TITLE 
II—RESTRICTIONS 
FOR
DRUG ADDICTS AND ALCO-
HOLICS
SEC. 201. TIME-LIMITED BENEFITS.
(a) IN GENERAL.—Section 1614(a) of the Social Se-
curity Act (42 U.S.C. 1382c(a)) is amended by adding at
the end the following:
‘‘(5)(A) The Secretary shall identify all recipients of
benefits under this title by reason of disability whose dis-
ability is a result of addiction to illegal drugs.
‘‘(B) The Secretary shall periodically, on a random
basis, test each recipient identified under subparagraph
(A) (including any recipient who had become temporarily
ineligible for benefits by reason of subparagraph (C)) to
determine whether the recipient is using illegal drugs.
‘‘(C)(i) Notwithstanding any other provision of this
title, any individual who is determined under subpara-
graph (B) to be using illegal drugs, or who refuses to sub-
mit to testing as provided for under subparagraph (B),
shall not be eligible for benefits under this title during the
period described in clause (ii).
‘‘(ii) The period described in this clause begins with
the date of the determination referred to in clause (i) and
ends with the passage by the individual of 2 tests adminis-
tered by the Secretary (and paid for by the individual)
to determine whether the individual is using illegal drugs,
which tests occur—
‘‘(I) at least 2 months apart; and
‘‘(II) after the 1-year period that begins with
the date of the determination.
‘‘(6)(A) The Secretary shall identify all recipients of
benefits under this title by reason of disability whose dis-
ability is a result of addiction to alcohol.
‘‘(B) The Secretary shall periodically, on a random
basis, test each recipient identified under subparagraph
(A) (including any recipient who had become temporarily
ineligible for benefits by reason of subparagraph (C)) to
determine whether the recipient is using alcohol.
‘‘(C)(i) Notwithstanding any other provision of this
title, any individual who is determined under subpara-
graph (B) to be using alcohol, or who refuses to submit
to testing as provided for under subparagraph (B), shall
not be eligible for benefits under this title during the pe-
riod described in clause (ii).
‘‘(ii) The period described in this clause begins with
the date of the determination referred to in clause (i) and
ends with the passage by the individual of 2 tests adminis-
tered by the Secretary (and paid for by the individual)
to determine whether the individual is using alcohol, which
tests occur—
‘‘(I) at least 2 months apart; and
‘‘(II) after the 6-month period that begins with
the date of the determination.’’.
(b) PRESERVATION OF ELIGIBILITY FOR MEDICAID
BENEFITS.—Section 1634 of the Social Security Act (42
U.S.C. 1383c) is amended by adding at the end the
following:
‘‘(e) For purposes of title XIX, an individual is
deemed to be receiving benefits under this title if the indi-
vidual is ineligible for such benefits solely by reason of
paragraph (5) or (6) of section 1614(a).’’.
SEC. 202. RESTRICTIONS ON PAYMENT OF BENEFITS BASED
ON DISABILITY TO SUBSTANCE ABUSERS.
(a) REQUIRED PAYMENT
OF BENEFITS
TO REP-
RESENTATIVE PAYEES.—
(1) IN GENERAL.—Section 1631(a)(2)(A) of the
Social Security Act (42 U.S.C. 1383(a)(2)(A)) is
amended—
(A) in clause (ii), by adding at the end the
following: ‘‘In the case of an individual entitled
to benefits under this title by reason of disabil-
ity, if alcoholism or drug addiction is a contrib-
uting factor material to the Secretary’s deter-
mination that the individual is disabled, the
payment of such benefits to a representative
payee shall be deemed to serve the interest of
such individual under this title.’’; and
(B) in clause (iii), by striking ‘‘to the indi-
vidual or eligible spouse or to an alternative
representative payee of the individual or eligible
spouse’’ and inserting ‘‘to an alternative rep-
resentative payee of the individual or eligible
spouse or, if the interest of the individual under
this title would be served thereby, to the indi-
vidual or eligible spouse’’.
(2) 
CONFORMING
AMENDMENT.—Section
1631(a)(2)(B)(viii)(II) of such Act (42 U.S.C.
1383(a)(2)(B)(viii)(II)) is amended by striking ‘‘15
years’’ and all that follows and inserting ‘‘of 15
years, or (if alcoholism or drug addition is a contrib-
uting factor material to the Secretary’s determina-
tion that the individual is disabled) is entitled to
benefits under this title by reason of disability.’’.
(3) EFFECTIVE DATE.—The amendments made
by this subsection shall apply with respect to bene-
fits for months beginning after 180 days after the
date of the enactment of this Act.
(b) INCREASED RELIANCE ON PROFESSIONAL REP-
RESENTATIVE PAYEES.—
(1) PREFERENCE
REQUIRED
FOR
ORGANIZA-
TIONAL
REPRESENTATIVE
PAYEES.—Section
1631(a)(2)(B) 
of 
such 
Act 
(42 
U.S.C.
1383(a)(2)(B)) is amended—
(A) by redesignating clauses (vii) through
(xii) as clauses (viii) through (xiii), respectively;
(B) by inserting after clause (vi) the
following:
‘‘(vii) In the case of an individual entitled to benefits
under this title by reason of disability, if alcoholism or
drug addiction is a contributing factor material to the Sec-
retary’s determination that the individual is disabled,
when selecting such individual’s representative payee,
preference shall be given to a—
‘‘(I) community-based nonprofit social service
agency licensed or bonded by the State;
‘‘(II) State or local government agency whose
mission is to carry out income maintenance, social
service, or health care-related activities; or
‘‘(III) State or local government agency with
fiduciary responsibilities,
(or a designee of such an agency if the Secretary deems
it appropriate), unless the Secretary determines that selec-
tion of such an agency would not be appropriate.’’;
(C) in clause (viii) (as so redesignated), by
striking ‘‘clause (viii)’’ and inserting ‘‘clause
(ix)’’;
(D) in clause (ix) (as so redesignated), by
striking ‘‘(vii)’’ and inserting ‘‘(viii)’’;
(E) in clause (xiii) (as so redesignated)—
(i) by striking ‘‘(xi)’’ and inserting
‘‘(xii)’’; and
(ii) by striking ‘‘(x)’’ and inserting
‘‘(xi)’’.
(2) AVAILABILITY OF PUBLIC AGENCIES AND
OTHER
QUALIFIED
ORGANIZATIONS
TO
SERVE
AS
REPRESENTATIVE
PAYEES.—Section 1631(a)(2)(D)
of such Act (42 U.S.C. 1383(a)(2)(D)) is amend-
ed—
(A) in clause (i)—
(i) by striking ‘‘exceed the lesser
of—’’ and inserting ‘‘exceed—’’; and
(ii) by striking subclauses (I) and (II)
and inserting the following:
‘‘(I) in any case in which an individual is enti-
tled to benefits under this title by reason of disabil-
ity and alcoholism or drug addiction is a contribut-
ing factor material to the Secretary’s determination
that the individual is disabled, 10 percent of the
monthly benefit involved, or
‘‘(II) in any other case, the lesser of—
‘‘(aa) 10 percent of the monthly benefit
involved, or
‘‘(bb) $25.00 per month.’’;
(B) in clause (ii)—
(i) by inserting ‘‘State or local govern-
ment agency whose mission is to carry out
income maintenance, social service, or
health care-related activities, any State or
local government agency with fiduciary re-
sponsibilities, or any’’ after ‘‘means any’’;
(ii) by inserting a comma after ‘‘serv-
ice agency’’;
(iii) by adding ‘‘and’’ at the end of
subclause (I); and
(iv) in subclause (II)—
(I) by adding ‘‘and’’ at the end
of item (aa);
(II) by striking ‘‘; and’’ at the
end of item (bb) and inserting a pe-
riod; and
(III) by striking item (cc); and
(C) by striking clause (iv), effective July 1,
1994.
(c) NONPAYMENT OR TERMINATION OF BENEFITS.—
(1) IN GENERAL.—Section 1611(e)(3) of such
Act (42 U.S.C. 1382(e)(3)), is amended by redesig-
nating subparagraph (B) as subparagraph (C) and
by inserting after subparagraph (A) the following:
‘‘(B)(i) Notwithstanding any other provision of this
title, in the case of any individual entitled to benefits
under this title solely by reason of disability, if alcoholism
or drug addiction is a contributing factor material to the
Secretary’s determination that such individual is disabled
and such individual is determined by the Secretary not
to be in compliance with the requirements of this subpara-
graph for a month, such benefits shall be suspended for
a period commencing with such month and ending with
the month preceding the first month, after the determina-
tion of noncompliance, in which such individual dem-
onstrates that he or she has reestablished and maintained
compliance with such requirements for the applicable pe-
riod specified in clause (iii).
‘‘(ii)(I) An individual described in clause (i) is in com-
pliance with the requirements of this subparagraph for a
month if the individual in such month undergoes any med-
ical or psychological treatment that may be appropriate,
for the individual’s condition diagnosed as substance
abuse or alcohol abuse and for the stage of the individual’s
rehabilitation, at an institution or facility approved for
purposes of this subparagraph by the Secretary, and com-
plies in such month with the terms, conditions, and re-
quirements of such treatment and with requirements im-
posed by the Secretary under subparagraph (C).
‘‘(II) An individual described in clause (i) shall not
be determined to be not in compliance with the require-
ments of this subparagraph for a month if access by such
individual to such treatment is not reasonably available
for the month, as determined under regulations of the
Secretary.
‘‘(iii) The applicable period specified in this clause
is—
‘‘(I) 2 consecutive months, in the case of a 1st
determination that an individual is not in compliance
with the requirements of this subparagraph;
‘‘(II) 3 consecutive months, in the case of the
2nd such determination with respect to the individ-
ual; or
‘‘(III) 6 consecutive months, in the case of the
3rd or subsequent such determination with respect
to the individual.
‘‘(iv) An individual shall not be an eligible individual
for purposes of this title for the 12-month period that be-
gins with the end of any period of 12 consecutive months
for which the benefits of the individual under this title
have been suspended by reason of this subparagraph.
‘‘(v) In the case of any individual entitled to benefits
under this title by reason of disability, if alcoholism or
drug addiction is a contributing factor material to the Sec-
retary’s determination that such individual is disabled,
such individual may not be entitled to such benefits by
reason of disability (or any past-due benefits under such
entitlement) for any month after the 36-month period be-
ginning with such individual’s first month of such entitle-
ment, notwithstanding section 1619(a).
‘‘(vi)(I) The Secretary shall not, in a month, pay to
an individual described in clause (i) benefits under this
title the payment of which is past due, in an amount that
exceeds the amount of benefits under this title which are
payable to the individual for the month and the payment
of which is not past due.
‘‘(II) As used in subclause (I) of this clause, the term
‘benefits under this title’ includes supplementary pay-
ments of the type described in section 1616(a) and pay-
ments pursuant to an agreement entered into under sec-
tion 212(a) of Public Law 93–66.’’.
(2) REFERRAL, 
MONITORING, 
AND
TREAT-
MENT.—Section 1611(e)(3)(C) of such Act (42
U.S.C. 1382(e)(3)(C)), as so designated by the
amendment made by paragraph (1) of this sub-
section, is amended—
(A) by adding at the end the following:
‘‘Each such annual report shall include the
number and percentage of such individuals who
did not receive regular drug testing during the
year covered by the report.’’;
(B) by inserting ‘‘(i)’’ after ‘‘(C)’’; and
(C) by adding after and below the end
following:
‘‘(ii) The Secretary, in consultation with drug and al-
cohol treatment professionals, shall issue regulations—
‘‘(I) defining appropriate treatment for alcohol-
ics and drug addicts who are subject to required
medical or psychological treatment under this sub-
paragraph; and
‘‘(II) establishing guidelines to be used to re-
view and evaluate their compliance, including meas-
ures of the progress of participants in such pro-
grams.
‘‘(iii)(I) For purposes of carrying out the require-
ments of clauses (i) and (ii), the Secretary shall establish
purposes of title XIX, as receiving benefits under this title
for such month.’’.
(4) 
CONFORMING
AMENDMENTS.—Section
1611(e)(3) of such Act (42 U.S.C. 1382(e)(3)), as
amended by paragraphs (1) and (2) of this sub-
section, is amended—
(A) in subparagraph (A), by striking ‘‘(B)’’
and inserting ‘‘(C)’’; and
(B) in subparagraph (C), by inserting ‘‘or
(B)’’ after ‘‘(A)’’.
(5) EFFECTIVE DATE.—
(A) IN GENERAL.—Except as provided in
subparagraphs (B) and (C), the amendments
made by this subsection shall apply with respect
to benefits for months beginning after 180 days
after the date of the enactment of this Act.
(B) TIME
LIMITATION
ON
BENEFITS.—
Section 1611(e)(3)(B)(v) of the Social Security
Act (as added by the amendment made by para-
graph (1) of this subsection) shall apply with
respect to benefits for months ending after 180
days after the date of the enactment of this
Act, and, for purposes of such section, in the
case of any individual entitled to benefits by
reason of disability for the first month ending
after 180 days after the date of the enactment
of this Act, such month shall be treated as such
individual’s first month of entitlement to such
benefits.
(C) 
ESTABLISHMENT
OF
REFERRAL
AND
MONITORING
AGENCIES.—Section
1611(e)(3)(C)(iii) of the Social Security Act (as
added by the amendment made by paragraph
(2)(C) of this subsection) shall take effect 180
days after the date of the enactment of this
Act.
(d) IRRELEVANCE OF LEGALITY OF SUBSTANTIAL
GAINFUL ACTIVITY.—
(1) IN
GENERAL.—Section 1614(a)(3)(D) of
such Act (42 U.S.C. 1382c(a)(3)(D)) is amended by
adding at the end the following: ‘‘The Secretary
shall make determinations under this title with re-
spect to substantial gainful activity, without regard
to the legality of the activity.’’.
(2) EFFECTIVE DATE.—The amendment made
by paragraph (1) shall take effect on the date of the
enactment of this Act.
(e) EFFECTIVE DATE.—Except as otherwise provided
in this section, the amendments made by this section shall
apply to benefits payable for months beginning 180 or
more days after the date of the enactment of this Act.
TITLE III—BENEFITS FOR
CHILDREN
SEC. 301. REPLACEMENT OF CASH BENEFIT WITH MEDICAL
VOUCHER.
(a) IN GENERAL.—Section 1611(b) of the Social Se-
curity Act (42 U.S.C. 1382(b)) is amended by adding at
the end the following:
‘‘(3) Notwithstanding paragraphs (1) and (2), the
benefit under this title for a child who has not attained
18 years of age shall be vouchers issued pursuant to sub-
section (j).’’.
(b) ISSUANCE OF VOUCHERS FOR TREATMENT OF
DISABLING CONDITIONS OF CHILDREN ELIGIBLE FOR
SSI BENEFITS.—Section 1611 of such Act (42 U.S.C.
1382(b)) is amended by adding at the end the following:
‘‘(j)(1) The Secretary of Health and Human Services
shall issue to each child eligible for benefits under this
title who has not attained 18 years of age a voucher which
may be used to cover the cost of any item—
‘‘(A) that is associated with treating the blind-
ness or disability of the child;
‘‘(B) for which a medical expense deduction
may be claimed under section 213 of the Internal
Revenue Code of 1986 by the child or any taxpayer
who may claim the child as a dependent; and
‘‘(C) the cost of which is not covered by the
program of medical assistance approved under title
XIX of the State in which the child resides.
‘‘(2) The face dollar amount of the voucher issued
with respect to a child shall not exceed the amount of the
cash benefit to which the child would (but for section
1611(b)(3)) have been entitled under this title.
‘‘(3) The Secretary shall pay to each provider of
health care goods or services that is licensed by a State,
or by a professional health care organization approved by
the Secretary, that submits to the Secretary a voucher is-
sued under this subsection an amount equal to the face
dollar amount of the voucher.’’.
SEC. 302. DISABILITY REVIEW REQUIRED FOR SSI RECIPI-
ENTS WHO ARE 18 YEARS OF AGE.
(a) IN GENERAL.—Section 1614(a)(3)(G) of the So-
cial Security Act (42 U.S.C. 1382c(a)(3)(G)) is amend-
ed—
(1) by inserting ‘‘(i)’’ after ‘‘(G)’’; and
(2) by adding after and below the end the
following:
‘‘(ii)(I) During the 1-year period that begins on the
date a recipient of benefits under this title by reason of
disability attains 18 years of age, the applicable State
agency or the Secretary (as may be appropriate) shall re-
determine the eligibility of the recipient for such benefits
by reason of disability, by applying the criteria used in
determining eligibility for such benefits of applicants who
have attained 18 years of age.
‘‘(II) A review under subclause (I) of this clause shall
be considered a substitute for a review required under
clause (i).’’.
(b) EFFECTIVE DATE.—The amendments made by
subsection (a) shall apply to individuals who attain 18
years of age in or after the 9th month after the month
in which this Act is enacted.
TITLE IV—FRAUD
SEC. 401. EXPANSION OF THE AUTHORITY OF THE SOCIAL
SECURITY ADMINISTRATION TO PREVENT,
DETECT, 
AND 
TERMINATE 
FRAUDULENT
CLAIMS FOR SSI BENEFITS.
(a) PREVENTION OF FRAUD IN THE SSI PROGRAM
BY TRANSLATORS OF FOREIGN LANGUAGES.—
(1) IN GENERAL.—Section 1631(e) of the So-
cial Security Act (42 U.S.C. 1383(e)) is amended by
inserting after paragraph (3) the following:
‘‘(4) A translation into English by a third party of
a statement made in a foreign language by an applicant