I

103D CONGRESS

2D SESSION H. R. 4281

To eliminate fraud in the payment of supplemental security income benefits

to children by reason of disability.

IN THE HOUSE OF REPRESENTATIVES

APRIL 21, 1994

Mr. DICKEY introduced the following bill; which was referred to the

Committee on Ways and Means

A BILL

To eliminate fraud in the payment of supplemental security

income benefits to children by reason of disability.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. REPLACEMENT OF CASH BENEFIT WITH MEDI4 CAL VOUCHER.

5 (a) IN GENERAL.—Section 1611(b) of the Social Se6 curity Act (42 U.S.C. 1382(b)) is amended by adding at

7 the end the following:

8 ‘‘(3) Notwithstanding paragraphs (1) and (2), the

9 benefit under this title for a child who has not attained
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1 18 years of age shall be vouchers issued pursuant to sub2 section (j).’’.

3 (b) ISSUANCE OF VOUCHERS FOR TREATMENT OF

4 DISABLING CONDITIONS OF CHILDREN ELIGIBLE FOR

5 SSI BENEFITS.—Section 1611 of such Act (42 U.S.C.

6 1382(b)) is amended by adding at the end the following:

7 ‘‘(j)(1) The Secretary of Health and Human Services

8 shall issue to each child eligible for benefits under this

9 title who has not attained 18 years of age vouchers which

10 may be used to cover the cost associated with treating the

11 blindness or disability of the child.

12 ‘‘(2) The Secretary shall, by regulation—

13 ‘‘(A) develop an appropriate measure of the an14 ticipated costs associated with treating each kind of

15 blindness or disability from which a child may suf16 fer, which shall take account of the severity of the

17 blindness or disability, any geographic variation in

18 such costs, and such other factors as the Secretary

19 deems appropriate; and

20 ‘‘(B) establish a schedule which shall be used to

21 determine the dollar value of the vouchers to be is22 sued to a child to cover the costs associated with

23 treating the blindness or disability of the child.

24 ‘‘(3) The Secretary shall pay to each provider of

25 health care goods or services that is licensed by a State,
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1 or by a professional health care organization approved by

2 the Secretary, that submits to the Secretary a voucher is3 sued under this subsection an amount equal to the face

4 dollar amount of the voucher.’’.

5 SEC. 2. FRAUD CONTROL.

6 Part B of title XVI of the Social Security Act (42

7 U.S.C. 1383–1383d) is amended by adding at the end the

8 following:

9 ‘‘SEC. 1636. FRAUD CONTROL.

10 ‘‘(a) NOTICE OF COOPERATION.—The Social Security

11 Administration shall notify the Inspector General of the

12 Department of Health and Human Services and each

13 State agency responsible for the detection of fraud in cases

14 involving benefits under this title, in writing, that the Ad15 ministration is willing to assist in the detection of such

16 fraud and that the Administration requests the name and

17 social security account number of each person who is sus18 pected of such fraud.

19 ‘‘(b) INVESTIGATION OF SUSPECTED FRAUD.—With20 in 30 days after the Social Security Administration re21 ceives a name submitted pursuant to the written request

22 required by subsection (a), the Administration shall con23 duct such activities as the Administration deems appro24 priate, including benefit redetermination, to ascertain
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1 whether the person named is eligible for benefits under

2 this title.

3 ‘‘(c) DEVELOPMENT OF PROFILES; PERIODIC TAR4 GETED REDETERMINATIONS.—The Social Security Ad5 ministration shall develop profiles of the kinds of cases

6 that have a high probability of fraud, and shall conduct

7 periodic targeted redeterminations based on such pro8 files.’’.

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