106TH CONGRESS

1ST SESSION H. R. 1180

AN ACT

To amend the Social Security Act to expand the

availability of health care coverage for workingindividuals with disabilities, to establish a Ticketto Work and Self-Sufficiency Program in the Social Security Administration to provide such individuals with meaningful opportunities to work,and for other purposes.
106TH CONGRESS

1ST SESSION H. R. 1180

AN ACT

To amend the Social Security Act to expand the availability

of health care coverage for working individuals with disabilities, to establish a Ticket to Work and Self-Sufficiency Program in the Social Security Administration

to provide such individuals with meaningful opportunities

to work, and for other purposes.
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1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

4 (a) SHORT TITLE.—This Act may be cited as the

5 ‘‘Ticket to Work and Work Incentives Improvement Act

6 of 1999’’.

7 (b) TABLE OF CONTENTS.—The table of contents is

8 as follows:

Sec. 1. Short title; table of contents.

TITLE I—TICKET TO WORK AND SELF-SUFFICIENCY AND

RELATED PROVISIONS

Subtitle A—Ticket to Work and Self-Sufficiency

Sec. 101. Establishment of the Ticket to Work and Self-Sufficiency Program.

Subtitle B—Elimination of Work Disincentives

Sec. 111. Work activity standard as a basis for review of an individual’s disabled status.

Sec. 112. Expedited reinstatement of disability benefits.

Subtitle C—Work Incentives Planning, Assistance, and Outreach

Sec. 121. Work incentives outreach program.

Sec. 122. State grants for work incentives assistance to disabled beneficiaries.

TITLE II—EXPANDED AVAILABILITY OF HEALTH CARE SERVICES

Sec. 201. Expanding State options under the medicaid program for workers

with disabilities.

Sec. 202. Extending medicare coverage for OASDI disability benefit recipients.

Sec. 203. Grants to develop and establish State infrastructures to support

working individuals with disabilities.

Sec. 204. Demonstration of coverage under the medicaid program of workers

with potentially severe disabilities.

Sec. 205. Election by disabled beneficiaries to suspend medigap insurance when

covered under a group health plan.

TITLE III—DEMONSTRATION PROJECTS AND STUDIES

Sec. 301. Extension of disability insurance program demonstration project authority.

Sec. 302. Demonstration projects providing for reductions in disability insurance benefits based on earnings.

Sec. 303. Studies and reports.
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TITLE IV—MISCELLANEOUS AND TECHNICAL AMENDMENTS

Sec. 401. Technical amendments relating to drug addicts and alcoholics.

Sec. 402. Treatment of prisoners.

Sec. 403. Revocation by members of the clergy of exemption from social security coverage.

Sec. 404. Additional technical amendment relating to cooperative research or

demonstration projects under titles II and XVI.

Sec. 405. Authorization for State to permit annual wage reports.

Sec. 406. Assessment on attorneys who receive their fees via the Social Security

Administration.

Sec. 407. Prevention of fraud and abuse associated with certain payments

under the medicaid program.Extension of authority of State

medicaid fraud control units.

Sec. 408. Extension of authority of State medicaid fraud control units.

Sec. 409. Special allowance adjustment for student loans.

1 TITLE I—TICKET TO WORK AND

2 SELF-SUFFICIENCY AND RE3 LATED PROVISIONS

4 Subtitle A—Ticket to Work and

5 Self-Sufficiency

6 SEC. 101. ESTABLISHMENT OF THE TICKET TO WORK AND

7 SELF-SUFFICIENCY PROGRAM.

8 (a) IN GENERAL.—Part A of title XI of the Social

9 Security Act (42 U.S.C. 1301 et seq.) is amended by add10 ing after section 1147 (as added by section 8 of the Non11 citizen Benefit Clarification and Other Technical Amend12 ments Act of 1998 (Public Law 105–306; 112 Stat.

13 2928)) the following:

14 ‘‘THE TICKET TO WORK AND SELF-SUFFICIENCY

15 PROGRAM

16 ‘‘SEC. 1148. (a) IN GENERAL.—The Commissioner

17 of Social Security shall establish a Ticket to Work and

18 Self-Sufficiency Program, under which a disabled bene-
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1 ficiary may use a ticket to work and self-sufficiency issued

2 by the Commissioner in accordance with this section to

3 obtain employment services, vocational rehabilitation serv4 ices, or other support services from an employment net5 work which is of the beneficiary’s choice and which is will6 ing to provide such services to such beneficiary.

7 ‘‘(b) TICKET SYSTEM.—

8 ‘‘(1) DISTRIBUTION OF TICKETS.—The Com9 missioner of Social Security may issue a ticket to

10 work and self-sufficiency to disabled beneficiaries for

11 participation in the Program.

12 ‘‘(2) ASSIGNMENT OF TICKETS.—A disabled

13 beneficiary holding a ticket to work and self-suffi14 ciency may assign the ticket to any employment net15 work of the beneficiary’s choice which is serving

16 under the Program and is willing to accept the as17 signment.

18 ‘‘(3) TICKET TERMS.—A ticket issued under

19 paragraph (1) shall consist of a document which evi20 dences the Commissioner’s agreement to pay (as

21 provided in paragraph (4)) an employment network,

22 which is serving under the Program and to which

23 such ticket is assigned by the beneficiary, for such

24 employment services, vocational rehabilitation serv-
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1 ices, and other support services as the employment

2 network may provide to the beneficiary.

3 ‘‘(4) PAYMENTS TO EMPLOYMENT NET4 WORKS.—The Commissioner shall pay an employ5 ment network under the Program in accordance with

6 the outcome payment system under subsection

7 (h)(2) or under the outcome-milestone payment sys8 tem under subsection (h)(3) (whichever is elected

9 pursuant to subsection (h)(1)). An employment net10 work may not request or receive compensation for

11 such services from the beneficiary.

12 ‘‘(c) STATE PARTICIPATION.—

13 ‘‘(1) IN GENERAL.—Each State agency admin14 istering or supervising the administration of the

15 State plan approved under title I of the Rehabilita16 tion Act of 1973 may elect to participate in the Pro17 gram as an employment network with respect to a

18 disabled beneficiary. If the State agency does elect

19 to participate in the Program, the State agency also

20 shall elect to be paid under the outcome payment

21 system or the outcome-milestone payment system in

22 accordance with subsection (h)(1). With respect to a

23 disabled beneficiary that the State agency does not

24 elect to have participate in the Program, the State

25 agency shall be paid for services provided to that
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1 beneficiary under the system for payment applicable

2 under section 222(d) and subsections (d) and (e) of

3 section 1615. The Commissioner shall provide for

4 periodic opportunities for exercising such elections.

5 ‘‘(2) EFFECT OF PARTICIPATION BY STATE

6 AGENCY.—

7 ‘‘(A) STATE AGENCIES PARTICIPATING.—

8 In any case in which a State agency described

9 in paragraph (1) elects under that paragraph to

10 participate in the Program, the employment

11 services, vocational rehabilitation services, and

12 other support services which, upon assignment

13 of tickets to work and self-sufficiency, are pro14 vided to disabled beneficiaries by the State

15 agency acting as an employment network shall

16 be governed by plans for vocational rehabilita17 tion services approved under title I of the Reha18 bilitation Act of 1973.

19 ‘‘(B) STATE AGENCIES ADMINISTERING

20 MATERNAL AND CHILD HEALTH SERVICES PRO21 GRAMS.—Subparagraph (A) shall not apply

22 with respect to any State agency administering

23 a program under title V of this Act.

24 ‘‘(3) AGREEMENTS BETWEEN STATE AGENCIES

25 AND EMPLOYMENT NETWORKS.—State agencies and
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1 employment networks shall enter into agreements re2 garding the conditions under which services will be

3 provided when an individual is referred by an em4 ployment network to a State agency for services.

5 The Commissioner of Social Security shall establish

6 by regulations the timeframe within which such

7 agreements must be entered into and the mecha8 nisms for dispute resolution between State agencies

9 and employment networks with respect to such

10 agreements.

11 ‘‘(d) RESPONSIBILITIES OF THE COMMISSIONER OF

12 SOCIAL SECURITY.—

13 ‘‘(1) SELECTION AND QUALIFICATIONS OF PRO14 GRAM MANAGERS.—The Commissioner of Social Se15 curity shall enter into agreements with 1 or more or16 ganizations in the private or public sector for service

17 as a program manager to assist the Commissioner in

18 administering the Program. Any such program man19 ager shall be selected by means of a competitive bid20 ding process, from among organizations in the pri21 vate or public sector with available expertise and ex22 perience in the field of vocational rehabilitation or

23 employment services.

24 ‘‘(2) TENURE, RENEWAL, AND EARLY TERMI25 NATION.—Each agreement entered into under para-
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1 graph (1) shall provide for early termination upon

2 failure to meet performance standards which shall be

3 specified in the agreement and which shall be

4 weighted to take into account any performance in

5 prior terms. Such performance standards shall

6 include—

7 ‘‘(A) measures for ease of access by bene8 ficiaries to services; and

9 ‘‘(B) measures for determining the extent

10 to which failures in obtaining services for bene11 ficiaries fall within acceptable parameters, as

12 determined by the Commissioner.

13 ‘‘(3) PRECLUSION FROM DIRECT PARTICIPA14 TION IN DELIVERY OF SERVICES IN OWN SERVICE

15 AREA.—Agreements under paragraph (1) shall

16 preclude—

17 ‘‘(A) direct participation by a program

18 manager in the delivery of employment services,

19 vocational rehabilitation services, or other sup20 port services to beneficiaries in the service area

21 covered by the program manager’s agreement;

22 and

23 ‘‘(B) the holding by a program manager of

24 a financial interest in an employment network

25 or service provider which provides services in a
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1 geographic area covered under the program

2 manager’s agreement.

3 ‘‘(4) SELECTION OF EMPLOYMENT NET4 WORKS.—

5 ‘‘(A) IN GENERAL.—The Commissioner

6 shall select and enter into agreements with em7 ployment networks for service under the Pro8 gram. Such employment networks shall be in

9 addition to State agencies serving as employ10 ment networks pursuant to elections under sub11 section (c).

12 ‘‘(B) ALTERNATE PARTICIPANTS.—In any

13 State where the Program is being implemented,

14 the Commissioner shall enter into an agreement

15 with any alternate participant that is operating

16 under the authority of section 222(d)(2) in the

17 State as of the date of the enactment of this

18 section and chooses to serve as an employment

19 network under the Program.

20 ‘‘(5) TERMINATION OF AGREEMENTS WITH EM21 PLOYMENT NETWORKS.—The Commissioner shall

22 terminate agreements with employment networks for

23 inadequate performance, as determined by the Com24 missioner.
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1 ‘‘(6) QUALITY ASSURANCE.—The Commissioner

2 shall provide for such periodic reviews as are nec3 essary to provide for effective quality assurance in

4 the provision of services by employment networks.

5 The Commissioner shall solicit and consider the

6 views of consumers and the program manager under

7 which the employment networks serve and shall con8 sult with providers of services to develop perform9 ance measurements. The Commissioner shall ensure

10 that the results of the periodic reviews are made

11 available to beneficiaries who are prospective service

12 recipients as they select employment networks. The

13 Commissioner shall ensure that the periodic surveys

14 of beneficiaries receiving services under the Program

15 are designed to measure customer service satisfac16 tion.

17 ‘‘(7) DISPUTE RESOLUTION.—The Commis18 sioner shall provide for a mechanism for resolving

19 disputes between beneficiaries and employment net20 works, between program managers and employment

21 networks, and between program managers and pro22 viders of services. The Commissioner shall afford a

23 party to such a dispute a reasonable opportunity for

24 a full and fair review of the matter in dispute.

25 ‘‘(e) PROGRAM MANAGERS.—
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1 ‘‘(1) IN GENERAL.—A program manager shall

2 conduct tasks appropriate to assist the Commis3 sioner in carrying out the Commissioner’s duties in

4 administering the Program.

5 ‘‘(2) RECRUITMENT OF EMPLOYMENT NET6 WORKS.—A program manager shall recruit, and rec7 ommend for selection by the Commissioner, employ8 ment networks for service under the Program. The

9 program manager shall carry out such recruitment

10 and provide such recommendations, and shall mon11 itor all employment networks serving in the Program

12 in the geographic area covered under the program

13 manager’s agreement, to the extent necessary and

14 appropriate to ensure that adequate choices of serv15 ices are made available to beneficiaries. Employment

16 networks may serve under the Program only pursu17 ant to an agreement entered into with the Commis18 sioner under the Program incorporating the applica19 ble provisions of this section and regulations there20 under, and the program manager shall provide and

21 maintain assurances to the Commissioner that pay22 ment by the Commissioner to employment networks

23 pursuant to this section is warranted based on com24 pliance by such employment networks with the terms

25 of such agreement and this section. The program
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1 manager shall not impose numerical limits on the

2 number of employment networks to be recommended

3 pursuant to this paragraph.

4 ‘‘(3) FACILITATION OF ACCESS BY BENE5 FICIARIES TO EMPLOYMENT NETWORKS.—A pro6 gram manager shall facilitate access by beneficiaries

7 to employment networks. The program manager

8 shall ensure that each beneficiary is allowed changes

9 in employment networks without being deemed to

10 have rejected services under the Program. When

11 such a change occurs, the program manager shall re12 assign the ticket based on the choice of the bene13 ficiary. Upon the request of the employment net14 work, the program manager shall make a determina15 tion of the allocation of the outcome or milestone16 outcome payments based on the services provided by

17 each employment network. The program manager

18 shall establish and maintain lists of employment net19 works available to beneficiaries and shall make such

20 lists generally available to the public. The program

21 manager shall ensure that all information provided

22 to disabled beneficiaries pursuant to this paragraph

23 is provided in accessible formats.

24 ‘‘(4) ENSURING AVAILABILITY OF ADEQUATE

25 SERVICES.—The program manager shall ensure that
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1 employment services, vocational rehabilitation serv2 ices, and other support services are provided to

3 beneficiaries throughout the geographic area covered

4 under the program manager’s agreement, including

5 rural areas.

6 ‘‘(5) REASONABLE ACCESS TO SERVICES.—The

7 program manager shall take such measures as are

8 necessary to ensure that sufficient employment net9 works are available and that each beneficiary receiv10 ing services under the Program has reasonable ac11 cess to employment services, vocational rehabilitation

12 services, and other support services. Services pro13 vided under the Program may include case manage14 ment, work incentives planning, supported employ15 ment, career planning, career plan development, vo16 cational assessment, job training, placement, follow17 up services, and such other services as may be speci18 fied by the Commissioner under the Program. The

19 program manager shall ensure that such services are

20 available in each service area.

21 ‘‘(f) EMPLOYMENT NETWORKS.—

22 ‘‘(1) QUALIFICATIONS FOR EMPLOYMENT NET23 WORKS.—

24 ‘‘(A) IN GENERAL.—Each employment net25 work serving under the Program shall consist of
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1 an agency or instrumentality of a State (or a

2 political subdivision thereof) or a private entity,

3 that assumes responsibility for the coordination

4 and delivery of services under the Program to

5 individuals assigning to the employment net6 work tickets to work and self-sufficiency issued

7 under subsection (b).

8 ‘‘(B) ONE-STOP DELIVERY SYSTEMS.—An

9 employment network serving under the Pro10 gram may consist of a one-stop delivery system

11 established under subtitle B of title I of the

12 Workforce Investment Act of 1998.

13 ‘‘(C) COMPLIANCE WITH SELECTION CRI14 TERIA.—No employment network may serve

15 under the Program unless it meets and main16 tains compliance with both general selection cri17 teria (such as professional and educational

18 qualifications, where applicable) and specific se19 lection criteria (such as substantial expertise

20 and experience in providing relevant employ21 ment services and supports).

22 ‘‘(D) SINGLE OR ASSOCIATED PROVIDERS

23 ALLOWED.—An employment network shall con24 sist of either a single provider of such services

25 or of an association of such providers organized
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1 so as to combine their resources into a single

2 entity. An employment network may meet the

3 requirements of subsection (e)(4) by providing

4 services directly, or by entering into agreements

5 with other individuals or entities providing ap6 propriate employment services, vocational reha7 bilitation services, or other support services.

8 ‘‘(2) REQUIREMENTS RELATING TO PROVISION

9 OF SERVICES.—Each employment network serving

10 under the Program shall be required under the

11 terms of its agreement with the Commissioner to—

12 ‘‘(A) serve prescribed service areas; and

13 ‘‘(B) take such measures as are necessary

14 to ensure that employment services, vocational

15 rehabilitation services, and other support serv16 ices provided under the Program by, or under

17 agreements entered into with, the employment

18 network are provided under appropriate indi19 vidual work plans meeting the requirements of

20 subsection (g).

21 ‘‘(3) ANNUAL FINANCIAL REPORTING.—Each

22 employment network shall meet financial reporting

23 requirements as prescribed by the Commissioner.

24 ‘‘(4) PERIODIC OUTCOMES REPORTING.—Each

25 employment network shall prepare periodic reports,
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1 on at least an annual basis, itemizing for the covered

2 period specific outcomes achieved with respect to

3 specific services provided by the employment net4 work. Such reports shall conform to a national

5 model prescribed under this section. Each employ6 ment network shall provide a copy of the latest re7 port issued by the employment network pursuant to

8 this paragraph to each beneficiary upon enrollment

9 under the Program for services to be received

10 through such employment network. Upon issuance of

11 each report to each beneficiary, a copy of the report

12 shall be maintained in the files of the employment

13 network. The program manager shall ensure that

14 copies of all such reports issued under this para15 graph are made available to the public under reason16 able terms.

17 ‘‘(g) INDIVIDUAL WORK PLANS.—

18 ‘‘(1) REQUIREMENTS.—Each employment net19 work shall—

20 ‘‘(A) take such measures as are necessary

21 to ensure that employment services, vocational

22 rehabilitation services, and other support serv23 ices provided under the Program by, or under

24 agreements entered into with, the employment

25 network are provided under appropriate indi-
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1 vidual work plans that meet the requirements of

2 subparagraph (C);

3 ‘‘(B) develop and implement each such in4 dividual work plan, in partnership with each

5 beneficiary receiving such services, in a manner

6 that affords such beneficiary the opportunity to

7 exercise informed choice in selecting an employ8 ment goal and specific services needed to

9 achieve that employment goal;

10 ‘‘(C) ensure that each individual work plan

11 includes at least—

12 ‘‘(i) a statement of the vocational goal

13 developed with the beneficiary, including,

14 as appropriate, goals for earnings and job

15 advancement;

16 ‘‘(ii) a statement of the services and

17 supports that have been deemed necessary

18 for the beneficiary to accomplish that goal;

19 ‘‘(iii) a statement of any terms and

20 conditions related to the provision of such

21 services and supports; and

22 ‘‘(iv) a statement of understanding re23 garding the beneficiary’s rights under the

24 Program (such as the right to retrieve the

25 ticket to work and self-sufficiency if the
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1 beneficiary is dissatisfied with the services

2 being provided by the employment net3 work) and remedies available to the indi4 vidual, including information on the avail5 ability of advocacy services and assistance

6 in resolving disputes through the State

7 grant program authorized under section

8 1150;

9 ‘‘(D) provide a beneficiary the opportunity

10 to amend the individual work plan if a change

11 in circumstances necessitates a change in the

12 plan; and

13 ‘‘(E) make each beneficiary’s individual

14 work plan available to the beneficiary in, as ap15 propriate, an accessible format chosen by the

16 beneficiary.

17 ‘‘(2) EFFECTIVE UPON WRITTEN APPROVAL.—

18 A beneficiary’s individual work plan shall take effect

19 upon written approval by the beneficiary or a rep20 resentative of the beneficiary and a representative of

21 the employment network that, in providing such

22 written approval, acknowledges assignment of the

23 beneficiary’s ticket to work and self-sufficiency.

24 ‘‘(h) EMPLOYMENT NETWORK PAYMENT SYSTEMS.—
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1 ‘‘(1) ELECTION OF PAYMENT SYSTEM BY EM2 PLOYMENT NETWORKS.—

3 ‘‘(A) IN GENERAL.—The Program shall

4 provide for payment authorized by the Commis5 sioner to employment networks under either an

6 outcome payment system or an outcome-mile7 stone payment system. Each employment net8 work shall elect which payment system will be

9 utilized by the employment network, and, for

10 such period of time as such election remains in

11 effect, the payment system so elected shall be

12 utilized exclusively in connection with such em13 ployment network (except as provided in sub14 paragraph (B)).

15 ‘‘(B) NO CHANGE IN METHOD OF PAY16 MENT FOR BENEFICIARIES WITH TICKETS AL17 READY ASSIGNED TO THE EMPLOYMENT NET18 WORKS.—Any election of a payment system by

19 an employment network that would result in a

20 change in the method of payment to the em21 ployment network for services provided to a

22 beneficiary who is receiving services from the

23 employment network at the time of the election

24 shall not be effective with respect to payment

25 for services provided to that beneficiary and the
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1 method of payment previously selected shall

2 continue to apply with respect to such services.

3 ‘‘(2) OUTCOME PAYMENT SYSTEM.—

4 ‘‘(A) IN GENERAL.—The outcome payment

5 system shall consist of a payment structure gov6 erning employment networks electing such sys7 tem under paragraph (1)(A) which meets the

8 requirements of this paragraph.

9 ‘‘(B) PAYMENTS MADE DURING OUTCOME

10 PAYMENT PERIOD.—The outcome payment sys11 tem shall provide for a schedule of payments to

12 an employment network, in connection with

13 each individual who is a beneficiary, for each

14 month, during the individual’s outcome pay15 ment period, for which benefits (described in

16 paragraphs (3) and (4) of subsection (k)) are

17 not payable to such individual because of work

18 or earnings.

19 ‘‘(C) COMPUTATION OF PAYMENTS TO EM20 PLOYMENT NETWORK.—The payment schedule

21 of the outcome payment system shall be de22 signed so that—

23 ‘‘(i) the payment for each month dur24 ing the outcome payment period for which

25 benefits (described in paragraphs (3) and
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1 (4) of subsection (k)) are not payable is

2 equal to a fixed percentage of the payment

3 calculation base for the calendar year in

4 which such month occurs; and

5 ‘‘(ii) such fixed percentage is set at a

6 percentage which does not exceed 40 per7 cent.

8 ‘‘(3) OUTCOME-MILESTONE PAYMENT SYS9 TEM.—

10 ‘‘(A) IN GENERAL.—The outcome-mile11 stone payment system shall consist of a pay12 ment structure governing employment networks

13 electing such system under paragraph (1)(A)

14 which meets the requirements of this para15 graph.

16 ‘‘(B) EARLY PAYMENTS UPON ATTAIN17 MENT OF MILESTONES IN ADVANCE OF OUT18 COME PAYMENT PERIODS.—The outcome-mile19 stone payment system shall provide for 1 or

20 more milestones, with respect to beneficiaries

21 receiving services from an employment network

22 under the Program, that are directed toward

23 the goal of permanent employment. Such mile24 stones shall form a part of a payment structure

25 that provides, in addition to payments made
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1 during outcome payment periods, payments

2 made prior to outcome payment periods in

3 amounts based on the attainment of such mile4 stones.

5 ‘‘(C) LIMITATION ON TOTAL PAYMENTS TO

6 EMPLOYMENT NETWORK.—The payment sched7 ule of the outcome milestone payment system

8 shall be designed so that the total of the pay9 ments to the employment network with respect

10 to each beneficiary is less than, on a net

11 present value basis (using an interest rate de12 termined by the Commissioner that appro13 priately reflects the cost of funds faced by pro14 viders), the total amount to which payments to

15 the employment network with respect to the

16 beneficiary would be limited if the employment

17 network were paid under the outcome payment

18 system.

19 ‘‘(4) DEFINITIONS.—In this subsection:

20 ‘‘(A) PAYMENT CALCULATION BASE.—The

21 term ‘payment calculation base’ means, for any

22 calendar year—

23 ‘‘(i) in connection with a title II dis24 ability beneficiary, the average disability

25 insurance benefit payable under section
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1 223 for all beneficiaries for months during

2 the preceding calendar year; and

3 ‘‘(ii) in connection with a title XVI

4 disability beneficiary (who is not concur5 rently a title II disability beneficiary), the

6 average payment of supplemental security

7 income benefits based on disability payable

8 under title XVI (excluding State sup9 plementation) for months during the pre10 ceding calendar year to all beneficiaries

11 who have attained 18 years of age but

12 have not attained 65 years of age.

13 ‘‘(B) OUTCOME PAYMENT PERIOD.—The

14 term ‘outcome payment period’ means, in con15 nection with any individual who had assigned a

16 ticket to work and self-sufficiency to an employ17 ment network under the Program, a period—

18 ‘‘(i) beginning with the first month,

19 ending after the date on which such ticket

20 was assigned to the employment network,

21 for which benefits (described in paragraphs

22 (3) and (4) of subsection (k)) are not pay23 able to such individual by reason of en24 gagement in substantial gainful activity or
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1 by reason of earnings from work activity;

2 and

3 ‘‘(ii) ending with the 60th month

4 (consecutive or otherwise), ending after

5 such date, for which such benefits are not

6 payable to such individual by reason of en7 gagement in substantial gainful activity or

8 by reason of earnings from work activity.

9 ‘‘(5) PERIODIC REVIEW AND ALTERATIONS OF

10 PRESCRIBED SCHEDULES.—

11 ‘‘(A) PERCENTAGES AND PERIODS.—The

12 Commissioner shall periodically review the per13 centage specified in paragraph (2)(C), the total

14 payments permissible under paragraph (3)(C),

15 and the period of time specified in paragraph

16 (4)(B) to determine whether such percentages,

17 such permissible payments, and such period

18 provide an adequate incentive for employment

19 networks to assist beneficiaries to enter the

20 workforce, while providing for appropriate

21 economies. The Commissioner may alter such

22 percentage, such total permissible payments, or

23 such period of time to the extent that the Com24 missioner determines, on the basis of the Com25 missioner’s review under this paragraph, that
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1 such an alteration would better provide the in2 centive and economies described in the pre3 ceding sentence.

4 ‘‘(B) NUMBER AND AMOUNT OF MILE5 STONE PAYMENTS.—The Commissioner shall

6 periodically review the number and amounts of

7 milestone payments established by the Commis8 sioner pursuant to this section to determine

9 whether they provide an adequate incentive for

10 employment networks to assist beneficiaries to

11 enter the workforce, taking into account infor12 mation provided to the Commissioner by pro13 gram managers, the Ticket to Work and Work

14 Incentives Advisory Panel established by section

15 101(f) of the Ticket to Work and Work Incen16 tives Improvement Act of 1999, and other reli17 able sources. The Commissioner may from time

18 to time alter the number and amounts of mile19 stone payments initially established by the

20 Commissioner pursuant to this section to the

21 extent that the Commissioner determines that

22 such an alteration would allow an adequate in23 centive for employment networks to assist bene24 ficiaries to enter the workforce. Such alteration

25 shall be based on information provided to the
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1 Commissioner by program managers, the Ticket

2 to Work and Work Incentives Advisory Panel

3 established by section 101(f) of the Ticket to

4 Work and Work Incentives Improvement Act of

5 1999, or other reliable sources.

6 ‘‘(C) REPORT ON THE ADEQUACY OF IN7 CENTIVES.—The Commissioner shall submit to

8 Congress not later than 36 months after the

9 date of the enactment of the Ticket to Work

10 and Work Incentives Improvement Act of 1999

11 a report with recommendations for a method or

12 methods to adjust payment rates under sub13 paragraphs (A) and (B), that would ensure ade14 quate incentives for the provision of services by

15 employment networks of—

16 ‘‘(i) individuals with a need for ongo17 ing support and services;

18 ‘‘(ii) individuals with a need for high19 cost accommodations;

20 ‘‘(iii) individuals who earn a submin21 imum wage; and

22 ‘‘(iv) individuals who work and receive

23 partial cash benefits.

24 The Commissioner shall consult with the Ticket

25 to Work and Work Incentives Advisory Panel
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1 established under section 101(f) of the Ticket

2 to Work and Work Incentives Improvement Act

3 of 1999 during the development and evaluation

4 of the study. The Commissioner shall imple5 ment the necessary adjusted payment rates

6 prior to full implementation of the Ticket to

7 Work and Self-Sufficiency Program.

8 ‘‘(i) SUSPENSION OF DISABILITY REVIEWS.—During

9 any period for which an individual is using, as defined by

10 the Commissioner, a ticket to work and self-sufficiency

11 issued under this section, the Commissioner (and any ap12 plicable State agency) may not initiate a continuing dis13 ability review or other review under section 221 of whether

14 the individual is or is not under a disability or a review

15 under title XVI similar to any such review under section

16 221.

17 ‘‘(j) AUTHORIZATIONS.—

18 ‘‘(1) PAYMENTS TO EMPLOYMENT NET19 WORKS.—

20 ‘‘(A) TITLE II DISABILITY BENE21 FICIARIES.—There are authorized to be trans22 ferred from the Federal Old-Age and Survivors

23 Insurance Trust Fund and the Federal Dis24 ability Insurance Trust Fund each fiscal year

25 such sums as may be necessary to make pay-
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1 ments to employment networks under this sec2 tion. Money paid from the Trust Funds under

3 this section with respect to title II disability

4 beneficiaries who are entitled to benefits under

5 section 223 or who are entitled to benefits

6 under section 202(d) on the basis of the wages

7 and self-employment income of such bene8 ficiaries, shall be charged to the Federal Dis9 ability Insurance Trust Fund, and all other

10 money paid from the Trust Funds under this

11 section shall be charged to the Federal Old-Age

12 and Survivors Insurance Trust Fund.

13 ‘‘(B) TITLE XVI DISABILITY BENE14 FICIARIES.—Amounts authorized to be appro15 priated to the Social Security Administration

16 under section 1601 (as in effect pursuant to the

17 amendments made by section 301 of the Social

18 Security Amendments of 1972) shall include

19 amounts necessary to carry out the provisions

20 of this section with respect to title XVI dis21 ability beneficiaries.

22 ‘‘(2) ADMINISTRATIVE EXPENSES.—The costs

23 of administering this section (other than payments

24 to employment networks) shall be paid from

25 amounts made available for the administration of
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1 title II and amounts made available for the adminis2 tration of title XVI, and shall be allocated among

3 such amounts as appropriate.

4 ‘‘(k) DEFINITIONS.—In this section:

5 ‘‘(1) COMMISSIONER.—The term ‘Commis6 sioner’ means the Commissioner of Social Security.

7 ‘‘(2) DISABLED BENEFICIARY.—The term ‘dis8 abled beneficiary’ means a title II disability bene9 ficiary or a title XVI disability beneficiary.

10 ‘‘(3) TITLE II DISABILITY BENEFICIARY.—The

11 term ‘title II disability beneficiary’ means an indi12 vidual entitled to disability insurance benefits under

13 section 223 or to monthly insurance benefits under

14 section 202 based on such individual’s disability (as

15 defined in section 223(d)). An individual is a title II

16 disability beneficiary for each month for which such

17 individual is entitled to such benefits.

18 ‘‘(4) TITLE XVI DISABILITY BENEFICIARY.—

19 The term ‘title XVI disability beneficiary’ means an

20 individual eligible for supplemental security income

21 benefits under title XVI on the basis of blindness

22 (within the meaning of section 1614(a)(2)) or dis23 ability (within the meaning of section 1614(a)(3)).

24 An individual is a title XVI disability beneficiary for
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1 each month for which such individual is eligible for

2 such benefits.

3 ‘‘(5) SUPPLEMENTAL SECURITY INCOME BEN4 EFIT.—The term ‘supplemental security income ben5 efit under title XVI’ means a cash benefit under sec6 tion 1611 or 1619(a), and does not include a State

7 supplementary payment, administered federally or

8 otherwise.

9 ‘‘(l) REGULATIONS.—Not later than 1 year after the

10 date of the enactment of the Ticket to Work and Work

11 Incentives Improvement Act of 1999, the Commissioner

12 shall prescribe such regulations as are necessary to carry

13 out the provisions of this section.’’.

14 (b) CONFORMING AMENDMENTS.—

15 (1) AMENDMENTS TO TITLE II.—

16 (A) Section 221(i) of the Social Security

17 Act (42 U.S.C. 421(i)) is amended by adding at

18 the end the following:

19 ‘‘(5) For suspension of reviews under this subsection

20 in the case of an individual using a ticket to work and

21 self-sufficiency, see section 1148(i).’’.

22 (B) Section 222(a) of such Act (42 U.S.C.

23 422(a)) is repealed.

24 (C) Section 222(b) of such Act (42 U.S.C.

25 422(b)) is repealed.
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1 (D) Section 225(b)(1) of such Act (42

2 U.S.C. 425(b)(1)) is amended by striking ‘‘a

3 program of vocational rehabilitation services’’

4 and inserting ‘‘a program consisting of the

5 Ticket to Work and Self-Sufficiency Program

6 under section 1148 or another program of voca7 tional rehabilitation services, employment serv8 ices, or other support services’’.

9 (2) AMENDMENTS TO TITLE XVI.—

10 (A) Section 1615(a) of such Act (42

11 U.S.C. 1382d(a)) is amended to read as follows:

12 ‘‘SEC. 1615. (a) In the case of any blind or disabled

13 individual who—

14 ‘‘(1) has not attained age 16; and

15 ‘‘(2) with respect to whom benefits are paid

16 under this title,

17 the Commissioner of Social Security shall make provision

18 for referral of such individual to the appropriate State

19 agency administering the State program under title V.’’.

20 (B) Section 1615(c) of such Act (42

21 U.S.C. 1382d(c)) is repealed.

22 (C) Section 1631(a)(6)(A) of such Act (42

23 U.S.C. 1383(a)(6)(A)) is amended by striking

24 ‘‘a program of vocational rehabilitation serv25 ices’’ and inserting ‘‘a program consisting of
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1 the Ticket to Work and Self-Sufficiency Pro2 gram under section 1148 or another program of

3 vocational rehabilitation services, employment

4 services, or other support services’’.

5 (D) Section 1633(c) of such Act (42

6 U.S.C. 1383b(c)) is amended—

7 (i) by inserting ‘‘(1)’’ after ‘‘(c)’’; and

8 (ii) by adding at the end the fol9 lowing:

10 ‘‘(2) For suspension of continuing disability reviews

11 and other reviews under this title similar to reviews under

12 section 221 in the case of an individual using a ticket to

13 work and self-sufficiency, see section 1148(i).’’.

14 (c) EFFECTIVE DATE.—Subject to subsection (d),

15 the amendments made by subsections (a) and (b) shall

16 take effect with the first month following 1 year after the

17 date of the enactment of this Act.

18 (d) GRADUATED IMPLEMENTATION OF PROGRAM.—

19 (1) IN GENERAL.—Not later than 1 year after

20 the date of the enactment of this Act, the Commis21 sioner of Social Security shall commence implemen22 tation of the amendments made by this section

23 (other than paragraphs (1)(C) and (2)(B) of sub24 section (b)) in graduated phases at phase-in sites se25 lected by the Commissioner. Such phase-in sites
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1 shall be selected so as to ensure, prior to full imple2 mentation of the Ticket to Work and Self-Suffi3 ciency Program, the development and refinement of

4 referral processes, payment systems, computer link5 ages, management information systems, and admin6 istrative processes necessary to provide for full im7 plementation of such amendments. Subsection (c)

8 shall apply with respect to paragraphs (1)(C) and

9 (2)(B) of subsection (b) without regard to this sub10 section.

11 (2) REQUIREMENTS.—Implementation of the

12 Program at each phase-in site shall be carried out

13 on a wide enough scale to permit a thorough evalua14 tion of the alternative methods under consideration,

15 so as to ensure that the most efficacious methods

16 are determined and in place for full implementation

17 of the Program on a timely basis.

18 (3) FULL IMPLEMENTATION.—The Commis19 sioner shall ensure that ability to provide tickets and

20 services to individuals under the Program exists in

21 every State as soon as practicable on or after the ef22 fective date specified in subsection (c) but not later

23 than 3 years after such date.

24 (4) ONGOING EVALUATION OF PROGRAM.—
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1 (A) IN GENERAL.—The Commissioner

2 shall design and conduct a series of evaluations

3 to assess the cost-effectiveness of activities car4 ried out under this section and the amendments

5 made thereby, as well as the effects of this sec6 tion and the amendments made thereby on

7 work outcomes for beneficiaries receiving tickets

8 to work and self-sufficiency under the Program.

9 (B) CONSULTATION.—The Commissioner

10 shall design and carry out the series of evalua11 tions after receiving relevant advice from ex12 perts in the fields of disability, vocational reha13 bilitation, and program evaluation and individ14 uals using tickets to work and self-sufficiency

15 under the Program and consulting with the

16 Ticket to Work and Work Incentives Advisory

17 Panel established under section 101(f), the

18 Comptroller General of the United States, other

19 agencies of the Federal Government, and pri20 vate organizations with appropriate expertise.

21 (C) METHODOLOGY.—

22 (i) IMPLEMENTATION.—The Commis23 sioner, in consultation with the Ticket to

24 Work and Work Incentives Advisory Panel

25 established under section 101(f), shall en-
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1 sure that plans for evaluations and data

2 collection methods under the Program are

3 appropriately designed to obtain detailed

4 employment information.

5 (ii) SPECIFIC MATTERS TO BE AD6 DRESSED.—Each such evaluation shall ad7 dress (but is not limited to)—

8 (I) the annual cost (including net

9 cost) of the Program and the annual

10 cost (including net cost) that would

11 have been incurred in the absence of

12 the Program;

13 (II) the determinants of return to

14 work, including the characteristics of

15 beneficiaries in receipt of tickets

16 under the Program;

17 (III) the types of employment

18 services, vocational rehabilitation serv19 ices, and other support services fur20 nished to beneficiaries in receipt of

21 tickets under the Program who return

22 to work and to those who do not re23 turn to work;

24 (IV) the duration of employment

25 services, vocational rehabilitation serv-
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1 ices, and other support services fur2 nished to beneficiaries in receipt of

3 tickets under the Program who return

4 to work and the duration of such serv5 ices furnished to those who do not re6 turn to work and the cost to employ7 ment networks of furnishing such

8 services;

9 (V) the employment outcomes,

10 including wages, occupations, benefits,

11 and hours worked, of beneficiaries

12 who return to work after receiving

13 tickets under the Program and those

14 who return to work without receiving

15 such tickets;

16 (VI) the characteristics of indi17 viduals in possession of tickets under

18 the Program who are not accepted for

19 services and, to the extent reasonably

20 determinable, the reasons for which

21 such beneficiaries were not accepted

22 for services;

23 (VII) the characteristics of pro24 viders whose services are provided
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1 within an employment network under

2 the Program;

3 (VIII) the extent (if any) to

4 which employment networks display a

5 greater willingness to provide services

6 to beneficiaries with a range of dis7 abilities;

8 (IX) the characteristics (includ9 ing employment outcomes) of those

10 beneficiaries who receive services

11 under the outcome payment system

12 and of those beneficiaries who receive

13 services under the outcome-milestone

14 payment system;

15 (X) measures of satisfaction

16 among beneficiaries in receipt of tick17 ets under the Program; and

18 (XI) reasons for (including com19 ments solicited from beneficiaries re20 garding) their choice not to use their

21 tickets or their inability to return to

22 work despite the use of their tickets.

23 (D) PERIODIC EVALUATION REPORTS.—

24 Following the close of the third and fifth fiscal

25 years ending after the effective date under sub-
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1 section (c), and prior to the close of the seventh

2 fiscal year ending after such date, the Commis3 sioner shall transmit to the Committee on Ways

4 and Means of the House of Representatives and

5 the Committee on Finance of the Senate a re6 port containing the Commissioner’s evaluation

7 of the progress of activities conducted under the

8 provisions of this section and the amendments

9 made thereby. Each such report shall set forth

10 the Commissioner’s evaluation of the extent to

11 which the Program has been successful and the

12 Commissioner’s conclusions on whether or how

13 the Program should be modified. Each such re14 port shall include such data, findings, materials,

15 and recommendations as the Commissioner may

16 consider appropriate.

17 (5) EXTENT OF STATE’S RIGHT OF FIRST RE18 FUSAL IN ADVANCE OF FULL IMPLEMENTATION OF

19 AMENDMENTS IN SUCH STATE.—

20 (A) IN GENERAL.—In the case of any

21 State in which the amendments made by sub22 section (a) have not been fully implemented

23 pursuant to this subsection, the Commissioner

24 shall determine by regulation the extent to

25 which—
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1 (i) the requirement under section

2 222(a) for prompt referrals to a State

3 agency; and

4 (ii) the authority of the Commissioner

5 under section 222(d)(2) of the Social Secu6 rity Act to provide vocational rehabilitation

7 services in such State by agreement or

8 contract with other public or private agen9 cies, organizations, institutions, or individ10 uals,

11 shall apply in such State.

12 (B) EXISTING AGREEMENTS.—Nothing in

13 subparagraph (A) or the amendments made by

14 subsection (a) shall be construed to limit, im15 pede, or otherwise affect any agreement entered

16 into pursuant to section 222(d)(2) of the Social

17 Security Act before the date of the enactment

18 of this Act with respect to services provided

19 pursuant to such agreement to beneficiaries re20 ceiving services under such agreement as of

21 such date, except with respect to services (if

22 any) to be provided after 3 years after the ef23 fective date provided in subsection (c).

24 (e) SPECIFIC REGULATIONS REQUIRED.—
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1 (1) IN GENERAL.—The Commissioner of Social

2 Security shall prescribe such regulations as are nec3 essary to implement the amendments made by this

4 section.

5 (2) SPECIFIC MATTERS TO BE INCLUDED IN

6 REGULATIONS.—The matters which shall be ad7 dressed in such regulations shall include—

8 (A) the form and manner in which tickets

9 to work and self-sufficiency may be distributed

10 to beneficiaries pursuant to section 1148(b)(1)

11 of the Social Security Act;

12 (B) the format and wording of such tick13 ets, which shall incorporate by reference any

14 contractual terms governing service by employ15 ment networks under the Program;

16 (C) the form and manner in which State

17 agencies may elect participation in the Ticket to

18 Work and Self-Sufficiency Program pursuant to

19 section 1148(c)(1) of such Act and provision for

20 periodic opportunities for exercising such elec21 tions;

22 (D) the status of State agencies under sec23 tion 1148(c)(1) of such Act at the time that

24 State agencies exercise elections under that sec25 tion;
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1 (E) the terms of agreements to be entered

2 into with program managers pursuant to sec3 tion 1148(d) of such Act, including—

4 (i) the terms by which program man5 agers are precluded from direct participa6 tion in the delivery of services pursuant to

7 section 1148(d)(3) of such Act;

8 (ii) standards which must be met by

9 quality assurance measures referred to in

10 paragraph (6) of section 1148(d) of such

11 Act and methods of recruitment of employ12 ment networks utilized pursuant to para13 graph (2) of section 1148(e) of such Act;

14 and

15 (iii) the format under which dispute

16 resolution will operate under section

17 1148(d)(7) of such Act;

18 (F) the terms of agreements to be entered

19 into with employment networks pursuant to sec20 tion 1148(d)(4) of such Act, including—

21 (i) the manner in which service areas

22 are specified pursuant to section

23 1148(f)(2)(A) of such Act;

24 (ii) the general selection criteria and

25 the specific selection criteria which are ap-
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1 plicable to employment networks under

2 section 1148(f)(1)(C) of such Act in select3 ing service providers;

4 (iii) specific requirements relating to

5 annual financial reporting by employment

6 networks pursuant to section 1148(f)(3) of

7 such Act; and

8 (iv) the national model to which peri9 odic outcomes reporting by employment

10 networks must conform under section

11 1148(f)(4) of such Act;

12 (G) standards which must be met by indi13 vidual work plans pursuant to section 1148(g)

14 of such Act;

15 (H) standards which must be met by pay16 ment systems required under section 1148(h) of

17 such Act, including—

18 (i) the form and manner in which

19 elections by employment networks of pay20 ment systems are to be exercised pursuant

21 to section 1148(h)(1)(A) of such Act;

22 (ii) the terms which must be met by

23 an outcome payment system under section

24 1148(h)(2) of such Act;
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1 (iii) the terms which must be met by

2 an outcome-milestone payment system

3 under section 1148(h)(3) of such Act;

4 (iv) any revision of the percentage

5 specified in paragraph (2)(C) of section

6 1148(h) of such Act or the period of time

7 specified in paragraph (4)(B) of such sec8 tion 1148(h) of such Act; and

9 (v) annual oversight procedures for

10 such systems; and

11 (I) procedures for effective oversight of the

12 Program by the Commissioner of Social Secu13 rity, including periodic reviews and reporting

14 requirements.

15 (f) THE TICKET TO WORK AND WORK INCENTIVES

16 ADVISORY PANEL.—

17 (1) ESTABLISHMENT.—There is established

18 within the Social Security Administration a panel to

19 be known as the ‘‘Ticket to Work and Work Incen20 tives Advisory Panel’’ (in this subsection referred to

21 as the ‘‘Panel’’).

22 (2) DUTIES OF PANEL.—It shall be the duty of

23 the Panel to—

24 (A) advise the President, the Congress,

25 and the Commissioner of Social Security on
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1 issues related to work incentives programs,

2 planning, and assistance for individuals with

3 disabilities, including work incentive provisions

4 under titles II, XI, XVI, XVIII, and XIX of the

5 Social Security Act (42 U.S.C. 401 et seq.,

6 1301 et seq., 1381 et seq., 1395 et seq., 1396

7 et seq.); and

8 (B) with respect to the Ticket to Work and

9 Self-Sufficiency Program established under sec10 tion 1148 of such Act—

11 (i) advise the Commissioner of Social

12 Security with respect to establishing phase13 in sites for such Program and fully imple14 menting the Program thereafter, the re15 finement of access of disabled beneficiaries

16 to employment networks, payment systems,

17 and management information systems, and

18 advise the Commissioner whether such

19 measures are being taken to the extent

20 necessary to ensure the success of the Pro21 gram;

22 (ii) advise the Commissioner regard23 ing the most effective designs for research

24 and demonstration projects associated with
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1 the Program or conducted pursuant to sec2 tion 302 of this Act;

3 (iii) advise the Commissioner on the

4 development of performance measurements

5 relating to quality assurance under section

6 1148(d)(6) of the Social Security Act; and

7 (iv) furnish progress reports on the

8 Program to the Commissioner and each

9 House of Congress.

10 (3) MEMBERSHIP.—

11 (A) NUMBER AND APPOINTMENT.—The

12 Panel shall be composed of 12 members as fol13 lows:

14 (i) 4 members appointed by the Presi15 dent, not more than 2 of whom may be of

16 the same political party;

17 (ii) 2 members appointed by the

18 Speaker of the House of Representatives,

19 in consultation with the Chairman of the

20 Committee on Ways and Means of the

21 House of Representatives;

22 (iii) 2 members appointed by the mi23 nority leader of the House of Representa24 tives, in consultation with the ranking
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1 member of the Committee on Ways and

2 Means of the House of Representatives;

3 (iv) 2 members appointed by the ma4 jority leader of the Senate, in consultation

5 with the Chairman of the Committee on

6 Finance of the Senate; and

7 (v) 2 members appointed by the mi8 nority leader of the Senate, in consultation

9 with the ranking member of the Committee

10 on Finance of the Senate.

11 (B) REPRESENTATION.—Of the members

12 appointed under subparagraph (A), at least 8

13 shall have experience or expert knowledge as a

14 recipient, provider, employer, or employee in the

15 fields of, or related to, employment services, vo16 cational rehabilitation services, and other sup17 port services, of whom—

18 (i) at least 2 shall represent the inter19 ests of recipients of employment services,

20 vocational rehabilitation services, and other

21 support services;

22 (ii) at least 2 shall represent the in23 terests of providers of employment serv24 ices, vocational rehabilitation services, and

25 other support services;
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1 (iii) at least 2 shall represent the in2 terests of private employers; and

3 (iv) at least 2 shall represent the in4 terests of employees.

At least 1 5 ⁄2 of the members described in each

6 clause of subparagraph (A) shall be individuals

7 with disabilities, or representatives of individ8 uals with disabilities, with consideration to cur9 rent or former title II disability beneficiaries or

10 title XVI disability beneficiaries (as such terms

11 are defined in section 1148(k) of the Social Se12 curity Act (as added by subsection (a)).

13 (C) TERMS.—

14 (i) IN GENERAL.—Each member shall

15 be appointed for a term of 4 years (or, if

16 less, for the remaining life of the Panel),

17 except as provided in clauses (ii) and (iii).

18 The initial members shall be appointed not

19 later than 90 days after the date of the en20 actment of this Act.

21 (ii) TERMS OF INITIAL AP22 POINTEES.—As designated by the Presi23 dent at the time of appointment, of the

24 members first appointed—
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(I) 1 1 ⁄2 of the members appointed

2 under subparagraph (A) shall be ap3 pointed for a term of 2 years; and

4 (II) the remaining members ap5 pointed under subparagraph (A) shall

6 be appointed for a term of 4 years.

7 (iii) VACANCIES.—Any member ap8 pointed to fill a vacancy occurring before

9 the expiration of the term for which the

10 member’s predecessor was appointed shall

11 be appointed only for the remainder of that

12 term. A member may serve after the expi13 ration of that member’s term until a suc14 cessor has taken office. A vacancy in the

15 Panel shall be filled in the manner in

16 which the original appointment was made.

17 (D) BASIC PAY.—Members shall each be

18 paid at a rate, and in a manner, that is con19 sistent with guidelines established under section

20 7 of the Federal Advisory Committee Act (5

21 U.S.C. App.).

22 (E) TRAVEL EXPENSES.—Each member

23 shall receive travel expenses, including per diem

24 in lieu of subsistence, in accordance with sec-
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1 tions 5702 and 5703 of title 5, United States

2 Code.

3 (F) QUORUM.—8 members of the Panel

4 shall constitute a quorum but a lesser number

5 may hold hearings.

6 (G) CHAIRPERSON.—The Chairperson of

7 the Panel shall be designated by the President.

8 The term of office of the Chairperson shall be

9 4 years.

10 (H) MEETINGS.—The Panel shall meet at

11 least quarterly and at other times at the call of

12 the Chairperson or a majority of its members.

13 (4) DIRECTOR AND STAFF OF PANEL; EXPERTS

14 AND CONSULTANTS.—

15 (A) DIRECTOR.—The Panel shall have a

16 Director who shall be appointed by the Panel,

17 and paid at a rate, and in a manner, that is

18 consistent with guidelines established under sec19 tion 7 of the Federal Advisory Committee Act

20 (5 U.S.C. App.).

21 (B) STAFF.—Subject to rules prescribed

22 by the Commissioner of Social Security, the Di23 rector may appoint and fix the pay of additional

24 personnel as the Director considers appropriate.
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1 (C) EXPERTS AND CONSULTANTS.—Sub2 ject to rules prescribed by the Commissioner of

3 Social Security, the Director may procure tem4 porary and intermittent services under section

5 3109(b) of title 5, United States Code.

6 (D) STAFF OF FEDERAL AGENCIES.—

7 Upon request of the Panel, the head of any

8 Federal department or agency may detail, on a

9 reimbursable basis, any of the personnel of that

10 department or agency to the Panel to assist it

11 in carrying out its duties under this Act.

12 (5) POWERS OF PANEL.—

13 (A) HEARINGS AND SESSIONS.—The Panel

14 may, for the purpose of carrying out its duties

15 under this subsection, hold such hearings, sit

16 and act at such times and places, and take such

17 testimony and evidence as the Panel considers

18 appropriate.

19 (B) POWERS OF MEMBERS AND AGENTS.—

20 Any member or agent of the Panel may, if au21 thorized by the Panel, take any action which

22 the Panel is authorized to take by this section.

23 (C) MAILS.—The Panel may use the

24 United States mails in the same manner and
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1 under the same conditions as other departments

2 and agencies of the United States.

3 (6) REPORTS.—

4 (A) INTERIM REPORTS.—The Panel shall

5 submit to the President and the Congress in6 terim reports at least annually.

7 (B) FINAL REPORT.—The Panel shall

8 transmit a final report to the President and the

9 Congress not later than eight years after the

10 date of the enactment of this Act. The final re11 port shall contain a detailed statement of the

12 findings and conclusions of the Panel, together

13 with its recommendations for legislation and ad14 ministrative actions which the Panel considers

15 appropriate.

16 (7) TERMINATION.—The Panel shall terminate

17 30 days after the date of the submission of its final

18 report under paragraph (6)(B).

19 (8) AUTHORIZATION OF APPROPRIATIONS.—

20 There are authorized to be appropriated from the

21 Federal Old-Age and Survivors Insurance Trust

22 Fund, the Federal Disability Insurance Trust Fund,

23 and the general fund of the Treasury, as appro24 priate, such sums as are necessary to carry out this

25 subsection.
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1 Subtitle B—Elimination of Work

2 Disincentives

3 SEC. 111. WORK ACTIVITY STANDARD AS A BASIS FOR RE4 VIEW OF AN INDIVIDUAL’S DISABLED STATUS.

5 (a) IN GENERAL.—Section 221 of the Social Security

6 Act (42 U.S.C. 421) is amended by adding at the end the

7 following:

8 ‘‘(m)(1) In any case where an individual entitled to

9 disability insurance benefits under section 223 or to

10 monthly insurance benefits under section 202 based on

11 such individual’s disability (as defined in section 223(d))

12 has received such benefits for at least 24 months—

13 ‘‘(A) no continuing disability review conducted

14 by the Commissioner may be scheduled for the indi15 vidual solely as a result of the individual’s work ac16 tivity;

17 ‘‘(B) no work activity engaged in by the indi18 vidual may be used as evidence that the individual

19 is no longer disabled; and

20 ‘‘(C) no cessation of work activity by the indi21 vidual may give rise to a presumption that the indi22 vidual is unable to engage in work.

23 ‘‘(2) An individual to which paragraph (1) applies

24 shall continue to be subject to—
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1 ‘‘(A) continuing disability reviews on a regularly

2 scheduled basis that is not triggered by work; and

3 ‘‘(B) termination of benefits under this title in

4 the event that the individual has earnings that ex5 ceed the level of earnings established by the Com6 missioner to represent substantial gainful activity.’’.

7 (b) EFFECTIVE DATE.—The amendment made by

8 subsection (a) shall take effect on January 1, 2003.

9 SEC. 112. EXPEDITED REINSTATEMENT OF DISABILITY

10 BENEFITS.

11 (a) OASDI BENEFITS.—Section 223 of the Social

12 Security Act (42 U.S.C. 423) is amended—

13 (1) by redesignating subsection (i) as subsection

14 (j); and

15 (2) by inserting after subsection (h) the fol16 lowing:

17 ‘‘Reinstatement of Entitlement

18 ‘‘(i)(1)(A) Entitlement to benefits described in sub19 paragraph (B)(i)(I) shall be reinstated in any case where

20 the Commissioner determines that an individual described

21 in subparagraph (B) has filed a request for reinstatement

22 meeting the requirements of paragraph (2)(A) during the

23 period prescribed in subparagraph (C). Reinstatement of

24 such entitlement shall be in accordance with the terms of

25 this subsection.
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1 ‘‘(B) An individual is described in this subparagraph

2 if—

3 ‘‘(i) prior to the month in which the individual

4 files a request for reinstatement—

5 ‘‘(I) the individual was entitled to benefits

6 under this section or section 202 on the basis

7 of disability pursuant to an application filed

8 therefor; and

9 ‘‘(II) such entitlement terminated due to

10 the performance of substantial gainful activity;

11 ‘‘(ii) the individual is under a disability and the

12 physical or mental impairment that is the basis for

13 the finding of disability is the same as (or related

14 to) the physical or mental impairment that was the

15 basis for the finding of disability that gave rise to

16 the entitlement described in clause (i); and

17 ‘‘(iii) the individual’s disability renders the indi18 vidual unable to perform substantial gainful activity.

19 ‘‘(C)(i) Except as provided in clause (ii), the period

20 prescribed in this subparagraph with respect to an indi21 vidual is 60 consecutive months beginning with the month

22 following the most recent month for which the individual

23 was entitled to a benefit described in subparagraph

24 (B)(i)(I) prior to the entitlement termination described in

25 subparagraph (B)(i)(II).
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1 ‘‘(ii) In the case of an individual who fails to file a

2 reinstatement request within the period prescribed in

3 clause (i), the Commissioner may extend the period if the

4 Commissioner determines that the individual had good

5 cause for the failure to so file.

6 ‘‘(2)(A)(i) A request for reinstatement shall be filed

7 in such form, and containing such information, as the

8 Commissioner may prescribe.

9 ‘‘(ii) A request for reinstatement shall include express

10 declarations by the individual that the individual meets the

11 requirements specified in clauses (ii) and (iii) of para12 graph (1)(B).

13 ‘‘(B) A request for reinstatement filed in accordance

14 with subparagraph (A) may constitute an application for

15 benefits in the case of any individual who the Commis16 sioner determines is not entitled to reinstated benefits

17 under this subsection.

18 ‘‘(3) In determining whether an individual meets the

19 requirements of paragraph (1)(B)(ii), the provisions of

20 subsection (f) shall apply.

21 ‘‘(4)(A)(i) Subject to clause (ii), entitlement to bene22 fits reinstated under this subsection shall commence with

23 the benefit payable for the month in which a request for

24 reinstatement is filed.
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1 ‘‘(ii) An individual whose entitlement to a benefit for

2 any month would have been reinstated under this sub3 section had the individual filed a request for reinstatement

4 before the end of such month shall be entitled to such ben5 efit for such month if such request for reinstatement is

6 filed before the end of the twelfth month immediately suc7 ceeding such month.

8 ‘‘(B)(i) Subject to clauses (ii) and (iii), the amount

9 of the benefit payable for any month pursuant to the rein10 statement of entitlement under this subsection shall be de11 termined in accordance with the provisions of this title.

12 ‘‘(ii) For purposes of computing the primary insur13 ance amount of an individual whose entitlement to benefits

14 under this section is reinstated under this subsection, the

15 date of onset of the individual’s disability shall be the date

16 of onset used in determining the individual’s most recent

17 period of disability arising in connection with such benefits

18 payable on the basis of an application.

19 ‘‘(iii) Benefits under this section or section 202 pay20 able for any month pursuant to a request for reinstate21 ment filed in accordance with paragraph (2) shall be re22 duced by the amount of any provisional benefit paid to

23 such individual for such month under paragraph (7).

24 ‘‘(C) No benefit shall be payable pursuant to an enti25 tlement reinstated under this subsection to an individual
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1 for any month in which the individual engages in substan2 tial gainful activity.

3 ‘‘(D) The entitlement of any individual that is rein4 stated under this subsection shall end with the benefits

5 payable for the month preceding whichever of the following

6 months is the earliest:

7 ‘‘(i) The month in which the individual dies.

8 ‘‘(ii) The month in which the individual attains

9 retirement age.

10 ‘‘(iii) The third month following the month in

11 which the individual’s disability ceases.

12 ‘‘(5) Whenever an individual’s entitlement to benefits

13 under this section is reinstated under this subsection, enti14 tlement to benefits payable on the basis of such individ15 ual’s wages and self-employment income may be reinstated

16 with respect to any person previously entitled to such ben17 efits on the basis of an application if the Commissioner

18 determines that such person satisfies all the requirements

19 for entitlement to such benefits except requirements re20 lated to the filing of an application. The provisions of

21 paragraph (4) shall apply to the reinstated entitlement of

22 any such person to the same extent that they apply to

23 the reinstated entitlement of such individual.

24 ‘‘(6) An individual to whom benefits are payable

25 under this section or section 202 pursuant to a reinstate-
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1 ment of entitlement under this subsection for 24 months

2 (whether or not consecutive) shall, with respect to benefits

3 so payable after such twenty-fourth month, be deemed for

4 purposes of paragraph (1)(B)(i)(I) and the determination,

5 if appropriate, of the termination month in accordance

6 with subsection (a)(1) of this section, or subsection (d)(1),

7 (e)(1), or (f)(1) of section 202, to be entitled to such bene8 fits on the basis of an application filed therefor.

9 ‘‘(7)(A) An individual described in paragraph (1)(B)

10 who files a request for reinstatement in accordance with

11 the provisions of paragraph (2)(A) shall be entitled to pro12 visional benefits payable in accordance with this para13 graph, unless the Commissioner determines that the indi14 vidual does not meet the requirements of paragraph

15 (1)(B)(i) or that the individual’s declaration under para16 graph (2)(A)(ii) is false. Any such determination by the

17 Commissioner shall be final and not subject to review

18 under subsection (b) or (g) of section 205.

19 ‘‘(B) The amount of a provisional benefit for a month

20 shall equal the amount of the last monthly benefit payable

21 to the individual under this title on the basis of an applica22 tion increased by an amount equal to the amount, if any,

23 by which such last monthly benefit would have been in24 creased as a result of the operation of section 215(i).
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1 ‘‘(C)(i) Provisional benefits shall begin with the

2 month in which a request for reinstatement is filed in ac3 cordance with paragraph (2)(A).

4 ‘‘(ii) Provisional benefits shall end with the earliest

5 of—

6 ‘‘(I) the month in which the Commissioner

7 makes a determination regarding the individual’s en8 titlement to reinstated benefits;

9 ‘‘(II) the fifth month following the month de10 scribed in clause (i);

11 ‘‘(III) the month in which the individual per12 forms substantial gainful activity; or

13 ‘‘(IV) the month in which the Commissioner de14 termines that the individual does not meet the re15 quirements of paragraph (1)(B)(i) or that the indi16 vidual’s declaration made in accordance with para17 graph (2)(A)(ii) is false.

18 ‘‘(D) In any case in which the Commissioner deter19 mines that an individual is not entitled to reinstated bene20 fits, any provisional benefits paid to the individual under

21 this paragraph shall not be subject to recovery as an over22 payment unless the Commissioner determines that the in23 dividual knew or should have known that the individual

24 did not meet the requirements of paragraph (1)(B).’’.

25 (b) SSI BENEFITS.—
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1 (1) IN GENERAL.—Section 1631 of the Social

2 Security Act (42 U.S.C. 1383) is amended by add3 ing at the end the following:

4 ‘‘Reinstatement of Eligibility on the Basis of Blindness

5 or Disability

6 ‘‘(p)(1)(A) Eligibility for benefits under this title

7 shall be reinstated in any case where the Commissioner

8 determines that an individual described in subparagraph

9 (B) has filed a request for reinstatement meeting the re10 quirements of paragraph (2)(A) during the period pre11 scribed in subparagraph (C). Reinstatement of eligibility

12 shall be in accordance with the terms of this subsection.

13 ‘‘(B) An individual is described in this subparagraph

14 if—

15 ‘‘(i) prior to the month in which the individual

16 files a request for reinstatement—

17 ‘‘(I) the individual was eligible for benefits

18 under this title on the basis of blindness or dis19 ability pursuant to an application filed therefor;

20 and

21 ‘‘(II) the individual thereafter was ineli22 gible for such benefits due to earned income (or

23 earned and unearned income) for a period of 12

24 or more consecutive months;
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1 ‘‘(ii) the individual is blind or disabled and the

2 physical or mental impairment that is the basis for

3 the finding of blindness or disability is the same as

4 (or related to) the physical or mental impairment

5 that was the basis for the finding of blindness or

6 disability that gave rise to the eligibility described in

7 clause (i);

8 ‘‘(iii) the individual’s blindness or disability ren9 ders the individual unable to perform substantial

10 gainful activity; and

11 ‘‘(iv) the individual satisfies the nonmedical re12 quirements for eligibility for benefits under this title.

13 ‘‘(C)(i) Except as provided in clause (ii), the period

14 prescribed in this subparagraph with respect to an indi15 vidual is 60 consecutive months beginning with the month

16 following the most recent month for which the individual

17 was eligible for a benefit under this title (including section

18 1619) prior to the period of ineligibility described in sub19 paragraph (B)(i)(II).

20 ‘‘(ii) In the case of an individual who fails to file a

21 reinstatement request within the period prescribed in

22 clause (i), the Commissioner may extend the period if the

23 Commissioner determines that the individual had good

24 cause for the failure to so file.
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1 ‘‘(2)(A)(i) A request for reinstatement shall be filed

2 in such form, and containing such information, as the

3 Commissioner may prescribe.

4 ‘‘(ii) A request for reinstatement shall include express

5 declarations by the individual that the individual meets the

6 requirements specified in clauses (ii) through (iv) of para7 graph (1)(B).

8 ‘‘(B) A request for reinstatement filed in accordance

9 with subparagraph (A) may constitute an application for

10 benefits in the case of any individual who the Commis11 sioner determines is not eligible for reinstated benefits

12 under this subsection.

13 ‘‘(3) In determining whether an individual meets the

14 requirements of paragraph (1)(B)(ii), the provisions of

15 section 1614(a)(4) shall apply.

16 ‘‘(4)(A) Eligibility for benefits reinstated under this

17 subsection shall commence with the benefit payable for the

18 month following the month in which a request for rein19 statement is filed.

20 ‘‘(B)(i) Subject to clause (ii), the amount of the ben21 efit payable for any month pursuant to the reinstatement

22 of eligibility under this subsection shall be determined in

23 accordance with the provisions of this title.

24 ‘‘(ii) The benefit under this title payable for any

25 month pursuant to a request for reinstatement filed in ac-
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1 cordance with paragraph (2) shall be reduced by the

2 amount of any provisional benefit paid to such individual

3 for such month under paragraph (7).

4 ‘‘(C) Except as otherwise provided in this subsection,

5 eligibility for benefits under this title reinstated pursuant

6 to a request filed under paragraph (2) shall be subject

7 to the same terms and conditions as eligibility established

8 pursuant to an application filed therefor.

9 ‘‘(5) Whenever an individual’s eligibility for benefits

10 under this title is reinstated under this subsection, eligi11 bility for such benefits shall be reinstated with respect to

12 the individual’s spouse if such spouse was previously an

13 eligible spouse of the individual under this title and the

14 Commissioner determines that such spouse satisfies all the

15 requirements for eligibility for such benefits except re16 quirements related to the filing of an application. The pro17 visions of paragraph (4) shall apply to the reinstated eligi18 bility of the spouse to the same extent that they apply

19 to the reinstated eligibility of such individual.

20 ‘‘(6) An individual to whom benefits are payable

21 under this title pursuant to a reinstatement of eligibility

22 under this subsection for twenty-four months (whether or

23 not consecutive) shall, with respect to benefits so payable

24 after such twenty-fourth month, be deemed for purposes
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1 of paragraph (1)(B)(i)(I) to be eligible for such benefits

2 on the basis of an application filed therefor.

3 ‘‘(7)(A) An individual described in paragraph (1)(B)

4 who files a request for reinstatement in accordance with

5 the provisions of paragraph (2)(A) shall be eligible for pro6 visional benefits payable in accordance with this para7 graph, unless the Commissioner determines that the indi8 vidual does not meet the requirements of paragraph

9 (1)(B)(i) or that the individual’s declaration under para10 graph (2)(A)(ii) is false. Any such determination by the

11 Commissioner shall be final and not subject to review

12 under paragraph (1) or (3) of subsection (c).

13 ‘‘(B)(i) Except as otherwise provided in clause (ii),

14 the amount of a provisional benefit for a month shall equal

15 the amount of the monthly benefit that would be payable

16 to an eligible individual under this title with the same kind

17 and amount of income.

18 ‘‘(ii) If the individual has a spouse who was pre19 viously an eligible spouse of the individual under this title

20 and the Commissioner determines that such spouse satis21 fies all the requirements of section 1614(b) except require22 ments related to the filing of an application, the amount

23 of a provisional benefit for a month shall equal the amount

24 of the monthly benefit that would be payable to an eligible
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1 individual and eligible spouse under this title with the

2 same kind and amount of income.

3 ‘‘(C)(i) Provisional benefits shall begin with the

4 month following the month in which a request for rein5 statement is filed in accordance with paragraph (2)(A).

6 ‘‘(ii) Provisional benefits shall end with the earliest

7 of—

8 ‘‘(I) the month in which the Commissioner

9 makes a determination regarding the individual’s eli10 gibility for reinstated benefits;

11 ‘‘(II) the fifth month following the month for

12 which provisional benefits are first payable under

13 clause (i); or

14 ‘‘(III) the month in which the Commissioner de15 termines that the individual does not meet the re16 quirements of paragraph (1)(B)(i) or that the indi17 vidual’s declaration made in accordance with para18 graph (2)(A)(ii) is false.

19 ‘‘(D) In any case in which the Commissioner deter20 mines that an individual is not eligible for reinstated bene21 fits, any provisional benefits paid to the individual under

22 this paragraph shall not be subject to recovery as an over23 payment unless the Commissioner determines that the in24 dividual knew or should have known that the individual

25 did not meet the requirements of paragraph (1)(B).
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1 ‘‘(8) For purposes of this subsection other than para2 graph (7), the term ‘benefits under this title’ includes

3 State supplementary payments made pursuant to an

4 agreement under section 1616(a) of this Act or section

5 212(b) of Public Law 93–66.’’.

6 (2) CONFORMING AMENDMENTS.—

7 (A) Section 1631(j)(1) of such Act (42

8 U.S.C. 1383(j)(1)) is amended by striking the

9 period and inserting ‘‘, or has filed a request

10 for reinstatement of eligibility under subsection

11 (p)(2) and been determined to be eligible for re12 instatement.’’.

13 (B) Section 1631(j)(2)(A)(i)(I) of such Act

14 (42 U.S.C. 1383(j)(2)(A)(i)(I)) is amended by

15 inserting ‘‘(other than pursuant to a request for

16 reinstatement under subsection (p))’’ after ‘‘eli17 gible’’.

18 (c) EFFECTIVE DATE.—

19 (1) IN GENERAL.—The amendments made by

20 this section shall take effect on the first day of the

21 thirteenth month beginning after the date of the en22 actment of this Act.

23 (2) LIMITATION.—No benefit shall be payable

24 under title II or XVI on the basis of a request for

25 reinstatement filed under section 223(i) or 1631(p)
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1 of the Social Security Act before the effective date

2 described in paragraph (1).

3 Subtitle C—Work Incentives

4 Planning, Assistance, and Outreach

5 SEC. 121. WORK INCENTIVES OUTREACH PROGRAM.

6 Part A of title XI of the Social Security Act (42

7 U.S.C. 1301 et seq.), as amended by section 101, is

8 amended by adding after section 1148 the following:

9 ‘‘WORK INCENTIVES OUTREACH PROGRAM

10 ‘‘SEC. 1149. (a) ESTABLISHMENT.—

11 ‘‘(1) IN GENERAL.—The Commissioner, in con12 sultation with the Ticket to Work and Work Incen13 tives Advisory Panel established under section 101(f)

14 of the Ticket to Work and Work Incentives Improve15 ment Act of 1999, shall establish a community-based

16 work incentives planning and assistance program for

17 the purpose of disseminating accurate information to

18 disabled beneficiaries on work incentives programs

19 and issues related to such programs.

20 ‘‘(2) GRANTS, COOPERATIVE AGREEMENTS,

21 CONTRACTS, AND OUTREACH.—Under the program

22 established under this section, the Commissioner

23 shall—

24 ‘‘(A) establish a competitive program of

25 grants, cooperative agreements, or contracts to

26 provide benefits planning and assistance, in-
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1 cluding information on the availability of pro2 tection and advocacy services, to disabled bene3 ficiaries, including individuals participating in

4 the Ticket to Work and Self-Sufficiency Pro5 gram established under section 1148, the pro6 gram established under section 1619, and other

7 programs that are designed to encourage dis8 abled beneficiaries to work;

9 ‘‘(B) conduct directly, or through grants,

10 cooperative agreements, or contracts, ongoing

11 outreach efforts to disabled beneficiaries (and

12 to the families of such beneficiaries) who are

13 potentially eligible to participate in Federal or

14 State work incentive programs that are de15 signed to assist disabled beneficiaries to work,

16 including—

17 ‘‘(i) preparing and disseminating in18 formation explaining such programs; and

19 ‘‘(ii) working in cooperation with

20 other Federal, State, and private agencies

21 and nonprofit organizations that serve dis22 abled beneficiaries, and with agencies and

23 organizations that focus on vocational re24 habilitation and work-related training and

25 counseling;
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1 ‘‘(C) establish a corps of trained, acces2 sible, and responsive work incentives specialists

3 within the Social Security Administration who

4 will specialize in disability work incentives

5 under titles II and XVI for the purpose of dis6 seminating accurate information with respect to

7 inquiries and issues relating to work incentives

8 to—

9 ‘‘(i) disabled beneficiaries;

10 ‘‘(ii) benefit applicants under titles II

11 and XVI; and

12 ‘‘(iii) individuals or entities awarded

13 grants under subparagraphs (A) or (B);

14 and

15 ‘‘(D) provide—

16 ‘‘(i) training for work incentives spe17 cialists and individuals providing planning

18 assistance described in subparagraph (C);

19 and

20 ‘‘(ii) technical assistance to organiza21 tions and entities that are designed to en22 courage disabled beneficiaries to return to

23 work.

24 ‘‘(3) COORDINATION WITH OTHER PRO25 GRAMS.—The responsibilities of the Commissioner
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1 established under this section shall be coordinated

2 with other public and private programs that provide

3 information and assistance regarding rehabilitation

4 services and independent living supports and bene5 fits planning for disabled beneficiaries including the

6 program under section 1619, the plans for achieving

7 self-support program (PASS), and any other Federal

8 or State work incentives programs that are designed

9 to assist disabled beneficiaries, including educational

10 agencies that provide information and assistance re11 garding rehabilitation, school-to-work programs,

12 transition services (as defined in, and provided in ac13 cordance with, the Individuals with Disabilities Edu14 cation Act (20 U.S.C. 1400 et seq.)), a one-stop de15 livery system established under subtitle B of title I

16 of the Workforce Investment Act of 1998, and other

17 services.

18 ‘‘(b) CONDITIONS.—

19 ‘‘(1) SELECTION OF ENTITIES.—

20 ‘‘(A) APPLICATION.—An entity shall sub21 mit an application for a grant, cooperative

22 agreement, or contract to provide benefits plan23 ning and assistance to the Commissioner at

24 such time, in such manner, and containing such

25 information as the Commissioner may deter-
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1 mine is necessary to meet the requirements of

2 this section.

3 ‘‘(B) STATEWIDENESS.—The Commis4 sioner shall ensure that the planning, assist5 ance, and information described in paragraph

6 (2) shall be available on a statewide basis.

7 ‘‘(C) ELIGIBILITY OF STATES AND PRI8 VATE ORGANIZATIONS.—

9 ‘‘(i) IN GENERAL.—The Commissioner

10 may award a grant, cooperative agreement,

11 or contract under this section to a State or

12 a private agency or organization (other

13 than Social Security Administration Field

14 Offices and the State agency administering

15 the State medicaid program under title

16 XIX, including any agency or entity de17 scribed in clause (ii), that the Commis18 sioner determines is qualified to provide

19 the planning, assistance, and information

20 described in paragraph (2)).

21 ‘‘(ii) AGENCIES AND ENTITIES DE22 SCRIBED.—The agencies and entities de23 scribed in this clause are the following:

24 ‘‘(I) Any public or private agency

25 or organization (including Centers for
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1 Independent Living established under

2 title VII of the Rehabilitation Act of

3 1973, protection and advocacy organi4 zations, client assistance programs es5 tablished in accordance with section

6 112 of the Rehabilitation Act of 1973,

7 and State Developmental Disabilities

8 Councils established in accordance

9 with section 124 of the Developmental

10 Disabilities Assistance and Bill of

11 Rights Act (42 U.S.C. 6024)) that the

12 Commissioner determines satisfies the

13 requirements of this section.

14 ‘‘(II) The State agency admin15 istering the State program funded

16 under part A of title IV.

17 ‘‘(D) EXCLUSION FOR CONFLICT OF IN18 TEREST.—The Commissioner may not award a

19 grant, cooperative agreement, or contract under

20 this section to any entity that the Commissioner

21 determines would have a conflict of interest if

22 the entity were to receive a grant, cooperative

23 agreement, or contract under this section.

24 ‘‘(2) SERVICES PROVIDED.—A recipient of a

25 grant, cooperative agreement, or contract to provide
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1 benefits planning and assistance shall select individ2 uals who will act as planners and provide informa3 tion, guidance, and planning to disabled beneficiaries

4 on the—

5 ‘‘(A) availability and interrelation of any

6 Federal or State work incentives programs de7 signed to assist disabled beneficiaries that the

8 individual may be eligible to participate in;

9 ‘‘(B) adequacy of any health benefits cov10 erage that may be offered by an employer of

11 the individual and the extent to which other

12 health benefits coverage may be available to the

13 individual; and

14 ‘‘(C) availability of protection and advo15 cacy services for disabled beneficiaries and how

16 to access such services.

17 ‘‘(3) AMOUNT OF GRANTS, COOPERATIVE

18 AGREEMENTS, OR CONTRACTS.—

19 ‘‘(A) BASED ON POPULATION OF DIS20 ABLED BENEFICIARIES.—Subject to subpara21 graph (B), the Commissioner shall award a

22 grant, cooperative agreement, or contract under

23 this section to an entity based on the percent24 age of the population of the State where the en25 tity is located who are disabled beneficiaries.
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1 ‘‘(B) LIMITATIONS.—

2 ‘‘(i) PER GRANT.—No entity shall re3 ceive a grant, cooperative agreement, or

4 contract under this section for a fiscal year

5 that is less than $50,000 or more than

6 $300,000.

7 ‘‘(ii) TOTAL AMOUNT FOR ALL

8 GRANTS, COOPERATIVE AGREEMENTS, AND

9 CONTRACTS.—The total amount of all

10 grants, cooperative agreements, and con11 tracts awarded under this section for a fis12 cal year may not exceed $23,000,000.

13 ‘‘(4) ALLOCATION OF COSTS.—The costs of car14 rying out this section shall be paid from amounts

15 made available for the administration of title II and

16 amounts made available for the administration of

17 title XVI, and shall be allocated among those

18 amounts as appropriate.

19 ‘‘(c) DEFINITIONS.—In this section:

20 ‘‘(1) COMMISSIONER.—The term ‘Commis21 sioner’ means the Commissioner of Social Security.

22 ‘‘(2) DISABLED BENEFICIARY.—The term ‘dis23 abled beneficiary’ has the meaning given that term

24 in section 1148(k)(2).
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1 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There

2 is authorized to be appropriated to carry out this section

3 $23,000,000 for each of the fiscal years 2000 through

4 2004.’’.

5 SEC. 122. STATE GRANTS FOR WORK INCENTIVES ASSIST6 ANCE TO DISABLED BENEFICIARIES.

7 Part A of title XI of the Social Security Act (42

8 U.S.C. 1301 et seq.), as amended by section 121, is

9 amended by adding after section 1149 the following:

10 ‘‘STATE GRANTS FOR WORK INCENTIVES ASSISTANCE TO

11 DISABLED BENEFICIARIES

12 ‘‘SEC. 1150. (a) IN GENERAL.—Subject to subsection

13 (c), the Commissioner may make payments in each State

14 to the protection and advocacy system established pursu15 ant to part C of title I of the Developmental Disabilities

16 Assistance and Bill of Rights Act (42 U.S.C. 6041 et seq.)

17 for the purpose of providing services to disabled bene18 ficiaries.

19 ‘‘(b) SERVICES PROVIDED.—Services provided to dis20 abled beneficiaries pursuant to a payment made under this

21 section may include—

22 ‘‘(1) information and advice about obtaining vo23 cational rehabilitation and employment services; and

24 ‘‘(2) advocacy or other services that a disabled

25 beneficiary may need to secure or regain gainful em26 ployment.
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1 ‘‘(c) APPLICATION.—In order to receive payments

2 under this section, a protection and advocacy system shall

3 submit an application to the Commissioner, at such time,

4 in such form and manner, and accompanied by such infor5 mation and assurances as the Commissioner may require.

6 ‘‘(d) AMOUNT OF PAYMENTS.—

7 ‘‘(1) IN GENERAL.—Subject to the amount ap8 propriated for a fiscal year for making payments

9 under this section, a protection and advocacy system

10 shall not be paid an amount that is less than—

11 ‘‘(A) in the case of a protection and advo12 cacy system located in a State (including the

13 District of Columbia and Puerto Rico) other

14 than Guam, American Samoa, the United

15 States Virgin Islands, and the Commonwealth

16 of the Northern Mariana Islands, the greater

17 of—

18 ‘‘(i) $100,000; or

‘‘(ii) 1 19 ⁄3 of 1 percent of the amount

20 available for payments under this section;

21 and

22 ‘‘(B) in the case of a protection and advo23 cacy system located in Guam, American Samoa,

24 the United States Virgin Islands, and the Com-
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1 monwealth of the Northern Mariana Islands,

2 $50,000.

3 ‘‘(2) INFLATION ADJUSTMENT.—For each fiscal

4 year in which the total amount appropriated to carry

5 out this section exceeds the total amount appro6 priated to carry out this section in the preceding fis7 cal year, the Commissioner shall increase each min8 imum payment under subparagraphs (A) and (B) of

9 paragraph (1) by a percentage equal to the percent10 age increase in the total amount so appropriated to

11 carry out this section.

12 ‘‘(e) ANNUAL REPORT.—Each protection and advo13 cacy system that receives a payment under this section

14 shall submit an annual report to the Commissioner and

15 the Ticket to Work and Work Incentives Advisory Panel

16 established under section 101(f) of the Ticket to Work and

17 Work Incentives Improvement Act of 1999 on the services

18 provided to individuals by the system.

19 ‘‘(f) FUNDING.—

20 ‘‘(1) ALLOCATION OF PAYMENTS.—Payments

21 under this section shall be made from amounts made

22 available for the administration of title II and

23 amounts made available for the administration of

24 title XVI, and shall be allocated among those

25 amounts as appropriate.
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1 ‘‘(2) CARRYOVER.—Any amounts allotted for

2 payment to a protection and advocacy system under

3 this section for a fiscal year shall remain available

4 for payment to or on behalf of the protection and

5 advocacy system until the end of the succeeding fis6 cal year.

7 ‘‘(g) DEFINITIONS.—In this section:

8 ‘‘(1) COMMISSIONER.—The term ‘Commis9 sioner’ means the Commissioner of Social Security.

10 ‘‘(2) DISABLED BENEFICIARY.—The term ‘dis11 abled beneficiary’ has the meaning given that term

12 in section 1148(k)(2).

13 ‘‘(3) PROTECTION AND ADVOCACY SYSTEM.—

14 The term ‘protection and advocacy system’ means a

15 protection and advocacy system established pursuant

16 to part C of title I of the Developmental Disabilities

17 Assistance and Bill of Rights Act (42 U.S.C. 6041

18 et seq.).

19 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There

20 is authorized to be appropriated to carry out this section

21 $7,000,000 for each of the fiscal years 2000 through

22 2004.’’.
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1 TITLE II—EXPANDED AVAIL2 ABILITY OF HEALTH CARE

3 SERVICES

4 SEC. 201. EXPANDING STATE OPTIONS UNDER THE MED5 ICAID PROGRAM FOR WORKERS WITH DIS6 ABILITIES.

7 (a) IN GENERAL.—

8 (1) STATE OPTION TO PROVIDE OPPORTUNITY

9 FOR EMPLOYED INDIVIDUALS WITH A MEDICALLY

10 IMPROVED DISABILITY TO BUY INTO MEDICAID.—

11 (A) ELIGIBILITY.—Section

12 1902(a)(10)(A)(ii) of the Social Security Act

13 (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended—

14 (i) in subclause (XIII), by striking

15 ‘‘or’’ at the end;

16 (ii) in subclause (XIV), by adding

17 ‘‘or’’ at the end; and

18 (iii) by adding at the end the fol19 lowing:

20 ‘‘(XV) who are employed individ21 uals with a medically improved dis22 ability described in section 1905(v)(1)

23 and whose assets, resources, and

24 earned or unearned income (or both)

25 do not exceed such limitations (if any)
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1 as the State may establish, but only if

2 the State provides medical assistance

3 to individuals described in subclause

4 (XIII);’’.

5 (B) DEFINITION OF EMPLOYED INDIVID6 UALS WITH A MEDICALLY IMPROVED DIS7 ABILITY.—Section 1905 of the Social Security

8 Act (42 U.S.C. 1396d) is amended by adding at

9 the end the following:

10 ‘‘(v)(1) The term ‘employed individual with a medi11 cally improved disability’ means an individual who—

12 ‘‘(A) is at least 16, but less than 65, years of

13 age;

14 ‘‘(B) is employed (as defined in paragraph (2));

15 ‘‘(C) ceases to be eligible for medical assistance

16 under section 1902(a)(10)(A)(ii)(XIII) because the

17 individual, by reason of medical improvement, is de18 termined at the time of a regularly scheduled con19 tinuing disability review to no longer be eligible for

20 benefits under section 223(d) or 1614(a)(3); and

21 ‘‘(D) continues to have a severe medically deter22 minable impairment, as determined under regula23 tions of the Secretary.

24 ‘‘(2) For purposes of paragraph (1), an individual is

25 considered to be ‘employed’ if the individual—
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1 ‘‘(A) is earning at least the applicable minimum

2 wage requirement under section 6 of the Fair Labor

3 Standards Act (29 U.S.C. 206) and working at least

4 40 hours per month; or

5 ‘‘(B) is engaged in a work effort that meets

6 substantial and reasonable threshold criteria for

7 hours of work, wages, or other measures, as defined

8 by the State and approved by the Secretary.’’.

9 (C) CONFORMING AMENDMENT.—Section

10 1905(a) of such Act (42 U.S.C. 1396d(a)) is

11 amended in the matter preceding paragraph

12 (1)—

13 (i) in clause (x), by striking ‘‘or’’ at

14 the end;

15 (ii) in clause (xi), by adding ‘‘or’’ at

16 the end; and

17 (iii) by inserting after clause (xi), the

18 following:

19 ‘‘(xii) employed individuals with a medically im20 proved disability (as defined in subsection (v)),’’.

21 (2) STATE AUTHORITY TO IMPOSE INCOME-RE22 LATED PREMIUMS AND COST-SHARING.—Section

23 1916 of such Act (42 U.S.C. 1396o) is amended—
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1 (A) in subsection (a), by striking ‘‘The

2 State plan’’ and inserting ‘‘Subject to sub3 section (g), the State plan’’; and

4 (B) by adding at the end the following:

5 ‘‘(g) With respect to individuals provided medical as6 sistance only under subclause (XV) of section

7 1902(a)(10)(A)(ii), a State may (in a uniform manner for

8 individuals described in either such subclause)—

9 ‘‘(1) require such individuals to pay premiums

10 or other cost-sharing charges set on a sliding scale

11 based on income that the State may determine; and

12 ‘‘(2) require payment of 100 percent of such

13 premiums in the case of such an individual who has

14 income that exceeds 250 percent of the income offi15 cial poverty line (referred to in subsection (c)(1)) ap16 plicable to a family of the size involved.’’.

17 (3) PROHIBITION AGAINST SUPPLANTATION OF

18 STATE FUNDS AND STATE FAILURE TO MAINTAIN

19 EFFORT.—Section 1903(i) of such Act (42 U.S.C.

20 1396b(i)) is amended—

21 (A) by striking the period at the end of

22 paragraph (19) and inserting ‘‘; or’’; and

23 (B) by inserting after such paragraph the

24 following:
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1 ‘‘(20) with respect to amounts expended for

2 medical assistance provided to an individual de3 scribed in subclause (XV) of section

4 1902(a)(10)(A)(ii) for a fiscal year unless the State

5 demonstrates to the satisfaction of the Secretary

6 that the level of State funds expended for such fiscal

7 year for programs to enable working individuals with

8 disabilities to work (other than for such medical as9 sistance) is not less than the level expended for such

10 programs during the most recent State fiscal year

11 ending before the date of the enactment of this para12 graph.’’.

13 (b) CONFORMING AMENDMENTS.—

14 (1) Section 1903(f)(4) of the Social Security

15 Act (42 U.S.C. 1396b(f)(4)) is amended in the mat16 ter preceding subparagraph (A) by inserting

17 ‘‘1902(a)(10)(A)(ii)(XV),’’ after

18 ‘‘1902(a)(10)(A)(ii)(X),’’.

19 (2) Section 1903(f)(4) of such Act, as amended

20 by paragraph (1), is amended by inserting

21 ‘‘1902(a)(10)(A)(ii)(XIII),’’ before

22 ‘‘1902(a)(10)(A)(ii)(XV)’’.

23 (c) EFFECTIVE DATE.—

24 (1) IN GENERAL.—Except as provided in para25 graph (2), the amendments made by this section
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1 apply to medical assistance for items and services

2 furnished on or after October 1, 1999.

3 (2) RETROACTIVITY OF CONFORMING AMEND4 MENT.—The amendment made by subsection (b)(2)

5 takes effect as if included in the enactment of the

6 Balanced Budget Act of 1997.

7 SEC. 202. EXTENDING MEDICARE COVERAGE FOR OASDI

8 DISABILITY BENEFIT RECIPIENTS.

9 (a) IN GENERAL.—The next to last sentence of sec10 tion 226(b) of the Social Security Act (42 U.S.C. 426)

11 is amended by striking ‘‘24’’ and inserting ‘‘96’’.

12 (b) EFFECTIVE DATE.—The amendment made by

13 subsection (a) shall be effective on and after October 1,

14 2000.

15 (c) GAO REPORT.—Not later than 5 years after the

16 date of the enactment of this Act, the Comptroller General

17 of the United States shall submit a report to the Congress

18 that—

19 (1) examines the effectiveness and cost of the

20 amendment made by subsection (a);

21 (2) examines the necessity and effectiveness of

22 providing continuation of medicare coverage under

23 section 226(b) of the Social Security Act to individ24 uals whose annual income exceeds the contribution
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1 and benefit base (as determined under section 230

2 of such Act);

3 (3) examines the viability of providing the con4 tinuation of medicare coverage under such section

5 226(b) based on a sliding scale premium for individ6 uals whose annual income exceeds such contribution

7 and benefit base;

8 (4) examines the viability of providing the con9 tinuation of medicare coverage under such section

10 226(b) based on a premium buy-in by the bene11 ficiary’s employer in lieu of coverage under private

12 health insurance;

13 (5) examines the interrelation between the use

14 of the continuation of medicare coverage under such

15 section 226(b) and the use of private health insur16 ance coverage by individuals during the extended pe17 riod; and

18 (6) recommends such legislative or administra19 tive changes relating to the continuation of medicare

20 coverage for recipients of social security disability

21 benefits as the Comptroller General determines are

22 appropriate.
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1 SEC. 203. GRANTS TO DEVELOP AND ESTABLISH STATE IN2 FRASTRUCTURES TO SUPPORT WORKING IN3 DIVIDUALS WITH DISABILITIES.

4 (a) ESTABLISHMENT.—

5 (1) IN GENERAL.—The Secretary of Health and

6 Human Services (in this section referred to as the

7 ‘‘Secretary’’) shall award grants described in sub8 section (b) to States to support the design, establish9 ment, and operation of State infrastructures that

10 provide items and services to support working indi11 viduals with disabilities.

12 (2) APPLICATION.—In order to be eligible for

13 an award of a grant under this section, a State shall

14 submit an application to the Secretary at such time,

15 in such manner, and containing such information as

16 the Secretary shall require.

17 (3) DEFINITION OF STATE.—In this section,

18 the term ‘‘State’’ means each of the 50 States, the

19 District of Columbia, Puerto Rico, Guam, the

20 United States Virgin Islands, American Samoa, and

21 the Commonwealth of the Northern Mariana Is22 lands.

23 (b) GRANTS FOR INFRASTRUCTURE AND OUT24 REACH.—
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1 (1) IN GENERAL.—Out of the funds appro2 priated under subsection (e), the Secretary shall

3 award grants to States to—

4 (A) support the establishment, implemen5 tation, and operation of the State infrastruc6 tures described in subsection (a); and

7 (B) conduct outreach campaigns regarding

8 the existence of such infrastructures.

9 (2) ELIGIBILITY FOR GRANTS.—

10 (A) IN GENERAL.—No State may receive a

11 grant under this subsection unless the State—

12 (i) has an approved amendment to the

13 State plan under title XIX of the Social

14 Security Act (42 U.S.C. 1396 et seq.) that

15 provides medical assistance under such

16 plan to individuals described in section

17 1902(a)(10)(A)(ii)(XIII) of the Social Se18 curity Act (42 U.S.C.

19 1396a(a)(10)(A)(ii)(XIII)); and

20 (ii) demonstrates to the satisfaction of

21 the Secretary that the State makes per22 sonal assistance services available under

23 the State plan under title XIX of the So24 cial Security Act (42 U.S.C. 1396 et seq.)

25 to the extent necessary to enable individ-
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1 uals described in clause (i) to remain em2 ployed (as determined under section

3 1905(v)(2) of the Social Security Act (42

4 U.S.C. 1396d(v)(2))).

5 (B) DEFINITION OF PERSONAL ASSIST6 ANCE SERVICES.—In this paragraph, the term

7 ‘‘personal assistance services’’ means a range of

8 services, provided by 1 or more persons, de9 signed to assist an individual with a disability

10 to perform daily activities on and off the job

11 that the individual would typically perform if

12 the individual did not have a disability. Such

13 services shall be designed to increase the indi14 vidual’s control in life and ability to perform ev15 eryday activities on or off the job.

16 (3) DETERMINATION OF AWARDS.—

17 (A) IN GENERAL.—Subject to subpara18 graph (B), the Secretary shall determine a for19 mula for awarding grants to States under this

20 section that provides special consideration to

21 States that provide medical assistance under

22 title XIX of the Social Security Act to individ23 uals described in section

24 1902(a)(10)(A)(ii)(XV) of that Act (42 U.S.C.

25 1396a(a)(10)(A)(ii)(XV)).
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1 (B) AWARD LIMITS.—

2 (i) MINIMUM AWARDS.—

3 (I) IN GENERAL.—Subject to

4 subclause (II), no State with an ap5 proved application under this section

6 shall receive a grant for a fiscal year

7 that is less than $500,000.

8 (II) PRO RATA REDUCTIONS.—If

9 the funds appropriated under sub10 section (e) for a fiscal year are not

11 sufficient to pay each State with an

12 application approved under this sec13 tion the minimum amount described

14 in subclause (I), the Secretary shall

15 pay each such State an amount equal

16 to the pro rata share of the amount

17 made available.

18 (ii) MAXIMUM AWARDS.—No State

19 with an application that has been approved

20 under this section shall receive a grant for

21 a fiscal year that exceeds 15 percent of the

22 total expenditures by the State (including

23 the reimbursed Federal share of such ex24 penditures) for medical assistance for indi25 viduals eligible under subclause (XIII) or
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1 (XV) of section 1902(a)(10)(A)(ii) of the

2 Social Security Act (42 U.S.C.

3 1396a(a)(10)(A)(ii)), as estimated by the

4 State and approved by the Secretary.

5 (c) AVAILABILITY OF FUNDS.—

6 (1) FUNDS AWARDED TO STATES.—Funds

7 awarded to a State under a grant made under this

8 section for a fiscal year shall remain available until

9 expended.

10 (2) FUNDS NOT AWARDED TO STATES.—Funds

11 not awarded to States in the fiscal year for which

12 they are appropriated shall remain available in suc13 ceeding fiscal years for awarding by the Secretary.

14 (d) ANNUAL REPORT.—A State that is awarded a

15 grant under this section shall submit an annual report to

16 the Secretary on the use of funds provided under the

17 grant. Each report shall include the percentage increase

18 in the number of title II disability beneficiaries, as defined

19 in section 1148(k)(3) of the Social Security Act (as

20 amended by section 101(a)) in the State, and title XVI

21 disability beneficiaries, as defined in section 1148(k)(4) of

22 the Social Security Act (as so amended) in the State who

23 return to work.

24 (e) APPROPRIATION.—
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1 (1) IN GENERAL.—Out of any funds in the

2 Treasury not otherwise appropriated, there is appro3 priated to make grants under this section—

4 (A) for fiscal year 2000, $20,000,000;

5 (B) for fiscal year 2001, $25,000,000;

6 (C) for fiscal year 2002, $30,000,000;

7 (D) for fiscal year 2003, $35,000,000;

8 (E) for fiscal year 2004, $40,000,000; and

9 (F) for each of fiscal years 2005 through

10 2010, the amount appropriated for the pre11 ceding fiscal year increased by the percentage

12 increase (if any) in the Consumer Price Index

13 for All Urban Consumers (United States city

14 average) for the preceding fiscal year.

15 (2) BUDGET AUTHORITY.—This subsection con16 stitutes budget authority in advance of appropria17 tions Acts and represents the obligation of the Fed18 eral Government to provide for the payment of the

19 amounts appropriated under paragraph (1).

20 (f) RECOMMENDATION.—Not later than October 1,

21 2009, the Secretary, in consultation with the Work Incen22 tives Advisory Panel established under section 201(f),

23 shall submit a recommendation to the Committee on Com24 merce of the House of Representatives and the Committee

25 on Finance of the Senate regarding whether the grant pro-
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1 gram established under this section should be continued

2 after fiscal year 2010.

3 SEC. 204. DEMONSTRATION OF COVERAGE UNDER THE

4 MEDICAID PROGRAM OF WORKERS WITH PO5 TENTIALLY SEVERE DISABILITIES.

6 (a) STATE APPLICATION.—A State may apply to the

7 Secretary of Health and Human Services (in this section

8 referred to as the ‘‘Secretary’’) for approval of a dem9 onstration project (in this section referred to as a ‘‘dem10 onstration project’’) under which up to a specified max11 imum number of individuals who are workers with a po12 tentially severe disability (as defined in subsection (b)(1))

13 are provided medical assistance equal to that provided

14 under section 1905(a) of the Social Security Act (42

15 U.S.C. 1396d(a)) to individuals described in section

16 1902(a)(10)(A)(ii)(XIII) of that Act (42 U.S.C.

17 1396a(a)(10)(A)(ii)(XIII)).

18 (b) WORKER WITH A POTENTIALLY SEVERE DIS19 ABILITY DEFINED.—For purposes of this section—

20 (1) IN GENERAL.—The term ‘‘worker with a

21 potentially severe disability’’ means, with respect to

22 a demonstration project, an individual who—

23 (A) is at least 16, but less than 65, years

24 of age;
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1 (B) has a specific physical or mental im2 pairment that, as defined by the State under

3 the demonstration project, is reasonably ex4 pected, but for the receipt of items and services

5 described in section 1905(a) of the Social Secu6 rity Act (42 U.S.C. 1396d(a)), to become blind

7 or disabled (as defined under section 1614(a) of

8 the Social Security Act (42 U.S.C. 1382c(a)));

9 and

10 (C) is employed (as defined in paragraph

11 (2)).

12 (2) DEFINITION OF EMPLOYED.—An individual

13 is considered to be ‘‘employed’’ if the individual—

14 (A) is earning at least the applicable min15 imum wage requirement under section 6 of the

16 Fair Labor Standards Act (29 U.S.C. 206) and

17 working at least 40 hours per month; or

18 (B) is engaged in a work effort that meets

19 substantial and reasonable threshold criteria for

20 hours of work, wages, or other measures, as de21 fined under the demonstration project and ap22 proved by the Secretary.

23 (c) APPROVAL OF DEMONSTRATION PROJECTS.—

24 (1) IN GENERAL.—Subject to paragraph (3),

25 the Secretary shall approve applications under sub-
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1 section (a) that meet the requirements of paragraph

2 (2) and such additional terms and conditions as the

3 Secretary may require. The Secretary may waive the

4 requirement of section 1902(a)(1) of the Social Se5 curity Act (42 U.S.C. 1396a(a)(1)) to allow for sub6 State demonstrations.

7 (2) TERMS AND CONDITIONS OF DEMONSTRA8 TION PROJECTS.—The Secretary may not approve a

9 demonstration project under this section unless the

10 State provides assurances satisfactory to the Sec11 retary that the following conditions are or will be

12 met:

13 (A) ELECTION OF OPTIONAL CATEGORY.—

14 The State has elected to provide coverage under

15 its plan under title XIX of the Social Security

16 Act of individuals described in section

17 1902(a)(10)(A)(ii)(XIII) of the Social Security

18 Act (42 U.S.C. 1396a(a)(10)(A)(ii)(XIII)).

19 (B) MAINTENANCE OF STATE EFFORT.—

20 Federal funds paid to a State pursuant to this

21 section must be used to supplement, but not

22 supplant, the level of State funds expended for

23 workers with potentially severe disabilities

24 under programs in effect for such individuals at
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1 the time the demonstration project is approved

2 under this section.

3 (C) INDEPENDENT EVALUATION.—The

4 State provides for an independent evaluation of

5 the project.

6 (3) LIMITATIONS ON FEDERAL FUNDING.—

7 (A) APPROPRIATION.—

8 (i) IN GENERAL.—Out of any funds in

9 the Treasury not otherwise appropriated,

10 there is appropriated to carry out this sec11 tion for the 5-fiscal-year period beginning

12 with fiscal year 2000, $56,000,000.

13 (ii) BUDGET AUTHORITY.—Clause (i)

14 constitutes budget authority in advance of

15 appropriations Acts and represents the ob16 ligation of the Federal Government to pro17 vide for the payment of the amounts ap18 propriated under clause (i).

19 (B) LIMITATION ON PAYMENTS.—In no

20 case may—

21 (i) the aggregate amount of payments

22 made by the Secretary to States under this

23 section exceed $56,000,000; or
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1 (ii) payments be provided by the Sec2 retary for a fiscal year after fiscal year

3 2005.

4 (C) FUNDS ALLOCATED TO STATES.—The

5 Secretary shall allocate funds to States based

6 on their applications and the availability of

7 funds. Funds allocated to a State under a grant

8 made under this section for a fiscal year shall

9 remain available until expended.

10 (D) FUNDS NOT ALLOCATED TO STATES.—

11 Funds not allocated to States in the fiscal year

12 for which they are appropriated shall remain

13 available in succeeding fiscal years for alloca14 tion by the Secretary using the allocation for15 mula established under this section.

16 (E) PAYMENTS TO STATES.—The Sec17 retary shall pay to each State with a dem18 onstration project approved under this section,

19 from its allocation under subparagraph (C), an

20 amount for each quarter equal to the Federal

21 medical assistance percentage (as defined in

22 section 1905(b) of the Social Security Act (42

23 U.S.C. 1395d(b)) of expenditures in the quarter

24 for medical assistance provided to workers with

25 a potentially severe disability.
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1 (d) RECOMMENDATION.—Not later than October 1,

2 2002, the Secretary shall submit a recommendation to the

3 Committee on Commerce of the House of Representatives

4 and the Committee on Finance of the Senate regarding

5 whether the demonstration project established under this

6 section should be continued after fiscal year 2003.

7 (e) STATE DEFINED.—In this section, the term

8 ‘‘State’’ has the meaning given such term for purposes of

9 title XIX of the Social Security Act (42 U.S.C. 1396 et

10 seq.).

11 SEC. 205. ELECTION BY DISABLED BENEFICIARIES TO SUS12 PEND MEDIGAP INSURANCE WHEN COVERED

13 UNDER A GROUP HEALTH PLAN.

14 (a) IN GENERAL.—Section 1882(q) of the Social Se15 curity Act (42 U.S.C. 1395ss(q)) is amended—

16 (1) in paragraph (5)(C), by inserting ‘‘or para17 graph (6)’’ after ‘‘this paragraph’’; and

18 (2) by adding at the end the following new

19 paragraph:

20 ‘‘(6) Each medicare supplemental policy shall

21 provide that benefits and premiums under the policy

22 shall be suspended at the request of the policyholder

23 if the policyholder is entitled to benefits under sec24 tion 226(b) and is covered under a group health

25 plan (as defined in section 1862(b)(1)(A)(v)). If
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1 such suspension occurs and if the policyholder or

2 certificate holder loses coverage under the group

3 health plan, such policy shall be automatically re4 instituted (effective as of the date of such loss of

5 coverage) under terms described in subsection

6 (n)(6)(A)(ii) as of the loss of such coverage if the

7 policyholder provides notice of loss of such coverage

8 within 90 days after the date of such loss.’’.

9 (b) EFFECTIVE DATE.—The amendments made by

10 subsection (a) apply with respect to requests made after

11 the date of the enactment of this Act.

12 TITLE III—DEMONSTRATION

13 PROJECTS AND STUDIES

14 SEC. 301. EXTENSION OF DISABILITY INSURANCE PRO15 GRAM DEMONSTRATION PROJECT AUTHOR16 ITY.

17 (a) EXTENSION OF AUTHORITY.—Title II of the So18 cial Security Act (42 U.S.C. 401 et seq.) is amended by

19 adding at the end the following:

20 ‘‘DEMONSTRATION PROJECT AUTHORITY

21 ‘‘SEC. 234. (a) AUTHORITY.—

22 ‘‘(1) IN GENERAL.—The Commissioner of So23 cial Security (in this section referred to as the ‘Com24 missioner’) shall develop and carry out experiments

25 and demonstration projects designed to determine

26 the relative advantages and disadvantages of—
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1 ‘‘(A) various alternative methods of treat2 ing the work activity of individuals entitled to

3 disability insurance benefits under section 223

4 or to monthly insurance benefits under section

5 202 based on such individual’s disability (as de6 fined in section 223(d)), including such meth7 ods as a reduction in benefits based on earn8 ings, designed to encourage the return to work

9 of such individuals;

10 ‘‘(B) altering other limitations and condi11 tions applicable to such individuals (including

12 lengthening the trial work period (as defined in

13 section 222(c)), altering the 24-month waiting

14 period for hospital insurance benefits under sec15 tion 226, altering the manner in which the pro16 gram under this title is administered, earlier re17 ferral of such individuals for rehabilitation, and

18 greater use of employers and others to develop,

19 perform, and otherwise stimulate new forms of

20 rehabilitation); and

21 ‘‘(C) implementing sliding scale benefit off22 sets using variations in—

23 ‘‘(i) the amount of the offset as a pro24 portion of earned income;
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1 ‘‘(ii) the duration of the offset period;

2 and

3 ‘‘(iii) the method of determining the

4 amount of income earned by such individ5 uals,

6 to the end that savings will accrue to the Trust

7 Funds, or to otherwise promote the objectives or fa8 cilitate the administration of this title.

9 ‘‘(2) AUTHORITY FOR EXPANSION OF SCOPE.—

10 The Commissioner may expand the scope of any

11 such experiment or demonstration project to include

12 any group of applicants for benefits under the pro13 gram established under this title with impairments

14 that reasonably may be presumed to be disabling for

15 purposes of such demonstration project, and may

16 limit any such demonstration project to any such

17 group of applicants, subject to the terms of such

18 demonstration project which shall define the extent

19 of any such presumption.

20 ‘‘(b) REQUIREMENTS.—The experiments and dem21 onstration projects developed under subsection (a) shall be

22 of sufficient scope and shall be carried out on a wide

23 enough scale to permit a thorough evaluation of the alter24 native methods under consideration while giving assurance

25 that the results derived from the experiments and projects
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1 will obtain generally in the operation of the disability in2 surance program under this title without committing such

3 program to the adoption of any particular system either

4 locally or nationally.

5 ‘‘(c) AUTHORITY TO WAIVE COMPLIANCE WITH

6 BENEFITS REQUIREMENTS.—In the case of any experi7 ment or demonstration project conducted under subsection

8 (a), the Commissioner may waive compliance with the ben9 efit requirements of this title and the requirements of sec10 tion 1148 as they relate to the program established under

11 this title, and the Secretary may (upon the request of the

12 Commissioner) waive compliance with the benefits require13 ments of title XVIII, insofar as is necessary for a thorough

14 evaluation of the alternative methods under consideration.

15 No such experiment or project shall be actually placed in

16 operation unless at least 90 days prior thereto a written

17 report, prepared for purposes of notification and informa18 tion only and containing a full and complete description

19 thereof, has been transmitted by the Commissioner to the

20 Committee on Ways and Means of the House of Rep21 resentatives and to the Committee on Finance of the Sen22 ate. Periodic reports on the progress of such experiments

23 and demonstration projects shall be submitted by the

24 Commissioner to such committees. When appropriate,

25 such reports shall include detailed recommendations for
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1 changes in administration or law, or both, to carry out

2 the objectives stated in subsection (a).

3 ‘‘(d) REPORTS.—

4 ‘‘(1) INTERIM REPORTS.—On or before June 9

5 of each year, the Commissioner shall submit to the

6 Committee on Ways and Means of the House of

7 Representatives and to the Committee on Finance of

8 the Senate an annual interim report on the progress

9 of the experiments and demonstration projects car10 ried out under this subsection together with any re11 lated data and materials that the Commissioner may

12 consider appropriate.

13 ‘‘(2) TERMINATION AND FINAL REPORT.—The

14 authority under the preceding provisions of this sec15 tion (including any waiver granted pursuant to sub16 section (c)) shall terminate 5 years after the date of

17 the enactment of this Act. Not later than 90 days

18 after the termination of any experiment or dem19 onstration project carried out under this section, the

20 Commissioner shall submit to the Committee on

21 Ways and Means of the House of Representatives

22 and to the Committee on Finance of the Senate a

23 final report with respect to that experiment or dem24 onstration project.’’.
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1 (b) CONFORMING AMENDMENTS; TRANSFER OF

2 PRIOR AUTHORITY.—

3 (1) CONFORMING AMENDMENTS.—

4 (A) REPEAL OF PRIOR AUTHORITY.—Para5 graphs (1) through (4) of subsection (a) and

6 subsection (c) of section 505 of the Social Secu7 rity Disability Amendments of 1980 (42 U.S.C.

8 1310 note) are repealed.

9 (B) CONFORMING AMENDMENT REGARD10 ING FUNDING.—Section 201(k) of the Social

11 Security Act (42 U.S.C. 401(k)) is amended by

12 striking ‘‘section 505(a) of the Social Security

13 Disability Amendments of 1980’’ and inserting

14 ‘‘section 234’’.

15 (2) TRANSFER OF PRIOR AUTHORITY.—With

16 respect to any experiment or demonstration project

17 being conducted under section 505(a) of the Social

18 Security Disability Amendments of 1980 (42 U.S.C.

19 1310 note) as of the date of the enactment of this

20 Act, the authority to conduct such experiment or

21 demonstration project (including the terms and con22 ditions applicable to the experiment or demonstra23 tion project) shall be treated as if that authority

24 (and such terms and conditions) had been estab-
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1 lished under section 234 of the Social Security Act,

2 as added by subsection (a).

3 SEC. 302. DEMONSTRATION PROJECTS PROVIDING FOR RE4 DUCTIONS IN DISABILITY INSURANCE BENE5 FITS BASED ON EARNINGS.

6 (a) AUTHORITY.—The Commissioner of Social Secu7 rity shall conduct demonstration projects for the purpose

8 of evaluating, through the collection of data, a program

9 for title II disability beneficiaries (as defined in section

10 1148(k)(3) of the Social Security Act) under which bene11 fits payable under section 223 of such Act, or under sec12 tion 202 of such Act based on the beneficiary’s disability,

13 are reduced by $1 for each $2 of the beneficiary’s earnings

14 that is above a level to be determined by the Commis15 sioner. Such projects shall be conducted at a number of

16 localities which the Commissioner shall determine is suffi17 cient to adequately evaluate the appropriateness of na18 tional implementation of such a program. Such projects

19 shall identify reductions in Federal expenditures that may

20 result from the permanent implementation of such a pro21 gram.

22 (b) SCOPE AND SCALE AND MATTERS TO BE DETER23 MINED.—

24 (1) IN GENERAL.—The demonstration projects

25 developed under subsection (a) shall be of sufficient
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1 duration, shall be of sufficient scope, and shall be

2 carried out on a wide enough scale to permit a thor3 ough evaluation of the project to determine—

4 (A) the effects, if any, of induced entry

5 into the project and reduced exit from the

6 project;

7 (B) the extent, if any, to which the project

8 being tested is affected by whether it is in oper9 ation in a locality within an area under the ad10 ministration of the Ticket to Work and Self11 Sufficiency Program established under section

12 1148 of the Social Security Act; and

13 (C) the savings that accrue to the Federal

14 Old-Age and Survivors Insurance Trust Fund,

15 the Federal Disability Insurance Trust Fund,

16 and other Federal programs under the project

17 being tested.

18 The Commissioner shall take into account advice

19 provided by the Ticket to Work and Work Incentives

20 Advisory Panel pursuant to section 101(f)(2)(B)(ii)

21 of this Act.

22 (2) ADDITIONAL MATTERS.—The Commissioner

23 shall also determine with respect to each project—

24 (A) the annual cost (including net cost) of

25 the project and the annual cost (including net
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1 cost) that would have been incurred in the ab2 sence of the project;

3 (B) the determinants of return to work, in4 cluding the characteristics of the beneficiaries

5 who participate in the project; and

6 (C) the employment outcomes, including

7 wages, occupations, benefits, and hours worked,

8 of beneficiaries who return to work as a result

9 of participation in the project.

10 The Commissioner may include within the matters

11 evaluated under the project the merits of trial work

12 periods and periods of extended eligibility.

13 (c) WAIVERS.—The Commissioner may waive compli14 ance with the benefit provisions of title II of the Social

15 Security Act, and the Secretary of Health and Human

16 Services may waive compliance with the benefit require17 ments of title XVIII of such Act, insofar as is necessary

18 for a thorough evaluation of the alternative methods under

19 consideration. No such project shall be actually placed in

20 operation unless at least 90 days prior thereto a written

21 report, prepared for purposes of notification and informa22 tion only and containing a full and complete description

23 thereof, has been transmitted by the Commissioner to the

24 Committee on Ways and Means of the House of Rep25 resentatives and to the Committee on Finance of the Sen-
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1 ate. Periodic reports on the progress of such projects shall

2 be submitted by the Commissioner to such committees.

3 When appropriate, such reports shall include detailed rec4 ommendations for changes in administration or law, or

5 both, to carry out the objectives stated in subsection (a).

6 (d) INTERIM REPORTS.—Not later than 2 years after

7 the date of the enactment of this Act, and annually there8 after, the Commissioner of Social Security shall submit

9 to Congress an interim report on the progress of the dem10 onstration projects carried out under this subsection to11 gether with any related data and materials that the Com12 missioner of Social Security may consider appropriate.

13 (e) FINAL REPORT.—The Commissioner of Social Se14 curity shall submit to Congress a final report with respect

15 to all demonstration projects carried out under this section

16 not later than 1 year after their completion.

17 (f) EXPENDITURES.—Expenditures made for dem18 onstration projects under this section shall be made from

19 the Federal Disability Insurance Trust Fund and the Fed20 eral Old-Age and Survivors Insurance Trust Fund, as de21 termined appropriate by the Commissioner of Social Secu22 rity, and from the Federal Hospital Insurance Trust Fund

23 and the Federal Supplementary Medical Insurance Trust

24 Fund, as determined appropriate by the Secretary of
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1 Health and Human Services, to the extent provided in ad2 vance in appropriation Acts.

3 SEC. 303. STUDIES AND REPORTS.

4 (a) STUDY BY GENERAL ACCOUNTING OFFICE OF

5 EXISTING DISABILITY-RELATED EMPLOYMENT INCEN6 TIVES.—

7 (1) STUDY.—As soon as practicable after the

8 date of the enactment of this Act, the Comptroller

9 General of the United States shall undertake a study

10 to assess existing tax credits and other disability-re11 lated employment incentives under the Americans

12 with Disabilities Act of 1990 and other Federal

13 laws. In such study, the Comptroller General shall

14 specifically address the extent to which such credits

15 and other incentives would encourage employers to

16 hire and retain individuals with disabilities.

17 (2) REPORT.—Not later than 3 years after the

18 date of the enactment of this Act, the Comptroller

19 General shall transmit to the Committee on Ways

20 and Means of the House of Representatives and the

21 Committee on Finance of the Senate a written re22 port presenting the results of the Comptroller Gen23 eral’s study conducted pursuant to this subsection,

24 together with such recommendations for legislative
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1 or administrative changes as the Comptroller Gen2 eral determines are appropriate.

3 (b) STUDY BY GENERAL ACCOUNTING OFFICE OF

4 EXISTING COORDINATION OF THE DI AND SSI PROGRAMS

5 AS THEY RELATE TO INDIVIDUALS ENTERING OR LEAV6 ING CONCURRENT ENTITLEMENT.—

7 (1) STUDY.—As soon as practicable after the

8 date of the enactment of this Act, the Comptroller

9 General of the United States shall undertake a study

10 to evaluate the coordination under current law of the

11 disability insurance program under title II of the So12 cial Security Act and the supplemental security in13 come program under title XVI of such Act, as such

14 programs relate to individuals entering or leaving

15 concurrent entitlement under such programs. In

16 such study, the Comptroller General shall specifically

17 address the effectiveness of work incentives under

18 such programs with respect to such individuals and

19 the effectiveness of coverage of such individuals

20 under titles XVIII and XIX of such Act.

21 (2) REPORT.—Not later than 3 years after the

22 date of the enactment of this Act, the Comptroller

23 General shall transmit to the Committee on Ways

24 and Means of the House of Representatives and the

25 Committee on Finance of the Senate a written re-
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1 port presenting the results of the Comptroller Gen2 eral’s study conducted pursuant to this subsection,

3 together with such recommendations for legislative

4 or administrative changes as the Comptroller Gen5 eral determines are appropriate.

6 (c) STUDY BY GENERAL ACCOUNTING OFFICE OF

7 THE IMPACT OF THE SUBSTANTIAL GAINFUL ACTIVITY

8 LIMIT ON RETURN TO WORK.—

9 (1) STUDY.—As soon as practicable after the

10 date of the enactment of this Act, the Comptroller

11 General of the United States shall undertake a study

12 of the substantial gainful activity level applicable as

13 of that date to recipients of benefits under section

14 223 of the Social Security Act (42 U.S.C. 423) and

15 under section 202 of such Act (42 U.S.C. 402) on

16 the basis of a recipient having a disability, and the

17 effect of such level as a disincentive for those recipi18 ents to return to work. In the study, the Comptroller

19 General also shall address the merits of increasing

20 the substantial gainful activity level applicable to

21 such recipients of benefits and the rationale for not

22 yearly indexing that level to inflation.

23 (2) REPORT.—Not later than 2 years after the

24 date of the enactment of this Act, the Comptroller

25 General shall transmit to the Committee on Ways
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1 and Means of the House of Representatives and the

2 Committee on Finance of the Senate a written re3 port presenting the results of the Comptroller Gen4 eral’s study conducted pursuant to this subsection,

5 together with such recommendations for legislative

6 or administrative changes as the Comptroller Gen7 eral determines are appropriate.

8 (d) REPORT ON DISREGARDS UNDER THE DI AND

9 SSI PROGRAMS.—Not later than 90 days after the date

10 of the enactment of this Act, the Commissioner of Social

11 Security shall submit to the Committee on Ways and

12 Means of the House of Representatives and the Committee

13 on Finance of the Senate a report that—

14 (1) identifies all income, assets, and resource

15 disregards (imposed under statutory or regulatory

16 authority) that are applicable to individuals receiving

17 benefits under title II or XVI of the Social Security

18 Act (42 U.S.C. 401 et seq., 1381 et seq.);

19 (2) with respect to each such disregard—

20 (A) specifies the most recent statutory or

21 regulatory modification of the disregard; and

22 (B) recommends whether further statutory

23 or regulatory modification of the disregard

24 would be appropriate; and
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1 (3) with respect to the disregard described in

2 section 1612(b)(7) of such Act (42 U.S.C.

3 1382a(b)(7)) (relating to grants, scholarships, or fel4 lowships received for use in paying the cost of tui5 tion and fees at any educational (including technical

6 or vocational education) institution)—

7 (A) identifies the number of individuals re8 ceiving benefits under title XVI of such Act (42

9 U.S.C. 1381 et seq.) who have attained age 22

10 and have not had any portion of any grant,

11 scholarship, or fellowship received for use in

12 paying the cost of tuition and fees at any edu13 cational (including technical or vocational edu14 cation) institution excluded from their income

15 in accordance with that section;

16 (B) recommends whether the age at which

17 such grants, scholarships, or fellowships are ex18 cluded from income for purposes of determining

19 eligibility under title XVI of such Act should be

20 increased to age 25; and

21 (C) recommends whether such disregard

22 should be expanded to include any such grant,

23 scholarship, or fellowship received for use in

24 paying the cost of room and board at any such

25 institution.
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1 (e) STUDY BY THE GENERAL ACCOUNTING OFFICE

2 OF SOCIAL SECURITY ADMINISTRATION’S DISABILITY IN3 SURANCE PROGRAM DEMONSTRATION AUTHORITY.—

4 (1) STUDY.—As soon as practicable after the

5 date of the enactment of this Act, the Comptroller

6 General of the United States shall undertake a study

7 to assess the results of the Social Security Adminis8 tration’s efforts to conduct disability demonstrations

9 authorized under prior law as well as under section

10 301 of this Act.

11 (2) REPORT.—Not later than 5 years after the

12 date of the enactment of this Act, the Comptroller

13 General shall transmit to the Committee on Ways

14 and Means of the House of Representatives and the

15 Committee on Finance of the Senate a written re16 port presenting the results of the Comptroller Gen17 eral’s study conducted pursuant to this section, to18 gether with a recommendation as to whether the

19 demonstration authority authorized under section

20 301 of this Act should be made permanent.
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1 TITLE IV—MISCELLANEOUS AND

2 TECHNICAL AMENDMENTS

3 SEC. 401. TECHNICAL AMENDMENTS RELATING TO DRUG

4 ADDICTS AND ALCOHOLICS.

5 (a) CLARIFICATION RELATING TO THE EFFECTIVE

6 DATE OF THE DENIAL OF SOCIAL SECURITY DISABILITY

7 BENEFITS TO DRUG ADDICTS AND ALCOHOLICS.—Sec8 tion 105(a)(5) of the Contract with America Advancement

9 Act of 1996 (42 U.S.C. 405 note) is amended—

10 (1) in subparagraph (A), by striking ‘‘by the

11 Commissioner of Social Security’’ and ‘‘by the Com12 missioner’’; and

13 (2) by adding at the end the following:

14 ‘‘(D) For purposes of this paragraph, an

15 individual’s claim, with respect to benefits

16 under title II based on disability, which has

17 been denied in whole before the date of the en18 actment of this Act, may not be considered to

19 be finally adjudicated before such date if, on or

20 after such date—

21 ‘‘(i) there is pending a request for ei22 ther administrative or judicial review with

23 respect to such claim; or

24 ‘‘(ii) there is pending, with respect to

25 such claim, a readjudication by the Com-
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1 missioner of Social Security pursuant to

2 relief in a class action or implementation

3 by the Commissioner of a court remand

4 order.

5 ‘‘(E) Notwithstanding the provisions of

6 this paragraph, with respect to any individual

7 for whom the Commissioner of Social Security

8 does not perform the entitlement redetermina9 tion before the date prescribed in subparagraph

10 (C), the Commissioner shall perform such enti11 tlement redetermination in lieu of a continuing

12 disability review whenever the Commissioner de13 termines that the individual’s entitlement is

14 subject to redetermination based on the pre15 ceding provisions of this paragraph, and the

16 provisions of section 223(f) shall not apply to

17 such redetermination.’’.

18 (b) CORRECTION TO EFFECTIVE DATE OF PROVI19 SIONS CONCERNING REPRESENTATIVE PAYEES AND

20 TREATMENT REFERRALS OF SOCIAL SECURITY BENE21 FICIARIES WHO ARE DRUG ADDICTS AND ALCOHOLICS.—

22 Section 105(a)(5)(B) of the Contract with America Ad23 vancement Act of 1996 (42 U.S.C. 405 note) is amended

24 to read as follows:
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1 ‘‘(B) The amendments made by para2 graphs (2) and (3) shall take effect on July 1,

3 1996, with respect to any individual—

4 ‘‘(i) whose claim for benefits is finally

5 adjudicated on or after the date of the en6 actment of this Act; or

7 ‘‘(ii) whose entitlement to benefits is

8 based upon an entitlement redetermination

9 made pursuant to subparagraph (C).’’.

10 (c) EFFECTIVE DATES.—The amendments made by

11 this section shall take effect as if included in the enact12 ment of section 105 of the Contract with America Ad13 vancement Act of 1996 (Public Law 104–121; 110 Stat.

14 852 et seq.).

15 SEC. 402. TREATMENT OF PRISONERS.

16 (a) IMPLEMENTATION OF PROHIBITION AGAINST

17 PAYMENT OF TITLE II BENEFITS TO PRISONERS.—

18 (1) IN GENERAL.—Section 202(x)(3) of the So19 cial Security Act (42 U.S.C. 402(x)(3)) is

20 amended—

21 (A) by inserting ‘‘(A)’’ after ‘‘(3)’’; and

22 (B) by adding at the end the following:

23 ‘‘(B)(i) The Commissioner shall enter into an agree24 ment under this subparagraph with any interested State

25 or local institution comprising a jail, prison, penal institu-
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1 tion, or correctional facility, or comprising any other insti2 tution a purpose of which is to confine individuals as de3 scribed in paragraph (1)(A)(ii). Under such agreement—

4 ‘‘(I) the institution shall provide to the Com5 missioner, on a monthly basis and in a manner spec6 ified by the Commissioner, the names, Social Secu7 rity account numbers, dates of birth, confinement

8 commencement dates, and, to the extent available to

9 the institution, such other identifying information

10 concerning the individuals confined in the institution

11 as the Commissioner may require for the purpose of

12 carrying out paragraph (1) and other provisions of

13 this title; and

14 ‘‘(II) the Commissioner shall pay to the institu15 tion, with respect to information described in sub16 clause (I) concerning each individual who is confined

17 therein as described in paragraph (1)(A), who re18 ceives a benefit under this title for the month pre19 ceding the first month of such confinement, and

20 whose benefit under this title is determined by the

21 Commissioner to be not payable by reason of con22 finement based on the information provided by the

23 institution, $400 (subject to reduction under clause

24 (ii)) if the institution furnishes the information to

25 the Commissioner within 30 days after the date such
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1 individual’s confinement in such institution begins,

2 or $200 (subject to reduction under clause (ii)) if

3 the institution furnishes the information after 30

4 days after such date but within 90 days after such

5 date.

6 ‘‘(ii) The dollar amounts specified in clause (i)(II)

7 shall be reduced by 50 percent if the Commissioner is also

8 required to make a payment to the institution with respect

9 to the same individual under an agreement entered into

10 under section 1611(e)(1)(I).

11 ‘‘(iii) There are authorized to be transferred from the

12 Federal Old-Age and Survivors Insurance Trust Fund and

13 the Federal Disability Insurance Trust Fund, as appro14 priate, such sums as may be necessary to enable the Com15 missioner to make payments to institutions required by

16 clause (i)(II).

17 ‘‘(iv) The Commissioner shall maintain, and shall

18 provide on a reimbursable basis, information obtained pur19 suant to agreements entered into under this paragraph to

20 any agency administering a Federal or federally-assisted

21 cash, food, or medical assistance program for eligibility

22 and other administrative purposes under such program.’’.

23 (2) CONFORMING AMENDMENTS TO THE PRI24 VACY ACT.—Section 552a(a)(8)(B) of title 5, United

25 States Code, is amended—
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1 (A) in clause (vi), by striking ‘‘or’’ at the

2 end;

3 (B) in clause (vii), by adding ‘‘or’’ at the

4 end; and

5 (C) by adding at the end the following:

6 ‘‘(viii) matches performed pursuant to

7 section 202(x)(3) or 1611(e)(1) of the So8 cial Security Act (42 U.S.C. 402(x)(3),

9 1382(e)(1));’’.

10 (3) CONFORMING AMENDMENTS TO TITLE

11 XVI.—

12 (A) Section 1611(e)(1)(I)(i)(I) of the So13 cial Security Act (42 U.S.C. 1382(e)(1)(I)(i)(I))

14 is amended by striking ‘‘; and’’ and inserting

15 ‘‘and the other provisions of this title; and’’.

16 (B) Section 1611(e)(1)(I)(ii)(II) of such

17 Act (42 U.S.C. 1382(e)(1)(I)(ii)(II)) is amend18 ed by striking ‘‘is authorized to provide, on a

19 reimbursable basis,’’ and inserting ‘‘shall main20 tain, and shall provide on a reimbursable

21 basis,’’.

22 (4) EFFECTIVE DATE.—The amendments made

23 by this subsection shall apply to individuals whose

24 period of confinement in an institution commences
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1 on or after the first day of the fourth month begin2 ning after the month in which this Act is enacted.

3 (b) ELIMINATION OF TITLE II REQUIREMENT THAT

4 CONFINEMENT STEM FROM CRIME PUNISHABLE BY IM5 PRISONMENT FOR MORE THAN 1 YEAR.—

6 (1) IN GENERAL.—Section 202(x)(1)(A) of the

7 Social Security Act (42 U.S.C. 402(x)(1)(A)) is

8 amended—

9 (A) in the matter preceding clause (i), by

10 striking ‘‘during which’’ and inserting ‘‘ending

11 with or during or beginning with or during a

12 period of more than 30 days throughout all of

13 which’’;

14 (B) in clause (i), by striking ‘‘an offense

15 punishable by imprisonment for more than 1

16 year (regardless of the actual sentence im17 posed)’’ and inserting ‘‘a criminal offense’’; and

18 (C) in clause (ii)(I), by striking ‘‘an of19 fense punishable by imprisonment for more

20 than 1 year’’ and inserting ‘‘a criminal of21 fense’’.

22 (2) EFFECTIVE DATE.—The amendments made

23 by this subsection shall apply to individuals whose

24 period of confinement in an institution commences
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1 on or after the first day of the fourth month begin2 ning after the month in which this Act is enacted.

3 (c) CONFORMING TITLE XVI AMENDMENTS.—

4 (1) 50 PERCENT REDUCTION IN TITLE XVI PAY5 MENT IN CASE INVOLVING COMPARABLE TITLE II

6 PAYMENT.—Section 1611(e)(1)(I) of the Social Se7 curity Act (42 U.S.C. 1382(e)(1)(I)) is amended—

8 (A) in clause (i)(II), by inserting ‘‘(subject

9 to reduction under clause (ii))’’ after ‘‘$400’’

10 and after ‘‘$200’’;

11 (B) by redesignating clauses (ii) and (iii)

12 as clauses (iii) and (iv) respectively; and

13 (C) by inserting after clause (i) the fol14 lowing:

15 ‘‘(ii) The dollar amounts specified in clause (i)(II)

16 shall be reduced by 50 percent if the Commissioner is also

17 required to make a payment to the institution with respect

18 to the same individual under an agreement entered into

19 under section 202(x)(3)(B).’’.

20 (2) EXPANSION OF CATEGORIES OF INSTITU21 TIONS ELIGIBLE TO ENTER INTO AGREEMENTS WITH

22 THE COMMISSIONER.—Section 1611(e)(1)(I)(i) of

23 such Act (42 U.S.C. 1382(e)(1)(I)(i)) is amended in

24 the matter preceding subclause (I) by striking ‘‘in25 stitution’’ and all that follows through ‘‘section
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1 202(x)(1)(A),’’ and inserting ‘‘institution comprising

2 a jail, prison, penal institution, or correctional facil3 ity, or with any other interested State or local insti4 tution a purpose of which is to confine individuals

5 as described in section 202(x)(1)(A)(ii),’’.

6 (3) ELIMINATION OF OVERLY BROAD EXEMP7 TION.—Section 1611(e)(1)(I)(iii) of such Act (as re8 designated by paragraph (1)(B)) is amended

9 further—

10 (A) by striking ‘‘(I) The provisions’’ and

11 all that follows through ‘‘(II)’’; and

12 (B) by striking ‘‘eligibility purposes’’ and

13 inserting ‘‘eligibility and other administrative

14 purposes under such program’’.

15 (4) EFFECTIVE DATE.—The amendments made

16 by this subsection shall take effect as if included in

17 the enactment of section 203(a) of the Personal Re18 sponsibility and Work Opportunity Reconciliation

19 Act of 1996 (Public Law 104–193; 110 Stat. 2186).

20 The reference to section 202(x)(1)(A)(ii) in section

21 1611(e)(1)(I)(i) of the Social Security Act as

22 amended by paragraph (2) shall be deemed a ref23 erence to such section 202(x)(1)(A)(ii) of such Act

24 as amended by subsection (b)(1)(C).
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1 (d) CONTINUED DENIAL OF BENEFITS TO SEX OF2 FENDERS REMAINING CONFINED TO PUBLIC INSTITU3 TIONS UPON COMPLETION OF PRISON TERM.—

4 (1) IN GENERAL.—Section 202(x)(1)(A) of the

5 Social Security Act (42 U.S.C. 402(x)(1)(A)) is

6 amended—

7 (A) in clause (i), by striking ‘‘or’’ at the

8 end;

9 (B) in clause (ii)(IV), by striking the pe10 riod and inserting ‘‘, or’’; and

11 (C) by adding at the end the following new

12 clause:

13 ‘‘(iii) immediately upon completion of confine14 ment as described in clause (i) pursuant to convic15 tion of a criminal offense an element of which is sex16 ual activity, is confined by court order in an institu17 tion at public expense pursuant to a finding that the

18 individual is a sexually dangerous person or a sexual

19 predator or a similar finding.’’.

20 (2) CONFORMING AMENDMENT.—Section

21 202(x)(1)(B)(ii) of such Act (42 U.S.C.

22 402(x)(1)(B)(ii)) is amended by striking ‘‘clause

23 (ii)’’ and inserting ‘‘clauses (ii) and (iii)’’.

24 (3) EFFECTIVE DATE.—The amendments made

25 by this subsection shall apply with respect to bene-
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1 fits for months ending after the date of the enact2 ment of this Act.

3 SEC. 403. REVOCATION BY MEMBERS OF THE CLERGY OF

4 EXEMPTION FROM SOCIAL SECURITY COV5 ERAGE.

6 (a) IN GENERAL.—Notwithstanding section

7 1402(e)(4) of the Internal Revenue Code of 1986, any ex8 emption which has been received under section 1402(e)(1)

9 of such Code by a duly ordained, commissioned, or li10 censed minister of a church, a member of a religious order,

11 or a Christian Science practitioner, and which is effective

12 for the taxable year in which this Act is enacted, may be

13 revoked by filing an application therefor (in such form and

14 manner, and with such official, as may be prescribed by

15 the Commissioner of Internal Revenue), if such applica16 tion is filed no later than the due date of the Federal in17 come tax return (including any extension thereof) for the

18 applicant’s second taxable year beginning after December

19 31, 1999. Any such revocation shall be effective (for pur20 poses of chapter 2 of the Internal Revenue Code of 1986

21 and title II of the Social Security Act), as specified in the

22 application, either with respect to the applicant’s first tax23 able year beginning after December 31, 1999, or with re24 spect to the applicant’s second taxable year beginning

25 after such date, and for all succeeding taxable years; and
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1 the applicant for any such revocation may not thereafter

2 again file application for an exemption under such section

3 1402(e)(1). If the application is filed after the due date

4 of the applicant’s Federal income tax return for a taxable

5 year and is effective with respect to that taxable year, it

6 shall include or be accompanied by payment in full of an

7 amount equal to the total of the taxes that would have

8 been imposed by section 1401 of the Internal Revenue

9 Code of 1986 with respect to all of the applicant’s income

10 derived in that taxable year which would have constituted

11 net earnings from self-employment for purposes of chapter

12 2 of such Code (notwithstanding paragraphs (4) and (5)

13 of section 1402(c)) except for the exemption under section

14 1402(e)(1) of such Code.

15 (b) EFFECTIVE DATE.—Subsection (a) shall apply

16 with respect to service performed (to the extent specified

17 in such subsection) in taxable years beginning after De18 cember 31, 1999, and with respect to monthly insurance

19 benefits payable under title II on the basis of the wages

20 and self-employment income of any individual for months

21 in or after the calendar year in which such individual’s

22 application for revocation (as described in such sub23 section) is effective (and lump-sum death payments pay24 able under such title on the basis of such wages and self-
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1 employment income in the case of deaths occurring in or

2 after such calendar year).

3 SEC. 404. ADDITIONAL TECHNICAL AMENDMENT RELATING

4 TO COOPERATIVE RESEARCH OR DEM5 ONSTRATION PROJECTS UNDER TITLES II

6 AND XVI.

7 (a) IN GENERAL.—Section 1110(a)(3) of the Social

8 Security Act (42 U.S.C. 1310(a)(3)) is amended by strik9 ing ‘‘title XVI’’ and inserting ‘‘title II or XVI’’.

10 (b) EFFECTIVE DATE.—The amendment made by

11 subsection (a) shall take effect as if included in the enact12 ment of the Social Security Independence and Program

13 Improvements Act of 1994 (Public Law 103–296; 108

14 Stat. 1464).

15 SEC. 405. AUTHORIZATION FOR STATE TO PERMIT ANNUAL

16 WAGE REPORTS.

17 (a) IN GENERAL.—Section 1137(a)(3) of the Social

18 Security Act (42 U.S.C. 1320b–7(a)(3)) is amended by

19 inserting before the semicolon the following: ‘‘, and except

20 that in the case of wage reports with respect to domestic

21 service employment, a State may permit employers (as so

22 defined) that make returns with respect to such employ23 ment on a calendar year basis pursuant to section 3510

24 of the Internal Revenue Code of 1986 to make such re25 ports on an annual basis’’.
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1 (b) TECHNICAL AMENDMENTS.—Section 1137(a)(3)

2 of the Social Security Act (42 U.S.C. 1320b–7(a)(3)) is

3 amended—

4 (1) by striking ‘‘(as defined in section

5 453A(a)(2)(B)(iii))’’; and

6 (2) by inserting ‘‘(as defined in section

7 453A(a)(2)(B))’’ after ‘‘employers’’ .

8 (c) EFFECTIVE DATE.—The amendments made by

9 this section shall apply to wage reports required to be sub10 mitted on and after the date of the enactment of this Act.

11 SEC. 406. ASSESSMENT ON ATTORNEYS WHO RECEIVE

12 THEIR FEES VIA THE SOCIAL SECURITY AD13 MINISTRATION.

14 (a) IN GENERAL.—Section 206 of the Social Security

15 Act (42 U.S.C. 606) is amended by adding at the end the

16 following:

17 ‘‘(d) ASSESSMENT ON ATTORNEYS.—

18 ‘‘(1) IN GENERAL.—Whenever a fee for services

19 is required to be certified for payment to an attorney

20 from a claimant’s past-due benefits pursuant to sub21 section (a)(4)(A) or (b)(1)(A), the Commissioner

22 shall impose on the attorney an assessment cal23 culated in accordance with paragraph (2).

24 ‘‘(2) AMOUNT.—
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1 ‘‘(A) The amount of an assessment under

2 paragraph (1) shall be equal to the product ob3 tained by multiplying the amount of the rep4 resentative’s fee that would be required to be so

5 certified by subsection (a)(4)(A) or (b)(1)(A)

6 before the application of this subsection, by the

7 percentage specified in subparagraph (B).

8 ‘‘(B) The percentage specified in this sub9 paragraph is—

10 ‘‘(i) for calendar years before 2001,

11 6.3 percent, and

12 ‘‘(ii) for calendar years after 2000,

13 6.3 percent or such different percentage

14 rate as the Commissioner determines is

15 necessary in order to achieve full recovery

16 of the costs of certifying fees to attorneys

17 from the past-due benefits of claimants.

18 ‘‘(3) COLLECTION.—The Commissioner may

19 collect the assessment imposed on an attorney under

20 paragraph (1) by offset from the amount of the fee

21 otherwise required by subsection (a)(4)(A) or

22 (b)(1)(A) to be certified for payment to the attorney

23 from a claimant’s past-due benefits.

24 ‘‘(4) PROHIBITION ON CLAIMANT REIMBURSE25 MENT.—An attorney subject to an assessment under
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1 paragraph (1) may not, directly or indirectly, re2 quest or otherwise obtain reimbursement for such

3 assessment from the claimant whose claim gave rise

4 to the assessment.

5 ‘‘(5) DISPOSITION OF ASSESSMENTS.—Assess6 ments on attorneys collected under this subsection

7 shall be credited to the Federal Old-Age and Sur8 vivors Insurance Trust Fund and the Federal Dis9 ability Insurance Trust Fund, as appropriate.

10 ‘‘(6) AUTHORIZATION OF APPROPRIATIONS.—

11 The assessments authorized under this section shall

12 be collected and available for obligation only to the

13 extent and in the amount provided in advance in ap14 propriations Acts. Amounts so appropriated are au15 thorized to remain available until expended, for ad16 ministrative expenses in carrying out title II of the

17 Social Security Act and related laws.

18 (b) CONFORMING AMENDMENTS.—

19 (1) Section 206(a)(4)(A) of such Act (42

20 U.S.C. 606(a)(4)(A)) is amended by inserting ‘‘and

21 subsection (d)’’ after ‘‘subparagraph (B)’’.

22 (2) Section 206(b)(1)(A) of such Act (42

23 U.S.C. 606(b)(1)(A)) is amended by inserting ‘‘, but

24 subject to subsection (d) of this section’’ after ‘‘sec25 tion 205(i)’’.
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1 (c) EFFECTIVE DATE.—The amendments made by

2 this section shall apply in the case of any attorney with

3 respect to whom a fee for services is required to be cer4 tified for payment from a claimant’s past-due benefits

5 pursuant to subsection (a)(4)(A) or (b)(4)(A) of section

6 206 of the Social Security Act after—

7 (1) December 31, 1999, or

8 (2) the last day of the first month beginning

9 after the month in which this Act is enacted.

10 SEC. 407. PREVENTION OF FRAUD AND ABUSE ASSOCIATED

11 WITH CERTAIN PAYMENTS UNDER THE MED12 ICAID PROGRAM.

13 (a) REQUIREMENTS FOR PAYMENTS.—Section

14 1903(i) of the Social Security Act (42 U.S.C. 1396b(i))

15 (as amended by section 201(a)(3)(B)) is amended

16 further—

17 (1) in paragraph (20), by striking the period at

18 the end and inserting ‘‘; or’’; and

19 (2) by inserting immediately after paragraph

20 (20) the following:

21 ‘‘(21) with respect to any amount expended for

22 an item or service provided under the plan, or for

23 any administrative expense incurred to carry out the

24 plan, which is provided or incurred by, or on behalf

25 of, a State or local educational agency or school dis-
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1 trict, unless payment for the item, service, or admin2 istrative expense is made in accordance with a meth3 odology approved in advance by the Secretary under

4 which—

5 ‘‘(A) in the case of payment for—

6 ‘‘(i) a group of individual items, serv7 ices, and administrative expenses, the

8 methodology—

9 ‘‘(I) provides for an itemization

10 to the Secretary that assures account11 ability of the cost of the grouped

12 items, services, and administrative ex13 penses and includes payment rates

14 and the methodologies underlying the

15 establishment of such rates;

16 ‘‘(II) has an actuarially sound

17 basis for determining the payment

18 rates and the methodologies; and

19 ‘‘(III) reconciles payments for

20 the grouped items, services, and ad21 ministrative expenses with items and

22 services provided and administrative

23 expenses incurred under this title; or

24 ‘‘(ii) an individual item, service, or ad25 ministrative expense, the amount of pay-
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1 ment for the item, service, or administra2 tive expense does not exceed the amount

3 that would be paid for the item, service, or

4 administrative expense if the item, service,

5 or administrative expense were incurred by

6 an entity other than a State or local edu7 cational agency or school district, unless

8 the State can demonstrate to the satisfac9 tion of the Secretary a higher amount for

10 such item, service, or administrative ex11 pense; and

12 ‘‘(B) in the case of a transportation service

13 for an individual under age 21 who is eligible

14 for medical assistance under this title (whether

15 or not the child has an individualized education

16 program established pursuant to part B of the

17 Individuals with Disabilities Education Act)—

18 ‘‘(i) a medical need for transportation

19 is noted in such an individualized edu20 cation program (if any) for the individual,

21 including such an individual residing in a

22 geographic area within which school bus

23 transportation is otherwise not provided;

24 ‘‘(ii) in the case of a child with special

25 medical needs, the vehicle used to furnish
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1 such transportation service is specially

2 equipped or staffed to accommodate indi3 viduals with special medical needs; and

4 ‘‘(iii) payment for such service only—

5 ‘‘(I) is made with respect to costs

6 directly attributable to the costs asso7 ciated with transporting such individ8 uals whose medical needs require

9 transport in such a vehicle; and

10 ‘‘(II) reflects the proportion of

11 transportation costs equal to the pro12 portion of the school day spent by

13 such individuals in activities relating

14 to the receipt of covered services

15 under this title or such other propor16 tion based on an allocation method

17 that the Secretary finds reasonable in

18 light of the benefit to the program

19 under this title and consistent with

20 the cost principles contained in OMB

21 Circular A–87; or

22 ‘‘(22) with respect to any amount expended for

23 an item or service under the plan or for any admin24 istrative expense to carry out the plan provided by

25 or on behalf of a State or local agency (including a
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1 State or local educational agency or school district)

2 that enters into a contract or other arrangement

3 with a person or entity for, or in connection with,

4 the collection or submission of claims for such ex5 penditures, unless, notwithstanding section

6 1902(a)(32), the agency—

7 ‘‘(A) uses a competitive bidding process or

8 otherwise to contract with such person or entity

9 at a reasonable rate commensurate with the

10 services performed by the person or entity; and

11 ‘‘(B) requires that any fees (including any

12 administrative fees) to be paid to the person or

13 entity for the collection or submission of such

14 claims are identified as a non-contingent, speci15 fied dollar amount in the contract.’’; and

16 (3) in the third sentence, by striking ‘‘(17), and

17 (18)’’ and inserting ‘‘(17), (18), (19), and (21)’’.

18 (b) PROVISION OF ITEMS AND SERVICES THROUGH

19 MEDICAID MANAGED CARE ORGANIZATIONS.—

20 (1) CONTRACTUAL REQUIREMENT.—Section

21 1903(m)(2)(A) of the Social Security Act (42 U.S.C.

22 1396b(m)(2)(A)) is amended by redesignating clause

23 (xi) (as added by section 4701(c)(3) of the Balanced

24 Budget Act of 1997) as clause (xiii), by striking
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1 ‘‘and’’ at the end of clause (xi), and by inserting

2 after clause (xi) the following:

3 ‘‘(xii) such contract provides that with respect

4 to payment for, and coverage of, such services, the

5 contract requires coordination between the State or

6 local educational agency or school district and the

7 medicaid managed care organization to prevent du8 plication of services and duplication of payments

9 under this title for such services.’’

10 (2) PROHIBITION ON DUPLICATIVE PAY11 MENTS.—

12 (A) IN GENERAL.—Section 1903(i) of the

13 Social Security Act (42 U.S.C 1396b(i)), as

14 amended by subsection (a), is amended—

15 (i) in paragraph (22), by striking the

16 period and inserting ‘‘; or’’; and

17 (ii) by adding at the end the fol18 lowing:

19 ‘‘(23) with respect to any amount ex20 pended under the plan for an item, service, or

21 administrative expense for which payment is or

22 may be made directly to a person or entity (in23 cluding a State or local educational agency or

24 school district) under the State plan if payment

25 for such item, service, or administrative expense
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1 was included in the determination of a prepaid

2 capitation or other risk-based rate of payment

3 to an entity under a contract pursuant to sec4 tion 1903(m).’’.

5 (B) CONFORMING AMENDMENT.—The

6 third sentence of section 1903(i) of such Act

7 (42 U.S.C. 1396b(i)), as amended by subsection

8 (a)(3), is amended by striking ‘‘and (21)’’ and

9 inserting ‘‘(21), and (23)’’.

10 (c) ALLOWABLE SHARE OF FFP WITH RESPECT TO

11 PAYMENT FOR SERVICES FURNISHED IN SCHOOL SET12 TING.—Section 1903(w)(6) of the Social Security Act (42

13 U.S.C. 1396b(w)(6)) is amended—

14 (1) in subparagraph (A), by inserting ‘‘subject

15 to subparagraph (C),’’ after ‘‘subsection,’’; and

16 (2) by adding at the end the following:

17 ‘‘(C) In the case of any Federal financial participa18 tion amount determined under subsection (a) with respect

19 to any expenditure for an item or service under the plan,

20 or for any administrative expense to carry out the plan,

21 that is furnished by a State or local educational agency

22 or school district, the State shall provide that there is paid

23 to the agency or district a percent of such amount that

24 is not less than the percentage of such expenditure or ex25 pense that is paid by such agency or district.’’.
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1 (d) UNIFORM METHODOLOGY FOR SCHOOL-BASED

2 ADMINISTRATIVE CLAIMS.—Not later than 90 days after

3 the date of the enactment of this Act, the Administrator

4 of the Health Care Financing Administration, in consulta5 tion with State medicaid and State educational agencies

6 and local school systems, shall develop and implement a

7 uniform methodology for claims for payment of adminis8 trative expenses furnished under title XIX of the Social

9 Security Act by State or local educational agencies or

10 school districts. Such methodology shall be based on

11 standards related to time studies and population estimates

12 and a national standard for determining payment for such

13 administrative expenses.

14 (e) EFFECTIVE DATE.—

15 (1) IN GENERAL.—The amendments made by

16 this section (other than by subsection (b)) shall

17 apply to items and services provided on and after

18 the date of the enactment of this Act, without re19 gard to whether implementing regulations are in ef20 fect.

21 (2) MANAGED CARE AMENDMENTS.—The

22 amendments made by subsection (b) shall apply to

23 contracts entered into or renewed on or after the

24 date of the enactment of this Act.
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1 (3) REGULATIONS.—The Secretary of Health

2 and Human Services shall promulgate such final

3 regulations as are necessary to carry out the amend4 ments made by this section not later than 1 year

5 after the date of the enactment of this Act.

6 SEC. 408. EXTENSION OF AUTHORITY OF STATE MEDICAID

7 FRAUD CONTROL UNITS.

8 (a) EXTENSION OF AUTHORITY TO INVESTIGATE

9 AND PROSECUTE FRAUD IN OTHER FEDERAL HEALTH

10 CARE PROGRAMS.—Section 1903(q)(3) of the Social Secu11 rity Act (42 U.S.C. 1396b(q)(3)) is amended—

12 (1) by inserting ‘‘(A)’’ after ‘‘in connection

13 with’’; and

14 (2) by striking ‘‘title.’’ and inserting ‘‘title; and

15 (B) upon the approval of the Inspector General of

16 the relevant Federal agency, any aspect of the provi17 sion of health care services and activities of pro18 viders of such services under any Federal health

19 care program (as defined in section 1128B(f)(1)), if

20 the suspected fraud or violation of law in such case

21 or investigation is primarily related to the State plan

22 under this title.’’.

23 (b) RECOUPMENT OF FUNDS.—Section 1903(q)(5) of

24 such Act (42 U.S.C. 1396b(q)(5)) is amended—
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1 (1) by inserting ‘‘or under any Federal health

2 care program (as so defined)’’ after ‘‘plan’’; and

3 (2) by adding at the end the following: ‘‘All

4 funds collected in accordance with this paragraph

5 shall be credited exclusively to, and available for ex6 penditure under, the Federal health care program

7 (including the State plan under this title) that was

8 subject to the activity that was the basis for the col9 lection.’’.

10 (c) EXTENSION OF AUTHORITY TO INVESTIGATE

11 AND PROSECUTE RESIDENT ABUSE IN NON-MEDICAID

12 BOARD AND CARE FACILITIES.—Section 1903(q)(4) of

13 such Act (42 U.S.C. 1396b(q)(4)) is amended to read as

14 follows:

15 ‘‘(4)(A) The entity has—

16 ‘‘(i) procedures for reviewing complaints of

17 abuse or neglect of patients in health care fa18 cilities which receive payments under the State

19 plan under this title;

20 ‘‘(ii) at the option of the entity, procedures

21 for reviewing complaints of abuse or neglect of

22 patients residing in board and care facilities;

23 and

24 ‘‘(iii) procedures for acting upon such com25 plaints under the criminal laws of the State or
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1 for referring such complaints to other State

2 agencies for action.

3 ‘‘(B) For purposes of this paragraph, the term

4 ‘board and care facility’ means a residential setting

5 which receives payment (regardless of whether such

6 payment is made under the State plan under this

7 title) from or on behalf of two or more unrelated

8 adults who reside in such facility, and for whom one

9 or both of the following is provided:

10 ‘‘(i) Nursing care services provided by, or

11 under the supervision of, a registered nurse, li12 censed practical nurse, or licensed nursing as13 sistant.

14 ‘‘(ii) A substantial amount of personal care

15 services that assist residents with the activities

16 of daily living, including personal hygiene,

17 dressing, bathing, eating, toileting, ambulation,

18 transfer, positioning, self-medication, body care,

19 travel to medical services, essential shopping,

20 meal preparation, laundry, and housework.’’.

21 (d) EFFECTIVE DATE.—The amendments made by

22 this section take effect on the date of the enactment of

23 this Act.
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1 SEC. 409. SPECIAL ALLOWANCE ADJUSTMENT FOR STU2 DENT LOANS.

3 (a) AMENDMENT.—Section 438(b)(2) of the Higher

4 Education Act of 1965 (20 U.S.C. 1087–1(b)(2)) is

5 amended—

6 (1) in subparagraph (A), by striking ‘‘(G), and

7 (H)’’ and inserting ‘‘(G), (H), and (I)’’;

8 (2) in subparagraph (B)(iv), by striking ‘‘(G),

9 or (H)’’ and inserting ‘‘(G), (H), or (I)’’;

10 (3) in subparagraph (C)(ii), by striking ‘‘(G)

11 and (H)’’ and inserting ‘‘(G), (H), and (I)’’;

12 (4) in the heading of subparagraph (H), by

13 striking ‘‘JULY 1, 2003’’ and inserting ‘‘JANUARY 1,

14 2000’’;

15 (5) in subparagraph (H), by striking ‘‘July 1,

16 2003,’’ each place it appears and inserting ‘‘January

17 1, 2000,’’; and

18 (6) by inserting after subparagraph (H) the fol19 lowing new subparagraph:

20 ‘‘(I) LOANS DISBURSED ON OR AFTER JAN21 UARY 1, 2000, AND BEFORE JULY 1, 2003.—

22 ‘‘(i) IN GENERAL.—Notwithstanding

23 subparagraphs (G) and (H), but subject to

24 paragraph (4) and clauses (ii), (iii), and

25 (iv) of this subparagraph, and except as

26 provided in subparagraph (B), the special
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1 allowance paid pursuant to this subsection

2 on loans for which the first disbursement

3 is made on or after January 1, 2000, and

4 before July 1, 2003, shall be computed—

5 ‘‘(I) by determining the average

6 of the bond equivalent rates of the

7 quotes of the 3-month commercial

8 paper (financial) rates in effect for

9 each of the days in such quarter as

10 reported by the Federal Reserve in

11 Publication H–15 (or its successor)

12 for such 3-month period;

13 ‘‘(II) by subtracting the applica14 ble interest rates on such loans from

15 such average bond equivalent rate;

16 ‘‘(III) by adding 2.34 percent to

17 the resultant percent; and

18 ‘‘(IV) by dividing the resultant

19 percent by 4.

20 ‘‘(ii) IN SCHOOL AND GRACE PE21 RIOD.—In the case of any loan for which

22 the first disbursement is made on or after

23 January 1, 2000, and before July 1, 2003,

24 and for which the applicable rate of inter25 est is described in section 427A(k)(2),
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1 clause (i)(III) of this subparagraph shall

2 be applied by substituting ‘1.74 percent’

3 for ‘2.34 percent’.

4 ‘‘(iii) PLUS LOANS.—In the case of

5 any loan for which the first disbursement

6 is made on or after January 1, 2000, and

7 before July 1, 2003, and for which the ap8 plicable rate of interest is described in sec9 tion 427A(k)(3), clause (i)(III) of this sub10 paragraph shall be applied by substituting

11 ‘2.64 percent’ for ‘2.34 percent’, subject to

12 clause (v) of this subparagraph.

13 ‘‘(iv) CONSOLIDATION LOANS.—In the

14 case of any consolidation loan for which

15 the application is received by an eligible

16 lender on or after January 1, 2000, and

17 before July 1, 2003, and for which the ap18 plicable interest rate is determined under

19 section 427A(k)(4), clause (i)(III) of this

20 subparagraph shall be applied by sub21 stituting ‘2.64 percent’ for ‘2.34 percent’,

22 subject to clause (vi) of this subparagraph.

23 ‘‘(v) LIMITATION ON SPECIAL ALLOW24 ANCES FOR PLUS LOANS.—In the case of

25 PLUS loans made under section 428B and
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1 first disbursed on or after January 1,

2 2000, and before July 1, 2003, for which

3 the interest rate is determined under sec4 tion 427A(k)(3), a special allowance shall

5 not be paid for such loan during any 12-

6 month period beginning on July 1 and

7 ending on June 30 unless, on the June 1

8 preceding such July 1—

9 ‘‘(I) the bond equivalent rate of

10 91-day Treasury bills auctioned at the

11 final auction held prior to such June

12 1 (as determined by the Secretary for

13 purposes of such section); plus

14 ‘‘(II) 3.1 percent,

15 exceeds 9.0 percent.

16 ‘‘(vi) LIMITATION ON SPECIAL ALLOW17 ANCES FOR CONSOLIDATION LOANS.—In

18 the case of consolidation loans made under

19 section 428C and for which the application

20 is received on or after January 1, 2000,

21 and before July 1, 2003, for which the in22 terest rate is determined under section

23 427A(k)(4), a special allowance shall not

24 be paid for such loan during any 3-month
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1 period ending March 31, June 30, Sep2 tember 30, or December 31 unless—

3 ‘‘(I) the average of the bond

4 equivalent rates of the quotes of the

5 3-month commercial paper (financial)

6 rates in effect for each of the days in

7 such quarter as reported by the Fed8 eral Reserve in Publication H–15 (or

9 its successor) for such 3-month pe10 riod; plus

11 ‘‘(II) 2.64 percent,

12 exceeds the rate determined under section

13 427A(k)(4).’’.

14 (b) EFFECTIVE DATE.—Subparagraph (I) of section

15 438(b)(2) of the Higher Education Act of 1965 (20

16 U.S.C. 1087–1(b)(2)) as added by subsection (a) of this

17 section shall apply with respect to any payment pursuant

18 to such section with respect to any 3-month period begin19 ning on or after January 1, 2000, for loans for which the

20 first disbursement is made after such date.

Passed the House of Representatives October 19,

1999.

Attest:

Clerk.