[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8546 Introduced in House (IH)]

<DOC>






118th CONGRESS
  2d Session
                                H. R. 8546

 To require the Commissioner of the Social Security Administration to 
 take certain actions to improve the processing of claims and appeals 
for disability insurance benefits and supplemental security income, and 
                          for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 23, 2024

  Mr. Neguse introduced the following bill; which was referred to the 
                      Committee on Ways and Means

_______________________________________________________________________

                                 A BILL


 
 To require the Commissioner of the Social Security Administration to 
 take certain actions to improve the processing of claims and appeals 
for disability insurance benefits and supplemental security income, 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 Administration 
Processing Claims Improvement Act of 2024''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) A recent Social Security Administration Inspector 
        General report found that nearly half of the 151,000,000 
        callers to field offices and the national 800-number went 
        unanswered.
            (2) In 2021, over 9,000,000 people received Social Security 
        disability insurance benefits.
            (3) According to the National Academy of Social Insurance, 
        over half of all beneficiaries rely on Disability Insurance and 
        Supplemental Security for 90 percent or more of their income.
            (4) Benefits are interrupted following the denial and often 
        remain paused until a review--which can take anywhere from 14 
        to 22 months--is complete.
            (5) Since 2011, the number of beneficiaries increased by 
        more than 22 percent while over the same period, Social 
        Security Administration's operating budget fell by more than 17 
        percent, after adjusting for inflation.

SEC. 3. SOCIAL SECURITY ADMINISTRATION CLAIMS PROCESSING REVIEW.

    Not later than 1 year after the date of enactment of this Act, and 
on an annual basis thereafter, the Commissioner shall conduct a review 
to--
            (1) identify--
                    (A) processing error trends of claims processors 
                and the training needs of claims processors and case 
                managers;
                    (B) possible improvements to the processing of 
                claims with respect to covered benefits, including 
                decision-making of claims processors;
                    (C) the most common causes of overpayments of 
                covered benefits; and
                    (D) the most common reasons for denying an 
                application for a covered benefit;
            (2) evaluate--
                    (A) any written or verbal instructions or training 
                given to benefits counselors;
                    (B) any guidance or regulation promulgated by the 
                Commissioner that is related to determinations of 
                eligibility for covered benefits and whether updates to 
                such guidance are necessary to provide claims 
                processors with better resources to carry out the 
                duties of such processors, including any guidance 
                regarding the processing of claims for a covered 
                benefit; and
            (3) after the training programs under section 4 are 
        established, identify improvements to the training programs 
        with regard to--
                    (A) the processing of claims for a covered benefit; 
                and
                    (B) decision-making for claims processors when 
                reconsidering the eligibility of a claimant for a 
                covered benefit.

SEC. 4. TRAININGS FOR CLAIMS PROCESSORS.

    (a) Annual Training Program.--
            (1) Establishment.--Not later than 1 year after the first 
        review under section 3 is conducted, the Commissioner shall 
        establish, and update on an ongoing basis, a national training 
        program for claims processors who review claims for covered 
        benefits, including appeals of continuing disability reviews.
            (2) Participation.--Not later than 180 days after the date 
        that the annual training program under paragraph (1) is 
        established, the Commissioner shall require that each claims 
        processor participates in such program at least once each year, 
        beginning in the second year in which the claims processor 
        carries out the duties of a claims processor for the agency.
            (3) Required elements.--The training established under 
        paragraph (1) shall include the following:
                    (A) Training on the quality assurance standards 
                established under section 6.
                    (B) Disability etiquette training for case managers 
                and claims processors to learn effective communication 
                and empathy.
                    (C) Training regarding internal communications to 
                prevent overpayments and subsequent benefit denials.
    (b) Ongoing Training Program.--
            (1) Establishment.--Not later than 1 year after the first 
        review under section 3 is conducted, the Commissioner shall 
        establish, and update on an ongoing basis, an ongoing training 
        program for claims processors who review claims for covered 
        benefits, including appeals of continuing disability reviews.
            (2) Participation.--Not later than 180 days after the date 
        that the ongoing training program under paragraph (1) is 
        established, the Commissioner shall require each claims 
        processor to participate in such program on an ongoing basis, 
        beginning in the second year in which the claims processor 
        carries out the duties of a claims processor for the agency.
            (3) Required elements.--The training program established 
        under paragraph (1) shall include the following:
                    (A) Workshops with claims processors every 6 
                months.
                    (B) Collaborative review of a complex case by all 
                claims processors at a field office every 2 months.
            (4) Definitions.--In this subsection:
                    (A) Complex case.--The term ``complex case'' means 
                a case that--
                            (i) has its processing time increased 
                        because of a mistake or error that is 
                        attributable to the Social Security 
                        Administration;
                            (ii) has conflicting evidence from multiple 
                        health care providers; or
                            (iii) involves an individual with a lapse 
                        for a period of time that is greater than 2 
                        weeks.
                    (B) Lapse.--The term ``lapse'' means, with respect 
                to an individual receiving a covered benefit, a 
                physical or mental impairment, as determined by a 
                health care provider, that prevents the individual from 
                providing information required for a continuing 
                disability review (as defined in section 201(g)(1)(A) 
                of the Social Security Act (42 U.S.C. 401(g)(1)(A)).
    (c) Consultation Required.--When establishing the training programs 
described in subsections (a) and (b), the Commissioner shall consult 
with an entity that advocates for, and provides resources and 
information to, individuals with disabilities to assist such 
individuals in overcoming barriers to independent living, including an 
entity carrying out a community rehabilitation program (as such term is 
defined in section 7 of the Rehabilitation Act of 1973 (29 U.S.C. 
705)).

SEC. 5. REPORTS.

    (a) Report on Backlogs.--Not later than 180 days after the date 
after the date of enactment of this Act, and on an annual basis 
thereafter, the Commissioner shall submit to Congress a report on the 
status of backlogs for determinations of eligibility for covered 
benefits and continuing disability review determinations, including, 
with respect to both such determination backlogs--
            (1) information on wait times for such determinations; and
            (2) recommendations on streamlining and improving the 
        determination processes.
    (b) Report on Accessibility.--Not later than 180 days after the 
date of enactment of this Act, and on an annual basis thereafter the 
Commissioner shall submit to Congress a report that includes--
            (1) a plan to ensure that all services at the Social 
        Security Administration, including appeals of covered benefit 
        denials, are in a format that is appropriate for the specific 
        needs of individuals with disabilities, such as audio versions 
        of notifications, large print and braille options, and easy-to-
        read information; and
            (2) the amount of funding needed to carry out the plan 
        described in subparagraph (A).

SEC. 6. QUALITY ASSURANCE STANDARDS.

    Not later than 180 days after the date of enactment of this Act, 
the Commissioner shall establish, and update on an ongoing basis, 
quality assurance standards to standardize how staff at field offices 
assist claimants, which shall include--
            (1) guidelines on how to answer questions of claimants in a 
        timely and polite manner; and
            (2) a process for a claimant to submit feedback to the 
        Commissioner on whether the claims processor who processed the 
        application of such claimant met such standards.

SEC. 7. DEFINITIONS.

    In this Act:
            (1) Covered benefit.--The term ``covered benefit'' means--
                    (A) a disability insurance benefit under section 
                223 of the Social Security Act (42 U.S.C. 423); and
                    (B) a supplemental security income benefit under 
                title XVI of the Social Security Act (42 U.S.C. 1381 
                et. seq).
            (2) Commissioner.--The term ``Commissioner'' means the 
        Commissioner of the Social Security Administration.
            (3) Continuing disability review.--The term ``continuing 
        disability review'' has the meaning given the term in 
        subsection (g)(1)(A) of section 201 of the Social Security Act 
        (42 U.S.C. 401(g)(1)(A)).

SEC. 8. SOCIAL SECURITY ACT AMENDMENTS.

    (a) Additional Review.--
            (1) Title ii amendment.--Section 205(b)(1) of the Social 
        Security Act (42 U.S.C. 405(b)(1)) is amended by striking ``Any 
        such decision by the Commissioner of Social Security which 
        involves a determination of disability and which is in whole or 
        in part unfavorable to such individual'' and inserting the 
        following: ``In the case of any such decision that involves a 
        determination of disability and that is in whole or in part 
        unfavorable to such individual, the Commissioner shall require 
        a person, other than the person who made the initial 
        unfavorable determination, to review the initial decision and 
        make a recommendation as to whether the initial decision should 
        be modified. The Commissioner shall make a final decision in 
        accordance with such recommendation. Any such final decision 
        which is in whole or in part unfavorable to such individual''.
            (2) Title xvi amendment.--Section 1631(c)(1)(A) of such Act 
        (42 U.S.C. 1383(c)(1)(A)) is amended by striking ``Any such 
        decision by the Commissioner of Social Security which involves 
        a determination of disability and which is in whole or in part 
        unfavorable to such individual'' and inserting the following: 
        ``In the case of any such decision that involves a 
        determination of disability and that is in whole or in part 
        unfavorable to the individual, the Commissioner shall require a 
        person, other than the person who made the initial unfavorable 
        determination, to review the initial decision and make a 
        recommendation as to whether the initial decision should be 
        modified. The Commissioner shall make a final decision in 
        accordance with the recommendation. Any such final decision 
        that is in whole or in part unfavorable to the individual''.
    (b) Modernization of Information Submission.--Part A of title XI of 
the Social Security Act (42 U.S.C. 1301 et. seq) is amended by 
inserting after section 1143 the following:

``SEC. 1143A. MODERNIZATION OF INFORMATION SUBMISSION.

    ``With respect to any information required to be submitted by an 
individual to the Social Security Administration regarding a proceeding 
or determination for a benefit under title II or a supplemental 
security income benefit under title XVI, the Commissioner shall accept 
such information in the following ways:
            ``(1) Email.
            ``(2) Fax machine, until December 31, 2045.''.
    (c) Social Security Wage Reporting App.--Part A of title XI of the 
Social Security Act (42 U.S.C. 1301 et. seq) is amended by adding at 
the end the following:

``SEC. 1150D. SOCIAL SECURITY WAGE REPORTING APP.

    ``The Commissioner of the Social Security Administration shall 
ensure that an individual who receives a disability insurance benefit 
under section 223 may use the SSA Mobile Wage Reporting App for the 
purpose of tracking the wages and employment of such individual.''.
    (d) Effective Date.--The amendments made by this section shall take 
effect 2 years after the date of enactment of this section.
                                 <all>