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 consider-
ation 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Social Security Fraud 
and Error Prevention Act of 2014’’. 
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SEC. 2. FRAUD AND ERROR PREVENTION. 
(a) IN GENERAL.—Section 201 of the Social Security 
Act (42 U.S.C. 401 et seq.) is amended by striking sub-
section (n) and inserting the following: 
‘‘(n) FRAUD AND ERROR PREVENTION.— 
‘‘(1) Subject to paragraph (4), there is hereby 
appropriated from any one or all of the Trust Funds 
to the Social Security Administration for each fiscal 
year beginning with fiscal year 2015 for fraud and 
error prevention activities described in paragraph 
(3), in addition to any other amounts otherwise ap-
propriated for such fiscal year, an amount equal to 
the sum of— 
‘‘(A) the applicable dollar amount (deter-
mined under paragraph (2)), plus 
‘‘(B) an amount equal to the sum of any 
fines or other monetary penalties recovered in 
the previous fiscal year pursuant to sections 
208(a), 1129(a), 1140 (to the extent that such 
penalties are imposed for misuse of words, let-
ters, symbols, or emblems relating to the Social 
Security Administration), and 1632(a). 
‘‘(2) The applicable dollar amount determined 
under this clause is— 
‘‘(A) for fiscal year 2015, $1,750,000,000; 
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‘‘(F) Quality reviews of decisions made by 
an administrative law judge under this title or 
title XVI in accordance with section 221(n). 
‘‘(G) Recovery of overpayments under sec-
tions 204 and 1631(b). 
‘‘(H) Recovery of civil penalties imposed 
under sections 1129 and 1140. 
‘‘(I) Supporting prosecution of felonies 
under section 208. 
‘‘(4) Funds appropriated under paragraph (1) 
for a fiscal year shall not be available for obligation 
until the report required to be submitted under 
paragraph (5) 60 days prior to the beginning of 
such fiscal year has been submitted. 
‘‘(5) Not later than 60 days prior to the begin-
ning of each fiscal year after 2014, the Commis-
sioner of Social Security shall submit a report to the 
Committee on Ways and Means of the House of 
Representatives, the Committee on Finance of the 
Senate, and the Office of Management and Budget 
that includes the following: 
‘‘(A) A plan for conducting the fraud and 
error prevention activities described in para-
graph (3) in such fiscal year, including— 
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‘‘(i) an itemized statement of the dol-
lar amounts expected to be spent on each 
such activity during such fiscal year; 
‘‘(ii) an itemized statement of the esti-
mated long-term savings to the Trust 
Funds and the Treasury expected to be ob-
tained as a result of each such activity, 
and a statement of the estimated total 
value of benefits paid under this title solely 
as a result of such activities; 
‘‘(iii) performance targets for each 
such activity; and 
‘‘(iv) a certification from the Chief 
Actuary of the Social Security Administra-
tion that the plan will improve the actu-
arial status of the Trust Funds. 
‘‘(B) An assessment of the fraud and error 
prevention activities described in paragraph (3) 
conducted in the previous fiscal year, includ-
ing— 
‘‘(i) an itemized statement of the dol-
lar amounts spent on each such activity 
during such fiscal year; 
‘‘(ii) an itemized statement of the esti-
mated long-term savings to the Trust 
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Funds and the Treasury obtained as a re-
sult of each such activity, and a statement 
of the estimated total value of benefits 
paid under this title solely as a result of 
such activities; 
‘‘(iii) an assessment of the extent to 
which performance targets set in the appli-
cable plan for such fiscal year were met; 
‘‘(iv) an explanation and a corrective 
action plan for any failure to meet such 
performance targets; and 
‘‘(v) an assessment of whether funds 
made available under paragraph (1) for 
such fiscal year were adequate to protect 
the Trust Funds from fraud and errors, an 
explanation of any such funds that re-
mained unobligated at the end of the fiscal 
year, and recommendations for needed ad-
justments to future funding in order to 
protect the Trust Funds from fraud and 
errors and any additional cost-effective 
strategies for improving the actuarial sta-
tus of the Trust Funds. 
‘‘(6) Of the discretionary amounts made avail-
able for ‘Social Security Administration—Limitation 
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on Administrative Expenses’ for each fiscal year be-
ginning with fiscal year 2015, the amount obligated 
for the activities described in paragraph (3) shall be 
not less than the sum of— 
‘‘(A) $273,000,000; plus 
‘‘(B) the amount obligated from funds 
made available for ‘Social Security Administra-
tion—Limitation on Administrative Expenses’ 
for fiscal year 2013 for the activities described 
in subparagraphs (C) through (I) of paragraph 
(3).’’. 
SEC. 3. EXPANSION OF COOPERATIVE DISABILITY INVES-
TIGATIONS UNITS. 
Not later than October 1, 2017, the Commissioner 
of Social Security shall take any necessary actions to en-
sure that cooperative disability investigations (CDI) units 
have been established for each of the 50 States, the Dis-
trict of Columbia, Puerto Rico, Guam, the Northern Mar-
iana Islands, the Virgin Islands, and American Samoa. 
SEC. 4. CODIFICATION OF REQUIREMENT TO CONDUCT 
QUALITY REVIEWS. 
Section 221 of the Social Security Act is amended 
by adding at the end the following: 
‘‘(n)(1) The Commissioner of Social Security shall 
conduct quality reviews in accordance with section 969 of 
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part 404 of title 20, Code of Federal Regulations, in cases 
described in section 970(a) of such part (as such sections 
were in effect on January 1, 2014) with respect to deci-
sions in connection with applications for benefits under 
this title and title XVI, in a sufficient number to ensure 
compliance with laws, regulations, and other guidance 
issued by the Commissioner of Social Security. 
‘‘(2) The Commissioner of Social Security shall annu-
ally submit to the Committee on Ways and Means of the 
House of Representatives and the Committee on Finance 
of the Senate a report that includes— 
‘‘(A) the total number of cases selected for a 
quality review as described in paragraph (1); 
‘‘(B) the number of such cases in which a deci-
sion is remanded; and 
‘‘(C) the number of such cases in which a deci-
sion is modified or reversed.’’. 
SEC. 5. REPORT ON WORK-RELATED CONTINUING DIS-
ABILITY REVIEWS. 
Section 223 of the Social Security Act is amended 
by adding at the end the following: 
‘‘(k) REPORT ON WORK-RELATED CONTINUING DIS-
ABILITY REVIEWS.—The Commissioner of Social Security 
shall annually submit to the Committee on Ways and 
Means of the House of Representatives and the Committee 
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on Finance of the Senate a report on the number of work- 
related continuing disability reviews conducted pursuant 
to subsection (f). Such report shall include— 
‘‘(1) the total number of reports of earnings re-
ceived by the Commissioner in the previous calendar 
year from individuals receiving benefits on account 
of disability under this title or title XVI; 
‘‘(2) the number of such reports that resulted 
in a determination by the Commissioner to conduct 
a work-related continuing disability review with re-
spect to the beneficiary to whom such report per-
tains, and the basis on which such determinations 
were made; 
‘‘(3) in the case of a beneficiary selected for a 
work-related continuing disability review on the basis 
of a report of earnings— 
‘‘(A) the average number of days between 
the submission of the report and the initiation 
of the review, and the average number of days 
between the initiation and the completion of the 
review; 
‘‘(B) the number of such reviews com-
pleted during such calendar year, and the num-
ber of such reviews that result in a suspension 
or termination of benefits; and 
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‘‘(C) the number of such reviews that had 
not been completed as of the end of such cal-
endar year; 
‘‘(4) the total savings to the Trust Funds and 
the Treasury generated from benefits terminated as 
a result of such reviews; and 
‘‘(5) with respect to individuals for whom a 
work-related continuing disability review was com-
pleted during such calendar year— 
‘‘(A) the number who participated in the 
Ticket to Work program under section 1148 
during such calendar year; 
‘‘(B) the number who used any program 
work incentives during such calendar year; and 
‘‘(C) the number who received vocational 
rehabilitation services during such calendar 
year with respect to which the Commissioner of 
Social Security reimbursed a State agency 
under section 222(d).’’. 
SEC. 6. COORDINATION OF REPORTS RELATING TO DIS-
ABILITY BENEFITS. 
Section 221(i)(3) of the Social Security Act (42 
U.S.C. 421(i)(3)) is amended by adding at the end the 
following: ‘‘To the extent the Commissioner of Social Se-
curity determines to be necessary for maximum efficiency, 
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the Commissioner may submit a combined report con-
sisting of the information required to be submitted under 
this paragraph, subsection (c)(3)(C), subsection (n)(2), 
section 201(n)(5), and section 223(k).’’. 
SEC. 7. INCREASED PENALTIES IN CERTAIN CASES OF 
FRAUD. 
(a) CONSPIRACY TO COMMIT SOCIAL SECURITY 
FRAUD.—Section 208(a) of the Social Security Act (42 
U.S.C. 408(a)) is amended— 
(1) in paragraph (7)(C), by striking ‘‘or’’ at the 
end; 
(2) in paragraph (8), by adding ‘‘or’’ at the 
end; and 
(3) by inserting after paragraph (8) the fol-
lowing: 
‘‘(9) conspires to commit any offense described in any 
of paragraphs (1) through (4),’’. 
(b) INCREASED CRIMINAL PENALTIES FOR CERTAIN 
INDIVIDUALS IN POSITIONS OF TRUST.—Section 208(a) 
of such Act (42 U.S.C. 408(a)), as amended by subsection 
(a), is further amended by striking the period at the end 
and inserting ‘‘, except that in the case of a person who 
receives a fee or other income for services performed in 
connection with any determination with respect to benefits 
under this title, or who is a physician or other health care 
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provider who submits medical evidence in connection with 
any such determination, such person shall be guilty of a 
felony and upon conviction thereof shall be fined under 
title 18, United States Code, or imprisoned for not more 
than ten years, or both.’’. 
(c) INCREASED CIVIL PENALTIES FOR CERTAIN IN-
DIVIDUALS IN POSITIONS OF TRUST.—Section 1129(a)(1) 
of such Act (42 U.S.C. 1320a–8(a)(1)) is amended, in the 
matter following subparagraph (C), by inserting after 
‘‘withholding disclosure of such fact’’ the following: ‘‘, ex-
cept that in the case of such a person who receives a fee 
or other income for services performed in connection with 
any such determination or who is a physician or other 
health care provider who submits medical evidence in con-
nection with any such determination, the amount of such 
penalty shall be not more than $7,500’’. 
(d) REFERENCES TO SOCIAL SECURITY AND MEDI-
CARE
IN
ELECTRONIC
COMMUNICATIONS.—Section 
1140(a)(1) of the Social Security Act (42 U.S.C. 1320b– 
10(a)(1)) is amended by inserting ‘‘(including any elec-
tronic communication)’’ after ‘‘or other communication’’. 
(e) INFLATION ADJUSTMENT
OF CERTAIN CIVIL 
PENALTIES.—Title XI of the Social Security Act is 
amended by inserting after section 1129B the following: 
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‘‘SEC. 1129C. CIVIL PENALTY INFLATION ADJUSTMENT. 
‘‘(a) ADJUSTMENT BY REGULATION.—The Commis-
sioner of Social Security shall, not later than 180 days 
after the date of enactment of the Social Security Fraud 
and Error Prevention Act of 2014, and at least once every 
4 years thereafter— 
‘‘(1) by regulation adjust the maximum amount 
of each civil monetary penalty by the inflation ad-
justment described under subsection (b); and 
‘‘(2) publish each such regulation in the Fed-
eral Register. 
‘‘(b) AMOUNT OF ADJUSTMENT.—The inflation ad-
justment under subsection (a) shall be determined by in-
creasing the maximum amount of each civil monetary pen-
alty by the cost-of-living adjustment. Any increase deter-
mined under this subsection shall be rounded to the near-
est— 
‘‘(1) multiple of $1,000 in the case of penalties 
greater than $1,000 but less than or equal to 
$10,000; and 
‘‘(2) multiple of $5,000 in the case of penalties 
greater than $10,000 but less than or equal to 
$100,000. 
‘‘(c) DEFINITIONS.—For purposes of this section— 
‘‘(1) the term ‘civil monetary penalty’ means— 
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‘‘(A) a penalty imposed by paragraph (1) 
or (3) of section 1129(a); and 
‘‘(B) a penalty imposed by paragraph (1) 
or (2) of section 1140(b). 
‘‘(2) the term ‘cost-of-living adjustment’ means 
the percentage (if any) for each civil monetary pen-
alty by which— 
‘‘(A) the Consumer Price Index for the 
month of June of the calendar year preceding 
the adjustment, exceeds 
‘‘(B) the Consumer Price Index for the 
month of June of the calendar year in which 
the amount of such civil monetary penalty was 
last set or adjusted pursuant to law. 
‘‘(d) APPLICATION
OF
INCREASE.—Any increase 
under this Act in a civil monetary penalty shall apply only 
to violations which occur after the date the increase takes 
effect.’’. 
SEC. 8. EXCLUSION OF CERTAIN MEDICAL EVIDENCE IN 
DISABILITY CASES. 
(a) IN GENERAL.—Section 223(d)(5) of the Social 
Security Act (42 U.S.C. 423(d)(5)) is amended by adding 
at the end the following: 
‘‘(C) In making any determination with respect to 
whether an individual is under a disability or continues 
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to be under a disability, the Commissioner of Social Secu-
rity may not consider, except for good cause as determined 
by the Commissioner, any evidence furnished by a physi-
cian or other health care provider who— 
‘‘(i) has been barred from practice in any State; 
or 
‘‘(ii) has been assessed a penalty under section 
1128 or 1129 for the submission of false evidence.’’. 
(b) REGULATIONS.—Not later than 1 year after the 
date of the enactment of this Act, the Commissioner of 
Social Security shall issue regulations to carry out the 
amendment made by subsection (a). 
(c) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply with respect to determinations 
of disability made on or after the date that is 1 year after 
the date of enactment of this Act. 
SEC. 9. REPEAL OF PROGRAM INTEGRITY ADJUSTMENTS 
TO DISCRETIONARY SPENDING LIMITS. 
Section 251(b)(2)(B)(i) of the Balanced Budget and 
Emergency Deficit Control Act of 1985 is amended— 
(1) in subclause (II), by adding ‘‘and’’ at the 
end; 
(2) in subclause (III), by striking the semicolon 
at the end and inserting a period; and 
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(3) by striking subclauses (IV) through (X). 
Æ 
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