I
106TH CONGRESS
1ST SESSION
H. R. 631
To combat fraud in, and to improve the administration of, the disability
programs under titles II and XVI of the Social Security Act, and for
other purposes.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 9, 1999
Mrs. JOHNSON of Connecticut (for herself and Mr. CARDIN) introduced the
following bill; which was referred to the Committee on Ways and Means
A BILL
To combat fraud in, and to improve the administration of,
the disability programs under titles II and XVI of the
Social Security Act, 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
‘‘SSI Fraud Prevention Act of 1999’’.
(b) TABLE OF CONTENTS.—The table of contents of
this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—FRAUD PREVENTION AND RELATED PROVISIONS
Sec. 101. Primary liability of representative payees for overpayments to de-
ceased recipients.
Sec. 102. Requirement to provide State prisoner information to Federal and
federally assisted benefit programs.
Sec. 103. Recovery of overpayments of SSI benefits from lump sum SSI benefit
payments.
Sec. 104. Rules relating to collection of overpayments from individuals con-
victed of crimes.
Sec. 105. Additional debt collection practices.
Sec. 106. Treatment of assets held in trust under the SSI program.
Sec. 107. Disposal of resources for less than fair market value under the SSI
program.
Sec. 108. Loss of benefits as penalty for fraud.
Sec. 109. Exclusion of attorneys and physicians convicted of violations from
participation in social security disability programs.
Sec. 110. Annual reviews by State disability determination services of profes-
sionals conducting consultative examinations.
Sec. 111. Computer matches with medicare and medicaid institutionalization
data.
Sec. 112. Access to information held by financial institutions.
Sec. 113. State data exchanges.
Sec. 114. Study on possible measures to improve fraud prevention and adminis-
trative processing.
Sec. 115. Annual report on amounts necessary to combat fraud.
TITLE II—BENEFITS FOR PHILIPPINO VETERANS OF WORLD
WAR II
Sec. 201. Provision of reduced SSI benefit to certain individuals who provided
service to the Armed Forces of the United States in the Phil-
ippines during World War II after they move back to the Phil-
ippines.
TITLE I—FRAUD PREVENTION
AND RELATED PROVISIONS
SEC. 101. PRIMARY LIABILITY OF REPRESENTATIVE PAY-
EES FOR OVERPAYMENTS TO DECEASED RE-
CIPIENTS.
(a) AMENDMENT TO TITLE II.—Section 204(a)(2) of
the Social Security Act (42 U.S.C. 404(a)(2)) is amended
by adding at the end the following new sentence: ‘‘If the
payment is made to a representative payee on behalf of
an individual who has died, the representative payee shall
be primarily liable for the repayment of the overpayment,
and the Commissioner of Social Security shall establish
an overpayment control record under the social security
account number of the representative payee.’’.
(b) 
AMENDMENT
TO
TITLE
XVI.—Section
1631(b)(2) of such Act (42 U.S.C. 1383(b)(2)) is amend-
ed by adding at the end the following new sentence: ‘‘If
the payment is made to a representative payee on behalf
of an individual who has died, the representative payee
shall be primarily liable for the repayment of the overpay-
ment, and the Commissioner of Social Security shall es-
tablish an overpayment control record under the social se-
curity account number of the representative payee.’’.
SEC. 102. REQUIREMENT TO PROVIDE STATE PRISONER IN-
FORMATION TO FEDERAL AND FEDERALLY
ASSISTED BENEFIT PROGRAMS.
Section 1611(e)(1)(I)(ii)(II) of the Social Security
Act (42 U.S.C. 1382(e)(1)(I)(ii)(II)) is amended by strik-
ing ‘‘is authorized to’’ and inserting ‘‘shall’’.
SEC. 103. RECOVERY OF OVERPAYMENTS OF SSI BENEFITS
FROM LUMP SUM SSI BENEFIT PAYMENTS.
(a) IN GENERAL.—Section 1631(b)(1)(B)(ii) of the
Social Security Act (42 U.S.C. 1383(b)(1)(B)(ii)) is
amended—
(1) by inserting ‘‘monthly’’ before ‘‘benefit pay-
ments’’; and
(2) by inserting ‘‘and in the case of an individ-
ual or eligible spouse to whom a lump sum is pay-
able under this title (including under section
1616(a) of this Act or under an agreement entered
into under section 212(a) of Public Law 93–66)
shall, as at least one means of recovering such over-
payment, make the adjustment or recovery from the
lump sum payment in an amount equal to not less
than the lesser of the amount of the overpayment or
50 percent of the lump sum payment,’’ before ‘‘un-
less fraud’’.
(b) EFFECTIVE DATE.—The amendments made by
this section shall take effect on the date of the enactment
of this Act and shall apply to amounts incorrectly paid
which remain outstanding on or after such date.
SEC. 104. RULES RELATING TO COLLECTION OF OVERPAY-
MENTS FROM INDIVIDUALS CONVICTED OF
CRIMES.
(a) WAIVERS INAPPLICABLE TO OVERPAYMENTS BY
REASON
OF PAYMENT
IN MONTHS
IN WHICH BENE-
FICIARY IS A PRISONER OR A FUGITIVE.—
(1) AMENDMENT TO TITLE II.—Section 204(b)
of the Social Security Act (42 U.S.C. 404(b)) is
amended—
(A) by inserting ‘‘(1)’’ after ‘‘(b)’’; and
(B) by adding at the end the following:
‘‘(2) Paragraph (1) shall not apply with respect to
any payment to any person made during a month in which
such benefit was not payable under section 202(x).’’.
(2) AMENDMENT
TO
TITLE
XVI.—Section
1631(b)(1)(B)(i) 
of 
such 
Act 
(42 
U.S.C.
1383(b)(1)(B)(i)) is amended by inserting ‘‘unless
(I) section 1611(e)(1) prohibits payment to the per-
son of a benefit under this title for the month by
reason of confinement of a type described in clause
(i) or (ii) of section 202(x)(1)(A), or (II) section
1611(e)(5) prohibits payment to the person of a
benefit under this title for the month,’’ after ‘‘ad-
ministration of this title’’.
(b) 10-YEAR PERIOD OF INELIGIBILITY FOR PER-
SONS FAILING TO NOTIFY COMMISSIONER OF OVERPAY-
MENTS IN MONTHS IN WHICH BENEFICIARY IS A PRIS-
ONER OR A FUGITIVE OR FAILING TO COMPLY WITH RE-
PAYMENT SCHEDULE FOR SUCH OVERPAYMENTS.—
(1) AMENDMENT TO TITLE II.—Section 202(x)
of such Act (42 U.S.C. 402(x)) is amended by add-
ing at the end the following:
‘‘(4)(A) No person shall be considered entitled to
monthly insurance benefits under this section based on the
person’s disability or to disability insurance benefits under
section 223 otherwise payable during the 10-year period
that begins on the date the person—
‘‘(i) knowingly fails to timely notify the Com-
missioner of Social Security, in connection with any
application for benefits under this title, of any prior
receipt by such person of any benefit under this title
or title XVI in any month in which such benefit was
not payable under the preceding provisions of this
subsection, or
‘‘(ii) knowingly fails to comply with any sched-
ule imposed by the Commissioner which is for repay-
ment of overpayments comprised of payments de-
scribed in subparagraph (A) and which is in compli-
ance with section 204.
‘‘(B) The Commissioner of Social Security shall, in
addition to any other relevant factors, take into account
any mental or linguistic limitations of a person (including
any lack of facility with the English language) in deter-
mining whether the person has knowingly failed to comply
with a requirement of clause (i) or (ii) of subparagraph
(A).’’.
(2) AMENDMENT
TO
TITLE
XVI.—Section
1611(e)(1) of such Act (42 U.S.C. 1382(e)(1)) is
amended by adding at the end the following:
‘‘(J)(i) A person shall not be considered an eligible
individual or eligible spouse for purposes of benefits under
this title by reason of disability, during the 10-year period
that begins on the date the person—
‘‘(I) knowingly fails to timely notify the Com-
missioner of Social Security, in an application for
benefits under this title, of any prior receipt by the
person of a benefit under this title or title II in a
month in which payment to the person of a benefit
under this title was prohibited by—
‘‘(aa) the preceding provisions of this para-
graph by reason of confinement of a type de-
scribed in clause (i) or (ii) of section
202(x)(1)(A); or
‘‘(bb) section 1611(e)(5); or
‘‘(II) knowingly fails to comply with any sched-
ule imposed by the Commissioner which is for repay-
ment of overpayments comprised of payments de-
scribed in clause (i) of this subparagraph and which
is in compliance with section 1631(b).
‘‘(ii) The Commissioner of Social Security shall, in
addition to any other relevant factors, take into account
any mental or linguistic limitations of a person (including
any lack of facility with the English language) in deter-
mining whether the person has knowingly failed to comply
with a requirement of subclause (I) or (II) of clause (i).’’.
(c) CONTINUED COLLECTION EFFORTS AGAINST
PRISONERS.—
(1) AMENDMENT TO TITLE II.—Section 204(b)
of such Act (as amended by subsection (a)(1)) is
amended further by adding at the end the following
new paragraph:
‘‘(3) The Commissioner shall not refrain from recov-
ering overpayments from resources currently available to
any overpaid person or to such person’s estate solely be-
cause such individual is confined as described in clause
(i) or (ii) of section 202(x)(1)(A).’’.
(2) AMENDMENT
TO
TITLE
XVI.—Section
1631(b)(1)(A) 
of 
such 
Act 
(42 
U.S.C.
1383(b)(1)(A)) is amended by adding after and
below clause (ii) the following flush left sentence:
‘‘The Commissioner shall not refrain from recovering over-
payments from resources currently available to any indi-
vidual solely because the individual is confined as de-
scribed in clause (i) or (ii) of section 202(x)(1)(A).’’.
SEC. 105. ADDITIONAL DEBT COLLECTION PRACTICES.
(a) IN GENERAL.—Section 1631(d)(1) of the Social
Security Act (42 U.S.C. 1383(d)(1)) is amended by strik-
ing ‘‘section 207’’ and inserting ‘‘sections 204(f) and
207’’.
(b) EFFECTIVE DATE.—The amendment made by
this section shall apply to debt outstanding on or after
the date of the enactment of this Act.
SEC. 106. TREATMENT OF ASSETS HELD IN TRUST UNDER
THE SSI PROGRAM.
(a) TREATMENT AS RESOURCE.—Section 1613 of the
Social Security Act (42 U.S.C. 1382b) is amended by add-
ing at the end the following:
‘‘Trusts
‘‘(e)(1) In determining the resources of an individual,
paragraph (3) shall apply to a trust (other than a trust
described in paragraph (5)) established by the individual.
‘‘(2)(A) For purposes of this subsection, an individual
shall be considered to have established a trust if any assets
of the individual (or of the individual’s spouse) are trans-
ferred to the trust other than by will.
‘‘(B) In the case of an irrevocable trust to which are
transferred the assets of an individual (or of the individ-
ual’s spouse) and the assets of any other person, this sub-
section shall apply to the portion of the trust attributable
to the assets of the individual (or of the individual’s
spouse).
‘‘(C) This subsection shall apply to a trust without
regard to—
‘‘(i) the purposes for which the trust is estab-
lished;
‘‘(ii) whether the trustees have or exercise any
discretion under the trust;
‘‘(iii) any restrictions on when or whether dis-
tributions may be made from the trust; or
‘‘(iv) any restrictions on the use of distributions
from the trust.
‘‘(3)(A) In the case of a revocable trust established
by an individual, the corpus of the trust shall be consid-
ered a resource available to the individual.
‘‘(B) In the case of an irrevocable trust established
by an individual, if there are any circumstances under
which payment from the trust could be made to or for
the benefit of the individual or the individual’s spouse, the
portion of the corpus from which payment to or for the
benefit of the individual or the individual’s spouse could
be made shall be considered a resource available to the
individual.
‘‘(4) The Commissioner of Social Security may waive
the application of this subsection with respect to an indi-
vidual if the Commissioner determines that such applica-
tion would work an undue hardship on the individual.
‘‘(5) This subsection shall not apply to a trust de-
scribed in subparagraph (A) or (C) of section 1917(d)(4).
‘‘(6) For purposes of this subsection—
‘‘(A) the term ‘trust’ includes any legal instru-
ment or device that is similar to a trust;
‘‘(B) the term ‘corpus’ means, with respect to
a trust, all property and other interests held by the
trust, including accumulated earnings and any other
addition to the trust after its establishment (except
that such term does not include any such earnings
or addition in the month in which the earnings or
addition is credited or otherwise transferred to the
trust); and
‘‘(C) the term ‘asset’ includes any income or re-
source of the individual or of the individual’s spouse,
including—
‘‘(i) any income excluded by section
1612(b);
‘‘(ii) any resource otherwise excluded by
this section; and
‘‘(iii) any other payment or property to
which the individual or the individual’s spouse
is entitled but does not receive or have access
to because of action by—
‘‘(I) the individual or spouse;
‘‘(II) a person or entity (including a
court) with legal authority to act in place
of, or on behalf of, the individual or
spouse; or
‘‘(III) a person or entity (including a
court) acting at the direction of, or on the
request of, the individual or spouse.’’.
(b) TREATMENT AS INCOME.—Section 1612(a)(2) of
such Act (42 U.S.C. 1382a(a)(2)) is amended—
(1) by striking ‘‘and’’ at the end of subpara-
graph (E);
(2) by striking the period at the end of sub-
paragraph (F) and inserting ‘‘; and’’; and
(3) by adding at the end the following:
‘‘(G) any earnings of, and additions to, the cor-
pus of a trust established by an individual (within
the meaning of section 1613(e)), of which the indi-
vidual is a beneficiary, to which section 1613(e) ap-
plies, and, in the case of an irrevocable trust, with
respect to which circumstances exist under which a
payment from the earnings or additions could be
made to or for the benefit of the individual.’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall take effect on January 1, 2000, and shall
apply to trusts established on or after such date.
SEC. 107. DISPOSAL OF RESOURCES FOR LESS THAN FAIR
MARKET VALUE UNDER THE SSI PROGRAM.
(a) IN GENERAL.—Section 1613(c) of the Social Se-
curity Act (42 U.S.C. 1382b(c)) is amended—
(1) in the caption, by striking ‘‘Notification of
Medicaid Policy Restricting Eligibility of Institu-
tionalized Individuals for Benefits Based on’’;
(2) in paragraph (1)—
(A) in subparagraph (A)—
(i) by inserting ‘‘paragraph (1) and’’
after ‘‘provisions of’’;
(ii) by striking ‘‘title XIX’’ the first
place it appears and inserting ‘‘this title
and title XIX, respectively,’’;
(iii) by striking ‘‘subparagraph (B)’’
and inserting ‘‘clause (ii)’’;
(iv) by striking ‘‘paragraph (2)’’ and
inserting ‘‘subparagraph (B)’’;
(B) in subparagraph (B)—
(i) by striking ‘‘by the State agency’’;
and
(ii) by striking ‘‘section 1917(c)’’ and
all that follows and inserting ‘‘paragraph
(1) or section 1917(c).’’; and
(C) by redesignating subparagraphs (A)
and (B) as clauses (i) and (ii), respectively;
(3) in paragraph (2)—
(A) by striking ‘‘(2)’’ and inserting ‘‘(B)’’;
and
(B) by striking ‘‘paragraph (1)(B)’’ and
inserting ‘‘subparagraph (A)(ii)’’;
(4) by striking ‘‘(c)(1)’’ and inserting ‘‘(2)(A)’’;
and
(5) by inserting before paragraph (2) (as redes-
ignated by paragraph (4) of this subsection) the fol-
lowing:
‘‘(c)(1)(A)(i) If an individual or the spouse of an indi-
vidual disposes of resources for less than fair market value
on or after the look-back date described in clause (ii)(I),
the individual is ineligible for benefits under this title for
months during the period beginning on the date described
in clause (iii) and equal to the number of months cal-
culated as provided in clause (iv).
‘‘(ii)(I) The look-back date described in this sub-
clause is a date that is 36 months before the date de-
scribed in subclause (II).
‘‘(II) The date described in this subclause is the date
on which the individual applies for benefits under this title
or, if later, the date on which the individual (or the spouse
of the individual) disposes of resources for less than fair
market value.
‘‘(iii) The date described in this clause is the first
day of the first month that follows the month in which
resources were disposed of for less than fair market value
and that does not occur in any other period of ineligibility
under this paragraph.
‘‘(iv) The number of months calculated under this
clause shall be equal to—
‘‘(I) the total, cumulative uncompensated value
of all resources so disposed of by the individual (or
the spouse of the individual) on or after the look-
back date described in clause (ii)(I); divided by
‘‘(II) the amount of the maximum monthly ben-
efit payable under section 1611(b) for the month in
which occurs the date described in clause (ii)(II),
rounded up, in the case of any fraction, to the next whole
number.
‘‘(B)(i) Notwithstanding subparagraph (A), this sub-
section shall not apply to a transfer of a resource to a
trust if the portion of the trust attributable to the resource
is considered a resource available to the individual pursu-
ant to subsection (e)(3) (or would be so considered but
for the application of subsection (e)(4)).
‘‘(ii) In the case of a trust established by an individ-
ual or an individual’s spouse (within the meaning of sub-
section (e)), if from such portion of the trust, if any, that
is considered a resource available to the individual pursu-
ant to subsection (e)(3) (or would be so considered but
for the application of subsection (e)(4)) or the residue of
the portion on the termination of the trust—
‘‘(I) there is made a payment other than to or
for the benefit of the individual; or
‘‘(II) no payment could under any circumstance
be made to the individual,
then, for purposes of this subsection, the payment de-
scribed in clause (I) or the foreclosure of payment de-
scribed in clause (II) shall be considered a transfer of re-
sources by the individual or the individual’s spouse as of
the date of the payment or foreclosure, as the case may
be.
‘‘(C) An individual shall not be ineligible for benefits
under this title by reason of the application of this para-
graph to a disposal of resources by the individual or the
spouse of the individual, to the extent that—
‘‘(i) the resources are a home and title to the
home was transferred to—
‘‘(I) the spouse of the transferor;
‘‘(II) a child of the transferor who has not
attained 21 years of age, or is blind or disabled;
‘‘(III) a sibling of the transferor who has
an equity interest in such home and who was
residing in the transferor’s home for a period of
at least 1 year immediately before the date the
transferor becomes an institutionalized individ-
ual; or
‘‘(IV) a son or daughter of the transferor
(other than a child described in subclause (II))
who was residing in the transferor’s home for
a period of at least 2 years immediately before
the date the transferor becomes an institu-
tionalized individual, and who provided care to
the transferor which permitted the transferor to
reside at home rather than in such an institu-
tion or facility;
‘‘(ii) the resources—
‘‘(I) were transferred to the transferor’s
spouse or to another for the sole benefit of the
transferor’s spouse;
‘‘(II) were transferred from the transfer-
or’s spouse to another for the sole benefit of the
transferor’s spouse;
‘‘(III) were transferred to, or to a trust
(including 
a 
trust 
described 
in 
section
1917(d)(4)) established solely for the benefit of,
the transferor’s child who is blind or disabled;
or
‘‘(IV) were transferred to a trust (includ-
ing a trust described in section 1917(d)(4)) es-
tablished solely for the benefit of an individual
who has not attained 65 years of age and who
is disabled;
‘‘(iii) a satisfactory showing is made to the
Commissioner of Social Security (in accordance with
regulations promulgated by the Commissioner)
that—
‘‘(I) the individual who disposed of the re-
sources intended to dispose of the resources ei-
ther at fair market value, or for other valuable
consideration;
‘‘(II) the resources were transferred exclu-
sively for a purpose other than to qualify for
benefits under this title; or
‘‘(III) all resources transferred for less
than fair market value have been returned to
the transferor; or
‘‘(iv) the Commissioner determines, under pro-
cedures established by the Commissioner, that the
denial of eligibility would work an undue hardship as
determined on the basis of criteria established by the
Commissioner;
‘‘(D) For purposes of this subsection, in the case of
a resource held by an individual in common with another
person or persons in a joint tenancy, tenancy in common,
or similar arrangement, the resource (or the affected por-
tion of such resource) shall be considered to be disposed
of by the individual when any action is taken, either by
the individual or by any other person, that reduces or
eliminates the individual’s ownership or control of such re-
source.
‘‘(E) In the case of a transfer by the spouse of an
individual that results in a period of ineligibility for the
individual under this subsection, the Commissioner shall
apportion the period (or any portion of the period) among
the individual and the individual’s spouse if the spouse be-
comes eligible for benefits under this title.
‘‘(F) For purposes of this paragraph—
‘‘(i) the term ‘benefits under this title’ includes
payments of the type described in section 1616(a) of
this Act and of the type described in section 212(b)
of Public Law 93–66;
‘‘(ii) the term ‘institutionalized individual’ has
the meaning given such term in section 1917(e)(3);
and
‘‘(iii) the term ‘trust’ has the meaning given
such term in subsection (e)(5)(A) of this section.’’.
(b) EFFECTIVE DATE.—The amendments made by
this section shall be effective with respect to disposals
made on or after the date of enactment of this Act.
SEC. 108. LOSS OF BENEFITS AS PENALTY FOR FRAUD.
(a) IN GENERAL.—Part A of title XI of the Social
Security Act (42 U.S.C. 1301 et seq.) is amended by in-
serting after section 1129 the following:
‘‘SEC. 1129A. LOSS OF BENEFITS AS PENALTY FOR FRAUD.
‘‘(a) IN GENERAL.—Any person who makes, or
causes to be made, a statement or representation of a ma-
terial fact for use in determining any initial or continuing
right to or the amount of—
‘‘(1) monthly insurance benefits under title II;
or
‘‘(2) benefits or payments under title XVI,
that the person knows or should know is false or mislead-
ing or knows or should know omits a material fact or
makes such a statement with knowing disregard for the
truth shall be subject to, in addition to any other penalties
that may be prescribed by law, a penalty described in sub-
section (b) which shall be imposed by the Commissioner
of Social Security.
‘‘(b) PENALTY.—The penalty described in this sub-
section is—