H. R. 3443—6
this section for fiscal year 1998 bears to the sum of such
excess amounts determined for all such States.
‘‘(d) USE OF FUNDS.—
‘‘(1) IN GENERAL.—A State to which an amount is paid
from its allotment under subsection (c) may use the amount
in any manner that is reasonably calculated to accomplish
the purposes of this section.
‘‘(2) NO SUPPLANTATION OF OTHER FUNDS AVAILABLE FOR
SAME GENERAL PURPOSES.—The amounts paid to a State from
its allotment under subsection (c) shall be used to supplement
and not supplant any other funds which are available for the
same general purposes in the State.
‘‘(3) TWO-YEAR AVAILABILITY OF FUNDS.—Payments made
to a State under this section for a fiscal year shall be expended
by the State in the fiscal year or in the succeeding fiscal
year.
‘‘(e) PENALTIES.—
‘‘(1) USE OF GRANT IN VIOLATION OF THIS PART.—If the
Secretary is made aware, by an audit conducted under chapter
75 of title 31, United States Code, or by any other means,
that a program receiving funds from an allotment made to
a State under subsection (c) has been operated in a manner
that is inconsistent with, or not disclosed in the State applica-
tion approved under subsection (b), the Secretary shall assess
a penalty against the State in an amount equal to not less
than 1 percent and not more than 5 percent of the amount
of the allotment.
‘‘(2) FAILURE TO COMPLY WITH DATA REPORTING REQUIRE-
MENT.—The Secretary shall assess a penalty against a State
that fails during a fiscal year to comply with an information
collection plan implemented under subsection (f ) in an amount
equal to not less than 1 percent and not more than 5 percent
of the amount allotted to the State for the fiscal year.
‘‘(3) PENALTIES BASED ON DEGREE OF NONCOMPLIANCE.—
The Secretary shall assess penalties under this subsection
based on the degree of noncompliance.
‘‘(f ) DATA COLLECTION
AND PERFORMANCE MEASUREMENT.—
‘‘(1) IN GENERAL.—The Secretary, in consultation with State
and local public officials responsible for administering inde-
pendent living and other child welfare programs, child welfare
advocates, Members of Congress, youth service providers, and
researchers, shall—
‘‘(A) develop outcome measures (including measures
of educational attainment, high school diploma, employ-
ment, avoidance of dependency, homelessness, nonmarital
childbirth, incarceration, and high-risk behaviors) that can
be used to assess the performance of States in operating
independent living programs;
‘‘(B) identify data elements needed to track—
‘‘(i) the number and characteristics of children
receiving services under this section;
‘‘(ii) the type and quantity of services being
provided; and
‘‘(iii) State performance on the outcome measures;
and
H. R. 3443—7
‘‘(C) develop and implement a plan to collect the needed
information beginning with the second fiscal year beginning
after the date of the enactment of this section.
‘‘(2) REPORT TO THE CONGRESS.—Within 12 months after
the date of the enactment of this section, the Secretary shall
submit to the Committee on Ways and Means of the House
of Representatives and the Committee on Finance of the Senate
a report detailing the plans and timetable for collecting from
the States the information described in paragraph (1) and a
proposal to impose penalties consistent with paragraph (e)(2)
on States that do not report data.
‘‘(g) EVALUATIONS.—
‘‘(1) IN GENERAL.—The Secretary shall conduct evaluations
of such State programs funded under this section as the Sec-
retary deems to be innovative or of potential national signifi-
cance. The evaluation of any such program shall include
information on the effects of the program on education, employ-
ment, and personal development. To the maximum extent prac-
ticable, the evaluations shall be based on rigorous scientific
standards including random assignment to treatment and con-
trol groups. The Secretary is encouraged to work directly with
State and local governments to design methods for conducting
the evaluations, directly or by grant, contract, or cooperative
agreement.
‘‘(2) FUNDING
OF
EVALUATIONS.—The Secretary shall
reserve 1.5 percent of the amount specified in subsection (h)
for a fiscal year to carry out, during the fiscal year, evaluation,
technical assistance, performance measurement, and data
collection activities related to this section, directly or through
grants, contracts, or cooperative agreements with appropriate
entities.
‘‘(h) LIMITATIONS ON AUTHORIZATION OF APPROPRIATIONS.—To
carry out this section and for payments to States under section
474(a)(4), there are authorized to be appropriated to the Secretary
$140,000,000 for each fiscal year.’’.
(c) PAYMENTS TO STATES.—Section 474(a)(4) of such Act (42
U.S.C. 674(a)(4)) is amended to read as follows:
‘‘(4) the lesser of—
‘‘(A) 80 percent of the amount (if any) by which—
‘‘(i) the total amount expended by the State during
the fiscal year in which the quarter occurs to carry
out programs in accordance with the State application
approved under section 477(b) for the period in which
the quarter occurs (including any amendment that
meets the requirements of section 477(b)(5)); exceeds
‘‘(ii) the total amount of any penalties assessed
against the State under section 477(e) during the fiscal
year in which the quarter occurs; or
‘‘(B) the amount allotted to the State under section
477 for the fiscal year in which the quarter occurs, reduced
by the total of the amounts payable to the State under
this paragraph for all prior quarters in the fiscal year.’’.
(d) REGULATIONS.—Not later than 12 months after the date
of the enactment of this Act, the Secretary of Health and Human
Services shall issue such regulations as may be necessary to carry
out the amendments made by this section.
H. R. 3443—8
(e) SENSE OF THE CONGRESS.—It is the sense of the Congress
that States should provide medical assistance under the State plan
approved under title XIX of the Social Security Act to
18-, 19-, and 20-year-olds who have been emancipated from foster
care.
Subtitle B—Related Foster Care Provision
SEC. 111. INCREASE IN AMOUNT OF ASSETS ALLOWABLE FOR
CHILDREN IN FOSTER CARE.
Section 472(a) of the Social Security Act (42 U.S.C. 672(a))
is amended by adding at the end the following: ‘‘In determining
whether a child would have received aid under a State plan
approved under section 402 (as in effect on July 16, 1996), a
child whose resources (determined pursuant to section 402(a)(7)(B),
as so in effect) have a combined value of not more than $10,000
shall be considered to be a child whose resources have a combined
value of not more than $1,000 (or such lower amount as the State
may determine for purposes of such section 402(a)(7)(B)).’’.
SEC. 112. PREPARATION OF FOSTER PARENTS TO PROVIDE FOR THE
NEEDS OF CHILDREN IN STATE CARE.
(a) STATE PLAN REQUIREMENT.—Section 471(a) of the Social
Security Act (42 U.S.C. 671(a)) is amended—
(1) by striking ‘‘and’’ at the end of paragraph (22);
(2) by striking the period at the end of paragraph (23)
and inserting ‘‘; and’’; and
(3) by adding at the end the following:
‘‘(24) include a certification that, before a child in foster
care under the responsibility of the State is placed with prospec-
tive foster parents, the prospective foster parents will be pre-
pared adequately with the appropriate knowledge and skills
to provide for the needs of the child, and that such preparation
will be continued, as necessary, after the placement of the
child.’’.
(b) EFFECTIVE DATE.—The amendments made by subsection
(a) shall take effect on October 1, 1999.
Subtitle C—Medicaid Amendments
SEC. 121. STATE OPTION OF MEDICAID COVERAGE FOR ADOLESCENTS
LEAVING FOSTER CARE.
(a) IN GENERAL.—Subject to subsection (c), title XIX of the
Social Security Act, is amended—
(1) 
in 
section 
1902(a)(10)(A)(ii) 
(42 
U.S.C.
1396a(a)(10)(A)(ii))—
(A) by striking ‘‘or’’ at the end of subclause (XIII);
(B) by adding ‘‘or’’ at the end of subclause (XIV); and
(C) by adding at the end the following new subclause:
‘‘(XV) who are independent foster care adoles-
cents (as defined in section 1905(v)(1)), or who
are within any reasonable categories of such
adolescents specified by the State;’’; and
(2) by adding at the end of section 1905 (42 U.S.C. 1396d)
the following new subsection:
H. R. 3443—9
‘‘(v)(1) For purposes of this title, the term ‘independent foster
care adolescent’ means an individual—
‘‘(A) who is under 21 years of age;
‘‘(B) who, on the individual’s 18th birthday, was in foster
care under the responsibility of a State; and
‘‘(C) whose assets, resources, and income do not exceed
such levels (if any) as the State may establish consistent with
paragraph (2).
‘‘(2) The levels established by a State under paragraph (1)(C)
may not be less than the corresponding levels applied by the State
under section 1931(b).
‘‘(3) A State may limit the eligibility of independent foster
care adolescents under section 1902(a)(10)(A)(ii)(XV) to those
individuals with respect to whom foster care maintenance payments
or independent living services were furnished under a program
funded under part E of title IV before the date the individuals
attained 18 years of age.’’.
(b) EFFECTIVE DATE.—The amendments made by subsection
(a) apply to medical assistance for items and services furnished
on or after October 1, 1999.
(c) CONTINGENCY IN ENACTMENT.—If the Ticket to Work and
Work Incentives Improvement Act of 1999 is enacted (whether
before, on, or after the date of the enactment of this Act)—
(1) the amendments made by that Act shall be executed
as if this Act had been enacted after the enactment of such
other Act;
(2) with respect to subsection (a)(1)(A) of this section, any
reference to subclause (XIII) is deemed a reference to subclause
(XV);
(3) with respect to subsection (a)(1)(B) of this section, any
reference to subclause (XIV) is deemed a reference to subclause
(XVI);
(4) the subclause (XV) added by subsection (a)(1)(C) of
this section—
(A) is redesignated as subclause (XVII); and
(B) is amended by striking ‘‘section 1905(v)(1)’’ and
inserting ‘‘section 1905(w)(1)’’; and
(5) the subsection (v) added by subsection (a)(2) of this
section—
(A) is redesignated as subsection (w); and
(B) is amended by striking ‘‘1902(a)(10)(A)(ii)(XV)’’ and
inserting ‘‘1902(a)(10)(A)(ii)(XVII)’’.
Subtitle D—Adoption Incentive Payments
SEC. 131. INCREASED FUNDING FOR ADOPTION INCENTIVE PAYMENTS.
(a) SUPPLEMENTAL GRANTS.—Section 473A of the Social Secu-
rity Act (42 U.S.C. 673b) is amended by adding at the end the
following:
‘‘( j) SUPPLEMENTAL GRANTS.—
‘‘(1) IN
GENERAL.—Subject to the availability of such
amounts as may be provided in advance in appropriations
Acts, in addition to any amount otherwise payable under this
section to any State that is an incentive-eligible State for fiscal
year 1998, the Secretary shall make a grant to the State
in an amount equal to the lesser of—
H. R. 3443—10
‘‘(A) the amount by which—
‘‘(i) the amount that would have been payable to
the State under this section during fiscal year 1999
(on the basis of adoptions in fiscal year 1998) in the
absence of subsection (d)(2) if sufficient funds had been
available for the payment; exceeds
‘‘(ii) the amount that, before the enactment of this
subsection, was payable to the State under this section
during fiscal year 1999 (on such basis); or
‘‘(B) the amount that bears the same ratio to the dollar
amount specified in paragraph (2) as the amount described
by subparagraph (A) for the State bears to the aggregate
of the amounts described by subparagraph (A) for all States
that are incentive-eligible States for fiscal year 1998.
‘‘(2) FUNDING.—$23,000,000 of the amounts appropriated
under subsection (h)(1) for fiscal year 2000 may be used for
grants under paragraph (1) of this subsection.’’.
(b) LIMITATION
ON
AUTHORIZATION
OF
APPROPRIATIONS.—
Section 473A(h)(1) of the Social Security Act (42 U.S.C. 673b(h)(1))
is amended to read as follows:
‘‘(1) IN GENERAL.—For grants under subsection (a), there
are authorized to be appropriated to the Secretary—
‘‘(A) $20,000,000 for fiscal year 1999;
‘‘(B) $43,000,000 for fiscal year 2000; and
‘‘(C) $20,000,000 for each of fiscal years 2001 through
2003.’’.
TITLE II—SSI FRAUD PREVENTION
Subtitle A—Fraud Prevention and Related
Provisions
SEC. 201. LIABILITY OF REPRESENTATIVE PAYEES FOR OVERPAY-
MENTS TO DECEASED RECIPIENTS.
(a) AMENDMENT TO TITLE II.—Section 204(a)(2) of the Social
Security Act (42 U.S.C. 404(a)(2)) is amended by adding at the
end the following new sentence: ‘‘If any payment of more than
the correct amount is made to a representative payee on behalf
of an individual after the individual’s death, the representative
payee shall be liable for the repayment of the overpayment, and
the Commissioner of Social Security shall establish an overpayment
control record under the social security account number of the
representative payee.’’.
(b) AMENDMENT TO TITLE XVI.—Section 1631(b)(2) of such Act
(42 U.S.C. 1383(b)(2)) is amended by adding at the end the following
new sentence: ‘‘If any payment of more than the correct amount
is made to a representative payee on behalf of an individual after
the individual’s death, the representative payee shall be liable
for the repayment of the overpayment, and the Commissioner of
Social Security shall establish an overpayment control record under
the social security account number of the representative payee.’’.
(c) EFFECTIVE DATE.—The amendments made by this section
shall apply to overpayments made 12 months or more after the
date of the enactment of this Act.
H. R. 3443—11
SEC. 202. RECOVERY OF OVERPAYMENTS OF SSI BENEFITS FROM
LUMP SUM SSI BENEFIT PAYMENTS.
(a) IN GENERAL.—Section 1631(b)(1)(B)(ii) of the Social Security
Act (42 U.S.C. 1383(b)(1)(B)(ii)) is amended—
(1) by inserting ‘‘monthly’’ before ‘‘benefit payments’’; and
(2) by inserting ‘‘and in the case of an individual or eligible
spouse to whom a lump sum is payable under this title
(including under section 1616(a) of this Act or under an agree-
ment entered into under section 212(a) of Public Law 93–
66) shall, as at least one means of recovering such overpayment,
make the adjustment or recovery from the lump sum payment
in an amount equal to not less than the lesser of the amount
of the overpayment or 50 percent of the lump sum payment,’’
before ‘‘unless fraud’’.
(b) EFFECTIVE DATE.—The amendments made by this section
shall take effect 12 months after the date of the enactment of
this Act and shall apply to amounts incorrectly paid which remain
outstanding on or after such date.
SEC. 203. ADDITIONAL DEBT COLLECTION PRACTICES.
(a) IN GENERAL.—Section 1631(b) of the Social Security Act
(42 U.S.C. 1383(b)) is amended—
(1) by redesignating paragraphs (4) and (5) as paragraphs
(5) and (6), respectively; and
(2) by inserting after paragraph (3) the following:
‘‘(4)(A) With respect to any delinquent amount, the Commis-
sioner of Social Security may use the collection practices described
in sections 3711(f ), 3716, 3717, and 3718 of title 31, United States
Code, and in section 5514 of title 5, United States Code, all as
in effect immediately after the enactment of the Debt Collection
Improvement Act of 1996.
‘‘(B) For purposes of subparagraph (A), the term ‘delinquent
amount’ means an amount—
‘‘(i) in excess of the correct amount of payment under
this title;
‘‘(ii) paid to a person after such person has attained 18
years of age; and
‘‘(iii) determined by the Commissioner of Social Security,
under regulations, to be otherwise unrecoverable under this
section after such person ceases to be a beneficiary under
this title.’’.
(b) CONFORMING AMENDMENTS.—Section 3701(d)(2) of title 31,
United States Code, is amended by striking ‘‘section 204(f )’’ and
inserting ‘‘sections 204(f ) and 1631(b)(4)’’.
(c) TECHNICAL AMENDMENTS.—Section 204(f ) of the Social Secu-
rity Act (42 U.S.C. 404(f )) is amended—
(1) by striking ‘‘3711(e)’’ and inserting ‘‘3711(f )’’; and
(2) by inserting ‘‘all’’ before ‘‘as in effect’’.
(d) EFFECTIVE DATE.—The amendments made by this section
shall apply to debt outstanding on or after the date of the enactment
of this Act.
H. R. 3443—12
SEC. 204. REQUIREMENT TO PROVIDE STATE PRISONER INFORMATION
TO FEDERAL AND FEDERALLY ASSISTED BENEFIT PRO-
GRAMS.
Section 1611(e)(1)(I)(ii)(II) of the Social Security Act (42 U.S.C.
1382(e)(1)(I)(ii)(II)) is amended by striking ‘‘is authorized to’’ and
inserting ‘‘shall’’.
SEC. 205. TREATMENT OF ASSETS HELD IN TRUST UNDER THE SSI
PROGRAM.
(a) TREATMENT
AS RESOURCE.—Section 1613 of the Social
Security Act (42 U.S.C. 1382b) is amended by adding at the end
the following:
‘‘Trusts
‘‘(e)(1) In determining the resources of an individual, paragraph
(3) shall apply to a trust (other than a trust described in paragraph
(5)) established by the individual.
‘‘(2)(A) For purposes of this subsection, an individual shall
be considered to have established a trust if any assets of the
individual (or of the individual’s spouse) are transferred to the
trust other than by will.
‘‘(B) In the case of an irrevocable trust to which are transferred
the assets of an individual (or of the individual’s spouse) and
the assets of any other person, this subsection shall apply to the
portion of the trust attributable to the assets of the individual
(or of the individual’s spouse).
‘‘(C) This subsection shall apply to a trust without regard
to—
‘‘(i) the purposes for which the trust is established;
‘‘(ii) whether the trustees have or exercise any discretion
under the trust;
‘‘(iii) any restrictions on when or whether distributions
may be made from the trust; or
‘‘(iv) any restrictions on the use of distributions from the
trust.
‘‘(3)(A) In the case of a revocable trust established by an indi-
vidual, the corpus of the trust shall be considered a resource avail-
able to the individual.
‘‘(B) In the case of an irrevocable trust established by an indi-
vidual, if there are any circumstances under which payment from
the trust could be made to or for the benefit of the individual
(or of the individual’s spouse), the portion of the corpus from which
payment to or for the benefit of the individual (or of the individual’s
spouse) could be made shall be considered a resource available
to the individual.
‘‘(4) The Commissioner of Social Security may waive the applica-
tion of this subsection with respect to an individual if the Commis-
sioner determines that such application would work an undue hard-
ship (as determined on the basis of criteria established by the
Commissioner) on the individual.
‘‘(5) This subsection shall not apply to a trust described in
subparagraph (A) or (C) of section 1917(d)(4).
‘‘(6) For purposes of this subsection—
‘‘(A) the term ‘trust’ includes any legal instrument or device
that is similar to a trust;
H. R. 3443—13
‘‘(B) the term ‘corpus’ means, with respect to a trust, all
property and other interests held by the trust, including
accumulated earnings and any other addition to the trust after
its establishment (except that such term does not include any
such earnings or addition in the month in which the earnings
or addition is credited or otherwise transferred to the trust);
and
‘‘(C) the term ‘asset’ includes any income or resource of
the individual (or of the individual’s spouse), including—
‘‘(i) any income excluded by section 1612(b);
‘‘(ii) any resource otherwise excluded by this section;
and
‘‘(iii) any other payment or property to which the indi-
vidual (or of the individual’s spouse) is entitled but does
not receive or have access to because of action by—
‘‘(I) the individual or spouse;
‘‘(II) a person or entity (including a court) with
legal authority to act in place of, or on behalf of,
the individual or spouse; or
‘‘(III) a person or entity (including a court) acting
at the direction of, or on the request of, the individual
or spouse.’’.
(b) TREATMENT
AS INCOME.—Section 1612(a)(2) of such Act
(42 U.S.C. 1382a(a)(2)) is amended—
(1) by striking ‘‘and’’ at the end of subparagraph (E);
(2) by striking the period at the end of subparagraph (F)
and inserting ‘‘; and’’; and
(3) by adding at the end the following:
‘‘(G) any earnings of, and additions to, the corpus of a
trust established by an individual (within the meaning of sec-
tion 1613(e)), of which the individual is a beneficiary, to which
section 1613(e) applies, and, in the case of an irrevocable trust,
with respect to which circumstances exist under which a pay-
ment from the earnings or additions could be made to or for
the benefit of the individual.’’.
(c) CONFORMING
AMENDMENTS.—Section 1902(a)(10) of the
Social Security Act (42 U.S.C. 1396a(a)(10)) is amended—
(1) by striking ‘‘and’’ at the end of subparagraph (E);
(2) by adding ‘‘and’’ at the end of subparagraph (F); and
(3) by inserting after subparagraph (F) the following:
‘‘(G) that, in applying eligibility criteria of the supple-
mental security income program under title XVI for pur-
poses of determining eligibility for medical assistance under
the State plan of an individual who is not receiving supple-
mental security income, the State will disregard the provi-
sions of section 1613(e);’’.
(d) EFFECTIVE DATE.—The amendments made by this section
shall take effect on January 1, 2000, and shall apply to trusts
established on or after such date.
SEC. 206. DISPOSAL OF RESOURCES FOR LESS THAN FAIR MARKET
VALUE UNDER THE SSI PROGRAM.
(a) IN GENERAL.—Section 1613(c) of the Social Security Act
(42 U.S.C. 1382b(c)) is amended—
(1) in the caption, by striking ‘‘Notification of Medicaid
Policy Restricting Eligibility of Institutionalized Individuals for
Benefits Based on’’;
H. R. 3443—14
(2) in paragraph (1)—
(A) in subparagraph (A)—
(i) by inserting ‘‘paragraph (1) and’’ after ‘‘provi-
sions of’’;
(ii) by striking ‘‘title XIX’’ the first place it appears
and inserting ‘‘this title and title XIX, respectively,’’;
(iii) by striking ‘‘subparagraph (B)’’ and inserting
‘‘clause (ii)’’;
(iv) by striking ‘‘paragraph (2)’’ and inserting
‘‘subparagraph (B)’’;
(B) in subparagraph (B)—
(i) by striking ‘‘by the State agency’’; and
(ii) by striking ‘‘section 1917(c)’’ and all that follows
and inserting ‘‘paragraph (1) or section 1917(c).’’; and
(C) by redesignating subparagraphs (A) and (B) as
clauses (i) and (ii), respectively;
(3) in paragraph (2)—
(A) by striking ‘‘(2)’’ and inserting ‘‘(B)’’; and
(B) by striking ‘‘paragraph (1)(B)’’ and inserting
‘‘subparagraph (A)(ii)’’;
(4) by striking ‘‘(c)(1)’’ and inserting ‘‘(2)(A)’’; and
(5) by inserting before paragraph (2) (as so redesignated
by paragraph (4) of this subsection) the following:
‘‘(c)(1)(A)(i) If an individual or the spouse of an individual
disposes of resources for less than fair market value on or after
the look-back date described in clause (ii)(I), the individual is ineli-
gible for benefits under this title for months during the period
beginning on the date described in clause (iii) and equal to the
number of months calculated as provided in clause (iv).
‘‘(ii)(I) The look-back date described in this subclause is a
date that is 36 months before the date described in subclause
(II).
‘‘(II) The date described in this subclause is the date on which
the individual applies for benefits under this title or, if later,
the date on which the individual (or the spouse of the individual)
disposes of resources for less than fair market value.
‘‘(iii) The date described in this clause is the first day of the
first month in or after which resources were disposed of for less
than fair market value and which does not occur in any other
period of ineligibility under this paragraph.
‘‘(iv) The number of months calculated under this clause shall
be equal to—
‘‘(I) the total, cumulative uncompensated value of all
resources so disposed of by the individual (or the spouse of
the individual) on or after the look-back date described in
clause (ii)(I); divided by
‘‘(II) the amount of the maximum monthly benefit payable
under section 1611(b), plus the amount (if any) of the maximum
State supplementary payment corresponding to the State’s pay-
ment level applicable to the individual’s living arrangement
and eligibility category that would otherwise be payable to
the individual by the Commissioner pursuant to an agreement
under section 1616(a) of this Act or section 212(b) of Public
Law 93–66, for the month in which occurs the date described
in clause (ii)(II),
rounded, in the case of any fraction, to the nearest whole number,
but shall not in any case exceed 36 months.
H. R. 3443—15
‘‘(B)(i) Notwithstanding subparagraph (A), this subsection shall
not apply to a transfer of a resource to a trust if the portion
of the trust attributable to the resource is considered a resource
available to the individual pursuant to subsection (e)(3) (or would
be so considered but for the application of subsection (e)(4)).
‘‘(ii) In the case of a trust established by an individual or
an individual’s spouse (within the meaning of subsection (e)), if
from such portion of the trust, if any, that is considered a resource
available to the individual pursuant to subsection (e)(3) (or would
be so considered but for the application of subsection (e)(4)) or
the residue of the portion on the termination of the trust—
‘‘(I) there is made a payment other than to or for the
benefit of the individual; or
‘‘(II) no payment could under any circumstance be made
to the individual,
then, for purposes of this subsection, the payment described in
clause (I) or the foreclosure of payment described in clause (II)
shall be considered a transfer of resources by the individual or
the individual’s spouse as of the date of the payment or foreclosure,
as the case may be.
‘‘(C) An individual shall not be ineligible for benefits under
this title by reason of the application of this paragraph to a disposal
of resources by the individual or the spouse of the individual,
to the extent that—
‘‘(i) the resources are a home and title to the home was
transferred to—
‘‘(I) the spouse of the transferor;
‘‘(II) a child of the transferor who has not attained
21 years of age, or is blind or disabled;
‘‘(III) a sibling of the transferor who has an equity
interest in such home and who was residing in the trans-
feror’s home for a period of at least 1 year immediately
before the date the transferor becomes an institutionalized
individual; or
‘‘(IV) a son or daughter of the transferor (other than
a child described in subclause (II)) who was residing in
the transferor’s home for a period of at least 2 years imme-
diately before the date the transferor becomes an institu-
tionalized individual, and who provided care to the trans-
feror which permitted the transferor to reside at home
rather than in such an institution or facility;
‘‘(ii) the resources—
‘‘(I) were transferred to the transferor’s spouse or to
another for the sole benefit of the transferor’s spouse;
‘‘(II) were transferred from the transferor’s spouse to
another for the sole benefit of the transferor’s spouse;
‘‘(III) were transferred to, or to a trust (including a
trust described in section 1917(d)(4)) established solely for
the benefit of, the transferor’s child who is blind or disabled;
or
‘‘(IV) were transferred to a trust (including a trust
described in section 1917(d)(4)) established solely for the
benefit of an individual who has not attained 65 years
of age and who is disabled;
‘‘(iii) a satisfactory showing is made to the Commissioner
of Social Security (in accordance with regulations promulgated
by the Commissioner) that—
H. R. 3443—16
‘‘(I) the individual who disposed of the resources
intended to dispose of the resources either at fair market
value, or for other valuable consideration;
‘‘(II) the resources were transferred exclusively for a
purpose other than to qualify for benefits under this title;
or
‘‘(III) all resources transferred for less than fair market
value have been returned to the transferor; or
‘‘(iv) the Commissioner determines, under procedures estab-
lished by the Commissioner, that the denial of eligibility would
work an undue hardship as determined on the basis of criteria
established by the Commissioner.
‘‘(D) For purposes of this subsection, in the case of a resource
held by an individual in common with another person or persons
in a joint tenancy, tenancy in common, or similar arrangement,
the resource (or the affected portion of such resource) shall be
considered to be disposed of by the individual when any action
is taken, either by the individual or by any other person, that
reduces or eliminates the individual’s ownership or control of such
resource.
‘‘(E) In the case of a transfer by the spouse of an individual
that results in a period of ineligibility for the individual under
this subsection, the Commissioner shall apportion the period (or
any portion of the period) among the individual and the individual’s
spouse if the spouse becomes eligible for benefits under this title.
‘‘(F) For purposes of this paragraph—
‘‘(i) the term ‘benefits under this title’ includes payments
of the type described in section 1616(a) of this Act and of
the type described in section 212(b) of Public Law 93–66;
‘‘(ii) the term ‘institutionalized individual’ has the meaning
given such term in section 1917(e)(3); and
‘‘(iii) the term ‘trust’ has the meaning given such term
in subsection (e)(6)(A) of this section.’’.
(b) CONFORMING AMENDMENT.—Section 1902(a)(10) of the Social
Security Act (42 U.S.C. 1396a(a)(10)), as amended by section 205(c)
of this Act, is amended by striking ‘‘section 1613(e)’’ and inserting
‘‘subsections (c) and (e) of section 1613’’.
(c) EFFECTIVE DATE.—The amendments made by this section
shall be effective with respect to disposals made on or after the
date of the enactment of this Act.
SEC. 207. ADMINISTRATIVE PROCEDURE FOR IMPOSING PENALTIES
FOR FALSE OR MISLEADING STATEMENTS.
(a) IN GENERAL.—Part A of title XI of the Social Security
Act (42 U.S.C. 1301 et seq.) is amended by inserting after section
1129 the following:
‘‘SEC. 1129A. ADMINISTRATIVE PROCEDURE FOR IMPOSING PENALTIES
FOR FALSE OR MISLEADING STATEMENTS.
‘‘(a) IN GENERAL.—Any person who makes, or causes to be
made, a statement or representation of a material fact for use
in determining any initial or continuing right to or the amount
of—
‘‘(1) monthly insurance benefits under title II; or
‘‘(2) benefits or payments under title XVI,
that the person knows or should know is false or misleading or
knows or should know omits a material fact or who makes such
a statement with knowing disregard for the truth shall be subject
H. R. 3443—17
to, in addition to any other penalties that may be prescribed by
law, a penalty described in subsection (b) to be imposed by the
Commissioner of Social Security.
‘‘(b) PENALTY.—The penalty described in this subsection is—
‘‘(1) nonpayment of benefits under title II that would other-
wise be payable to the person; and
‘‘(2) ineligibility for cash benefits under title XVI,
for each month that begins during the applicable period described
in subsection (c).
‘‘(c) DURATION OF PENALTY.—The duration of the applicable
period, with respect to a determination by the Commissioner under
subsection (a) that a person has engaged in conduct described
in subsection (a), shall be—
‘‘(1) six consecutive months, in the case of the first such
determination with respect to the person;
‘‘(2) twelve consecutive months, in the case of the second
such determination with respect to the person; and
‘‘(3) twenty-four consecutive months, in the case of the
third or subsequent such determination with respect to the
person.
‘‘(d) EFFECT ON OTHER ASSISTANCE.—A person subject to a
period of nonpayment of benefits under title II or ineligibility for
title XVI benefits by reason of this section nevertheless shall be
considered to be eligible for and receiving such benefits, to the
extent that the person would be receiving or eligible for such bene-
fits but for the imposition of the penalty, for purposes of—
‘‘(1) determination of the eligibility of the person for benefits
under titles XVIII and XIX; and
‘‘(2) determination of the eligibility or amount of benefits
payable under title II or XVI to another person.
‘‘(e) DEFINITION.—In this section, the term ‘benefits under title
XVI’ includes State supplementary payments made by the Commis-
sioner pursuant to an agreement under section 1616(a) of this
Act or section 212(b) of Public Law 93–66.
‘‘(f ) CONSULTATIONS.—The Commissioner of Social Security
shall consult with the Inspector General of the Social Security
Administration regarding initiating actions under this section.’’.
(b) CONFORMING AMENDMENT PRECLUDING DELAYED RETIRE-
MENT CREDIT FOR ANY MONTH TO WHICH A NONPAYMENT OF BENE-
FITS PENALTY APPLIES.—Section 202(w)(2)(B) of such Act (42 U.S.C.
402(w)(2)(B)) is amended—
(1) by striking ‘‘and’’ at the end of clause (i);
(2) by striking the period at the end of clause (ii) and
inserting ‘‘, and’’; and
(3) by adding at the end the following:
‘‘(iii) such individual was not subject to a penalty
imposed under section 1129A.’’.
(c) ELIMINATION OF REDUNDANT PROVISION.—Section 1611(e)
of such Act (42 U.S.C. 1382(e)) is amended—
(1) by striking paragraph (4);
(2) in paragraph (6)(A)(i), by striking ‘‘(5)’’ and inserting
‘‘(4)’’; and
(3) by redesignating paragraphs (5) and (6) as paragraphs
(4) and (5), respectively.
(d) REGULATIONS.—Within 6 months after the date of the enact-
ment of this Act, the Commissioner of Social Security shall develop
regulations that prescribe the administrative process for making
H. R. 3443—18
determinations under section 1129A of the Social Security Act
(including when the applicable period in subsection (c) of such
section shall commence), and shall provide guidance on the exercise
of discretion as to whether the penalty should be imposed in par-
ticular cases.
(e) EFFECTIVE DATE.—The amendments made by this section
shall apply to statements and representations made on or after
the date of the enactment of this Act.
SEC. 208. EXCLUSION OF REPRESENTATIVES AND HEALTH CARE
PROVIDERS CONVICTED OF VIOLATIONS FROM PARTICI-
PATION IN SOCIAL SECURITY PROGRAMS.
(a) IN GENERAL.—Part A of title XI of the Social Security
Act is amended by inserting before section 1137 (42 U.S.C. 1320b–
7) the following:
‘‘EXCLUSION
OF
REPRESENTATIVES
AND
HEALTH
CARE
PROVIDERS
CONVICTED OF VIOLATIONS FROM PARTICIPATION IN SOCIAL SECU-
RITY PROGRAMS
‘‘SEC. 1136. (a) IN GENERAL.—The Commissioner of Social Secu-
rity shall exclude from participation in the social security programs
any representative or health care provider—
‘‘(1) who is convicted of a violation of section 208 or 1632
of this Act;
‘‘(2) who is convicted of any violation under title 18, United
States Code, relating to an initial application for or continuing
entitlement to, or amount of, benefits under title II of this
Act, or an initial application for or continuing eligibility for,
or amount of, benefits under title XVI of this Act; or
‘‘(3) who the Commissioner determines has committed an
offense described in section 1129(a)(1) of this Act.
‘‘(b) NOTICE, EFFECTIVE DATE, AND PERIOD OF EXCLUSION.—
(1) An exclusion under this section shall be effective at such time,
for such period, and upon such reasonable notice to the public
and to the individual excluded as may be specified in regulations
consistent with paragraph (2).
‘‘(2) Such an exclusion shall be effective with respect to services
furnished to any individual on or after the effective date of the
exclusion. Nothing in this section may be construed to preclude,
in determining disability under title II or title XVI, consideration
of any medical evidence derived from services provided by a health
care provider before the effective date of the exclusion of the health
care provider under this section.
‘‘(3)(A) The Commissioner shall specify, in the notice of exclu-
sion under paragraph (1), the period of the exclusion.
‘‘(B) Subject to subparagraph (C), in the case of an exclusion
under subsection (a), the minimum period of exclusion shall be
5 years, except that the Commissioner may waive the exclusion
in the case of an individual who is the sole source of essential
services in a community. The Commissioner’s decision whether
to waive the exclusion shall not be reviewable.
‘‘(C) In the case of an exclusion of an individual under sub-
section (a) based on a conviction or a determination described
in subsection (a)(3) occurring on or after the date of the enactment
of this section, if the individual has (before, on, or after such
date of the enactment) been convicted, or if such a determination
has been made with respect to the individual—
H. R. 3443—19
‘‘(i) on one previous occasion of one or more offenses for
which an exclusion may be effected under such subsection,
the period of the exclusion shall be not less than 10 years;
or
‘‘(ii) on two or more previous occasions of one or more
offenses for which an exclusion may be effected under such
subsection, the period of the exclusion shall be permanent.
‘‘(c) NOTICE
TO STATE AGENCIES.—The Commissioner shall
promptly notify each appropriate State agency employed for the
purpose of making disability determinations under section 221 or
1633(a)—
‘‘(1) of the fact and circumstances of each exclusion effected
against an individual under this section; and
‘‘(2) of the period (described in subsection (b)(3)) for which
the State agency is directed to exclude the individual from
participation in the activities of the State agency in the course
of its employment.
‘‘(d) NOTICE
TO STATE LICENSING AGENCIES.—The Commis-
sioner shall—
‘‘(1) promptly notify the appropriate State or local agency
or authority having responsibility for the licensing or certifi-
cation of an individual excluded from participation under this
section of the fact and circumstances of the exclusion;
‘‘(2) request that appropriate investigations be made and
sanctions invoked in accordance with applicable State law and
policy; and
‘‘(3) request that the State or local agency or authority
keep the Commissioner and the Inspector General of the Social
Security Administration fully and currently informed with
respect to any actions taken in response to the request.
‘‘(e) NOTICE, HEARING, AND JUDICIAL REVIEW.—(1) Any indi-
vidual who is excluded (or directed to be excluded) from participa-
tion under this section is entitled to reasonable notice and oppor-
tunity for a hearing thereon by the Commissioner to the same
extent as is provided in section 205(b), and to judicial review of
the Commissioner’s final decision after such hearing as is provided
in section 205(g).
‘‘(2) The provisions of section 205(h) shall apply with respect
to this section to the same extent as it is applicable with respect
to title II.
‘‘(f ) APPLICATION FOR TERMINATION OF EXCLUSION.—(1) An indi-
vidual excluded from participation under this section may apply
to the Commissioner, in the manner specified by the Commissioner
in regulations and at the end of the minimum period of exclusion
provided under subsection (b)(3) and at such other times as the
Commissioner may provide, for termination of the exclusion effected
under this section.
‘‘(2) The Commissioner may terminate the exclusion if the
Commissioner determines, on the basis of the conduct of the
applicant which occurred after the date of the notice of exclusion
or which was unknown to the Commissioner at the time of the
exclusion, that—
‘‘(A) there is no basis under subsection (a) for a continuation
of the exclusion; and
‘‘(B) there are reasonable assurances that the types of
actions which formed the basis for the original exclusion have
not recurred and will not recur.