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 So-
cial Security Administration to provide such indi-
viduals 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 dis-
abilities, to establish a Ticket to Work and Self-Suffi-
ciency Program in the Social Security Administration
to provide such individuals with meaningful opportunities
to work, 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; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Ticket to Work and Work Incentives Improvement Act
of 1999’’.
(b) TABLE OF CONTENTS.—The table of contents is
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 dis-
abled 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 au-
thority.
Sec. 302. Demonstration projects providing for reductions in disability insur-
ance benefits based on earnings.
Sec. 303. Studies and reports.
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 secu-
rity 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.
TITLE I—TICKET TO WORK AND
SELF-SUFFICIENCY AND RE-
LATED PROVISIONS
Subtitle A—Ticket to Work and
Self-Sufficiency
SEC. 101. ESTABLISHMENT OF THE TICKET TO WORK AND
SELF-SUFFICIENCY PROGRAM.
(a) IN GENERAL.—Part A of title XI of the Social
Security Act (42 U.S.C. 1301 et seq.) is amended by add-
ing after section 1147 (as added by section 8 of the Non-
citizen Benefit Clarification and Other Technical Amend-
ments Act of 1998 (Public Law 105–306; 112 Stat.
2928)) the following:
‘‘THE TICKET TO WORK AND SELF-SUFFICIENCY
PROGRAM
‘‘SEC. 1148. (a) IN GENERAL.—The Commissioner
of Social Security shall establish a Ticket to Work and
Self-Sufficiency Program, under which a disabled bene-
ficiary may use a ticket to work and self-sufficiency issued
by the Commissioner in accordance with this section to
obtain employment services, vocational rehabilitation serv-
ices, or other support services from an employment net-
work which is of the beneficiary’s choice and which is will-
ing to provide such services to such beneficiary.
‘‘(b) TICKET SYSTEM.—
‘‘(1) DISTRIBUTION
OF
TICKETS.—The Com-
missioner of Social Security may issue a ticket to
work and self-sufficiency to disabled beneficiaries for
participation in the Program.
‘‘(2) ASSIGNMENT
OF
TICKETS.—A disabled
beneficiary holding a ticket to work and self-suffi-
ciency may assign the ticket to any employment net-
work of the beneficiary’s choice which is serving
under the Program and is willing to accept the as-
signment.
‘‘(3) TICKET
TERMS.—A ticket issued under
paragraph (1) shall consist of a document which evi-
dences the Commissioner’s agreement to pay (as
provided in paragraph (4)) an employment network,
which is serving under the Program and to which
such ticket is assigned by the beneficiary, for such
employment services, vocational rehabilitation serv-
ices, and other support services as the employment
network may provide to the beneficiary.
‘‘(4) 
PAYMENTS
TO
EMPLOYMENT
NET-
WORKS.—The Commissioner shall pay an employ-
ment network under the Program in accordance with
the outcome payment system under subsection
(h)(2) or under the outcome-milestone payment sys-
tem under subsection (h)(3) (whichever is elected
pursuant to subsection (h)(1)). An employment net-
work may not request or receive compensation for
such services from the beneficiary.
‘‘(c) STATE PARTICIPATION.—
‘‘(1) IN GENERAL.—Each State agency admin-
istering or supervising the administration of the
State plan approved under title I of the Rehabilita-
tion Act of 1973 may elect to participate in the Pro-
gram as an employment network with respect to a
disabled beneficiary. If the State agency does elect
to participate in the Program, the State agency also
shall elect to be paid under the outcome payment
system or the outcome-milestone payment system in
accordance with subsection (h)(1). With respect to a
disabled beneficiary that the State agency does not
elect to have participate in the Program, the State
agency shall be paid for services provided to that
beneficiary under the system for payment applicable
under section 222(d) and subsections (d) and (e) of
section 1615. The Commissioner shall provide for
periodic opportunities for exercising such elections.
‘‘(2) EFFECT
OF
PARTICIPATION
BY
STATE
AGENCY.—
‘‘(A) STATE AGENCIES PARTICIPATING.—
In any case in which a State agency described
in paragraph (1) elects under that paragraph to
participate in the Program, the employment
services, vocational rehabilitation services, and
other support services which, upon assignment
of tickets to work and self-sufficiency, are pro-
vided to disabled beneficiaries by the State
agency acting as an employment network shall
be governed by plans for vocational rehabilita-
tion services approved under title I of the Reha-
bilitation Act of 1973.
‘‘(B) STATE
AGENCIES
ADMINISTERING
MATERNAL AND CHILD HEALTH SERVICES PRO-
GRAMS.—Subparagraph (A) shall not apply
with respect to any State agency administering
a program under title V of this Act.
‘‘(3) AGREEMENTS BETWEEN STATE AGENCIES
AND EMPLOYMENT NETWORKS.—State agencies and
employment networks shall enter into agreements re-
garding the conditions under which services will be
provided when an individual is referred by an em-
ployment network to a State agency for services.
The Commissioner of Social Security shall establish
by regulations the timeframe within which such
agreements must be entered into and the mecha-
nisms for dispute resolution between State agencies
and employment networks with respect to such
agreements.
‘‘(d) RESPONSIBILITIES OF THE COMMISSIONER OF
SOCIAL SECURITY.—
‘‘(1) SELECTION AND QUALIFICATIONS OF PRO-
GRAM MANAGERS.—The Commissioner of Social Se-
curity shall enter into agreements with 1 or more or-
ganizations in the private or public sector for service
as a program manager to assist the Commissioner in
administering the Program. Any such program man-
ager shall be selected by means of a competitive bid-
ding process, from among organizations in the pri-
vate or public sector with available expertise and ex-
perience in the field of vocational rehabilitation or
employment services.
‘‘(2) TENURE, RENEWAL, AND EARLY TERMI-
NATION.—Each agreement entered into under para-
graph (1) shall provide for early termination upon
failure to meet performance standards which shall be
specified in the agreement and which shall be
weighted to take into account any performance in
prior terms. Such performance standards shall
include—
‘‘(A) measures for ease of access by bene-
ficiaries to services; and
‘‘(B) measures for determining the extent
to which failures in obtaining services for bene-
ficiaries fall within acceptable parameters, as
determined by the Commissioner.
‘‘(3) PRECLUSION
FROM
DIRECT
PARTICIPA-
TION IN DELIVERY OF SERVICES IN OWN SERVICE
AREA.—Agreements under paragraph (1) shall
preclude—
‘‘(A) direct participation by a program
manager in the delivery of employment services,
vocational rehabilitation services, or other sup-
port services to beneficiaries in the service area
covered by the program manager’s agreement;
and
‘‘(B) the holding by a program manager of
a financial interest in an employment network
or service provider which provides services in a
geographic area covered under the program
manager’s agreement.
‘‘(4) 
SELECTION
OF
EMPLOYMENT
NET-
WORKS.—
‘‘(A) IN
GENERAL.—The Commissioner
shall select and enter into agreements with em-
ployment networks for service under the Pro-
gram. Such employment networks shall be in
addition to State agencies serving as employ-
ment networks pursuant to elections under sub-
section (c).
‘‘(B) ALTERNATE PARTICIPANTS.—In any
State where the Program is being implemented,
the Commissioner shall enter into an agreement
with any alternate participant that is operating
under the authority of section 222(d)(2) in the
State as of the date of the enactment of this
section and chooses to serve as an employment
network under the Program.
‘‘(5) TERMINATION OF AGREEMENTS WITH EM-
PLOYMENT
NETWORKS.—The Commissioner shall
terminate agreements with employment networks for
inadequate performance, as determined by the Com-
missioner.
‘‘(6) QUALITY ASSURANCE.—The Commissioner
shall provide for such periodic reviews as are nec-
essary to provide for effective quality assurance in
the provision of services by employment networks.
The Commissioner shall solicit and consider the
views of consumers and the program manager under
which the employment networks serve and shall con-
sult with providers of services to develop perform-
ance measurements. The Commissioner shall ensure
that the results of the periodic reviews are made
available to beneficiaries who are prospective service
recipients as they select employment networks. The
Commissioner shall ensure that the periodic surveys
of beneficiaries receiving services under the Program
are designed to measure customer service satisfac-
tion.
‘‘(7) DISPUTE
RESOLUTION.—The Commis-
sioner shall provide for a mechanism for resolving
disputes between beneficiaries and employment net-
works, between program managers and employment
networks, and between program managers and pro-
viders of services. The Commissioner shall afford a
party to such a dispute a reasonable opportunity for
a full and fair review of the matter in dispute.
‘‘(e) PROGRAM MANAGERS.—
‘‘(1) IN GENERAL.—A program manager shall
conduct tasks appropriate to assist the Commis-
sioner in carrying out the Commissioner’s duties in
administering the Program.
‘‘(2) RECRUITMENT
OF
EMPLOYMENT
NET-
WORKS.—A program manager shall recruit, and rec-
ommend for selection by the Commissioner, employ-
ment networks for service under the Program. The
program manager shall carry out such recruitment
and provide such recommendations, and shall mon-
itor all employment networks serving in the Program
in the geographic area covered under the program
manager’s agreement, to the extent necessary and
appropriate to ensure that adequate choices of serv-
ices are made available to beneficiaries. Employment
networks may serve under the Program only pursu-
ant to an agreement entered into with the Commis-
sioner under the Program incorporating the applica-
ble provisions of this section and regulations there-
under, and the program manager shall provide and
maintain assurances to the Commissioner that pay-
ment by the Commissioner to employment networks
pursuant to this section is warranted based on com-
pliance by such employment networks with the terms
of such agreement and this section. The program
manager shall not impose numerical limits on the
number of employment networks to be recommended
pursuant to this paragraph.
‘‘(3) FACILITATION
OF
ACCESS
BY
BENE-
FICIARIES
TO
EMPLOYMENT
NETWORKS.—A pro-
gram manager shall facilitate access by beneficiaries
to employment networks. The program manager
shall ensure that each beneficiary is allowed changes
in employment networks without being deemed to
have rejected services under the Program. When
such a change occurs, the program manager shall re-
assign the ticket based on the choice of the bene-
ficiary. Upon the request of the employment net-
work, the program manager shall make a determina-
tion of the allocation of the outcome or milestone-
outcome payments based on the services provided by
each employment network. The program manager
shall establish and maintain lists of employment net-
works available to beneficiaries and shall make such
lists generally available to the public. The program
manager shall ensure that all information provided
to disabled beneficiaries pursuant to this paragraph
is provided in accessible formats.
‘‘(4) ENSURING
AVAILABILITY
OF
ADEQUATE
SERVICES.—The program manager shall ensure that
employment services, vocational rehabilitation serv-
ices, and other support services are provided to
beneficiaries throughout the geographic area covered
under the program manager’s agreement, including
rural areas.
‘‘(5) REASONABLE ACCESS TO SERVICES.—The
program manager shall take such measures as are
necessary to ensure that sufficient employment net-
works are available and that each beneficiary receiv-
ing services under the Program has reasonable ac-
cess to employment services, vocational rehabilitation
services, and other support services. Services pro-
vided under the Program may include case manage-
ment, work incentives planning, supported employ-
ment, career planning, career plan development, vo-
cational assessment, job training, placement, follow-
up services, and such other services as may be speci-
fied by the Commissioner under the Program. The
program manager shall ensure that such services are
available in each service area.
‘‘(f) EMPLOYMENT NETWORKS.—
‘‘(1) QUALIFICATIONS FOR EMPLOYMENT NET-
WORKS.—
‘‘(A) IN GENERAL.—Each employment net-
work serving under the Program shall consist of
an agency or instrumentality of a State (or a
political subdivision thereof) or a private entity,
that assumes responsibility for the coordination
and delivery of services under the Program to
individuals assigning to the employment net-
work tickets to work and self-sufficiency issued
under subsection (b).
‘‘(B) ONE-STOP DELIVERY SYSTEMS.—An
employment network serving under the Pro-
gram may consist of a one-stop delivery system
established under subtitle B of title I of the
Workforce Investment Act of 1998.
‘‘(C) COMPLIANCE WITH SELECTION CRI-
TERIA.—No employment network may serve
under the Program unless it meets and main-
tains compliance with both general selection cri-
teria (such as professional and educational
qualifications, where applicable) and specific se-
lection criteria (such as substantial expertise
and experience in providing relevant employ-
ment services and supports).
‘‘(D) SINGLE OR ASSOCIATED PROVIDERS
ALLOWED.—An employment network shall con-
sist of either a single provider of such services
or of an association of such providers organized
so as to combine their resources into a single
entity. An employment network may meet the
requirements of subsection (e)(4) by providing
services directly, or by entering into agreements
with other individuals or entities providing ap-
propriate employment services, vocational reha-
bilitation services, or other support services.
‘‘(2) REQUIREMENTS RELATING TO PROVISION
OF
SERVICES.—Each employment network serving
under the Program shall be required under the
terms of its agreement with the Commissioner to—
‘‘(A) serve prescribed service areas; and
‘‘(B) take such measures as are necessary
to ensure that employment services, vocational
rehabilitation services, and other support serv-
ices provided under the Program by, or under
agreements entered into with, the employment
network are provided under appropriate indi-
vidual work plans meeting the requirements of
subsection (g).
‘‘(3) ANNUAL
FINANCIAL
REPORTING.—Each
employment network shall meet financial reporting
requirements as prescribed by the Commissioner.
‘‘(4) PERIODIC OUTCOMES REPORTING.—Each
employment network shall prepare periodic reports,
on at least an annual basis, itemizing for the covered
period specific outcomes achieved with respect to
specific services provided by the employment net-
work. Such reports shall conform to a national
model prescribed under this section. Each employ-
ment network shall provide a copy of the latest re-
port issued by the employment network pursuant to
this paragraph to each beneficiary upon enrollment
under the Program for services to be received
through such employment network. Upon issuance of
each report to each beneficiary, a copy of the report
shall be maintained in the files of the employment
network. The program manager shall ensure that
copies of all such reports issued under this para-
graph are made available to the public under reason-
able terms.
‘‘(g) INDIVIDUAL WORK PLANS.—
‘‘(1) REQUIREMENTS.—Each employment net-
work shall—
‘‘(A) take such measures as are necessary
to ensure that employment services, vocational
rehabilitation services, and other support serv-
ices provided under the Program by, or under
agreements entered into with, the employment
network are provided under appropriate indi-
vidual work plans that meet the requirements of
subparagraph (C);
‘‘(B) develop and implement each such in-
dividual work plan, in partnership with each
beneficiary receiving such services, in a manner
that affords such beneficiary the opportunity to
exercise informed choice in selecting an employ-
ment goal and specific services needed to
achieve that employment goal;
‘‘(C) ensure that each individual work plan
includes at least—
‘‘(i) a statement of the vocational goal
developed with the beneficiary, including,
as appropriate, goals for earnings and job
advancement;
‘‘(ii) a statement of the services and
supports that have been deemed necessary
for the beneficiary to accomplish that goal;
‘‘(iii) a statement of any terms and
conditions related to the provision of such
services and supports; and
‘‘(iv) a statement of understanding re-
garding the beneficiary’s rights under the
Program (such as the right to retrieve the
ticket to work and self-sufficiency if the
beneficiary is dissatisfied with the services
being provided by the employment net-
work) and remedies available to the indi-
vidual, including information on the avail-
ability of advocacy services and assistance
in resolving disputes through the State
grant program authorized under section
1150;
‘‘(D) provide a beneficiary the opportunity
to amend the individual work plan if a change
in circumstances necessitates a change in the
plan; and
‘‘(E) make each beneficiary’s individual
work plan available to the beneficiary in, as ap-
propriate, an accessible format chosen by the
beneficiary.
‘‘(2) EFFECTIVE UPON WRITTEN APPROVAL.—
A beneficiary’s individual work plan shall take effect
upon written approval by the beneficiary or a rep-
resentative of the beneficiary and a representative of
the employment network that, in providing such
written approval, acknowledges assignment of the
beneficiary’s ticket to work and self-sufficiency.
‘‘(h) EMPLOYMENT NETWORK PAYMENT SYSTEMS.—
‘‘(1) ELECTION OF PAYMENT SYSTEM BY EM-
PLOYMENT NETWORKS.—
‘‘(A) IN
GENERAL.—The Program shall
provide for payment authorized by the Commis-
sioner to employment networks under either an
outcome payment system or an outcome-mile-
stone payment system. Each employment net-
work shall elect which payment system will be
utilized by the employment network, and, for
such period of time as such election remains in
effect, the payment system so elected shall be
utilized exclusively in connection with such em-
ployment network (except as provided in sub-
paragraph (B)).
‘‘(B) NO
CHANGE
IN
METHOD
OF
PAY-
MENT FOR BENEFICIARIES WITH TICKETS AL-
READY ASSIGNED TO THE EMPLOYMENT NET-
WORKS.—Any election of a payment system by
an employment network that would result in a
change in the method of payment to the em-
ployment network for services provided to a
beneficiary who is receiving services from the
employment network at the time of the election
shall not be effective with respect to payment
for services provided to that beneficiary and the
method of payment previously selected shall
continue to apply with respect to such services.
‘‘(2) OUTCOME PAYMENT SYSTEM.—
‘‘(A) IN GENERAL.—The outcome payment
system shall consist of a payment structure gov-
erning employment networks electing such sys-
tem under paragraph (1)(A) which meets the
requirements of this paragraph.
‘‘(B) PAYMENTS MADE DURING OUTCOME
PAYMENT PERIOD.—The outcome payment sys-
tem shall provide for a schedule of payments to
an employment network, in connection with
each individual who is a beneficiary, for each
month, during the individual’s outcome pay-
ment period, for which benefits (described in
paragraphs (3) and (4) of subsection (k)) are
not payable to such individual because of work
or earnings.
‘‘(C) COMPUTATION OF PAYMENTS TO EM-
PLOYMENT NETWORK.—The payment schedule
of the outcome payment system shall be de-
signed so that—
‘‘(i) the payment for each month dur-
ing the outcome payment period for which
benefits (described in paragraphs (3) and
(4) of subsection (k)) are not payable is
equal to a fixed percentage of the payment
calculation base for the calendar year in
which such month occurs; and
‘‘(ii) such fixed percentage is set at a
percentage which does not exceed 40 per-
cent.
‘‘(3) 
OUTCOME-MILESTONE
PAYMENT
SYS-
TEM.—
‘‘(A) IN
GENERAL.—The outcome-mile-
stone payment system shall consist of a pay-
ment structure governing employment networks
electing such system under paragraph (1)(A)
which meets the requirements of this para-
graph.
‘‘(B) EARLY
PAYMENTS
UPON
ATTAIN-
MENT OF MILESTONES IN ADVANCE OF OUT-
COME PAYMENT PERIODS.—The outcome-mile-
stone payment system shall provide for 1 or
more milestones, with respect to beneficiaries
receiving services from an employment network
under the Program, that are directed toward
the goal of permanent employment. Such mile-
stones shall form a part of a payment structure
that provides, in addition to payments made
during outcome payment periods, payments
made prior to outcome payment periods in
amounts based on the attainment of such mile-
stones.
‘‘(C) LIMITATION ON TOTAL PAYMENTS TO
EMPLOYMENT NETWORK.—The payment sched-
ule of the outcome milestone payment system
shall be designed so that the total of the pay-
ments to the employment network with respect
to each beneficiary is less than, on a net
present value basis (using an interest rate de-
termined by the Commissioner that appro-
priately reflects the cost of funds faced by pro-
viders), the total amount to which payments to
the employment network with respect to the
beneficiary would be limited if the employment
network were paid under the outcome payment
system.
‘‘(4) DEFINITIONS.—In this subsection:
‘‘(A) PAYMENT CALCULATION BASE.—The
term ‘payment calculation base’ means, for any
calendar year—
‘‘(i) in connection with a title II dis-
ability beneficiary, the average disability
insurance benefit payable under section
223 for all beneficiaries for months during
the preceding calendar year; and
‘‘(ii) in connection with a title XVI
disability beneficiary (who is not concur-
rently a title II disability beneficiary), the
average payment of supplemental security
income benefits based on disability payable
under title XVI (excluding State sup-
plementation) for months during the pre-
ceding calendar year to all beneficiaries
who have attained 18 years of age but
have not attained 65 years of age.
‘‘(B) OUTCOME
PAYMENT
PERIOD.—The
term ‘outcome payment period’ means, in con-
nection with any individual who had assigned a
ticket to work and self-sufficiency to an employ-
ment network under the Program, a period—
‘‘(i) beginning with the first month,
ending after the date on which such ticket
was assigned to the employment network,
for which benefits (described in paragraphs
(3) and (4) of subsection (k)) are not pay-
able to such individual by reason of en-
gagement in substantial gainful activity or
by reason of earnings from work activity;
and
‘‘(ii) ending with the 60th month
(consecutive or otherwise), ending after
such date, for which such benefits are not
payable to such individual by reason of en-
gagement in substantial gainful activity or
by reason of earnings from work activity.
‘‘(5) PERIODIC REVIEW AND ALTERATIONS OF
PRESCRIBED SCHEDULES.—
‘‘(A) PERCENTAGES
AND
PERIODS.—The
Commissioner shall periodically review the per-
centage specified in paragraph (2)(C), the total
payments permissible under paragraph (3)(C),
and the period of time specified in paragraph
(4)(B) to determine whether such percentages,
such permissible payments, and such period
provide an adequate incentive for employment
networks to assist beneficiaries to enter the
workforce, while providing for appropriate
economies. The Commissioner may alter such
percentage, such total permissible payments, or
such period of time to the extent that the Com-
missioner determines, on the basis of the Com-
missioner’s review under this paragraph, that
such an alteration would better provide the in-
centive and economies described in the pre-
ceding sentence.
‘‘(B) NUMBER
AND
AMOUNT
OF
MILE-
STONE
PAYMENTS.—The Commissioner shall
periodically review the number and amounts of
milestone payments established by the Commis-
sioner pursuant to this section to determine
whether they provide an adequate incentive for
employment networks to assist beneficiaries to
enter the workforce, taking into account infor-
mation provided to the Commissioner by pro-
gram managers, the Ticket to Work and Work
Incentives Advisory Panel established by section
101(f) of the Ticket to Work and Work Incen-
tives Improvement Act of 1999, and other reli-
able sources. The Commissioner may from time
to time alter the number and amounts of mile-
stone payments initially established by the
Commissioner pursuant to this section to the
extent that the Commissioner determines that
such an alteration would allow an adequate in-
centive for employment networks to assist bene-
ficiaries to enter the workforce. Such alteration
shall be based on information provided to the
Commissioner by program managers, the Ticket
to Work and Work Incentives Advisory Panel
established by section 101(f) of the Ticket to
Work and Work Incentives Improvement Act of
1999, or other reliable sources.
‘‘(C) REPORT ON THE ADEQUACY OF IN-
CENTIVES.—The Commissioner shall submit to
Congress not later than 36 months after the
date of the enactment of the Ticket to Work
and Work Incentives Improvement Act of 1999
a report with recommendations for a method or
methods to adjust payment rates under sub-
paragraphs (A) and (B), that would ensure ade-
quate incentives for the provision of services by
employment networks of—
‘‘(i) individuals with a need for ongo-
ing support and services;
‘‘(ii) individuals with a need for high-
cost accommodations;
‘‘(iii) individuals who earn a submin-
imum wage; and
‘‘(iv) individuals who work and receive
partial cash benefits.
The Commissioner shall consult with the Ticket
to Work and Work Incentives Advisory Panel
established under section 101(f) of the Ticket
to Work and Work Incentives Improvement Act
of 1999 during the development and evaluation
of the study. The Commissioner shall imple-
ment the necessary adjusted payment rates
prior to full implementation of the Ticket to
Work and Self-Sufficiency Program.
‘‘(i) SUSPENSION OF DISABILITY REVIEWS.—During
any period for which an individual is using, as defined by
the Commissioner, a ticket to work and self-sufficiency
issued under this section, the Commissioner (and any ap-
plicable State agency) may not initiate a continuing dis-
ability review or other review under section 221 of whether
the individual is or is not under a disability or a review
under title XVI similar to any such review under section
221.
‘‘(j) AUTHORIZATIONS.—
‘‘(1) 
PAYMENTS
TO
EMPLOYMENT
NET-
WORKS.—
‘‘(A) 
TITLE
II
DISABILITY
BENE-
FICIARIES.—There are authorized to be trans-
ferred from the Federal Old-Age and Survivors
Insurance Trust Fund and the Federal Dis-
ability Insurance Trust Fund each fiscal year
such sums as may be necessary to make pay-
ments to employment networks under this sec-
tion. Money paid from the Trust Funds under
this section with respect to title II disability
beneficiaries who are entitled to benefits under
section 223 or who are entitled to benefits
under section 202(d) on the basis of the wages
and self-employment income of such bene-
ficiaries, shall be charged to the Federal Dis-
ability Insurance Trust Fund, and all other
money paid from the Trust Funds under this
section shall be charged to the Federal Old-Age
and Survivors Insurance Trust Fund.
‘‘(B) 
TITLE
XVI
DISABILITY
BENE-
FICIARIES.—Amounts authorized to be appro-
priated to the Social Security Administration
under section 1601 (as in effect pursuant to the
amendments made by section 301 of the Social
Security Amendments of 1972) shall include
amounts necessary to carry out the provisions
of this section with respect to title XVI dis-
ability beneficiaries.
‘‘(2) ADMINISTRATIVE
EXPENSES.—The costs
of administering this section (other than payments
to employment networks) shall be paid from
amounts made available for the administration of
title II and amounts made available for the adminis-
tration of title XVI, and shall be allocated among
such amounts as appropriate.
‘‘(k) DEFINITIONS.—In this section:
‘‘(1) 
COMMISSIONER.—The 
term 
‘Commis-
sioner’ means the Commissioner of Social Security.
‘‘(2) DISABLED BENEFICIARY.—The term ‘dis-
abled beneficiary’ means a title II disability bene-
ficiary or a title XVI disability beneficiary.
‘‘(3) TITLE II DISABILITY BENEFICIARY.—The
term ‘title II disability beneficiary’ means an indi-
vidual entitled to disability insurance benefits under
section 223 or to monthly insurance benefits under
section 202 based on such individual’s disability (as
defined in section 223(d)). An individual is a title II
disability beneficiary for each month for which such
individual is entitled to such benefits.
‘‘(4) TITLE
XVI
DISABILITY
BENEFICIARY.—
The term ‘title XVI disability beneficiary’ means an
individual eligible for supplemental security income
benefits under title XVI on the basis of blindness
(within the meaning of section 1614(a)(2)) or dis-
ability (within the meaning of section 1614(a)(3)).
An individual is a title XVI disability beneficiary for
each month for which such individual is eligible for
such benefits.
‘‘(5) SUPPLEMENTAL SECURITY INCOME BEN-
EFIT.—The term ‘supplemental security income ben-
efit under title XVI’ means a cash benefit under sec-
tion 1611 or 1619(a), and does not include a State
supplementary payment, administered federally or
otherwise.
‘‘(l) REGULATIONS.—Not later than 1 year after the
date of the enactment of the Ticket to Work and Work
Incentives Improvement Act of 1999, the Commissioner
shall prescribe such regulations as are necessary to carry
out the provisions of this section.’’.
(b) CONFORMING AMENDMENTS.—
(1) AMENDMENTS TO TITLE II.—
(A) Section 221(i) of the Social Security
Act (42 U.S.C. 421(i)) is amended by adding at
the end the following:
‘‘(5) For suspension of reviews under this subsection
in the case of an individual using a ticket to work and
self-sufficiency, see section 1148(i).’’.
(B) Section 222(a) of such Act (42 U.S.C.
422(a)) is repealed.
(C) Section 222(b) of such Act (42 U.S.C.
422(b)) is repealed.
(D) Section 225(b)(1) of such Act (42
U.S.C. 425(b)(1)) is amended by striking ‘‘a
program of vocational rehabilitation services’’
and inserting ‘‘a program consisting of the
Ticket to Work and Self-Sufficiency Program
under section 1148 or another program of voca-
tional rehabilitation services, employment serv-
ices, or other support services’’.
(2) AMENDMENTS TO TITLE XVI.—
(A) Section 1615(a) of such Act (42
U.S.C. 1382d(a)) is amended to read as follows:
‘‘SEC. 1615. (a) In the case of any blind or disabled
individual who—
‘‘(1) has not attained age 16; and
‘‘(2) with respect to whom benefits are paid
under this title,
the Commissioner of Social Security shall make provision
for referral of such individual to the appropriate State
agency administering the State program under title V.’’.
(B) Section 1615(c) of such Act (42
U.S.C. 1382d(c)) is repealed.
(C) Section 1631(a)(6)(A) of such Act (42
U.S.C. 1383(a)(6)(A)) is amended by striking
‘‘a program of vocational rehabilitation serv-
ices’’ and inserting ‘‘a program consisting of
the Ticket to Work and Self-Sufficiency Pro-
gram under section 1148 or another program of
vocational rehabilitation services, employment
services, or other support services’’.
(D) Section 1633(c) of such Act (42
U.S.C. 1383b(c)) is amended—
(i) by inserting ‘‘(1)’’ after ‘‘(c)’’; and
(ii) by adding at the end the fol-
lowing:
‘‘(2) For suspension of continuing disability reviews
and other reviews under this title similar to reviews under
section 221 in the case of an individual using a ticket to
work and self-sufficiency, see section 1148(i).’’.
(c) EFFECTIVE DATE.—Subject to subsection (d),
the amendments made by subsections (a) and (b) shall
take effect with the first month following 1 year after the
date of the enactment of this Act.
(d) GRADUATED IMPLEMENTATION OF PROGRAM.—
(1) IN GENERAL.—Not later than 1 year after
the date of the enactment of this Act, the Commis-
sioner of Social Security shall commence implemen-
tation of the amendments made by this section
(other than paragraphs (1)(C) and (2)(B) of sub-
section (b)) in graduated phases at phase-in sites se-
lected by the Commissioner. Such phase-in sites
shall be selected so as to ensure, prior to full imple-
mentation of the Ticket to Work and Self-Suffi-
ciency Program, the development and refinement of
referral processes, payment systems, computer link-
ages, management information systems, and admin-
istrative processes necessary to provide for full im-
plementation of such amendments. Subsection (c)
shall apply with respect to paragraphs (1)(C) and
(2)(B) of subsection (b) without regard to this sub-
section.
(2) REQUIREMENTS.—Implementation of the
Program at each phase-in site shall be carried out
on a wide enough scale to permit a thorough evalua-
tion of the alternative methods under consideration,
so as to ensure that the most efficacious methods
are determined and in place for full implementation
of the Program on a timely basis.
(3) FULL
IMPLEMENTATION.—The Commis-
sioner shall ensure that ability to provide tickets and
services to individuals under the Program exists in
every State as soon as practicable on or after the ef-
fective date specified in subsection (c) but not later
than 3 years after such date.
(4) ONGOING EVALUATION OF PROGRAM.—
(A) IN
GENERAL.—The Commissioner
shall design and conduct a series of evaluations
to assess the cost-effectiveness of activities car-
ried out under this section and the amendments
made thereby, as well as the effects of this sec-
tion and the amendments made thereby on
work outcomes for beneficiaries receiving tickets
to work and self-sufficiency under the Program.
(B) CONSULTATION.—The Commissioner
shall design and carry out the series of evalua-
tions after receiving relevant advice from ex-
perts in the fields of disability, vocational reha-
bilitation, and program evaluation and individ-
uals using tickets to work and self-sufficiency
under the Program and consulting with the
Ticket to Work and Work Incentives Advisory
Panel established under section 101(f), the
Comptroller General of the United States, other
agencies of the Federal Government, and pri-
vate organizations with appropriate expertise.
(C) METHODOLOGY.—
(i) IMPLEMENTATION.—The Commis-
sioner, in consultation with the Ticket to
Work and Work Incentives Advisory Panel
established under section 101(f), shall en-
sure that plans for evaluations and data
collection methods under the Program are
appropriately designed to obtain detailed
employment information.
(ii) SPECIFIC
MATTERS
TO
BE
AD-
DRESSED.—Each such evaluation shall ad-
dress (but is not limited to)—
(I) the annual cost (including net
cost) of the Program and the annual
cost (including net cost) that would
have been incurred in the absence of
the Program;
(II) the determinants of return to
work, including the characteristics of
beneficiaries in receipt of tickets
under the Program;
(III) the types of employment
services, vocational rehabilitation serv-
ices, and other support services fur-
nished to beneficiaries in receipt of
tickets under the Program who return
to work and to those who do not re-
turn to work;
(IV) the duration of employment
services, vocational rehabilitation serv-
ices, and other support services fur-
nished to beneficiaries in receipt of
tickets under the Program who return
to work and the duration of such serv-
ices furnished to those who do not re-
turn to work and the cost to employ-
ment networks of furnishing such
services;
(V) the employment outcomes,
including wages, occupations, benefits,
and hours worked, of beneficiaries
who return to work after receiving
tickets under the Program and those
who return to work without receiving
such tickets;
(VI) the characteristics of indi-
viduals in possession of tickets under
the Program who are not accepted for
services and, to the extent reasonably
determinable, the reasons for which
such beneficiaries were not accepted
for services;
(VII) the characteristics of pro-
viders whose services are provided
within an employment network under
the Program;
(VIII) the extent (if any) to
which employment networks display a
greater willingness to provide services
to beneficiaries with a range of dis-
abilities;
(IX) the characteristics (includ-
ing employment outcomes) of those
beneficiaries 
who 
receive 
services
under the outcome payment system
and of those beneficiaries who receive
services under the outcome-milestone
payment system;
(X) 
measures 
of 
satisfaction
among beneficiaries in receipt of tick-
ets under the Program; and
(XI) reasons for (including com-
ments solicited from beneficiaries re-
garding) their choice not to use their
tickets or their inability to return to
work despite the use of their tickets.
(D) PERIODIC
EVALUATION
REPORTS.—
Following the close of the third and fifth fiscal
years ending after the effective date under sub-
section (c), and prior to the close of the seventh
fiscal year ending after such date, the Commis-
sioner shall transmit to the Committee on Ways
and Means of the House of Representatives and
the Committee on Finance of the Senate a re-
port containing the Commissioner’s evaluation
of the progress of activities conducted under the
provisions of this section and the amendments
made thereby. Each such report shall set forth
the Commissioner’s evaluation of the extent to
which the Program has been successful and the
Commissioner’s conclusions on whether or how
the Program should be modified. Each such re-
port shall include such data, findings, materials,
and recommendations as the Commissioner may
consider appropriate.
(5) EXTENT OF STATE’S RIGHT OF FIRST RE-
FUSAL IN ADVANCE OF FULL IMPLEMENTATION OF
AMENDMENTS IN SUCH STATE.—
(A) IN
GENERAL.—In the case of any
State in which the amendments made by sub-
section (a) have not been fully implemented
pursuant to this subsection, the Commissioner
shall determine by regulation the extent to
which—
(i) the requirement under section
222(a) for prompt referrals to a State
agency; and
(ii) the authority of the Commissioner
under section 222(d)(2) of the Social Secu-
rity Act to provide vocational rehabilitation
services in such State by agreement or
contract with other public or private agen-
cies, organizations, institutions, or individ-
uals,
shall apply in such State.
(B) EXISTING AGREEMENTS.—Nothing in
subparagraph (A) or the amendments made by
subsection (a) shall be construed to limit, im-
pede, or otherwise affect any agreement entered
into pursuant to section 222(d)(2) of the Social
Security Act before the date of the enactment
of this Act with respect to services provided
pursuant to such agreement to beneficiaries re-
ceiving services under such agreement as of
such date, except with respect to services (if
any) to be provided after 3 years after the ef-
fective date provided in subsection (c).
(e) SPECIFIC REGULATIONS REQUIRED.—
(1) IN GENERAL.—The Commissioner of Social
Security shall prescribe such regulations as are nec-
essary to implement the amendments made by this
section.
(2) SPECIFIC MATTERS TO BE INCLUDED IN
REGULATIONS.—The matters which shall be ad-
dressed in such regulations shall include—
(A) the form and manner in which tickets
to work and self-sufficiency may be distributed
to beneficiaries pursuant to section 1148(b)(1)
of the Social Security Act;
(B) the format and wording of such tick-
ets, which shall incorporate by reference any
contractual terms governing service by employ-
ment networks under the Program;
(C) the form and manner in which State
agencies may elect participation in the Ticket to
Work and Self-Sufficiency Program pursuant to
section 1148(c)(1) of such Act and provision for
periodic opportunities for exercising such elec-
tions;
(D) the status of State agencies under sec-
tion 1148(c)(1) of such Act at the time that
State agencies exercise elections under that sec-
tion;
(E) the terms of agreements to be entered
into with program managers pursuant to sec-
tion 1148(d) of such Act, including—
(i) the terms by which program man-
agers are precluded from direct participa-
tion in the delivery of services pursuant to
section 1148(d)(3) of such Act;
(ii) standards which must be met by
quality assurance measures referred to in
paragraph (6) of section 1148(d) of such
Act and methods of recruitment of employ-
ment networks utilized pursuant to para-
graph (2) of section 1148(e) of such Act;
and
(iii) the format under which dispute
resolution 
will 
operate 
under 
section
1148(d)(7) of such Act;
(F) the terms of agreements to be entered
into with employment networks pursuant to sec-
tion 1148(d)(4) of such Act, including—
(i) the manner in which service areas
are 
specified 
pursuant 
to 
section
1148(f)(2)(A) of such Act;
(ii) the general selection criteria and
the specific selection criteria which are ap-
plicable to employment networks under
section 1148(f)(1)(C) of such Act in select-
ing service providers;
(iii) specific requirements relating to
annual financial reporting by employment
networks pursuant to section 1148(f)(3) of
such Act; and
(iv) the national model to which peri-
odic outcomes reporting by employment
networks must conform under section
1148(f)(4) of such Act;
(G) standards which must be met by indi-
vidual work plans pursuant to section 1148(g)
of such Act;
(H) standards which must be met by pay-
ment systems required under section 1148(h) of
such Act, including—
(i) the form and manner in which
elections by employment networks of pay-
ment systems are to be exercised pursuant
to section 1148(h)(1)(A) of such Act;
(ii) the terms which must be met by
an outcome payment system under section
1148(h)(2) of such Act;
(iii) the terms which must be met by
an outcome-milestone payment system
under section 1148(h)(3) of such Act;
(iv) any revision of the percentage
specified in paragraph (2)(C) of section
1148(h) of such Act or the period of time
specified in paragraph (4)(B) of such sec-
tion 1148(h) of such Act; and
(v) annual oversight procedures for
such systems; and
(I) procedures for effective oversight of the
Program by the Commissioner of Social Secu-
rity, including periodic reviews and reporting
requirements.
(f) THE TICKET TO WORK AND WORK INCENTIVES
ADVISORY PANEL.—
(1) ESTABLISHMENT.—There is established
within the Social Security Administration a panel to
be known as the ‘‘Ticket to Work and Work Incen-
tives Advisory Panel’’ (in this subsection referred to
as the ‘‘Panel’’).
(2) DUTIES OF PANEL.—It shall be the duty of
the Panel to—
(A) advise the President, the Congress,
and the Commissioner of Social Security on
issues related to work incentives programs,
planning, and assistance for individuals with
disabilities, including work incentive provisions
under titles II, XI, XVI, XVIII, and XIX of the
Social Security Act (42 U.S.C. 401 et seq.,
1301 et seq., 1381 et seq., 1395 et seq., 1396
et seq.); and
(B) with respect to the Ticket to Work and
Self-Sufficiency Program established under sec-
tion 1148 of such Act—
(i) advise the Commissioner of Social
Security with respect to establishing phase-
in sites for such Program and fully imple-
menting the Program thereafter, the re-
finement of access of disabled beneficiaries
to employment networks, payment systems,
and management information systems, and
advise the Commissioner whether such
measures are being taken to the extent
necessary to ensure the success of the Pro-
gram;
(ii) advise the Commissioner regard-
ing the most effective designs for research
and demonstration projects associated with
the Program or conducted pursuant to sec-
tion 302 of this Act;
(iii) advise the Commissioner on the
development of performance measurements
relating to quality assurance under section
1148(d)(6) of the Social Security Act; and
(iv) furnish progress reports on the
Program to the Commissioner and each
House of Congress.
(3) MEMBERSHIP.—
(A) NUMBER
AND
APPOINTMENT.—The
Panel shall be composed of 12 members as fol-
lows:
(i) 4 members appointed by the Presi-
dent, not more than 2 of whom may be of
the same political party;
(ii) 2 members appointed by the
Speaker of the House of Representatives,
in consultation with the Chairman of the
Committee on Ways and Means of the
House of Representatives;
(iii) 2 members appointed by the mi-
nority leader of the House of Representa-
tives, in consultation with the ranking
member of the Committee on Ways and
Means of the House of Representatives;
(iv) 2 members appointed by the ma-
jority leader of the Senate, in consultation
with the Chairman of the Committee on
Finance of the Senate; and
(v) 2 members appointed by the mi-
nority leader of the Senate, in consultation
with the ranking member of the Committee
on Finance of the Senate.
(B) REPRESENTATION.—Of the members
appointed under subparagraph (A), at least 8
shall have experience or expert knowledge as a
recipient, provider, employer, or employee in the
fields of, or related to, employment services, vo-
cational rehabilitation services, and other sup-
port services, of whom—
(i) at least 2 shall represent the inter-
ests of recipients of employment services,
vocational rehabilitation services, and other
support services;
(ii) at least 2 shall represent the in-
terests of providers of employment serv-
ices, vocational rehabilitation services, and
other support services;
(iii) at least 2 shall represent the in-
terests of private employers; and
(iv) at least 2 shall represent the in-
terests of employees.
At least 1⁄2 of the members described in each
clause of subparagraph (A) shall be individuals
with disabilities, or representatives of individ-
uals with disabilities, with consideration to cur-
rent or former title II disability beneficiaries or
title XVI disability beneficiaries (as such terms
are defined in section 1148(k) of the Social Se-
curity Act (as added by subsection (a)).
(C) TERMS.—
(i) IN GENERAL.—Each member shall
be appointed for a term of 4 years (or, if
less, for the remaining life of the Panel),
except as provided in clauses (ii) and (iii).
The initial members shall be appointed not
later than 90 days after the date of the en-
actment of this Act.
(ii) 
TERMS
OF
INITIAL
AP-
POINTEES.—As designated by the Presi-
dent at the time of appointment, of the
members first appointed—
(I) 1⁄2 of the members appointed
under subparagraph (A) shall be ap-
pointed for a term of 2 years; and
(II) the remaining members ap-
pointed under subparagraph (A) shall
be appointed for a term of 4 years.
(iii) VACANCIES.—Any member ap-
pointed to fill a vacancy occurring before
the expiration of the term for which the
member’s predecessor was appointed shall
be appointed only for the remainder of that
term. A member may serve after the expi-
ration of that member’s term until a suc-
cessor has taken office. A vacancy in the
Panel shall be filled in the manner in
which the original appointment was made.
(D) BASIC PAY.—Members shall each be
paid at a rate, and in a manner, that is con-
sistent with guidelines established under section
7 of the Federal Advisory Committee Act (5
U.S.C. App.).
(E) TRAVEL
EXPENSES.—Each member
shall receive travel expenses, including per diem
in lieu of subsistence, in accordance with sec-
tions 5702 and 5703 of title 5, United States
Code.
(F) QUORUM.—8 members of the Panel
shall constitute a quorum but a lesser number
may hold hearings.
(G) CHAIRPERSON.—The Chairperson of
the Panel shall be designated by the President.
The term of office of the Chairperson shall be
4 years.
(H) MEETINGS.—The Panel shall meet at
least quarterly and at other times at the call of
the Chairperson or a majority of its members.
(4) DIRECTOR AND STAFF OF PANEL; EXPERTS
AND CONSULTANTS.—
(A) DIRECTOR.—The Panel shall have a
Director who shall be appointed by the Panel,
and paid at a rate, and in a manner, that is
consistent with guidelines established under sec-
tion 7 of the Federal Advisory Committee Act
(5 U.S.C. App.).
(B) STAFF.—Subject to rules prescribed
by the Commissioner of Social Security, the Di-
rector may appoint and fix the pay of additional
personnel as the Director considers appropriate.
(C) EXPERTS
AND
CONSULTANTS.—Sub-
ject to rules prescribed by the Commissioner of
Social Security, the Director may procure tem-
porary and intermittent services under section
3109(b) of title 5, United States Code.
(D) STAFF
OF
FEDERAL
AGENCIES.—
Upon request of the Panel, the head of any
Federal department or agency may detail, on a
reimbursable basis, any of the personnel of that
department or agency to the Panel to assist it
in carrying out its duties under this Act.
(5) POWERS OF PANEL.—
(A) HEARINGS AND SESSIONS.—The Panel
may, for the purpose of carrying out its duties
under this subsection, hold such hearings, sit
and act at such times and places, and take such
testimony and evidence as the Panel considers
appropriate.
(B) POWERS OF MEMBERS AND AGENTS.—
Any member or agent of the Panel may, if au-
thorized by the Panel, take any action which
the Panel is authorized to take by this section.
(C) MAILS.—The Panel may use the
United States mails in the same manner and
under the same conditions as other departments
and agencies of the United States.
(6) REPORTS.—
(A) INTERIM REPORTS.—The Panel shall
submit to the President and the Congress in-
terim reports at least annually.
(B) FINAL
REPORT.—The Panel shall
transmit a final report to the President and the
Congress not later than eight years after the
date of the enactment of this Act. The final re-
port shall contain a detailed statement of the
findings and conclusions of the Panel, together
with its recommendations for legislation and ad-
ministrative actions which the Panel considers
appropriate.
(7) TERMINATION.—The Panel shall terminate
30 days after the date of the submission of its final
report under paragraph (6)(B).
(8) AUTHORIZATION
OF
APPROPRIATIONS.—
There are authorized to be appropriated from the
Federal Old-Age and Survivors Insurance Trust
Fund, the Federal Disability Insurance Trust Fund,
and the general fund of the Treasury, as appro-
priate, such sums as are necessary to carry out this
subsection.
Subtitle B—Elimination of Work
Disincentives
SEC. 111. WORK ACTIVITY STANDARD AS A BASIS FOR RE-
VIEW OF AN INDIVIDUAL’S DISABLED STATUS.
(a) IN GENERAL.—Section 221 of the Social Security
Act (42 U.S.C. 421) is amended by adding at the end the
following:
‘‘(m)(1) In any case where an individual entitled to
disability insurance benefits under section 223 or to
monthly insurance benefits under section 202 based on
such individual’s disability (as defined in section 223(d))
has received such benefits for at least 24 months—
‘‘(A) no continuing disability review conducted
by the Commissioner may be scheduled for the indi-
vidual solely as a result of the individual’s work ac-
tivity;
‘‘(B) no work activity engaged in by the indi-
vidual may be used as evidence that the individual
is no longer disabled; and
‘‘(C) no cessation of work activity by the indi-
vidual may give rise to a presumption that the indi-
vidual is unable to engage in work.
‘‘(2) An individual to which paragraph (1) applies
shall continue to be subject to—
‘‘(A) continuing disability reviews on a regularly
scheduled basis that is not triggered by work; and
‘‘(B) termination of benefits under this title in
the event that the individual has earnings that ex-
ceed the level of earnings established by the Com-
missioner to represent substantial gainful activity.’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) shall take effect on January 1, 2003.
SEC. 112. EXPEDITED REINSTATEMENT OF DISABILITY
BENEFITS.
(a) OASDI BENEFITS.—Section 223 of the Social
Security Act (42 U.S.C. 423) is amended—
(1) by redesignating subsection (i) as subsection
(j); and
(2) by inserting after subsection (h) the fol-
lowing:
‘‘Reinstatement of Entitlement
‘‘(i)(1)(A) Entitlement to benefits described in sub-
paragraph (B)(i)(I) shall be reinstated in any case where
the Commissioner determines that an individual described
in subparagraph (B) has filed a request for reinstatement
meeting the requirements of paragraph (2)(A) during the
period prescribed in subparagraph (C). Reinstatement of
such entitlement shall be in accordance with the terms of
this subsection.
‘‘(B) An individual is described in this subparagraph
if—
‘‘(i) prior to the month in which the individual
files a request for reinstatement—
‘‘(I) the individual was entitled to benefits
under this section or section 202 on the basis
of disability pursuant to an application filed
therefor; and
‘‘(II) such entitlement terminated due to
the performance of substantial gainful activity;
‘‘(ii) the individual is under a disability and the
physical or mental impairment that is the basis for
the finding of disability is the same as (or related
to) the physical or mental impairment that was the
basis for the finding of disability that gave rise to
the entitlement described in clause (i); and
‘‘(iii) the individual’s disability renders the indi-
vidual unable to perform substantial gainful activity.
‘‘(C)(i) Except as provided in clause (ii), the period
prescribed in this subparagraph with respect to an indi-
vidual is 60 consecutive months beginning with the month
following the most recent month for which the individual
was entitled to a benefit described in subparagraph
(B)(i)(I) prior to the entitlement termination described in
subparagraph (B)(i)(II).
‘‘(ii) In the case of an individual who fails to file a
reinstatement request within the period prescribed in
clause (i), the Commissioner may extend the period if the
Commissioner determines that the individual had good
cause for the failure to so file.
‘‘(2)(A)(i) A request for reinstatement shall be filed
in such form, and containing such information, as the
Commissioner may prescribe.
‘‘(ii) A request for reinstatement shall include express
declarations by the individual that the individual meets the
requirements specified in clauses (ii) and (iii) of para-
graph (1)(B).
‘‘(B) A request for reinstatement filed in accordance
with subparagraph (A) may constitute an application for
benefits in the case of any individual who the Commis-
sioner determines is not entitled to reinstated benefits
under this subsection.
‘‘(3) In determining whether an individual meets the
requirements of paragraph (1)(B)(ii), the provisions of
subsection (f) shall apply.
‘‘(4)(A)(i) Subject to clause (ii), entitlement to bene-
fits reinstated under this subsection shall commence with
the benefit payable for the month in which a request for
reinstatement is filed.
‘‘(ii) An individual whose entitlement to a benefit for
any month would have been reinstated under this sub-
section had the individual filed a request for reinstatement
before the end of such month shall be entitled to such ben-
efit for such month if such request for reinstatement is
filed before the end of the twelfth month immediately suc-
ceeding such month.
‘‘(B)(i) Subject to clauses (ii) and (iii), the amount
of the benefit payable for any month pursuant to the rein-
statement of entitlement under this subsection shall be de-
termined in accordance with the provisions of this title.
‘‘(ii) For purposes of computing the primary insur-
ance amount of an individual whose entitlement to benefits
under this section is reinstated under this subsection, the
date of onset of the individual’s disability shall be the date
of onset used in determining the individual’s most recent
period of disability arising in connection with such benefits
payable on the basis of an application.
‘‘(iii) Benefits under this section or section 202 pay-
able for any month pursuant to a request for reinstate-
ment filed in accordance with paragraph (2) shall be re-
duced by the amount of any provisional benefit paid to
such individual for such month under paragraph (7).
‘‘(C) No benefit shall be payable pursuant to an enti-
tlement reinstated under this subsection to an individual
for any month in which the individual engages in substan-
tial gainful activity.
‘‘(D) The entitlement of any individual that is rein-
stated under this subsection shall end with the benefits
payable for the month preceding whichever of the following
months is the earliest:
‘‘(i) The month in which the individual dies.
‘‘(ii) The month in which the individual attains
retirement age.
‘‘(iii) The third month following the month in
which the individual’s disability ceases.
‘‘(5) Whenever an individual’s entitlement to benefits
under this section is reinstated under this subsection, enti-
tlement to benefits payable on the basis of such individ-
ual’s wages and self-employment income may be reinstated
with respect to any person previously entitled to such ben-
efits on the basis of an application if the Commissioner
determines that such person satisfies all the requirements
for entitlement to such benefits except requirements re-
lated to the filing of an application. The provisions of
paragraph (4) shall apply to the reinstated entitlement of
any such person to the same extent that they apply to
the reinstated entitlement of such individual.
‘‘(6) An individual to whom benefits are payable
under this section or section 202 pursuant to a reinstate-
ment of entitlement under this subsection for 24 months
(whether or not consecutive) shall, with respect to benefits
so payable after such twenty-fourth month, be deemed for
purposes of paragraph (1)(B)(i)(I) and the determination,
if appropriate, of the termination month in accordance
with subsection (a)(1) of this section, or subsection (d)(1),
(e)(1), or (f)(1) of section 202, to be entitled to such bene-
fits on the basis of an application filed therefor.
‘‘(7)(A) An individual described in paragraph (1)(B)
who files a request for reinstatement in accordance with
the provisions of paragraph (2)(A) shall be entitled to pro-
visional benefits payable in accordance with this para-
graph, unless the Commissioner determines that the indi-
vidual does not meet the requirements of paragraph
(1)(B)(i) or that the individual’s declaration under para-
graph (2)(A)(ii) is false. Any such determination by the
Commissioner shall be final and not subject to review
under subsection (b) or (g) of section 205.
‘‘(B) The amount of a provisional benefit for a month
shall equal the amount of the last monthly benefit payable
to the individual under this title on the basis of an applica-
tion increased by an amount equal to the amount, if any,
by which such last monthly benefit would have been in-
creased as a result of the operation of section 215(i).
‘‘(C)(i) Provisional benefits shall begin with the
month in which a request for reinstatement is filed in ac-
cordance with paragraph (2)(A).
‘‘(ii) Provisional benefits shall end with the earliest
of—
‘‘(I) the month in which the Commissioner
makes a determination regarding the individual’s en-
titlement to reinstated benefits;
‘‘(II) the fifth month following the month de-
scribed in clause (i);
‘‘(III) the month in which the individual per-
forms substantial gainful activity; or
‘‘(IV) the month in which the Commissioner de-
termines that the individual does not meet the re-
quirements of paragraph (1)(B)(i) or that the indi-
vidual’s declaration made in accordance with para-
graph (2)(A)(ii) is false.
‘‘(D) In any case in which the Commissioner deter-
mines that an individual is not entitled to reinstated bene-
fits, any provisional benefits paid to the individual under
this paragraph shall not be subject to recovery as an over-
payment unless the Commissioner determines that the in-
dividual knew or should have known that the individual
did not meet the requirements of paragraph (1)(B).’’.
(b) SSI BENEFITS.—
(1) IN GENERAL.—Section 1631 of the Social
Security Act (42 U.S.C. 1383) is amended by add-
ing at the end the following:
‘‘Reinstatement of Eligibility on the Basis of Blindness
or Disability
‘‘(p)(1)(A) Eligibility for benefits under this title
shall be reinstated in any case where the Commissioner
determines that an individual described in subparagraph
(B) has filed a request for reinstatement meeting the re-
quirements of paragraph (2)(A) during the period pre-
scribed in subparagraph (C). Reinstatement of eligibility
shall be in accordance with the terms of this subsection.
‘‘(B) An individual is described in this subparagraph
if—
‘‘(i) prior to the month in which the individual
files a request for reinstatement—
‘‘(I) the individual was eligible for benefits
under this title on the basis of blindness or dis-
ability pursuant to an application filed therefor;
and
‘‘(II) the individual thereafter was ineli-
gible for such benefits due to earned income (or
earned and unearned income) for a period of 12
or more consecutive months;
‘‘(ii) the individual is blind or disabled and the
physical or mental impairment that is the basis for
the finding of blindness or disability is the same as
(or related to) the physical or mental impairment
that was the basis for the finding of blindness or
disability that gave rise to the eligibility described in
clause (i);
‘‘(iii) the individual’s blindness or disability ren-
ders the individual unable to perform substantial
gainful activity; and
‘‘(iv) the individual satisfies the nonmedical re-
quirements for eligibility for benefits under this title.
‘‘(C)(i) Except as provided in clause (ii), the period
prescribed in this subparagraph with respect to an indi-
vidual is 60 consecutive months beginning with the month
following the most recent month for which the individual
was eligible for a benefit under this title (including section
1619) prior to the period of ineligibility described in sub-
paragraph (B)(i)(II).
‘‘(ii) In the case of an individual who fails to file a
reinstatement request within the period prescribed in
clause (i), the Commissioner may extend the period if the
Commissioner determines that the individual had good
cause for the failure to so file.
‘‘(2)(A)(i) A request for reinstatement shall be filed
in such form, and containing such information, as the
Commissioner may prescribe.
‘‘(ii) A request for reinstatement shall include express
declarations by the individual that the individual meets the
requirements specified in clauses (ii) through (iv) of para-
graph (1)(B).
‘‘(B) A request for reinstatement filed in accordance
with subparagraph (A) may constitute an application for
benefits in the case of any individual who the Commis-
sioner determines is not eligible for reinstated benefits
under this subsection.
‘‘(3) In determining whether an individual meets the
requirements of paragraph (1)(B)(ii), the provisions of
section 1614(a)(4) shall apply.
‘‘(4)(A) Eligibility for benefits reinstated under this
subsection shall commence with the benefit payable for the
month following the month in which a request for rein-
statement is filed.
‘‘(B)(i) Subject to clause (ii), the amount of the ben-
efit payable for any month pursuant to the reinstatement
of eligibility under this subsection shall be determined in
accordance with the provisions of this title.
‘‘(ii) The benefit under this title payable for any
month pursuant to a request for reinstatement filed in ac-
cordance with paragraph (2) shall be reduced by the
amount of any provisional benefit paid to such individual
for such month under paragraph (7).
‘‘(C) Except as otherwise provided in this subsection,
eligibility for benefits under this title reinstated pursuant
to a request filed under paragraph (2) shall be subject
to the same terms and conditions as eligibility established
pursuant to an application filed therefor.
‘‘(5) Whenever an individual’s eligibility for benefits
under this title is reinstated under this subsection, eligi-
bility for such benefits shall be reinstated with respect to
the individual’s spouse if such spouse was previously an
eligible spouse of the individual under this title and the
Commissioner determines that such spouse satisfies all the
requirements for eligibility for such benefits except re-
quirements related to the filing of an application. The pro-
visions of paragraph (4) shall apply to the reinstated eligi-
bility of the spouse to the same extent that they apply
to the reinstated eligibility of such individual.
‘‘(6) An individual to whom benefits are payable
under this title pursuant to a reinstatement of eligibility
under this subsection for twenty-four months (whether or
not consecutive) shall, with respect to benefits so payable
after such twenty-fourth month, be deemed for purposes
of paragraph (1)(B)(i)(I) to be eligible for such benefits
on the basis of an application filed therefor.
‘‘(7)(A) An individual described in paragraph (1)(B)
who files a request for reinstatement in accordance with
the provisions of paragraph (2)(A) shall be eligible for pro-
visional benefits payable in accordance with this para-
graph, unless the Commissioner determines that the indi-
vidual does not meet the requirements of paragraph
(1)(B)(i) or that the individual’s declaration under para-
graph (2)(A)(ii) is false. Any such determination by the
Commissioner shall be final and not subject to review
under paragraph (1) or (3) of subsection (c).
‘‘(B)(i) Except as otherwise provided in clause (ii),
the amount of a provisional benefit for a month shall equal
the amount of the monthly benefit that would be payable
to an eligible individual under this title with the same kind
and amount of income.
‘‘(ii) If the individual has a spouse who was pre-
viously an eligible spouse of the individual under this title
and the Commissioner determines that such spouse satis-
fies all the requirements of section 1614(b) except require-
ments related to the filing of an application, the amount
of a provisional benefit for a month shall equal the amount
of the monthly benefit that would be payable to an eligible
individual and eligible spouse under this title with the
same kind and amount of income.
‘‘(C)(i) Provisional benefits shall begin with the
month following the month in which a request for rein-
statement is filed in accordance with paragraph (2)(A).
‘‘(ii) Provisional benefits shall end with the earliest
of—
‘‘(I) the month in which the Commissioner
makes a determination regarding the individual’s eli-
gibility for reinstated benefits;
‘‘(II) the fifth month following the month for
which provisional benefits are first payable under
clause (i); or
‘‘(III) the month in which the Commissioner de-
termines that the individual does not meet the re-
quirements of paragraph (1)(B)(i) or that the indi-
vidual’s declaration made in accordance with para-
graph (2)(A)(ii) is false.
‘‘(D) In any case in which the Commissioner deter-
mines that an individual is not eligible for reinstated bene-
fits, any provisional benefits paid to the individual under
this paragraph shall not be subject to recovery as an over-
payment unless the Commissioner determines that the in-
dividual knew or should have known that the individual
did not meet the requirements of paragraph (1)(B).
‘‘(8) For purposes of this subsection other than para-
graph (7), the term ‘benefits under this title’ includes
State supplementary payments made pursuant to an
agreement under section 1616(a) of this Act or section
212(b) of Public Law 93–66.’’.
(2) CONFORMING AMENDMENTS.—
(A) Section 1631(j)(1) of such Act (42
U.S.C. 1383(j)(1)) is amended by striking the
period and inserting ‘‘, or has filed a request
for reinstatement of eligibility under subsection
(p)(2) and been determined to be eligible for re-
instatement.’’.
(B) Section 1631(j)(2)(A)(i)(I) of such Act
(42 U.S.C. 1383(j)(2)(A)(i)(I)) is amended by
inserting ‘‘(other than pursuant to a request for
reinstatement under subsection (p))’’ after ‘‘eli-
gible’’.
(c) EFFECTIVE DATE.—
(1) IN GENERAL.—The amendments made by
this section shall take effect on the first day of the
thirteenth month beginning after the date of the en-
actment of this Act.
(2) LIMITATION.—No benefit shall be payable
under title II or XVI on the basis of a request for
reinstatement filed under section 223(i) or 1631(p)
of the Social Security Act before the effective date
described in paragraph (1).
Subtitle C—Work Incentives
Planning, Assistance, and Outreach
SEC. 121. WORK INCENTIVES OUTREACH PROGRAM.
Part A of title XI of the Social Security Act (42
U.S.C. 1301 et seq.), as amended by section 101, is
amended by adding after section 1148 the following:
‘‘WORK INCENTIVES OUTREACH PROGRAM
‘‘SEC. 1149. (a) ESTABLISHMENT.—
‘‘(1) IN GENERAL.—The Commissioner, in con-
sultation with the Ticket to Work and Work Incen-
tives Advisory Panel established under section 101(f)
of the Ticket to Work and Work Incentives Improve-
ment Act of 1999, shall establish a community-based
work incentives planning and assistance program for
the purpose of disseminating accurate information to
disabled beneficiaries on work incentives programs
and issues related to such programs.
‘‘(2) GRANTS, 
COOPERATIVE
AGREEMENTS,
CONTRACTS, AND OUTREACH.—Under the program
established under this section, the Commissioner
shall—
‘‘(A) establish a competitive program of
grants, cooperative agreements, or contracts to
provide benefits planning and assistance, in-
cluding information on the availability of pro-
tection and advocacy services, to disabled bene-
ficiaries, including individuals participating in
the Ticket to Work and Self-Sufficiency Pro-
gram established under section 1148, the pro-
gram established under section 1619, and other
programs that are designed to encourage dis-
abled beneficiaries to work;
‘‘(B) conduct directly, or through grants,
cooperative agreements, or contracts, ongoing
outreach efforts to disabled beneficiaries (and
to the families of such beneficiaries) who are
potentially eligible to participate in Federal or
State work incentive programs that are de-
signed to assist disabled beneficiaries to work,
including—
‘‘(i) preparing and disseminating in-
formation explaining such programs; and
‘‘(ii) working in cooperation with
other Federal, State, and private agencies
and nonprofit organizations that serve dis-
abled beneficiaries, and with agencies and
organizations that focus on vocational re-
habilitation and work-related training and
counseling;
‘‘(C) establish a corps of trained, acces-
sible, and responsive work incentives specialists
within the Social Security Administration who
will specialize in disability work incentives
under titles II and XVI for the purpose of dis-
seminating accurate information with respect to
inquiries and issues relating to work incentives
to—
‘‘(i) disabled beneficiaries;
‘‘(ii) benefit applicants under titles II
and XVI; and
‘‘(iii) individuals or entities awarded
grants under subparagraphs (A) or (B);
and
‘‘(D) provide—
‘‘(i) training for work incentives spe-
cialists and individuals providing planning
assistance described in subparagraph (C);
and
‘‘(ii) technical assistance to organiza-
tions and entities that are designed to en-
courage disabled beneficiaries to return to
work.
‘‘(3) 
COORDINATION
WITH
OTHER
PRO-
GRAMS.—The responsibilities of the Commissioner
established under this section shall be coordinated
with other public and private programs that provide
information and assistance regarding rehabilitation
services and independent living supports and bene-
fits planning for disabled beneficiaries including the
program under section 1619, the plans for achieving
self-support program (PASS), and any other Federal
or State work incentives programs that are designed
to assist disabled beneficiaries, including educational
agencies that provide information and assistance re-
garding rehabilitation, school-to-work programs,
transition services (as defined in, and provided in ac-
cordance with, the Individuals with Disabilities Edu-
cation Act (20 U.S.C. 1400 et seq.)), a one-stop de-
livery system established under subtitle B of title I
of the Workforce Investment Act of 1998, and other
services.
‘‘(b) CONDITIONS.—
‘‘(1) SELECTION OF ENTITIES.—
‘‘(A) APPLICATION.—An entity shall sub-
mit an application for a grant, cooperative
agreement, or contract to provide benefits plan-
ning and assistance to the Commissioner at
such time, in such manner, and containing such
information as the Commissioner may deter-
mine is necessary to meet the requirements of
this section.
‘‘(B) 
STATEWIDENESS.—The 
Commis-
sioner shall ensure that the planning, assist-
ance, and information described in paragraph
(2) shall be available on a statewide basis.
‘‘(C) ELIGIBILITY
OF
STATES
AND
PRI-
VATE ORGANIZATIONS.—
‘‘(i) IN GENERAL.—The Commissioner
may award a grant, cooperative agreement,
or contract under this section to a State or
a private agency or organization (other
than Social Security Administration Field
Offices and the State agency administering
the State medicaid program under title
XIX, including any agency or entity de-
scribed in clause (ii), that the Commis-
sioner determines is qualified to provide
the planning, assistance, and information
described in paragraph (2)).
‘‘(ii) AGENCIES
AND
ENTITIES
DE-
SCRIBED.—The agencies and entities de-
scribed in this clause are the following:
‘‘(I) Any public or private agency
or organization (including Centers for
Independent Living established under
title VII of the Rehabilitation Act of
1973, protection and advocacy organi-
zations, client assistance programs es-
tablished in accordance with section
112 of the Rehabilitation Act of 1973,
and State Developmental Disabilities
Councils established in accordance
with section 124 of the Developmental
Disabilities Assistance and Bill of
Rights Act (42 U.S.C. 6024)) that the
Commissioner determines satisfies the
requirements of this section.
‘‘(II) The State agency admin-
istering the State program funded
under part A of title IV.
‘‘(D) EXCLUSION
FOR
CONFLICT
OF
IN-
TEREST.—The Commissioner may not award a
grant, cooperative agreement, or contract under
this section to any entity that the Commissioner
determines would have a conflict of interest if
the entity were to receive a grant, cooperative
agreement, or contract under this section.
‘‘(2) SERVICES
PROVIDED.—A recipient of a
grant, cooperative agreement, or contract to provide
benefits planning and assistance shall select individ-
uals who will act as planners and provide informa-
tion, guidance, and planning to disabled beneficiaries
on the—
‘‘(A) availability and interrelation of any
Federal or State work incentives programs de-
signed to assist disabled beneficiaries that the
individual may be eligible to participate in;
‘‘(B) adequacy of any health benefits cov-
erage that may be offered by an employer of
the individual and the extent to which other
health benefits coverage may be available to the
individual; and
‘‘(C) availability of protection and advo-
cacy services for disabled beneficiaries and how
to access such services.
‘‘(3) 
AMOUNT
OF
GRANTS, 
COOPERATIVE
AGREEMENTS, OR CONTRACTS.—
‘‘(A) BASED
ON
POPULATION
OF
DIS-
ABLED
BENEFICIARIES.—Subject to subpara-
graph (B), the Commissioner shall award a
grant, cooperative agreement, or contract under
this section to an entity based on the percent-
age of the population of the State where the en-
tity is located who are disabled beneficiaries.
‘‘(B) LIMITATIONS.—
‘‘(i) PER GRANT.—No entity shall re-
ceive a grant, cooperative agreement, or
contract under this section for a fiscal year
that is less than $50,000 or more than
$300,000.
‘‘(ii) 
TOTAL
AMOUNT
FOR
ALL
GRANTS, COOPERATIVE AGREEMENTS, AND
CONTRACTS.—The total amount of all
grants, cooperative agreements, and con-
tracts awarded under this section for a fis-
cal year may not exceed $23,000,000.
‘‘(4) ALLOCATION OF COSTS.—The costs of car-
rying out this section shall be paid from amounts
made available for the administration of title II and
amounts made available for the administration of
title XVI, and shall be allocated among those
amounts as appropriate.
‘‘(c) DEFINITIONS.—In this section:
‘‘(1) 
COMMISSIONER.—The 
term 
‘Commis-
sioner’ means the Commissioner of Social Security.
‘‘(2) DISABLED BENEFICIARY.—The term ‘dis-
abled beneficiary’ has the meaning given that term
in section 1148(k)(2).
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There
is authorized to be appropriated to carry out this section
$23,000,000 for each of the fiscal years 2000 through
2004.’’.
SEC. 122. STATE GRANTS FOR WORK INCENTIVES ASSIST-
ANCE TO DISABLED BENEFICIARIES.
Part A of title XI of the Social Security Act (42
U.S.C. 1301 et seq.), as amended by section 121, is
amended by adding after section 1149 the following:
‘‘STATE GRANTS FOR WORK INCENTIVES ASSISTANCE TO
DISABLED BENEFICIARIES
‘‘SEC. 1150. (a) IN GENERAL.—Subject to subsection
(c), the Commissioner may make payments in each State
to the protection and advocacy system established pursu-
ant to part C of title I of the Developmental Disabilities
Assistance and Bill of Rights Act (42 U.S.C. 6041 et seq.)
for the purpose of providing services to disabled bene-
ficiaries.
‘‘(b) SERVICES PROVIDED.—Services provided to dis-
abled beneficiaries pursuant to a payment made under this
section may include—
‘‘(1) information and advice about obtaining vo-
cational rehabilitation and employment services; and
‘‘(2) advocacy or other services that a disabled
beneficiary may need to secure or regain gainful em-
ployment.
‘‘(c) APPLICATION.—In order to receive payments
under this section, a protection and advocacy system shall
submit an application to the Commissioner, at such time,
in such form and manner, and accompanied by such infor-
mation and assurances as the Commissioner may require.
‘‘(d) AMOUNT OF PAYMENTS.—
‘‘(1) IN GENERAL.—Subject to the amount ap-
propriated for a fiscal year for making payments
under this section, a protection and advocacy system
shall not be paid an amount that is less than—
‘‘(A) in the case of a protection and advo-
cacy system located in a State (including the
District of Columbia and Puerto Rico) other
than Guam, American Samoa, the United
States Virgin Islands, and the Commonwealth
of the Northern Mariana Islands, the greater
of—
‘‘(i) $100,000; or
‘‘(ii) 1⁄3 of 1 percent of the amount
available for payments under this section;
and
‘‘(B) in the case of a protection and advo-
cacy system located in Guam, American Samoa,
the United States Virgin Islands, and the Com-
monwealth of the Northern Mariana Islands,
$50,000.
‘‘(2) INFLATION ADJUSTMENT.—For each fiscal
year in which the total amount appropriated to carry
out this section exceeds the total amount appro-
priated to carry out this section in the preceding fis-
cal year, the Commissioner shall increase each min-
imum payment under subparagraphs (A) and (B) of
paragraph (1) by a percentage equal to the percent-
age increase in the total amount so appropriated to
carry out this section.
‘‘(e) ANNUAL REPORT.—Each protection and advo-
cacy system that receives a payment under this section
shall submit an annual report to the Commissioner and
the Ticket to Work and Work Incentives Advisory Panel
established under section 101(f) of the Ticket to Work and
Work Incentives Improvement Act of 1999 on the services
provided to individuals by the system.
‘‘(f) FUNDING.—
‘‘(1) ALLOCATION
OF
PAYMENTS.—Payments
under this section shall be made from amounts made
available for the administration of title II and
amounts made available for the administration of
title XVI, and shall be allocated among those
amounts as appropriate.
‘‘(2) CARRYOVER.—Any amounts allotted for
payment to a protection and advocacy system under
this section for a fiscal year shall remain available
for payment to or on behalf of the protection and
advocacy system until the end of the succeeding fis-
cal year.
‘‘(g) DEFINITIONS.—In this section:
‘‘(1) 
COMMISSIONER.—The 
term 
‘Commis-
sioner’ means the Commissioner of Social Security.
‘‘(2) DISABLED BENEFICIARY.—The term ‘dis-
abled beneficiary’ has the meaning given that term
in section 1148(k)(2).
‘‘(3) PROTECTION AND ADVOCACY SYSTEM.—
The term ‘protection and advocacy system’ means a
protection and advocacy system established pursuant
to part C of title I of the Developmental Disabilities
Assistance and Bill of Rights Act (42 U.S.C. 6041
et seq.).
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There
is authorized to be appropriated to carry out this section
$7,000,000 for each of the fiscal years 2000 through
2004.’’.
TITLE 
II—EXPANDED 
AVAIL-
ABILITY OF HEALTH CARE
SERVICES
SEC. 201. EXPANDING STATE OPTIONS UNDER THE MED-
ICAID PROGRAM FOR WORKERS WITH DIS-
ABILITIES.
(a) IN GENERAL.—
(1) STATE OPTION TO PROVIDE OPPORTUNITY
FOR EMPLOYED INDIVIDUALS WITH A MEDICALLY
IMPROVED DISABILITY TO BUY INTO MEDICAID.—
(A) 
ELIGIBILITY.—Section
1902(a)(10)(A)(ii) of the Social Security Act
(42 U.S.C. 1396a(a)(10)(A)(ii)) is amended—
(i) in subclause (XIII), by striking
‘‘or’’ at the end;
(ii) in subclause (XIV), by adding
‘‘or’’ at the end; and
(iii) by adding at the end the fol-
lowing:
‘‘(XV) who are employed individ-
uals with a medically improved dis-
ability described in section 1905(v)(1)
and whose assets, resources, and
earned or unearned income (or both)
do not exceed such limitations (if any)
as the State may establish, but only if
the State provides medical assistance
to individuals described in subclause
(XIII);’’.
(B) DEFINITION OF EMPLOYED INDIVID-
UALS
WITH
A
MEDICALLY
IMPROVED
DIS-
ABILITY.—Section 1905 of the Social Security
Act (42 U.S.C. 1396d) is amended by adding at
the end the following:
‘‘(v)(1) The term ‘employed individual with a medi-
cally improved disability’ means an individual who—
‘‘(A) is at least 16, but less than 65, years of
age;
‘‘(B) is employed (as defined in paragraph (2));
‘‘(C) ceases to be eligible for medical assistance
under section 1902(a)(10)(A)(ii)(XIII) because the
individual, by reason of medical improvement, is de-
termined at the time of a regularly scheduled con-
tinuing disability review to no longer be eligible for
benefits under section 223(d) or 1614(a)(3); and
‘‘(D) continues to have a severe medically deter-
minable impairment, as determined under regula-
tions of the Secretary.
‘‘(2) For purposes of paragraph (1), an individual is
considered to be ‘employed’ if the individual—
‘‘(A) is earning at least the applicable minimum
wage requirement under section 6 of the Fair Labor
Standards Act (29 U.S.C. 206) and working at least
40 hours per month; or
‘‘(B) is engaged in a work effort that meets
substantial and reasonable threshold criteria for
hours of work, wages, or other measures, as defined
by the State and approved by the Secretary.’’.
(C) CONFORMING
AMENDMENT.—Section
1905(a) of such Act (42 U.S.C. 1396d(a)) is
amended in the matter preceding paragraph
(1)—
(i) in clause (x), by striking ‘‘or’’ at
the end;
(ii) in clause (xi), by adding ‘‘or’’ at
the end; and
(iii) by inserting after clause (xi), the
following:
‘‘(xii) employed individuals with a medically im-
proved disability (as defined in subsection (v)),’’.
(2) STATE AUTHORITY TO IMPOSE INCOME-RE-
LATED
PREMIUMS
AND
COST-SHARING.—Section
1916 of such Act (42 U.S.C. 1396o) is amended—
(A) in subsection (a), by striking ‘‘The
State plan’’ and inserting ‘‘Subject to sub-
section (g), the State plan’’; and
(B) by adding at the end the following:
‘‘(g) With respect to individuals provided medical as-
sistance 
only 
under 
subclause 
(XV) 
of 
section
1902(a)(10)(A)(ii), a State may (in a uniform manner for
individuals described in either such subclause)—
‘‘(1) require such individuals to pay premiums
or other cost-sharing charges set on a sliding scale
based on income that the State may determine; and
‘‘(2) require payment of 100 percent of such
premiums in the case of such an individual who has
income that exceeds 250 percent of the income offi-
cial poverty line (referred to in subsection (c)(1)) ap-
plicable to a family of the size involved.’’.
(3) PROHIBITION AGAINST SUPPLANTATION OF
STATE FUNDS AND STATE FAILURE TO MAINTAIN
EFFORT.—Section 1903(i) of such Act (42 U.S.C.
1396b(i)) is amended—
(A) by striking the period at the end of
paragraph (19) and inserting ‘‘; or’’; and
(B) by inserting after such paragraph the
following:
‘‘(20) with respect to amounts expended for
medical assistance provided to an individual de-
scribed 
in 
subclause 
(XV) 
of 
section
1902(a)(10)(A)(ii) for a fiscal year unless the State
demonstrates to the satisfaction of the Secretary
that the level of State funds expended for such fiscal
year for programs to enable working individuals with
disabilities to work (other than for such medical as-
sistance) is not less than the level expended for such
programs during the most recent State fiscal year
ending before the date of the enactment of this para-
graph.’’.
(b) CONFORMING AMENDMENTS.—
(1) Section 1903(f)(4) of the Social Security
Act (42 U.S.C. 1396b(f)(4)) is amended in the mat-
ter 
preceding 
subparagraph 
(A) 
by 
inserting
‘‘1902(a)(10)(A)(ii)(XV),’’ 
after
‘‘1902(a)(10)(A)(ii)(X),’’.
(2) Section 1903(f)(4) of such Act, as amended
by 
paragraph 
(1), 
is 
amended 
by 
inserting
‘‘1902(a)(10)(A)(ii)(XIII),’’ 
before
‘‘1902(a)(10)(A)(ii)(XV)’’.
(c) EFFECTIVE DATE.—
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this section
apply to medical assistance for items and services
furnished on or after October 1, 1999.
(2) RETROACTIVITY OF CONFORMING AMEND-
MENT.—The amendment made by subsection (b)(2)
takes effect as if included in the enactment of the
Balanced Budget Act of 1997.
SEC. 202. EXTENDING MEDICARE COVERAGE FOR OASDI
DISABILITY BENEFIT RECIPIENTS.
(a) IN GENERAL.—The next to last sentence of sec-
tion 226(b) of the Social Security Act (42 U.S.C. 426)
is amended by striking ‘‘24’’ and inserting ‘‘96’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) shall be effective on and after October 1,
2000.
(c) GAO REPORT.—Not later than 5 years after the
date of the enactment of this Act, the Comptroller General
of the United States shall submit a report to the Congress
that—
(1) examines the effectiveness and cost of the
amendment made by subsection (a);
(2) examines the necessity and effectiveness of
providing continuation of medicare coverage under
section 226(b) of the Social Security Act to individ-
uals whose annual income exceeds the contribution
and benefit base (as determined under section 230
of such Act);
(3) examines the viability of providing the con-
tinuation of medicare coverage under such section
226(b) based on a sliding scale premium for individ-
uals whose annual income exceeds such contribution
and benefit base;
(4) examines the viability of providing the con-
tinuation of medicare coverage under such section
226(b) based on a premium buy-in by the bene-
ficiary’s employer in lieu of coverage under private
health insurance;
(5) examines the interrelation between the use
of the continuation of medicare coverage under such
section 226(b) and the use of private health insur-
ance coverage by individuals during the extended pe-
riod; and
(6) recommends such legislative or administra-
tive changes relating to the continuation of medicare
coverage for recipients of social security disability
benefits as the Comptroller General determines are
appropriate.
SEC. 203. GRANTS TO DEVELOP AND ESTABLISH STATE IN-
FRASTRUCTURES TO SUPPORT WORKING IN-
DIVIDUALS WITH DISABILITIES.
(a) ESTABLISHMENT.—
(1) IN GENERAL.—The Secretary of Health and
Human Services (in this section referred to as the
‘‘Secretary’’) shall award grants described in sub-
section (b) to States to support the design, establish-
ment, and operation of State infrastructures that
provide items and services to support working indi-
viduals with disabilities.
(2) APPLICATION.—In order to be eligible for
an award of a grant under this section, a State shall
submit an application to the Secretary at such time,
in such manner, and containing such information as
the Secretary shall require.
(3) DEFINITION
OF
STATE.—In this section,
the term ‘‘State’’ means each of the 50 States, the
District of Columbia, Puerto Rico, Guam, the
United States Virgin Islands, American Samoa, and
the Commonwealth of the Northern Mariana Is-
lands.
(b) GRANTS
FOR
INFRASTRUCTURE
AND
OUT-
REACH.—
(1) IN
GENERAL.—Out of the funds appro-
priated under subsection (e), the Secretary shall
award grants to States to—
(A) support the establishment, implemen-
tation, and operation of the State infrastruc-
tures described in subsection (a); and
(B) conduct outreach campaigns regarding
the existence of such infrastructures.
(2) ELIGIBILITY FOR GRANTS.—
(A) IN GENERAL.—No State may receive a
grant under this subsection unless the State—
(i) has an approved amendment to the
State plan under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) that
provides medical assistance under such
plan to individuals described in section
1902(a)(10)(A)(ii)(XIII) of the Social Se-
curity 
Act 
(42 
U.S.C.
1396a(a)(10)(A)(ii)(XIII)); and
(ii) demonstrates to the satisfaction of
the Secretary that the State makes per-
sonal assistance services available under
the State plan under title XIX of the So-
cial Security Act (42 U.S.C. 1396 et seq.)
to the extent necessary to enable individ-
uals described in clause (i) to remain em-
ployed 
(as 
determined 
under 
section
1905(v)(2) of the Social Security Act (42
U.S.C. 1396d(v)(2))).
(B) DEFINITION
OF
PERSONAL
ASSIST-
ANCE SERVICES.—In this paragraph, the term
‘‘personal assistance services’’ means a range of
services, provided by 1 or more persons, de-
signed to assist an individual with a disability
to perform daily activities on and off the job
that the individual would typically perform if
the individual did not have a disability. Such
services shall be designed to increase the indi-
vidual’s control in life and ability to perform ev-
eryday activities on or off the job.
(3) DETERMINATION OF AWARDS.—
(A) IN
GENERAL.—Subject to subpara-
graph (B), the Secretary shall determine a for-
mula for awarding grants to States under this
section that provides special consideration to
States that provide medical assistance under
title XIX of the Social Security Act to individ-
uals 
described 
in 
section
1902(a)(10)(A)(ii)(XV) of that Act (42 U.S.C.
1396a(a)(10)(A)(ii)(XV)).
(B) AWARD LIMITS.—
(i) MINIMUM AWARDS.—
(I) IN
GENERAL.—Subject to
subclause (II), no State with an ap-
proved application under this section
shall receive a grant for a fiscal year
that is less than $500,000.
(II) PRO RATA REDUCTIONS.—If
the funds appropriated under sub-
section (e) for a fiscal year are not
sufficient to pay each State with an
application approved under this sec-
tion the minimum amount described
in subclause (I), the Secretary shall
pay each such State an amount equal
to the pro rata share of the amount
made available.
(ii) MAXIMUM
AWARDS.—No State
with an application that has been approved
under this section shall receive a grant for
a fiscal year that exceeds 15 percent of the
total expenditures by the State (including
the reimbursed Federal share of such ex-
penditures) for medical assistance for indi-
viduals eligible under subclause (XIII) or
(XV) of section 1902(a)(10)(A)(ii) of the
Social 
Security 
Act 
(42 
U.S.C.
1396a(a)(10)(A)(ii)), as estimated by the
State and approved by the Secretary.
(c) AVAILABILITY OF FUNDS.—
(1) FUNDS
AWARDED
TO
STATES.—Funds
awarded to a State under a grant made under this
section for a fiscal year shall remain available until
expended.
(2) FUNDS NOT AWARDED TO STATES.—Funds
not awarded to States in the fiscal year for which
they are appropriated shall remain available in suc-
ceeding fiscal years for awarding by the Secretary.
(d) ANNUAL REPORT.—A State that is awarded a
grant under this section shall submit an annual report to
the Secretary on the use of funds provided under the
grant. Each report shall include the percentage increase
in the number of title II disability beneficiaries, as defined
in section 1148(k)(3) of the Social Security Act (as
amended by section 101(a)) in the State, and title XVI
disability beneficiaries, as defined in section 1148(k)(4) of
the Social Security Act (as so amended) in the State who
return to work.
(e) APPROPRIATION.—
(1) IN
GENERAL.—Out of any funds in the
Treasury not otherwise appropriated, there is appro-
priated to make grants under this section—
(A) for fiscal year 2000, $20,000,000;
(B) for fiscal year 2001, $25,000,000;
(C) for fiscal year 2002, $30,000,000;
(D) for fiscal year 2003, $35,000,000;
(E) for fiscal year 2004, $40,000,000; and
(F) for each of fiscal years 2005 through
2010, the amount appropriated for the pre-
ceding fiscal year increased by the percentage
increase (if any) in the Consumer Price Index
for All Urban Consumers (United States city
average) for the preceding fiscal year.
(2) BUDGET AUTHORITY.—This subsection con-
stitutes budget authority in advance of appropria-
tions Acts and represents the obligation of the Fed-
eral Government to provide for the payment of the
amounts appropriated under paragraph (1).
(f) RECOMMENDATION.—Not later than October 1,
2009, the Secretary, in consultation with the Work Incen-
tives Advisory Panel established under section 201(f),
shall submit a recommendation to the Committee on Com-
merce of the House of Representatives and the Committee
on Finance of the Senate regarding whether the grant pro-
gram established under this section should be continued
after fiscal year 2010.
SEC. 204. DEMONSTRATION OF COVERAGE UNDER THE
MEDICAID PROGRAM OF WORKERS WITH PO-
TENTIALLY SEVERE DISABILITIES.
(a) STATE APPLICATION.—A State may apply to the
Secretary of Health and Human Services (in this section
referred to as the ‘‘Secretary’’) for approval of a dem-
onstration project (in this section referred to as a ‘‘dem-
onstration project’’) under which up to a specified max-
imum number of individuals who are workers with a po-
tentially severe disability (as defined in subsection (b)(1))
are provided medical assistance equal to that provided
under section 1905(a) of the Social Security Act (42
U.S.C. 1396d(a)) to individuals described in section
1902(a)(10)(A)(ii)(XIII) 
of 
that 
Act 
(42 
U.S.C.
1396a(a)(10)(A)(ii)(XIII)).
(b) WORKER WITH A POTENTIALLY SEVERE DIS-
ABILITY DEFINED.—For purposes of this section—
(1) IN GENERAL.—The term ‘‘worker with a
potentially severe disability’’ means, with respect to
a demonstration project, an individual who—
(A) is at least 16, but less than 65, years
of age;
(B) has a specific physical or mental im-
pairment that, as defined by the State under
the demonstration project, is reasonably ex-
pected, but for the receipt of items and services
described in section 1905(a) of the Social Secu-
rity Act (42 U.S.C. 1396d(a)), to become blind
or disabled (as defined under section 1614(a) of
the Social Security Act (42 U.S.C. 1382c(a)));
and
(C) is employed (as defined in paragraph
(2)).
(2) DEFINITION OF EMPLOYED.—An individual
is considered to be ‘‘employed’’ if the individual—
(A) is earning at least the applicable min-
imum wage requirement under section 6 of the
Fair Labor Standards Act (29 U.S.C. 206) and
working at least 40 hours per month; or
(B) is engaged in a work effort that meets
substantial and reasonable threshold criteria for
hours of work, wages, or other measures, as de-
fined under the demonstration project and ap-
proved by the Secretary.
(c) APPROVAL OF DEMONSTRATION PROJECTS.—
(1) IN GENERAL.—Subject to paragraph (3),
the Secretary shall approve applications under sub-
section (a) that meet the requirements of paragraph
(2) and such additional terms and conditions as the
Secretary may require. The Secretary may waive the
requirement of section 1902(a)(1) of the Social Se-
curity Act (42 U.S.C. 1396a(a)(1)) to allow for sub-
State demonstrations.
(2) TERMS AND CONDITIONS OF DEMONSTRA-
TION PROJECTS.—The Secretary may not approve a
demonstration project under this section unless the
State provides assurances satisfactory to the Sec-
retary that the following conditions are or will be
met:
(A) ELECTION OF OPTIONAL CATEGORY.—
The State has elected to provide coverage under
its plan under title XIX of the Social Security
Act 
of 
individuals 
described 
in 
section
1902(a)(10)(A)(ii)(XIII) of the Social Security
Act (42 U.S.C. 1396a(a)(10)(A)(ii)(XIII)).
(B) MAINTENANCE OF STATE EFFORT.—
Federal funds paid to a State pursuant to this
section must be used to supplement, but not
supplant, the level of State funds expended for
workers with potentially severe disabilities
under programs in effect for such individuals at
the time the demonstration project is approved
under this section.
(C) 
INDEPENDENT
EVALUATION.—The
State provides for an independent evaluation of
the project.
(3) LIMITATIONS ON FEDERAL FUNDING.—
(A) APPROPRIATION.—
(i) IN GENERAL.—Out of any funds in
the Treasury not otherwise appropriated,
there is appropriated to carry out this sec-
tion for the 5-fiscal-year period beginning
with fiscal year 2000, $56,000,000.
(ii) BUDGET AUTHORITY.—Clause (i)
constitutes budget authority in advance of
appropriations Acts and represents the ob-
ligation of the Federal Government to pro-
vide for the payment of the amounts ap-
propriated under clause (i).
(B) LIMITATION
ON
PAYMENTS.—In no
case may—
(i) the aggregate amount of payments
made by the Secretary to States under this
section exceed $56,000,000; or
(ii) payments be provided by the Sec-
retary for a fiscal year after fiscal year
2005.
(C) FUNDS ALLOCATED TO STATES.—The
Secretary shall allocate funds to States based
on their applications and the availability of
funds. Funds allocated to a State under a grant
made under this section for a fiscal year shall
remain available until expended.
(D) FUNDS NOT ALLOCATED TO STATES.—
Funds not allocated to States in the fiscal year
for which they are appropriated shall remain
available in succeeding fiscal years for alloca-
tion by the Secretary using the allocation for-
mula established under this section.
(E) PAYMENTS
TO
STATES.—The Sec-
retary shall pay to each State with a dem-
onstration project approved under this section,
from its allocation under subparagraph (C), an
amount for each quarter equal to the Federal
medical assistance percentage (as defined in
section 1905(b) of the Social Security Act (42
U.S.C. 1395d(b)) of expenditures in the quarter
for medical assistance provided to workers with
a potentially severe disability.
(d) RECOMMENDATION.—Not later than October 1,
2002, the Secretary shall submit a recommendation to the
Committee on Commerce of the House of Representatives
and the Committee on Finance of the Senate regarding
whether the demonstration project established under this
section should be continued after fiscal year 2003.
(e) STATE DEFINED.—In this section, the term
‘‘State’’ has the meaning given such term for purposes of
title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.).
SEC. 205. ELECTION BY DISABLED BENEFICIARIES TO SUS-
PEND MEDIGAP INSURANCE WHEN COVERED
UNDER A GROUP HEALTH PLAN.
(a) IN GENERAL.—Section 1882(q) of the Social Se-
curity Act (42 U.S.C. 1395ss(q)) is amended—
(1) in paragraph (5)(C), by inserting ‘‘or para-
graph (6)’’ after ‘‘this paragraph’’; and
(2) by adding at the end the following new
paragraph:
‘‘(6) Each medicare supplemental policy shall
provide that benefits and premiums under the policy
shall be suspended at the request of the policyholder
if the policyholder is entitled to benefits under sec-
tion 226(b) and is covered under a group health
plan (as defined in section 1862(b)(1)(A)(v)). If
such suspension occurs and if the policyholder or
certificate holder loses coverage under the group
health plan, such policy shall be automatically re-
instituted (effective as of the date of such loss of
coverage) under terms described in subsection
(n)(6)(A)(ii) as of the loss of such coverage if the
policyholder provides notice of loss of such coverage
within 90 days after the date of such loss.’’.
(b) EFFECTIVE DATE.—The amendments made by
subsection (a) apply with respect to requests made after
the date of the enactment of this Act.
TITLE III—DEMONSTRATION
PROJECTS AND STUDIES
SEC. 301. EXTENSION OF DISABILITY INSURANCE PRO-
GRAM DEMONSTRATION PROJECT AUTHOR-
ITY.
(a) EXTENSION OF AUTHORITY.—Title II of the So-
cial Security Act (42 U.S.C. 401 et seq.) is amended by
adding at the end the following:
‘‘DEMONSTRATION PROJECT AUTHORITY
‘‘SEC. 234. (a) AUTHORITY.—
‘‘(1) IN GENERAL.—The Commissioner of So-
cial Security (in this section referred to as the ‘Com-
missioner’) shall develop and carry out experiments
and demonstration projects designed to determine
the relative advantages and disadvantages of—
‘‘(A) various alternative methods of treat-
ing the work activity of individuals entitled to
disability insurance benefits under section 223
or to monthly insurance benefits under section
202 based on such individual’s disability (as de-
fined in section 223(d)), including such meth-
ods as a reduction in benefits based on earn-
ings, designed to encourage the return to work
of such individuals;
‘‘(B) altering other limitations and condi-
tions applicable to such individuals (including
lengthening the trial work period (as defined in
section 222(c)), altering the 24-month waiting
period for hospital insurance benefits under sec-
tion 226, altering the manner in which the pro-
gram under this title is administered, earlier re-
ferral of such individuals for rehabilitation, and
greater use of employers and others to develop,
perform, and otherwise stimulate new forms of
rehabilitation); and
‘‘(C) implementing sliding scale benefit off-
sets using variations in—
‘‘(i) the amount of the offset as a pro-
portion of earned income;
100
‘‘(ii) the duration of the offset period;
and
‘‘(iii) the method of determining the
amount of income earned by such individ-
uals,
to the end that savings will accrue to the Trust
Funds, or to otherwise promote the objectives or fa-
cilitate the administration of this title.
‘‘(2) AUTHORITY FOR EXPANSION OF SCOPE.—
The Commissioner may expand the scope of any
such experiment or demonstration project to include
any group of applicants for benefits under the pro-
gram established under this title with impairments
that reasonably may be presumed to be disabling for
purposes of such demonstration project, and may
limit any such demonstration project to any such
group of applicants, subject to the terms of such
demonstration project which shall define the extent
of any such presumption.
‘‘(b) REQUIREMENTS.—The experiments and dem-
onstration projects developed under subsection (a) shall be
of sufficient scope and shall be carried out on a wide
enough scale to permit a thorough evaluation of the alter-
native methods under consideration while giving assurance
that the results derived from the experiments and projects
101
will obtain generally in the operation of the disability in-
surance program under this title without committing such
program to the adoption of any particular system either
locally or nationally.
‘‘(c) AUTHORITY TO WAIVE COMPLIANCE WITH
BENEFITS REQUIREMENTS.—In the case of any experi-
ment or demonstration project conducted under subsection
(a), the Commissioner may waive compliance with the ben-
efit requirements of this title and the requirements of sec-
tion 1148 as they relate to the program established under
this title, and the Secretary may (upon the request of the
Commissioner) waive compliance with the benefits require-
ments of title XVIII, insofar as is necessary for a thorough
evaluation of the alternative methods under consideration.
No such experiment or project shall be actually placed in
operation unless at least 90 days prior thereto a written
report, prepared for purposes of notification and informa-
tion only and containing a full and complete description
thereof, has been transmitted by the Commissioner to the
Committee on Ways and Means of the House of Rep-
resentatives and to the Committee on Finance of the Sen-
ate. Periodic reports on the progress of such experiments
and demonstration projects shall be submitted by the
Commissioner to such committees. When appropriate,
such reports shall include detailed recommendations for
102
changes in administration or law, or both, to carry out
the objectives stated in subsection (a).
‘‘(d) REPORTS.—
‘‘(1) INTERIM REPORTS.—On or before June 9
of each year, the Commissioner shall submit to the
Committee on Ways and Means of the House of
Representatives and to the Committee on Finance of
the Senate an annual interim report on the progress
of the experiments and demonstration projects car-
ried out under this subsection together with any re-
lated data and materials that the Commissioner may
consider appropriate.
‘‘(2) TERMINATION AND FINAL REPORT.—The
authority under the preceding provisions of this sec-
tion (including any waiver granted pursuant to sub-
section (c)) shall terminate 5 years after the date of
the enactment of this Act. Not later than 90 days
after the termination of any experiment or dem-
onstration project carried out under this section, the
Commissioner shall submit to the Committee on
Ways and Means of the House of Representatives
and to the Committee on Finance of the Senate a
final report with respect to that experiment or dem-
onstration project.’’.
103
(b) CONFORMING
AMENDMENTS; TRANSFER
OF
PRIOR AUTHORITY.—
(1) CONFORMING AMENDMENTS.—
(A) REPEAL OF PRIOR AUTHORITY.—Para-
graphs (1) through (4) of subsection (a) and
subsection (c) of section 505 of the Social Secu-
rity Disability Amendments of 1980 (42 U.S.C.
1310 note) are repealed.
(B) CONFORMING
AMENDMENT
REGARD-
ING
FUNDING.—Section 201(k) of the Social
Security Act (42 U.S.C. 401(k)) is amended by
striking ‘‘section 505(a) of the Social Security
Disability Amendments of 1980’’ and inserting
‘‘section 234’’.
(2) TRANSFER
OF
PRIOR
AUTHORITY.—With
respect to any experiment or demonstration project
being conducted under section 505(a) of the Social
Security Disability Amendments of 1980 (42 U.S.C.
1310 note) as of the date of the enactment of this
Act, the authority to conduct such experiment or
demonstration project (including the terms and con-
ditions applicable to the experiment or demonstra-
tion project) shall be treated as if that authority
(and such terms and conditions) had been estab-
104
lished under section 234 of the Social Security Act,
as added by subsection (a).
SEC. 302. DEMONSTRATION PROJECTS PROVIDING FOR RE-
DUCTIONS IN DISABILITY INSURANCE BENE-
FITS BASED ON EARNINGS.
(a) AUTHORITY.—The Commissioner of Social Secu-
rity shall conduct demonstration projects for the purpose
of evaluating, through the collection of data, a program
for title II disability beneficiaries (as defined in section
1148(k)(3) of the Social Security Act) under which bene-
fits payable under section 223 of such Act, or under sec-
tion 202 of such Act based on the beneficiary’s disability,
are reduced by $1 for each $2 of the beneficiary’s earnings
that is above a level to be determined by the Commis-
sioner. Such projects shall be conducted at a number of
localities which the Commissioner shall determine is suffi-
cient to adequately evaluate the appropriateness of na-
tional implementation of such a program. Such projects
shall identify reductions in Federal expenditures that may
result from the permanent implementation of such a pro-
gram.
(b) SCOPE AND SCALE AND MATTERS TO BE DETER-
MINED.—
(1) IN GENERAL.—The demonstration projects
developed under subsection (a) shall be of sufficient
105
duration, shall be of sufficient scope, and shall be
carried out on a wide enough scale to permit a thor-
ough evaluation of the project to determine—
(A) the effects, if any, of induced entry
into the project and reduced exit from the
project;
(B) the extent, if any, to which the project
being tested is affected by whether it is in oper-
ation in a locality within an area under the ad-
ministration of the Ticket to Work and Self-
Sufficiency Program established under section
1148 of the Social Security Act; and
(C) the savings that accrue to the Federal
Old-Age and Survivors Insurance Trust Fund,
the Federal Disability Insurance Trust Fund,
and other Federal programs under the project
being tested.
The Commissioner shall take into account advice
provided by the Ticket to Work and Work Incentives
Advisory Panel pursuant to section 101(f)(2)(B)(ii)
of this Act.
(2) ADDITIONAL MATTERS.—The Commissioner
shall also determine with respect to each project—
(A) the annual cost (including net cost) of
the project and the annual cost (including net
106
cost) that would have been incurred in the ab-
sence of the project;
(B) the determinants of return to work, in-
cluding the characteristics of the beneficiaries
who participate in the project; and
(C) the employment outcomes, including
wages, occupations, benefits, and hours worked,
of beneficiaries who return to work as a result
of participation in the project.
The Commissioner may include within the matters
evaluated under the project the merits of trial work
periods and periods of extended eligibility.
(c) WAIVERS.—The Commissioner may waive compli-
ance with the benefit provisions of title II of the Social
Security Act, and the Secretary of Health and Human
Services may waive compliance with the benefit require-
ments of title XVIII of such Act, insofar as is necessary
for a thorough evaluation of the alternative methods under
consideration. No such project shall be actually placed in
operation unless at least 90 days prior thereto a written
report, prepared for purposes of notification and informa-
tion only and containing a full and complete description
thereof, has been transmitted by the Commissioner to the
Committee on Ways and Means of the House of Rep-
resentatives and to the Committee on Finance of the Sen-
107
ate. Periodic reports on the progress of such projects shall
be submitted by the Commissioner to such committees.
When appropriate, such reports shall include detailed rec-
ommendations for changes in administration or law, or
both, to carry out the objectives stated in subsection (a).
(d) INTERIM REPORTS.—Not later than 2 years after
the date of the enactment of this Act, and annually there-
after, the Commissioner of Social Security shall submit
to Congress an interim report on the progress of the dem-
onstration projects carried out under this subsection to-
gether with any related data and materials that the Com-
missioner of Social Security may consider appropriate.
(e) FINAL REPORT.—The Commissioner of Social Se-
curity shall submit to Congress a final report with respect
to all demonstration projects carried out under this section
not later than 1 year after their completion.
(f) EXPENDITURES.—Expenditures made for dem-
onstration projects under this section shall be made from
the Federal Disability Insurance Trust Fund and the Fed-
eral Old-Age and Survivors Insurance Trust Fund, as de-
termined appropriate by the Commissioner of Social Secu-
rity, and from the Federal Hospital Insurance Trust Fund
and the Federal Supplementary Medical Insurance Trust
Fund, as determined appropriate by the Secretary of
108
Health and Human Services, to the extent provided in ad-
vance in appropriation Acts.
SEC. 303. STUDIES AND REPORTS.
(a) STUDY BY GENERAL ACCOUNTING OFFICE OF
EXISTING DISABILITY-RELATED EMPLOYMENT INCEN-
TIVES.—
(1) STUDY.—As soon as practicable after the
date of the enactment of this Act, the Comptroller
General of the United States shall undertake a study
to assess existing tax credits and other disability-re-
lated employment incentives under the Americans
with Disabilities Act of 1990 and other Federal
laws. In such study, the Comptroller General shall
specifically address the extent to which such credits
and other incentives would encourage employers to
hire and retain individuals with disabilities.
(2) REPORT.—Not later than 3 years after the
date of the enactment of this Act, the Comptroller
General shall transmit to the Committee on Ways
and Means of the House of Representatives and the
Committee on Finance of the Senate a written re-
port presenting the results of the Comptroller Gen-
eral’s study conducted pursuant to this subsection,
together with such recommendations for legislative
109
or administrative changes as the Comptroller Gen-
eral determines are appropriate.
(b) STUDY BY GENERAL ACCOUNTING OFFICE OF
EXISTING COORDINATION OF THE DI AND SSI PROGRAMS
AS THEY RELATE TO INDIVIDUALS ENTERING OR LEAV-
ING CONCURRENT ENTITLEMENT.—
(1) STUDY.—As soon as practicable after the
date of the enactment of this Act, the Comptroller
General of the United States shall undertake a study
to evaluate the coordination under current law of the
disability insurance program under title II of the So-
cial Security Act and the supplemental security in-
come program under title XVI of such Act, as such
programs relate to individuals entering or leaving
concurrent entitlement under such programs. In
such study, the Comptroller General shall specifically
address the effectiveness of work incentives under
such programs with respect to such individuals and
the effectiveness of coverage of such individuals
under titles XVIII and XIX of such Act.
(2) REPORT.—Not later than 3 years after the
date of the enactment of this Act, the Comptroller
General shall transmit to the Committee on Ways
and Means of the House of Representatives and the
Committee on Finance of the Senate a written re-
110
port presenting the results of the Comptroller Gen-
eral’s study conducted pursuant to this subsection,
together with such recommendations for legislative
or administrative changes as the Comptroller Gen-
eral determines are appropriate.
(c) STUDY BY GENERAL ACCOUNTING OFFICE OF
THE IMPACT OF THE SUBSTANTIAL GAINFUL ACTIVITY
LIMIT ON RETURN TO WORK.—
(1) STUDY.—As soon as practicable after the
date of the enactment of this Act, the Comptroller
General of the United States shall undertake a study
of the substantial gainful activity level applicable as
of that date to recipients of benefits under section
223 of the Social Security Act (42 U.S.C. 423) and
under section 202 of such Act (42 U.S.C. 402) on
the basis of a recipient having a disability, and the
effect of such level as a disincentive for those recipi-
ents to return to work. In the study, the Comptroller
General also shall address the merits of increasing
the substantial gainful activity level applicable to
such recipients of benefits and the rationale for not
yearly indexing that level to inflation.
(2) REPORT.—Not later than 2 years after the
date of the enactment of this Act, the Comptroller
General shall transmit to the Committee on Ways
111
and Means of the House of Representatives and the
Committee on Finance of the Senate a written re-
port presenting the results of the Comptroller Gen-
eral’s study conducted pursuant to this subsection,
together with such recommendations for legislative
or administrative changes as the Comptroller Gen-
eral determines are appropriate.
(d) REPORT ON DISREGARDS UNDER THE DI AND
SSI PROGRAMS.—Not later than 90 days after the date
of the enactment of this Act, the Commissioner of Social
Security shall submit to the Committee on Ways and
Means of the House of Representatives and the Committee
on Finance of the Senate a report that—
(1) identifies all income, assets, and resource
disregards (imposed under statutory or regulatory
authority) that are applicable to individuals receiving
benefits under title II or XVI of the Social Security
Act (42 U.S.C. 401 et seq., 1381 et seq.);
(2) with respect to each such disregard—
(A) specifies the most recent statutory or
regulatory modification of the disregard; and
(B) recommends whether further statutory
or regulatory modification of the disregard
would be appropriate; and
112
(3) with respect to the disregard described in
section 
1612(b)(7) 
of 
such 
Act 
(42 
U.S.C.
1382a(b)(7)) (relating to grants, scholarships, or fel-
lowships received for use in paying the cost of tui-
tion and fees at any educational (including technical
or vocational education) institution)—
(A) identifies the number of individuals re-
ceiving benefits under title XVI of such Act (42
U.S.C. 1381 et seq.) who have attained age 22
and have not had any portion of any grant,
scholarship, or fellowship received for use in
paying the cost of tuition and fees at any edu-
cational (including technical or vocational edu-
cation) institution excluded from their income
in accordance with that section;
(B) recommends whether the age at which
such grants, scholarships, or fellowships are ex-
cluded from income for purposes of determining
eligibility under title XVI of such Act should be
increased to age 25; and
(C) recommends whether such disregard
should be expanded to include any such grant,
scholarship, or fellowship received for use in
paying the cost of room and board at any such
institution.
113
(e) STUDY BY THE GENERAL ACCOUNTING OFFICE
OF SOCIAL SECURITY ADMINISTRATION’S DISABILITY IN-
SURANCE PROGRAM DEMONSTRATION AUTHORITY.—
(1) STUDY.—As soon as practicable after the
date of the enactment of this Act, the Comptroller
General of the United States shall undertake a study
to assess the results of the Social Security Adminis-
tration’s efforts to conduct disability demonstrations
authorized under prior law as well as under section
301 of this Act.
(2) REPORT.—Not later than 5 years after the
date of the enactment of this Act, the Comptroller
General shall transmit to the Committee on Ways
and Means of the House of Representatives and the
Committee on Finance of the Senate a written re-
port presenting the results of the Comptroller Gen-
eral’s study conducted pursuant to this section, to-
gether with a recommendation as to whether the
demonstration authority authorized under section
301 of this Act should be made permanent.
114
TITLE IV—MISCELLANEOUS AND
TECHNICAL AMENDMENTS
SEC. 401. TECHNICAL AMENDMENTS RELATING TO DRUG
ADDICTS AND ALCOHOLICS.
(a) CLARIFICATION RELATING TO THE EFFECTIVE
DATE OF THE DENIAL OF SOCIAL SECURITY DISABILITY
BENEFITS TO DRUG ADDICTS AND ALCOHOLICS.—Sec-
tion 105(a)(5) of the Contract with America Advancement
Act of 1996 (42 U.S.C. 405 note) is amended—
(1) in subparagraph (A), by striking ‘‘by the
Commissioner of Social Security’’ and ‘‘by the Com-
missioner’’; and
(2) by adding at the end the following:
‘‘(D) For purposes of this paragraph, an
individual’s claim, with respect to benefits
under title II based on disability, which has
been denied in whole before the date of the en-
actment of this Act, may not be considered to
be finally adjudicated before such date if, on or
after such date—
‘‘(i) there is pending a request for ei-
ther administrative or judicial review with
respect to such claim; or
‘‘(ii) there is pending, with respect to
such claim, a readjudication by the Com-
115
missioner of Social Security pursuant to
relief in a class action or implementation
by the Commissioner of a court remand
order.
‘‘(E) Notwithstanding the provisions of
this paragraph, with respect to any individual
for whom the Commissioner of Social Security
does not perform the entitlement redetermina-
tion before the date prescribed in subparagraph
(C), the Commissioner shall perform such enti-
tlement redetermination in lieu of a continuing
disability review whenever the Commissioner de-
termines that the individual’s entitlement is
subject to redetermination based on the pre-
ceding provisions of this paragraph, and the
provisions of section 223(f) shall not apply to
such redetermination.’’.
(b) CORRECTION TO EFFECTIVE DATE OF PROVI-
SIONS
CONCERNING
REPRESENTATIVE
PAYEES
AND
TREATMENT REFERRALS OF SOCIAL SECURITY BENE-
FICIARIES WHO ARE DRUG ADDICTS AND ALCOHOLICS.—
Section 105(a)(5)(B) of the Contract with America Ad-
vancement Act of 1996 (42 U.S.C. 405 note) is amended
to read as follows:
116
‘‘(B) The amendments made by para-
graphs (2) and (3) shall take effect on July 1,
1996, with respect to any individual—
‘‘(i) whose claim for benefits is finally
adjudicated on or after the date of the en-
actment of this Act; or
‘‘(ii) whose entitlement to benefits is
based upon an entitlement redetermination
made pursuant to subparagraph (C).’’.
(c) EFFECTIVE DATES.—The amendments made by
this section shall take effect as if included in the enact-
ment of section 105 of the Contract with America Ad-
vancement Act of 1996 (Public Law 104–121; 110 Stat.
852 et seq.).
SEC. 402. TREATMENT OF PRISONERS.
(a) IMPLEMENTATION
OF PROHIBITION AGAINST
PAYMENT OF TITLE II BENEFITS TO PRISONERS.—
(1) IN GENERAL.—Section 202(x)(3) of the So-
cial 
Security 
Act 
(42 
U.S.C. 
402(x)(3)) 
is
amended—
(A) by inserting ‘‘(A)’’ after ‘‘(3)’’; and
(B) by adding at the end the following:
‘‘(B)(i) The Commissioner shall enter into an agree-
ment under this subparagraph with any interested State
or local institution comprising a jail, prison, penal institu-
117
tion, or correctional facility, or comprising any other insti-
tution a purpose of which is to confine individuals as de-
scribed in paragraph (1)(A)(ii). Under such agreement—
‘‘(I) the institution shall provide to the Com-
missioner, on a monthly basis and in a manner spec-
ified by the Commissioner, the names, Social Secu-
rity account numbers, dates of birth, confinement
commencement dates, and, to the extent available to
the institution, such other identifying information
concerning the individuals confined in the institution
as the Commissioner may require for the purpose of
carrying out paragraph (1) and other provisions of
this title; and
‘‘(II) the Commissioner shall pay to the institu-
tion, with respect to information described in sub-
clause (I) concerning each individual who is confined
therein as described in paragraph (1)(A), who re-
ceives a benefit under this title for the month pre-
ceding the first month of such confinement, and
whose benefit under this title is determined by the
Commissioner to be not payable by reason of con-
finement based on the information provided by the
institution, $400 (subject to reduction under clause
(ii)) if the institution furnishes the information to
the Commissioner within 30 days after the date such
118
individual’s confinement in such institution begins,
or $200 (subject to reduction under clause (ii)) if
the institution furnishes the information after 30
days after such date but within 90 days after such
date.
‘‘(ii) The dollar amounts specified in clause (i)(II)
shall be reduced by 50 percent if the Commissioner is also
required to make a payment to the institution with respect
to the same individual under an agreement entered into
under section 1611(e)(1)(I).
‘‘(iii) There are authorized to be transferred from the
Federal Old-Age and Survivors Insurance Trust Fund and
the Federal Disability Insurance Trust Fund, as appro-
priate, such sums as may be necessary to enable the Com-
missioner to make payments to institutions required by
clause (i)(II).
‘‘(iv) The Commissioner shall maintain, and shall
provide on a reimbursable basis, information obtained pur-
suant to agreements entered into under this paragraph to
any agency administering a Federal or federally-assisted
cash, food, or medical assistance program for eligibility
and other administrative purposes under such program.’’.
(2) CONFORMING AMENDMENTS TO THE PRI-
VACY ACT.—Section 552a(a)(8)(B) of title 5, United
States Code, is amended—
119
(A) in clause (vi), by striking ‘‘or’’ at the
end;
(B) in clause (vii), by adding ‘‘or’’ at the
end; and
(C) by adding at the end the following:
‘‘(viii) matches performed pursuant to
section 202(x)(3) or 1611(e)(1) of the So-
cial Security Act (42 U.S.C. 402(x)(3),
1382(e)(1));’’.
(3) CONFORMING
AMENDMENTS
TO
TITLE
XVI.—
(A) Section 1611(e)(1)(I)(i)(I) of the So-
cial Security Act (42 U.S.C. 1382(e)(1)(I)(i)(I))
is amended by striking ‘‘; and’’ and inserting
‘‘and the other provisions of this title; and’’.
(B) Section 1611(e)(1)(I)(ii)(II) of such
Act (42 U.S.C. 1382(e)(1)(I)(ii)(II)) is amend-
ed by striking ‘‘is authorized to provide, on a
reimbursable basis,’’ and inserting ‘‘shall main-
tain, and shall provide on a reimbursable
basis,’’.
(4) EFFECTIVE DATE.—The amendments made
by this subsection shall apply to individuals whose
period of confinement in an institution commences
120
on or after the first day of the fourth month begin-
ning after the month in which this Act is enacted.
(b) ELIMINATION OF TITLE II REQUIREMENT THAT
CONFINEMENT STEM FROM CRIME PUNISHABLE BY IM-
PRISONMENT FOR MORE THAN 1 YEAR.—
(1) IN GENERAL.—Section 202(x)(1)(A) of the
Social Security Act (42 U.S.C. 402(x)(1)(A)) is
amended—
(A) in the matter preceding clause (i), by
striking ‘‘during which’’ and inserting ‘‘ending
with or during or beginning with or during a
period of more than 30 days throughout all of
which’’;
(B) in clause (i), by striking ‘‘an offense
punishable by imprisonment for more than 1
year (regardless of the actual sentence im-
posed)’’ and inserting ‘‘a criminal offense’’; and
(C) in clause (ii)(I), by striking ‘‘an of-
fense punishable by imprisonment for more
than 1 year’’ and inserting ‘‘a criminal of-
fense’’.
(2) EFFECTIVE DATE.—The amendments made
by this subsection shall apply to individuals whose
period of confinement in an institution commences
121
on or after the first day of the fourth month begin-
ning after the month in which this Act is enacted.
(c) CONFORMING TITLE XVI AMENDMENTS.—
(1) 50 PERCENT REDUCTION IN TITLE XVI PAY-
MENT IN CASE INVOLVING COMPARABLE TITLE II
PAYMENT.—Section 1611(e)(1)(I) of the Social Se-
curity Act (42 U.S.C. 1382(e)(1)(I)) is amended—
(A) in clause (i)(II), by inserting ‘‘(subject
to reduction under clause (ii))’’ after ‘‘$400’’
and after ‘‘$200’’;
(B) by redesignating clauses (ii) and (iii)
as clauses (iii) and (iv) respectively; and
(C) by inserting after clause (i) the fol-
lowing:
‘‘(ii) The dollar amounts specified in clause (i)(II)
shall be reduced by 50 percent if the Commissioner is also
required to make a payment to the institution with respect
to the same individual under an agreement entered into
under section 202(x)(3)(B).’’.
(2) EXPANSION OF CATEGORIES OF INSTITU-
TIONS ELIGIBLE TO ENTER INTO AGREEMENTS WITH
THE
COMMISSIONER.—Section 1611(e)(1)(I)(i) of
such Act (42 U.S.C. 1382(e)(1)(I)(i)) is amended in
the matter preceding subclause (I) by striking ‘‘in-
stitution’’ and all that follows through ‘‘section
122
202(x)(1)(A),’’ and inserting ‘‘institution comprising
a jail, prison, penal institution, or correctional facil-
ity, or with any other interested State or local insti-
tution a purpose of which is to confine individuals
as described in section 202(x)(1)(A)(ii),’’.
(3) ELIMINATION OF OVERLY BROAD EXEMP-
TION.—Section 1611(e)(1)(I)(iii) of such Act (as re-
designated by paragraph (1)(B)) is amended
further—
(A) by striking ‘‘(I) The provisions’’ and
all that follows through ‘‘(II)’’; and
(B) by striking ‘‘eligibility purposes’’ and
inserting ‘‘eligibility and other administrative
purposes under such program’’.
(4) EFFECTIVE DATE.—The amendments made
by this subsection shall take effect as if included in
the enactment of section 203(a) of the Personal Re-
sponsibility and Work Opportunity Reconciliation
Act of 1996 (Public Law 104–193; 110 Stat. 2186).
The reference to section 202(x)(1)(A)(ii) in section
1611(e)(1)(I)(i) of the Social Security Act as
amended by paragraph (2) shall be deemed a ref-
erence to such section 202(x)(1)(A)(ii) of such Act
as amended by subsection (b)(1)(C).
123
(d) CONTINUED DENIAL OF BENEFITS TO SEX OF-
FENDERS REMAINING CONFINED TO PUBLIC INSTITU-
TIONS UPON COMPLETION OF PRISON TERM.—
(1) IN GENERAL.—Section 202(x)(1)(A) of the
Social Security Act (42 U.S.C. 402(x)(1)(A)) is
amended—
(A) in clause (i), by striking ‘‘or’’ at the
end;
(B) in clause (ii)(IV), by striking the pe-
riod and inserting ‘‘, or’’; and
(C) by adding at the end the following new
clause:
‘‘(iii) immediately upon completion of confine-
ment as described in clause (i) pursuant to convic-
tion of a criminal offense an element of which is sex-
ual activity, is confined by court order in an institu-
tion at public expense pursuant to a finding that the
individual is a sexually dangerous person or a sexual
predator or a similar finding.’’.
(2) 
CONFORMING
AMENDMENT.—Section
202(x)(1)(B)(ii) 
of 
such 
Act 
(42 
U.S.C.
402(x)(1)(B)(ii)) is amended by striking ‘‘clause
(ii)’’ and inserting ‘‘clauses (ii) and (iii)’’.
(3) EFFECTIVE DATE.—The amendments made
by this subsection shall apply with respect to bene-
124
fits for months ending after the date of the enact-
ment of this Act.
SEC. 403. REVOCATION BY MEMBERS OF THE CLERGY OF
EXEMPTION FROM SOCIAL SECURITY COV-
ERAGE.
(a) 
IN
GENERAL.—Notwithstanding 
section
1402(e)(4) of the Internal Revenue Code of 1986, any ex-
emption which has been received under section 1402(e)(1)
of such Code by a duly ordained, commissioned, or li-
censed minister of a church, a member of a religious order,
or a Christian Science practitioner, and which is effective
for the taxable year in which this Act is enacted, may be
revoked by filing an application therefor (in such form and
manner, and with such official, as may be prescribed by
the Commissioner of Internal Revenue), if such applica-
tion is filed no later than the due date of the Federal in-
come tax return (including any extension thereof) for the
applicant’s second taxable year beginning after December
31, 1999. Any such revocation shall be effective (for pur-
poses of chapter 2 of the Internal Revenue Code of 1986
and title II of the Social Security Act), as specified in the
application, either with respect to the applicant’s first tax-
able year beginning after December 31, 1999, or with re-
spect to the applicant’s second taxable year beginning
after such date, and for all succeeding taxable years; and
125
the applicant for any such revocation may not thereafter
again file application for an exemption under such section
1402(e)(1). If the application is filed after the due date
of the applicant’s Federal income tax return for a taxable
year and is effective with respect to that taxable year, it
shall include or be accompanied by payment in full of an
amount equal to the total of the taxes that would have
been imposed by section 1401 of the Internal Revenue
Code of 1986 with respect to all of the applicant’s income
derived in that taxable year which would have constituted
net earnings from self-employment for purposes of chapter
2 of such Code (notwithstanding paragraphs (4) and (5)
of section 1402(c)) except for the exemption under section
1402(e)(1) of such Code.
(b) EFFECTIVE DATE.—Subsection (a) shall apply
with respect to service performed (to the extent specified
in such subsection) in taxable years beginning after De-
cember 31, 1999, and with respect to monthly insurance
benefits payable under title II on the basis of the wages
and self-employment income of any individual for months
in or after the calendar year in which such individual’s
application for revocation (as described in such sub-
section) is effective (and lump-sum death payments pay-
able under such title on the basis of such wages and self-
126
employment income in the case of deaths occurring in or
after such calendar year).
SEC. 404. ADDITIONAL TECHNICAL AMENDMENT RELATING
TO 
COOPERATIVE 
RESEARCH 
OR 
DEM-
ONSTRATION PROJECTS UNDER TITLES II
AND XVI.
(a) IN GENERAL.—Section 1110(a)(3) of the Social
Security Act (42 U.S.C. 1310(a)(3)) is amended by strik-
ing ‘‘title XVI’’ and inserting ‘‘title II or XVI’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) shall take effect as if included in the enact-
ment of the Social Security Independence and Program
Improvements Act of 1994 (Public Law 103–296; 108
Stat. 1464).
SEC. 405. AUTHORIZATION FOR STATE TO PERMIT ANNUAL
WAGE REPORTS.
(a) IN GENERAL.—Section 1137(a)(3) of the Social
Security Act (42 U.S.C. 1320b–7(a)(3)) is amended by
inserting before the semicolon the following: ‘‘, and except
that in the case of wage reports with respect to domestic
service employment, a State may permit employers (as so
defined) that make returns with respect to such employ-
ment on a calendar year basis pursuant to section 3510
of the Internal Revenue Code of 1986 to make such re-
ports on an annual basis’’.
127
(b) TECHNICAL AMENDMENTS.—Section 1137(a)(3)
of the Social Security Act (42 U.S.C. 1320b–7(a)(3)) is
amended—
(1) by striking ‘‘(as defined in section
453A(a)(2)(B)(iii))’’; and
(2) by inserting ‘‘(as defined in section
453A(a)(2)(B))’’ after ‘‘employers’’ .
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply to wage reports required to be sub-
mitted on and after the date of the enactment of this Act.
SEC. 406. ASSESSMENT ON ATTORNEYS WHO RECEIVE
THEIR FEES VIA THE SOCIAL SECURITY AD-
MINISTRATION.
(a) IN GENERAL.—Section 206 of the Social Security
Act (42 U.S.C. 606) is amended by adding at the end the
following:
‘‘(d) ASSESSMENT ON ATTORNEYS.—
‘‘(1) IN GENERAL.—Whenever a fee for services
is required to be certified for payment to an attorney
from a claimant’s past-due benefits pursuant to sub-
section (a)(4)(A) or (b)(1)(A), the Commissioner
shall impose on the attorney an assessment cal-
culated in accordance with paragraph (2).
‘‘(2) AMOUNT.—
128
‘‘(A) The amount of an assessment under
paragraph (1) shall be equal to the product ob-
tained by multiplying the amount of the rep-
resentative’s fee that would be required to be so
certified by subsection (a)(4)(A) or (b)(1)(A)
before the application of this subsection, by the
percentage specified in subparagraph (B).
‘‘(B) The percentage specified in this sub-
paragraph is—
‘‘(i) for calendar years before 2001,
6.3 percent, and
‘‘(ii) for calendar years after 2000,
6.3 percent or such different percentage
rate as the Commissioner determines is
necessary in order to achieve full recovery
of the costs of certifying fees to attorneys
from the past-due benefits of claimants.
‘‘(3) COLLECTION.—The Commissioner may
collect the assessment imposed on an attorney under
paragraph (1) by offset from the amount of the fee
otherwise required by subsection (a)(4)(A) or
(b)(1)(A) to be certified for payment to the attorney
from a claimant’s past-due benefits.
‘‘(4) PROHIBITION ON CLAIMANT REIMBURSE-
MENT.—An attorney subject to an assessment under
129
paragraph (1) may not, directly or indirectly, re-
quest or otherwise obtain reimbursement for such
assessment from the claimant whose claim gave rise
to the assessment.
‘‘(5) DISPOSITION OF ASSESSMENTS.—Assess-
ments on attorneys collected under this subsection
shall be credited to the Federal Old-Age and Sur-
vivors Insurance Trust Fund and the Federal Dis-
ability Insurance Trust Fund, as appropriate.
‘‘(6) AUTHORIZATION
OF
APPROPRIATIONS.—
The assessments authorized under this section shall
be collected and available for obligation only to the
extent and in the amount provided in advance in ap-
propriations Acts. Amounts so appropriated are au-
thorized to remain available until expended, for ad-
ministrative expenses in carrying out title II of the
Social Security Act and related laws.
(b) CONFORMING AMENDMENTS.—
(1) Section 206(a)(4)(A) of such Act (42
U.S.C. 606(a)(4)(A)) is amended by inserting ‘‘and
subsection (d)’’ after ‘‘subparagraph (B)’’.
(2) Section 206(b)(1)(A) of such Act (42
U.S.C. 606(b)(1)(A)) is amended by inserting ‘‘, but
subject to subsection (d) of this section’’ after ‘‘sec-
tion 205(i)’’.
130
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply in the case of any attorney with
respect to whom a fee for services is required to be cer-
tified for payment from a claimant’s past-due benefits
pursuant to subsection (a)(4)(A) or (b)(4)(A) of section
206 of the Social Security Act after—
(1) December 31, 1999, or
(2) the last day of the first month beginning
after the month in which this Act is enacted.
SEC. 407. PREVENTION OF FRAUD AND ABUSE ASSOCIATED
WITH CERTAIN PAYMENTS UNDER THE MED-
ICAID PROGRAM.
(a) 
REQUIREMENTS
FOR
PAYMENTS.—Section
1903(i) of the Social Security Act (42 U.S.C. 1396b(i))
(as amended by section 201(a)(3)(B)) is amended
further—
(1) in paragraph (20), by striking the period at
the end and inserting ‘‘; or’’; and
(2) by inserting immediately after paragraph
(20) the following:
‘‘(21) with respect to any amount expended for
an item or service provided under the plan, or for
any administrative expense incurred to carry out the
plan, which is provided or incurred by, or on behalf
of, a State or local educational agency or school dis-
131
trict, unless payment for the item, service, or admin-
istrative expense is made in accordance with a meth-
odology approved in advance by the Secretary under
which—
‘‘(A) in the case of payment for—
‘‘(i) a group of individual items, serv-
ices, and administrative expenses, the
methodology—
‘‘(I) provides for an itemization
to the Secretary that assures account-
ability of the cost of the grouped
items, services, and administrative ex-
penses and includes payment rates
and the methodologies underlying the
establishment of such rates;
‘‘(II) has an actuarially sound
basis for determining the payment
rates and the methodologies; and
‘‘(III) reconciles payments for
the grouped items, services, and ad-
ministrative expenses with items and
services provided and administrative
expenses incurred under this title; or
‘‘(ii) an individual item, service, or ad-
ministrative expense, the amount of pay-
132
ment for the item, service, or administra-
tive expense does not exceed the amount
that would be paid for the item, service, or
administrative expense if the item, service,
or administrative expense were incurred by
an entity other than a State or local edu-
cational agency or school district, unless
the State can demonstrate to the satisfac-
tion of the Secretary a higher amount for
such item, service, or administrative ex-
pense; and
‘‘(B) in the case of a transportation service
for an individual under age 21 who is eligible
for medical assistance under this title (whether
or not the child has an individualized education
program established pursuant to part B of the
Individuals with Disabilities Education Act)—
‘‘(i) a medical need for transportation
is noted in such an individualized edu-
cation program (if any) for the individual,
including such an individual residing in a
geographic area within which school bus
transportation is otherwise not provided;
‘‘(ii) in the case of a child with special
medical needs, the vehicle used to furnish
133
such transportation service is specially
equipped or staffed to accommodate indi-
viduals with special medical needs; and
‘‘(iii) payment for such service only—
‘‘(I) is made with respect to costs
directly attributable to the costs asso-
ciated with transporting such individ-
uals whose medical needs require
transport in such a vehicle; and
‘‘(II) reflects the proportion of
transportation costs equal to the pro-
portion of the school day spent by
such individuals in activities relating
to the receipt of covered services
under this title or such other propor-
tion based on an allocation method
that the Secretary finds reasonable in
light of the benefit to the program
under this title and consistent with
the cost principles contained in OMB
Circular A–87; or
‘‘(22) with respect to any amount expended for
an item or service under the plan or for any admin-
istrative expense to carry out the plan provided by
or on behalf of a State or local agency (including a
134
State or local educational agency or school district)
that enters into a contract or other arrangement
with a person or entity for, or in connection with,
the collection or submission of claims for such ex-
penditures, 
unless, 
notwithstanding 
section
1902(a)(32), the agency—
‘‘(A) uses a competitive bidding process or
otherwise to contract with such person or entity
at a reasonable rate commensurate with the
services performed by the person or entity; and
‘‘(B) requires that any fees (including any
administrative fees) to be paid to the person or
entity for the collection or submission of such
claims are identified as a non-contingent, speci-
fied dollar amount in the contract.’’; and
(3) in the third sentence, by striking ‘‘(17), and
(18)’’ and inserting ‘‘(17), (18), (19), and (21)’’.
(b) PROVISION OF ITEMS AND SERVICES THROUGH
MEDICAID MANAGED CARE ORGANIZATIONS.—
(1) 
CONTRACTUAL
REQUIREMENT.—Section
1903(m)(2)(A) of the Social Security Act (42 U.S.C.
1396b(m)(2)(A)) is amended by redesignating clause
(xi) (as added by section 4701(c)(3) of the Balanced
Budget Act of 1997) as clause (xiii), by striking
135
‘‘and’’ at the end of clause (xi), and by inserting
after clause (xi) the following:
‘‘(xii) such contract provides that with respect
to payment for, and coverage of, such services, the
contract requires coordination between the State or
local educational agency or school district and the
medicaid managed care organization to prevent du-
plication of services and duplication of payments
under this title for such services.’’
(2) 
PROHIBITION
ON
DUPLICATIVE
PAY-
MENTS.—
(A) IN GENERAL.—Section 1903(i) of the
Social Security Act (42 U.S.C 1396b(i)), as
amended by subsection (a), is amended—
(i) in paragraph (22), by striking the
period and inserting ‘‘; or’’; and
(ii) by adding at the end the fol-
lowing:
‘‘(23) with respect to any amount ex-
pended under the plan for an item, service, or
administrative expense for which payment is or
may be made directly to a person or entity (in-
cluding a State or local educational agency or
school district) under the State plan if payment
for such item, service, or administrative expense
136
was included in the determination of a prepaid
capitation or other risk-based rate of payment
to an entity under a contract pursuant to sec-
tion 1903(m).’’.
(B) 
CONFORMING
AMENDMENT.—The
third sentence of section 1903(i) of such Act
(42 U.S.C. 1396b(i)), as amended by subsection
(a)(3), is amended by striking ‘‘and (21)’’ and
inserting ‘‘(21), and (23)’’.
(c) ALLOWABLE SHARE OF FFP WITH RESPECT TO
PAYMENT FOR SERVICES FURNISHED IN SCHOOL SET-
TING.—Section 1903(w)(6) of the Social Security Act (42
U.S.C. 1396b(w)(6)) is amended—
(1) in subparagraph (A), by inserting ‘‘subject
to subparagraph (C),’’ after ‘‘subsection,’’; and
(2) by adding at the end the following:
‘‘(C) In the case of any Federal financial participa-
tion amount determined under subsection (a) with respect
to any expenditure for an item or service under the plan,
or for any administrative expense to carry out the plan,
that is furnished by a State or local educational agency
or school district, the State shall provide that there is paid
to the agency or district a percent of such amount that
is not less than the percentage of such expenditure or ex-
pense that is paid by such agency or district.’’.
137
(d) UNIFORM METHODOLOGY FOR SCHOOL-BASED
ADMINISTRATIVE CLAIMS.—Not later than 90 days after
the date of the enactment of this Act, the Administrator
of the Health Care Financing Administration, in consulta-
tion with State medicaid and State educational agencies
and local school systems, shall develop and implement a
uniform methodology for claims for payment of adminis-
trative expenses furnished under title XIX of the Social
Security Act by State or local educational agencies or
school districts. Such methodology shall be based on
standards related to time studies and population estimates
and a national standard for determining payment for such
administrative expenses.
(e) EFFECTIVE DATE.—
(1) IN GENERAL.—The amendments made by
this section (other than by subsection (b)) shall
apply to items and services provided on and after
the date of the enactment of this Act, without re-
gard to whether implementing regulations are in ef-
fect.
(2) 
MANAGED
CARE
AMENDMENTS.—The
amendments made by subsection (b) shall apply to
contracts entered into or renewed on or after the
date of the enactment of this Act.
138
(3) REGULATIONS.—The Secretary of Health
and Human Services shall promulgate such final
regulations as are necessary to carry out the amend-
ments made by this section not later than 1 year
after the date of the enactment of this Act.
SEC. 408. EXTENSION OF AUTHORITY OF STATE MEDICAID
FRAUD CONTROL UNITS.
(a) EXTENSION
OF AUTHORITY TO INVESTIGATE
AND PROSECUTE FRAUD IN OTHER FEDERAL HEALTH
CARE PROGRAMS.—Section 1903(q)(3) of the Social Secu-
rity Act (42 U.S.C. 1396b(q)(3)) is amended—
(1) by inserting ‘‘(A)’’ after ‘‘in connection
with’’; and
(2) by striking ‘‘title.’’ and inserting ‘‘title; and
(B) upon the approval of the Inspector General of
the relevant Federal agency, any aspect of the provi-
sion of health care services and activities of pro-
viders of such services under any Federal health
care program (as defined in section 1128B(f)(1)), if
the suspected fraud or violation of law in such case
or investigation is primarily related to the State plan
under this title.’’.
(b) RECOUPMENT OF FUNDS.—Section 1903(q)(5) of
such Act (42 U.S.C. 1396b(q)(5)) is amended—
139
(1) by inserting ‘‘or under any Federal health
care program (as so defined)’’ after ‘‘plan’’; and
(2) by adding at the end the following: ‘‘All
funds collected in accordance with this paragraph
shall be credited exclusively to, and available for ex-
penditure under, the Federal health care program
(including the State plan under this title) that was
subject to the activity that was the basis for the col-
lection.’’.
(c) EXTENSION
OF AUTHORITY TO INVESTIGATE
AND PROSECUTE RESIDENT ABUSE IN NON-MEDICAID
BOARD AND CARE FACILITIES.—Section 1903(q)(4) of
such Act (42 U.S.C. 1396b(q)(4)) is amended to read as
follows:
‘‘(4)(A) The entity has—
‘‘(i) procedures for reviewing complaints of
abuse or neglect of patients in health care fa-
cilities which receive payments under the State
plan under this title;
‘‘(ii) at the option of the entity, procedures
for reviewing complaints of abuse or neglect of
patients residing in board and care facilities;
and
‘‘(iii) procedures for acting upon such com-
plaints under the criminal laws of the State or
140
for referring such complaints to other State
agencies for action.
‘‘(B) For purposes of this paragraph, the term
‘board and care facility’ means a residential setting
which receives payment (regardless of whether such
payment is made under the State plan under this
title) from or on behalf of two or more unrelated
adults who reside in such facility, and for whom one
or both of the following is provided:
‘‘(i) Nursing care services provided by, or
under the supervision of, a registered nurse, li-
censed practical nurse, or licensed nursing as-
sistant.
‘‘(ii) A substantial amount of personal care
services that assist residents with the activities
of daily living, including personal hygiene,
dressing, bathing, eating, toileting, ambulation,
transfer, positioning, self-medication, body care,
travel to medical services, essential shopping,
meal preparation, laundry, and housework.’’.
(d) EFFECTIVE DATE.—The amendments made by
this section take effect on the date of the enactment of
this Act.
141
SEC. 409. SPECIAL ALLOWANCE ADJUSTMENT FOR STU-
DENT LOANS.
(a) AMENDMENT.—Section 438(b)(2) of the Higher
Education Act of 1965 (20 U.S.C. 1087–1(b)(2)) is
amended—
(1) in subparagraph (A), by striking ‘‘(G), and
(H)’’ and inserting ‘‘(G), (H), and (I)’’;
(2) in subparagraph (B)(iv), by striking ‘‘(G),
or (H)’’ and inserting ‘‘(G), (H), or (I)’’;
(3) in subparagraph (C)(ii), by striking ‘‘(G)
and (H)’’ and inserting ‘‘(G), (H), and (I)’’;
(4) in the heading of subparagraph (H), by
striking ‘‘JULY 1, 2003’’ and inserting ‘‘JANUARY 1,
2000’’;
(5) in subparagraph (H), by striking ‘‘July 1,
2003,’’ each place it appears and inserting ‘‘January
1, 2000,’’; and
(6) by inserting after subparagraph (H) the fol-
lowing new subparagraph:
‘‘(I) LOANS DISBURSED ON OR AFTER JAN-
UARY 1, 2000, AND BEFORE JULY 1, 2003.—
‘‘(i) IN
GENERAL.—Notwithstanding
subparagraphs (G) and (H), but subject to
paragraph (4) and clauses (ii), (iii), and
(iv) of this subparagraph, and except as
provided in subparagraph (B), the special
142
allowance paid pursuant to this subsection
on loans for which the first disbursement
is made on or after January 1, 2000, and
before July 1, 2003, shall be computed—
‘‘(I) by determining the average
of the bond equivalent rates of the
quotes of the 3-month commercial
paper (financial) rates in effect for
each of the days in such quarter as
reported by the Federal Reserve in
Publication H–15 (or its successor)
for such 3-month period;
‘‘(II) by subtracting the applica-
ble interest rates on such loans from
such average bond equivalent rate;
‘‘(III) by adding 2.34 percent to
the resultant percent; and
‘‘(IV) by dividing the resultant
percent by 4.
‘‘(ii) IN
SCHOOL
AND
GRACE
PE-
RIOD.—In the case of any loan for which
the first disbursement is made on or after
January 1, 2000, and before July 1, 2003,
and for which the applicable rate of inter-
est is described in section 427A(k)(2),
143
clause (i)(III) of this subparagraph shall
be applied by substituting ‘1.74 percent’
for ‘2.34 percent’.
‘‘(iii) PLUS LOANS.—In the case of
any loan for which the first disbursement
is made on or after January 1, 2000, and
before July 1, 2003, and for which the ap-
plicable rate of interest is described in sec-
tion 427A(k)(3), clause (i)(III) of this sub-
paragraph shall be applied by substituting
‘2.64 percent’ for ‘2.34 percent’, subject to
clause (v) of this subparagraph.
‘‘(iv) CONSOLIDATION LOANS.—In the
case of any consolidation loan for which
the application is received by an eligible
lender on or after January 1, 2000, and
before July 1, 2003, and for which the ap-
plicable interest rate is determined under
section 427A(k)(4), clause (i)(III) of this
subparagraph shall be applied by sub-
stituting ‘2.64 percent’ for ‘2.34 percent’,
subject to clause (vi) of this subparagraph.
‘‘(v) LIMITATION ON SPECIAL ALLOW-
ANCES FOR PLUS LOANS.—In the case of
PLUS loans made under section 428B and
144
first disbursed on or after January 1,
2000, and before July 1, 2003, for which
the interest rate is determined under sec-
tion 427A(k)(3), a special allowance shall
not be paid for such loan during any 12-
month period beginning on July 1 and
ending on June 30 unless, on the June 1
preceding such July 1—
‘‘(I) the bond equivalent rate of
91-day Treasury bills auctioned at the
final auction held prior to such June
1 (as determined by the Secretary for
purposes of such section); plus
‘‘(II) 3.1 percent,
exceeds 9.0 percent.
‘‘(vi) LIMITATION ON SPECIAL ALLOW-
ANCES
FOR
CONSOLIDATION
LOANS.—In
the case of consolidation loans made under
section 428C and for which the application
is received on or after January 1, 2000,
and before July 1, 2003, for which the in-
terest rate is determined under section
427A(k)(4), a special allowance shall not
be paid for such loan during any 3-month
145
period ending March 31, June 30, Sep-
tember 30, or December 31 unless—
‘‘(I) the average of the bond
equivalent rates of the quotes of the
3-month commercial paper (financial)
rates in effect for each of the days in
such quarter as reported by the Fed-
eral Reserve in Publication H–15 (or
its successor) for such 3-month pe-
riod; plus
‘‘(II) 2.64 percent,
exceeds the rate determined under section
427A(k)(4).’’.
(b) EFFECTIVE DATE.—Subparagraph (I) of section
438(b)(2) of the Higher Education Act of 1965 (20
U.S.C. 1087–1(b)(2)) as added by subsection (a) of this
section shall apply with respect to any payment pursuant
to such section with respect to any 3-month period begin-
ning on or after January 1, 2000, for loans for which the
first disbursement is made after such date.
Passed the House of Representatives October 19,
1999.
Attest:
Clerk.