I 

113TH CONGRESS 

2D SESSION H. R. 4090 

To amend title II of the Social Security Act to improve the Social Security 

Administration’s ability to fight fraud, prevent errors, and protect the 

Social Security Trust Fund, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 26, 2014 

Mr. BECERRA (for himself, Mr. LEVIN, Mr. RANGEL, Mr. DOGGETT, Mr. 

THOMPSON of California, Ms. SCHWARTZ, and Mr. CROWLEY) introduced 

the following bill; which was referred to the Committee on Ways and 

Means, and in addition to the Committee on the Budget, for a period to 

be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee 

concerned 

A BILL 

To amend title II of the Social Security Act to improve 

the Social Security Administration’s ability to fight 

fraud, prevent errors, and protect the Social Security 

Trust Fund, and for other purposes. 

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. 

4 This Act may be cited as the ‘‘Social Security Fraud 

5 and Error Prevention Act of 2014’’. 


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1 SEC. 2. FRAUD AND ERROR PREVENTION. 

2 (a) IN GENERAL.—Section 201 of the Social Security 

3 Act (42 U.S.C. 401 et seq.) is amended by striking sub4 section (n) and inserting the following: 

5 ‘‘(n) FRAUD AND ERROR PREVENTION.— 

6 ‘‘(1) Subject to paragraph (4), there is hereby 

7 appropriated from any one or all of the Trust Funds 

8 to the Social Security Administration for each fiscal 

9 year beginning with fiscal year 2015 for fraud and 

10 error prevention activities described in paragraph 

11 (3), in addition to any other amounts otherwise ap12 propriated for such fiscal year, an amount equal to 

13 the sum of— 

14 ‘‘(A) the applicable dollar amount (deter15 mined under paragraph (2)), plus 

16 ‘‘(B) an amount equal to the sum of any 

17 fines or other monetary penalties recovered in 

18 the previous fiscal year pursuant to sections 

19 208(a), 1129(a), 1140 (to the extent that such 

20 penalties are imposed for misuse of words, let21 ters, symbols, or emblems relating to the Social 

22 Security Administration), and 1632(a). 

23 ‘‘(2) The applicable dollar amount determined 

24 under this clause is— 

25 ‘‘(A) for fiscal year 2015, $1,750,000,000; 


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1 ‘‘(B) for each of fiscal years 2016 through 

2 2020, $1,800,000,000; and 

3 ‘‘(C) for each fiscal year thereafter, 

4 $1,800,000,000 multiplied by the ratio (not less 

5 than 1) of— 

6 ‘‘(i) the Consumer Price Index for all 

7 Urban Consumers (CPI–U, published by 

8 the Bureau of Labor Statistics of the De9 partment of Labor) for the 1st full cal10 endar year preceding such fiscal year, to 

11 ‘‘(ii) the CPI–U for 2018. 

12 ‘‘(3) The Commissioner of Social Security may 

13 use funds appropriated under paragraph (1) for the 

14 following purposes: 

15 ‘‘(A) Medical continuing disability reviews 

16 conducted pursuant to section 221(i) and sec17 tion 1614(a)(3)(H). 

18 ‘‘(B) SSI redeterminations conducted pur19 suant to section 1611(c). 

20 ‘‘(C) Work-related continuing disability re21 views conducted pursuant to section 223(f). 

22 ‘‘(D) Establishment or expansion of coop23 erative disability investigations (CDI) units. 

24 ‘‘(E) Pre-effectuation reviews conducted 

25 pursuant to section 221(c) and section 1633(e). 


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1 ‘‘(F) Quality reviews of decisions made by 

2 an administrative law judge under this title or 

3 title XVI in accordance with section 221(n). 

4 ‘‘(G) Recovery of overpayments under sec5 tions 204 and 1631(b). 

6 ‘‘(H) Recovery of civil penalties imposed 

7 under sections 1129 and 1140. 

8 ‘‘(I) Supporting prosecution of felonies 

9 under section 208. 

10 ‘‘(4) Funds appropriated under paragraph (1) 

11 for a fiscal year shall not be available for obligation 

12 until the report required to be submitted under 

13 paragraph (5) 60 days prior to the beginning of 

14 such fiscal year has been submitted. 

15 ‘‘(5) Not later than 60 days prior to the begin16 ning of each fiscal year after 2014, the Commis17 sioner of Social Security shall submit a report to the 

18 Committee on Ways and Means of the House of 

19 Representatives, the Committee on Finance of the 

20 Senate, and the Office of Management and Budget 

21 that includes the following: 

22 ‘‘(A) A plan for conducting the fraud and 

23 error prevention activities described in para24 graph (3) in such fiscal year, including— 


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1 ‘‘(i) an itemized statement of the dol2 lar amounts expected to be spent on each 

3 such activity during such fiscal year; 

4 ‘‘(ii) an itemized statement of the esti5 mated long-term savings to the Trust 

6 Funds and the Treasury expected to be ob7 tained as a result of each such activity, 

8 and a statement of the estimated total 

9 value of benefits paid under this title solely 

10 as a result of such activities; 

11 ‘‘(iii) performance targets for each 

12 such activity; and 

13 ‘‘(iv) a certification from the Chief 

14 Actuary of the Social Security Administra15 tion that the plan will improve the actu16 arial status of the Trust Funds. 

17 ‘‘(B) An assessment of the fraud and error 

18 prevention activities described in paragraph (3) 

19 conducted in the previous fiscal year, includ20 ing— 

21 ‘‘(i) an itemized statement of the dol22 lar amounts spent on each such activity 

23 during such fiscal year; 

24 ‘‘(ii) an itemized statement of the esti25 mated long-term savings to the Trust 


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1 Funds and the Treasury obtained as a re2 sult of each such activity, and a statement 

3 of the estimated total value of benefits 

4 paid under this title solely as a result of 

5 such activities; 

6 ‘‘(iii) an assessment of the extent to 

7 which performance targets set in the appli8 cable plan for such fiscal year were met; 

9 ‘‘(iv) an explanation and a corrective 

10 action plan for any failure to meet such 

11 performance targets; and 

12 ‘‘(v) an assessment of whether funds 

13 made available under paragraph (1) for 

14 such fiscal year were adequate to protect 

15 the Trust Funds from fraud and errors, an 

16 explanation of any such funds that re17 mained unobligated at the end of the fiscal 

18 year, and recommendations for needed ad19 justments to future funding in order to 

20 protect the Trust Funds from fraud and 

21 errors and any additional cost-effective 

22 strategies for improving the actuarial sta23 tus of the Trust Funds. 

24 ‘‘(6) Of the discretionary amounts made avail25 able for ‘Social Security Administration—Limitation 


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1 on Administrative Expenses’ for each fiscal year be2 ginning with fiscal year 2015, the amount obligated 

3 for the activities described in paragraph (3) shall be 

4 not less than the sum of— 

5 ‘‘(A) $273,000,000; plus 

6 ‘‘(B) the amount obligated from funds 

7 made available for ‘Social Security Administra8 tion—Limitation on Administrative Expenses’ 

9 for fiscal year 2013 for the activities described 

10 in subparagraphs (C) through (I) of paragraph 

11 (3).’’. 

12 SEC. 3. EXPANSION OF COOPERATIVE DISABILITY INVES13 TIGATIONS UNITS. 

14 Not later than October 1, 2017, the Commissioner 

15 of Social Security shall take any necessary actions to en16 sure that cooperative disability investigations (CDI) units 

17 have been established for each of the 50 States, the Dis18 trict of Columbia, Puerto Rico, Guam, the Northern Mar19 iana Islands, the Virgin Islands, and American Samoa. 

20 SEC. 4. CODIFICATION OF REQUIREMENT TO CONDUCT 

21 QUALITY REVIEWS. 

22 Section 221 of the Social Security Act is amended 

23 by adding at the end the following: 

24 ‘‘(n)(1) The Commissioner of Social Security shall 

25 conduct quality reviews in accordance with section 969 of 


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1 part 404 of title 20, Code of Federal Regulations, in cases 

2 described in section 970(a) of such part (as such sections 

3 were in effect on January 1, 2014) with respect to deci4 sions in connection with applications for benefits under 

5 this title and title XVI, in a sufficient number to ensure 

6 compliance with laws, regulations, and other guidance 

7 issued by the Commissioner of Social Security. 

8 ‘‘(2) The Commissioner of Social Security shall annu9 ally submit to the Committee on Ways and Means of the 

10 House of Representatives and the Committee on Finance 

11 of the Senate a report that includes— 

12 ‘‘(A) the total number of cases selected for a 

13 quality review as described in paragraph (1); 

14 ‘‘(B) the number of such cases in which a deci15 sion is remanded; and 

16 ‘‘(C) the number of such cases in which a deci17 sion is modified or reversed.’’. 

18 SEC. 5. REPORT ON WORK-RELATED CONTINUING DIS19 ABILITY REVIEWS. 

20 Section 223 of the Social Security Act is amended 

21 by adding at the end the following: 

22 ‘‘(k) REPORT ON WORK-RELATED CONTINUING DIS23 ABILITY REVIEWS.—The Commissioner of Social Security 

24 shall annually submit to the Committee on Ways and 

25 Means of the House of Representatives and the Committee 


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1 on Finance of the Senate a report on the number of work2 related continuing disability reviews conducted pursuant 

3 to subsection (f). Such report shall include— 

4 ‘‘(1) the total number of reports of earnings re5 ceived by the Commissioner in the previous calendar 

6 year from individuals receiving benefits on account 

7 of disability under this title or title XVI; 

8 ‘‘(2) the number of such reports that resulted 

9 in a determination by the Commissioner to conduct 

10 a work-related continuing disability review with re11 spect to the beneficiary to whom such report per12 tains, and the basis on which such determinations 

13 were made; 

14 ‘‘(3) in the case of a beneficiary selected for a 

15 work-related continuing disability review on the basis 

16 of a report of earnings— 

17 ‘‘(A) the average number of days between 

18 the submission of the report and the initiation 

19 of the review, and the average number of days 

20 between the initiation and the completion of the 

21 review; 

22 ‘‘(B) the number of such reviews com23 pleted during such calendar year, and the num24 ber of such reviews that result in a suspension 

25 or termination of benefits; and 


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1 ‘‘(C) the number of such reviews that had 

2 not been completed as of the end of such cal3 endar year; 

4 ‘‘(4) the total savings to the Trust Funds and 

5 the Treasury generated from benefits terminated as 

6 a result of such reviews; and 

7 ‘‘(5) with respect to individuals for whom a 

8 work-related continuing disability review was com9 pleted during such calendar year— 

10 ‘‘(A) the number who participated in the 

11 Ticket to Work program under section 1148 

12 during such calendar year; 

13 ‘‘(B) the number who used any program 

14 work incentives during such calendar year; and 

15 ‘‘(C) the number who received vocational 

16 rehabilitation services during such calendar 

17 year with respect to which the Commissioner of 

18 Social Security reimbursed a State agency 

19 under section 222(d).’’. 

20 SEC. 6. COORDINATION OF REPORTS RELATING TO DIS21 ABILITY BENEFITS. 

22 Section 221(i)(3) of the Social Security Act (42 

23 U.S.C. 421(i)(3)) is amended by adding at the end the 

24 following: ‘‘To the extent the Commissioner of Social Se25 curity determines to be necessary for maximum efficiency, 


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1 the Commissioner may submit a combined report con2 sisting of the information required to be submitted under 

3 this paragraph, subsection (c)(3)(C), subsection (n)(2), 

4 section 201(n)(5), and section 223(k).’’. 

5 SEC. 7. INCREASED PENALTIES IN CERTAIN CASES OF 

6 FRAUD. 

7 (a) CONSPIRACY TO COMMIT SOCIAL SECURITY

8 FRAUD.—Section 208(a) of the Social Security Act (42 

9 U.S.C. 408(a)) is amended— 

10 (1) in paragraph (7)(C), by striking ‘‘or’’ at the 

11 end; 

12 (2) in paragraph (8), by adding ‘‘or’’ at the 

13 end; and 

14 (3) by inserting after paragraph (8) the fol15 lowing: 

16 ‘‘(9) conspires to commit any offense described in any 

17 of paragraphs (1) through (4),’’. 

18 (b) INCREASED CRIMINAL PENALTIES FOR CERTAIN

19 INDIVIDUALS IN POSITIONS OF TRUST.—Section 208(a) 

20 of such Act (42 U.S.C. 408(a)), as amended by subsection 

21 (a), is further amended by striking the period at the end 

22 and inserting ‘‘, except that in the case of a person who 

23 receives a fee or other income for services performed in 

24 connection with any determination with respect to benefits 

25 under this title, or who is a physician or other health care 


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1 provider who submits medical evidence in connection with 

2 any such determination, such person shall be guilty of a 

3 felony and upon conviction thereof shall be fined under 

4 title 18, United States Code, or imprisoned for not more 

5 than ten years, or both.’’. 

6 (c) INCREASED CIVIL PENALTIES FOR CERTAIN IN7 DIVIDUALS IN POSITIONS OF TRUST.—Section 1129(a)(1) 

8 of such Act (42 U.S.C. 1320a–8(a)(1)) is amended, in the 

9 matter following subparagraph (C), by inserting after 

10 ‘‘withholding disclosure of such fact’’ the following: ‘‘, ex11 cept that in the case of such a person who receives a fee 

12 or other income for services performed in connection with 

13 any such determination or who is a physician or other 

14 health care provider who submits medical evidence in con15 nection with any such determination, the amount of such 

16 penalty shall be not more than $7,500’’. 

17 (d) REFERENCES TO SOCIAL SECURITY AND MEDI18 CARE IN ELECTRONIC COMMUNICATIONS.—Section 

19 1140(a)(1) of the Social Security Act (42 U.S.C. 1320b– 

20 10(a)(1)) is amended by inserting ‘‘(including any elec21 tronic communication)’’ after ‘‘or other communication’’. 

22 (e) INFLATION ADJUSTMENT OF CERTAIN CIVIL

23 PENALTIES.—Title XI of the Social Security Act is 

24 amended by inserting after section 1129B the following: 


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1 ‘‘SEC. 1129C. CIVIL PENALTY INFLATION ADJUSTMENT. 

2 ‘‘(a) ADJUSTMENT BY REGULATION.—The Commis3 sioner of Social Security shall, not later than 180 days 

4 after the date of enactment of the Social Security Fraud 

5 and Error Prevention Act of 2014, and at least once every 

6 4 years thereafter— 

7 ‘‘(1) by regulation adjust the maximum amount 

8 of each civil monetary penalty by the inflation ad9 justment described under subsection (b); and 

10 ‘‘(2) publish each such regulation in the Fed11 eral Register. 

12 ‘‘(b) AMOUNT OF ADJUSTMENT.—The inflation ad13 justment under subsection (a) shall be determined by in14 creasing the maximum amount of each civil monetary pen15 alty by the cost-of-living adjustment. Any increase deter16 mined under this subsection shall be rounded to the near17 est— 

18 ‘‘(1) multiple of $1,000 in the case of penalties 

19 greater than $1,000 but less than or equal to 

20 $10,000; and 

21 ‘‘(2) multiple of $5,000 in the case of penalties 

22 greater than $10,000 but less than or equal to 

23 $100,000. 

24 ‘‘(c) DEFINITIONS.—For purposes of this section— 

25 ‘‘(1) the term ‘civil monetary penalty’ means— 


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1 ‘‘(A) a penalty imposed by paragraph (1) 

2 or (3) of section 1129(a); and 

3 ‘‘(B) a penalty imposed by paragraph (1) 

4 or (2) of section 1140(b). 

5 ‘‘(2) the term ‘cost-of-living adjustment’ means 

6 the percentage (if any) for each civil monetary pen7 alty by which— 

8 ‘‘(A) the Consumer Price Index for the 

9 month of June of the calendar year preceding 

10 the adjustment, exceeds 

11 ‘‘(B) the Consumer Price Index for the 

12 month of June of the calendar year in which 

13 the amount of such civil monetary penalty was 

14 last set or adjusted pursuant to law. 

15 ‘‘(d) APPLICATION OF INCREASE.—Any increase 

16 under this Act in a civil monetary penalty shall apply only 

17 to violations which occur after the date the increase takes 

18 effect.’’. 

19 SEC. 8. EXCLUSION OF CERTAIN MEDICAL EVIDENCE IN 

20 DISABILITY CASES. 

21 (a) IN GENERAL.—Section 223(d)(5) of the Social 

22 Security Act (42 U.S.C. 423(d)(5)) is amended by adding 

23 at the end the following: 

24 ‘‘(C) In making any determination with respect to 

25 whether an individual is under a disability or continues 


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1 to be under a disability, the Commissioner of Social Secu2 rity may not consider, except for good cause as determined 

3 by the Commissioner, any evidence furnished by a physi4 cian or other health care provider who— 

5 ‘‘(i) has been barred from practice in any State; 

6 or 

7 ‘‘(ii) has been assessed a penalty under section 

8 1128 or 1129 for the submission of false evidence.’’. 

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

10 date of the enactment of this Act, the Commissioner of 

11 Social Security shall issue regulations to carry out the 

12 amendment made by subsection (a). 

13 (c) EFFECTIVE DATE.—The amendment made by 

14 subsection (a) shall apply with respect to determinations 

15 of disability made on or after the date that is 1 year after 

16 the date of enactment of this Act. 

17 SEC. 9. REPEAL OF PROGRAM INTEGRITY ADJUSTMENTS 

18 TO DISCRETIONARY SPENDING LIMITS. 

19 Section 251(b)(2)(B)(i) of the Balanced Budget and 

20 Emergency Deficit Control Act of 1985 is amended— 

21 (1) in subclause (II), by adding ‘‘and’’ at the 

22 end; 

23 (2) in subclause (III), by striking the semicolon 

24 at the end and inserting a period; and 


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1 (3) by striking subclauses (IV) through (X). 

Æ 


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