federal Register.
    ``(b) Amount of Adjustment.--The inflation adjustment under 
subsection (a) shall be determined by increasing the maximum amount of 
each civil monetary penalty by the cost-of-living adjustment. Any 
increase determined under this subsection shall be rounded to the 
nearest--
            ``(1) multiple of $1,000 in the case of penalties greater 
        than $1,000 but less than or equal to $10,000; and
            ``(2) multiple of $5,000 in the case of penalties greater 
        than $10,000 but less than or equal to $100,000.
    ``(c) Definitions.--For purposes of this section--
            ``(1) the term `civil monetary penalty' means--
                    ``(A) a penalty imposed by paragraph (1) or (3) of 
                section 1129(a); and
                    ``(B) a penalty imposed by paragraph (1) or (2) of 
                section 1140(b).
            ``(2) the term `cost-of-living adjustment' means the 
        percentage (if any) for each civil monetary penalty by which--
                    ``(A) the Consumer Price Index for Urban Wager 
                Earners and Clerical Workers (CPI-W, as published by 
                the Bureau of Labor Statistics of the Department of 
                Labor) for the month of June of the calendar year 
                preceding the adjustment, exceeds
                    ``(B) the CPI-W for the month of June of the 
                calendar year in which the amount of such civil 
                monetary penalty was last set or adjusted pursuant to 
                law.
    ``(d) Application of Increase.--Any increase under this Act in a 
civil monetary penalty shall apply only to violations which occur after 
the date the increase takes effect.''.

SEC. 8. EXCLUSION OF CERTAIN MEDICAL EVIDENCE IN DISABILITY CASES.

    (a) In General.--Section 223(d)(5) of the Social Security Act (42 
U.S.C. 423(d)(5)) is amended by adding at the end the following:
    ``(C) In making any determination with respect to whether an 
individual is under a disability or continues to be under a disability, 
the Commissioner of Social Security may not consider, except for good 
cause as determined by the Commissioner, any evidence furnished by a 
physician or other health care provider who--
            ``(i) has been barred from practice in any State;
            ``(ii) has been assessed a penalty under section 1129 for 
        the submission of false evidence; or
            ``(iii) is excluded (at the time of such determination) 
        from participation in any Federal health care program under 
        section 1128.''.
    (b) Regulations.--Not later than 1 year after the date of the 
enactment of this Act, the Commissioner of Social Security shall issue 
regulations to carry out the amendment made by subsection (a).
    (c) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to determinations of disability made on or after the 
date that is 1 year after the date of enactment of this Act.

SEC. 9. REPEAL OF PROGRAM INTEGRITY ADJUSTMENTS TO DISCRETIONARY 
              SPENDING LIMITS.

    Section 251(b)(2)(B)(i) of the Balanced Budget and Emergency 
Deficit Control Act of 1985 is amended--
            (1) in subclause (II), by adding ``and'' at the end;
            (2) in subclause (III), by striking the semicolon at the 
        end and inserting a period; and
            (3) by striking subclauses (IV) through (X).
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