[Federal Register Volume 59, Number 36 (Wednesday, February 23, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-3961]


[[Page Unknown]]

[Federal Register: February 23, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Social Security Administration

20 CFR Parts 404 and 416

RIN 0960-AD46

 

Federal Old-Age, Survivors, and Disability Insurance and 
Supplemental Security Income for the Aged, Blind, and Disabled; 
Limitation of Travel Expenses for Representation of Claimants at 
Administrative Proceedings

AGENCY: Social Security Administration, HHS.

ACTION: Final rules.

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SUMMARY: We are amending our regulations concerning payment of certain 
travel expenses to implement section 5106(c) of the Omnibus Budget 
Reconciliation Act of 1990 (OBRA 1990). Section 5106(c) amends certain 
sections of the Social Security Act (the Act) to limit the amount 
available for payment under those sections for travel expenses of 
individuals who represent claimants at certain administrative 
proceedings.

EFFECTIVE DATE: These final rules are effective February 23, 1994.

FOR FURTHER INFORMATION CONTACT: Philip Berge, Legal Assistant, 3-B-1 
Operations Building, 6401 Security Boulevard, Baltimore, MD 21235, 
(410) 965-1769.

SUPPLEMENTARY INFORMATION: We published proposed rules to implement 
section 5106(c) of OBRA 1990, Public Law 101-508, in a Notice of 
Proposed Rulemaking in the Federal Register on January 19, 1993 (58 FR 
4950). We provided interested individuals and organizations 60 days 
within which to submit comments on the proposed rules. The comment 
period closed March 22, 1993. We did not receive any comments on the 
proposed rules. Therefore, except for a technical correction discussed 
below and some editorial changes, these final rules are the same as the 
proposed rules.
    These final rules amend our regulations on the payment of travel 
expenses of individuals who represent claimants at certain 
administrative proceedings to implement the amendments to sections 
201(j), 1631(h) and 1817(i) of the Act made by section 5106(c) of OBRA 
1990. In general, sections 201(j), 1631(h) and 1817(i) of the Act 
provide authority to reimburse certain persons for certain travel 
expenses which they incur in connection with the Social Security, 
Supplemental Security Income (SSI) or Medicare program under titles II, 
XVI and XVIII of the Act, respectively. Among other things, these 
sections of the Act authorize the payment of certain travel expenses to 
a claimant's representative for travel to attend a reconsideration 
interview or a proceeding before an administrative law judge (ALJ).
    Section 5106(c) of OBRA 1990 amends sections 201(j), 1631(h) and 
1817(i) of the Act to limit the amount available for payment under 
these sections of the Act for travel by a representative to attend an 
administrative proceeding before an ALJ or other adjudicator. The 
amendments under section 5106(c) specify that the amount available for 
such payment shall not exceed the maximum amount allowable under these 
sections of the Act for a representative's travel originating within 
the geographic area of the office having jurisdiction over the 
proceeding. The Conference Committee Report on OBRA 1990 states that 
under the amendments the reimbursement for travel by a representative 
``could not exceed the maximum amount that would be payable for travel 
to the site of the reconsideration interview or proceeding before an 
ALJ from a point within the geographical area served by the office 
having jurisdiction over the interview or proceeding.'' H.R. Rep. No. 
964, 101st Cong., 2d Sess. 934 (1990).
    The final regulations amend our regulations relating to the payment 
of travel expenses of a claimant's representative for travel to attend 
a disability hearing or hearing before an ALJ under the Social Security 
or SSI programs to implement the amendments made by section 5106(c) of 
OBRA 1990. The title II regulations on travel reimbursement, like the 
rules in subpart J of 20 CFR part 404 generally, are made applicable to 
certain proceedings under the Medicare program pursuant to 42 CFR 
405.701(c). Therefore, the changes to the title II regulations on 
travel reimbursement also affect reimbursement of travel expenses of a 
representative in connection with those Medicare proceedings under the 
Medicare program and, thus, implement the amendment to section 1817(i) 
of the Act made by section 5106(c) of OBRA 1990.
    Our existing regulations on the payment of certain travel expenses, 
Secs. 404.999a et seq. and Secs. 416.1495 et seq., implement the 
pertinent provisions of the Act regarding travel reimbursement that 
were in effect prior to April 1, 1991, the effective date of section 
5106(c) of OBRA 1990. With respect to travel expenses incurred prior to 
that date, we reimbursed a representative for allowable expenses for 
travel to a disability hearing or ALJ hearing site from the 
representative's residence or office (depending upon whether the 
representative's travel originated from his or her residence or from 
the office) regardless of its geographic location. Based on travel 
distance between the hearing site and the representative's travel 
origination point (residence or office) and subject to the limitations 
in Secs. 404.999c(d) and 416.1498(d), we determined the amount 
allowable for reimbursement for the ordinary expenses of transportation 
(Secs. 404.999c(a) and 416.1498(a)) and for unusual travel costs 
(Secs. 404.999c(b) and 416.1498(b)) pursuant to the applicable rules 
governing rates and conditions of payment (Secs. 404.999c(c) and 
416.1498(c)).
    Effective with travel expenses incurred by a representative on or 
after April 1, 1991, however, section 5106(c) of OBRA 1990 provides 
that the amount of reimbursement for such expenses shall not exceed the 
allowable amount that we could reimburse the representative for travel 
originating within the geographic area of the office having 
jurisdiction over the proceeding. Accordingly, the final regulations 
amend our regulations to provide that the amount available to reimburse 
a representative for travel to attend a disability hearing or a hearing 
before an ALJ shall not exceed the maximum amount allowable for travel 
to the hearing site from any point within the geographic area of the 
office having jurisdiction over the hearing.
    The final rules explain that the geographic area of the office 
having jurisdiction over the hearing means, as appropriate--

--The designated georgraphic service area of the State agency 
adjudicatory unit having responsibility for providing the disability 
hearing;
--If a Federal disability hearing officer holds the disability hearing, 
the geographic area of the State in which the claimant resides or, if 
the claimant is not a resident of a State, in which the hearing officer 
holds the disability hearing; or
--The designated geographic service area of the Office of Hearings and 
Appeals hearing office having responsibility for providing the hearing 
before an ALJ.

    In cases in which a Federal disability hearing officer holds the 
disability hearing, the hearing officer travels to the State in which 
the claimant resides to hold the hearing. In those infrequent cases in 
which the claimant is not a resident of a State, the Federal disability 
hearing officer holds the disability hearing in a location in a State 
that is convenient for the claimant and the hearing officer. With 
respect to these cases, the final regulations define the geographic 
area of the office having jurisdiction over the hearing to mean the 
geographic area of the State in which the claimant resides or, if the 
claimant is not a resident of a State, in which the hearing officer 
holds the disability hearing. This definition is consistent with the 
congressional intent underlying section 5106(c) of OBRA 1990 in that it 
treats the claimant and his or her representative in the same manner as 
if a State agency hearing officer held the disability hearing. In the 
final title II regulations relating to cases in which a Federal 
disability hearing officer holds the disability hearing, the term 
``State'' has the meaning assigned to it in current Sec. 404.2(c)(5), 
except that the term also includes the Northern Mariana Islands. In the 
final title XVI regulations relating to such cases, the term ``State'' 
means a State as defined in current Sec. 416.120(c)(9). This definition 
of ``State'' in the final title XVI regulations 
Sec. 416.1498(d)(3)(i)(B), was omitted from the text of the proposed 
rules, although it was discussed in the preamble to those rules (58 FR 
4950, 4951). Its inclusion in the final rules represents a technical 
correction.
    We are basing the maximum amount allowable on the distance to the 
hearing site from the farthest point within the appropriate geographic 
area. We will determine the maximum amount allowable for travel between 
these two points under the existing regulations, i.e., subject to the 
existing limitations in paragraph (d)(1) and paragraph (d)(3) (herein 
to be redesignated as paragraph (d)(4)) of Secs. 404.999c and 416.1498 
(relating to travel within the United States and a claimant's request 
for a change to a more distant hearing site) and pursuant to the 
applicable rules governing rates and conditions of payment under 
paragraphs (a) through (c) of Secs. 404.999c and 416.1498. Under our 
existing regulations, we will not reimburse a representative's travel 
expenses unless the distance he or she travels, i.e., the distance to 
the hearing site from the representative's residence or office 
(whichever he or she travels from), exceeds 75 miles 
(Secs. 404.999c(d)(2) and 416.1498(d)(2)). The final regulations 
provide a similar limitation. Under the final rules, we will use the 
point within the appropriate geographic area that is the farthest point 
from the hearing site as the representative's travel origination point 
(equivalent to residence or office under the existing regulations) for 
purposes of determining the maximum amount allowable for reimbursement. 
The final rules provide that if the distance to the hearing site from 
the farthest point within the appropriate geographic area does not 
exceed 75 miles, we will not reimburse a representative for any travel 
expenses. This is consistent with the 75-mile rule in the current 
regulations.
    Under the final regulations, actual reimbursement for a 
representative's travel expenses is limited to the lesser of: (1) 
Actual travel expenses incurred and allowable under the regulations 
(whether travel actually originates within the designated geographic 
area or outside that area); or (2) the maximum amount allowable for 
travel to the hearing site from the farthest point within the 
geographic area of the office having jurisdiction over the hearing.
    In practice, the final rules will not affect reimbursement of 
travel expenses of a representative whose travel originates within the 
geographic area of the office having jurisdiction over the hearing. 
This is because the expenses incurred and allowable under the 
regulations for such travel would be less than, or equal to, the 
maximum amount allowable for travel to the hearing site from the 
farthest point within the appropriate geographic area.
    We are amending Secs. 404.999c and 416.1498 by redesignating 
paragraph (d)(3) as (d)(4) and adding a new paragraph (d)(3) to state 
and define the limit on the amount of reimbursement for a 
representative's travel expenses mandated by section 5106(c) of OBRA 
1990. The final regulations state that the amount of reimbursement for 
travel expenses for a representative shall not exceed the maximum 
amount allowable for travel to the hearing site from any point within 
the geographic area of the office having jurisdiction over the hearing; 
define the geographic area of the office having jurisdiction over the 
hearing; and explain how we determine the maximum amount allowable for 
travel by a representative based on the distance to the hearing site 
from the farthest point within the appropriate geographic area.
    We also are amending Secs. 404.999c(c) and 416.1498(c) to change 
the reference from 41 CFR Part 101-7 to 41 CFR chapter 301, where the 
Federal Travel Regulations are now codified.

Regulatory Procedures

Regulatory Flexibility Act

    We certify that these regulations will not have a significant 
economic impact on a substantial number of small entities because these 
rules will affect only individuals. Therefore, a regulatory flexibility 
analysis as provided in Pub. L. 96-354, the Regulatory Flexibility Act, 
is not required.

Paperwork Reduction Act

    These regulations impose no new reporting or recordkeeping 
requirements requiring Office of Management and Budget clearance.

(Catalog of Federal Domestic Assistance Program Nos. 93.773 and 
93.774, Medicare; 93.802-93.805, Social Security; and 93.807, 
Supplemental Security Income.)

List of Subjects

20 CFR Part 404

    Administrative practice and procedure, Aged, Blind, Death benefits, 
Disability benefits, Insurance, Old-Age, Survivors, and Disability 
Insurance, Reporting and recordkeeping requirements.

20 CFR Part 416

    Administrative practice and procedure, Aged, Blind, Disability 
benefits, Public Assistance programs, Supplemental Security Income 
(SSI), Reporting and recordkeeping requirements.

    Dated: November 19, 1993.
Shirley Chater,
Commissioner of Social Security.
    Approved: February 8, 1994.
Donna E. Shalala,
Secretary of Health and Human Services.

For the reasons set out in the preamble, subpart J of part 404 and 
subpart N of part 416 of 20 CFR chapter III are amended as follows:

PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITYINSURANCE (1950- 
 )

    1. The authority citation for subpart J of part 404 continues to 
read as follows:

    Authority: Secs. 201(j), 205 (a), (b), and (d)-(h), 221(d), and 
1102 of the Social Security Act; 31 U.S.C. 3720A; 42 U.S.C. 401(j), 
405 (a), (b), and (d)-(h), 421(d), and 1302.


Sec. 404.999c  [Amended]

    2. In Sec. 404.999c(c) introductory text, the reference to ``41 CFR 
part 101-7'' is revised to read ``41 CFR chapter 301''.
    3. Section 404.999c is amended by redesignating paragraph (d)(3) as 
(d)(4) and adding a new paragraph (d)(3) to read as follows:


Sec. 404.999c  What travel expenses are reimbursable.

* * * * *
    (d) * * *
    (3) For travel expenses incurred on or after April 1, 1991, the 
amount of reimbursement under this section for travel by your 
representative to attend a disability hearing or a hearing before an 
administrative law judge shall not exceed the maximum amount allowable 
under this section for travel to the hearing site from any point within 
the geographic area of the office having jurisdiction over the hearing.
    (i) The geographic area of the office having jurisdiction over the 
hearing means, as appropriate--
    (A) The designated geographic service area of the State agency 
adjudicatory unit having responsibility for providing the disability 
hearing;
    (B) If a Federal disability hearing officer holds the disability 
hearing, the geographic area of the State (which includes a State as 
defined in Sec. 404.2(c)(5) and also includes the Northern Mariana 
Islands) in which the claimant resides or, if the claimant is not a 
resident of a State, in which the hearing officer holds the disability 
hearing; or
    (C) The designated geographic service area of the Office of 
Hearings and Appeals hearing office having responsibility for providing 
the hearing before an administrative law judge.
    (ii) We or the State agency determine the maximum amount allowable 
for travel by a representative based on the distance to the hearing 
site from the farthest point within the appropriate geographic area. In 
determining the maximum amount allowable for travel between these two 
points, we or the State agency apply the rules in paragraphs (a) 
through (c) of this section and the limitations in paragraph (d) (1) 
and (4) of this section. If the distance between these two points does 
not exceed 75 miles, we or the State agency will not reimburse any of 
your representative's travel expenses.
* * * * *

PART 416--SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND 
DISABLED

    1. The authority citation for subpart N of part 416 is revised to 
read as follows:

    Authority: Secs. 1102, 1631, and 1633 of the Social Security 
Act; 42 U.S.C. 1302, 1383, and 1383b.


Sec. 416.1498  [Amended]

    2. In Sec. 416.1498(c) introductory text, the reference to ``41 CFR 
part 101-7'' is revised to read ``41 CFR chapter 301''.
    3. Section 416.1498 is amended by redesignating paragraph (d)(3) as 
(d)(4) and adding a new paragraph (d)(3) to read as follows:


Sec. 416.1498  What travel expenses are reimbursable.

* * * * *
    (d) * * *
    (3) For travel expenses incurred on or after April 1, 1991, the 
amount of reimbursement under this section for travel by your 
representative to attend a disability hearing or a hearing before an 
administrative law judge shall not exceed the maximum amount allowable 
under this section for travel to the hearing site from any point within 
the geographic area of the office having jurisdiction over the hearing.
    (i) The geographic area of the office having jurisdiction over the 
hearing means, as appropriate--
    (A) The designated geographic service area of the State agency 
adjudicatory unit having responsibility for providing the disability 
hearing;
    (B) If a Federal disability hearing officer holds the disability 
hearing, the geographic area of the State (as defined in 
Sec. 416.120(c)(9)) in which the claimant resides or, if the claimant 
is not a resident of a State, in which the hearing officer holds the 
disability hearing; or
    (C) The designated geographic service area of the Office of 
Hearings and Appeals hearing office having responsibility for providing 
the hearing before an administrative law judge.
    (ii) We or the State agency determine the maximum amount allowable 
for travel by a representative based on the distance to the hearing 
site from the farthest point within the appropriate geographic area. In 
determining the maximum amount allowable for travel between these two 
points, we or the State agency apply the rules in paragraphs (a) 
through (c) of this section and the limitations in paragraph (d) (1) 
and (4) of this section. If the distance between these two points does 
not exceed 75 miles, we or the State agency will not reimburse any of 
your representative's travel expenses.
* * * * *
[FR Doc. 94-3961 Filed 2-22-94; 8:45 am]
BILLING CODE 4190-29-P