Pub. L. 103-296, tit. II

(2) Conforming amendments.— Section 1128 of such Act (42 U.S.C. 1320a-7) is amended— (A) in subsection (b)(7), by striking “or section 1128B” and inserting “, 1128B, or 1129”; (B) in subsection (b)(8)(B)(ii), by inserting “or 1129” after “section 1128A”; and (C) in subsection (f)(3), by inserting “, 1129,” after “sections 1128A”. (3) Effective date.— The amendments made by this subsection shall apply to conduct occurring on or after October 1, 1994. (c) SSI Fraud Considered a Felony.— (1) In general.— Section 1632(a) of the Social Security Act (42 U.S.C. 1383a(a)) is amended by striking “shall” the 1st place such term appears and all that follows and inserting “shall be fined under title 18, United States Code, imprisoned not more than 5 years, or both.”. (2) Conforming amendment.— Section 1632(b) of such Act (42 U.S.C. 1383a(b)) is amended to read as follows: 108 STAT. 1514 “(b) (1) If a person or entity violates subsection (a) in the person’s or entity’s role as, or in applying to become, a representative payee under section 1631(a)(2) on behalf of another individual (other than the person’s eligible spouse), and the violation includes a willful misuse of funds by the person or entity, the court may also require that full or partial restitution of minds be made to such other individual. “(2) Any person or entity convicted of a violation of subsection (a) of this section or of section 208 may not be certified as a representative payee under section 1631(a)(2).”. (3) Effective date.— The amendments made by this subsection shall apply to conduct occurring on or after October 1, 1994. (d) Authority to Redetermine Eligibility if Fraud is Involved, and to Terminate Benefits if There is Insufficient Reliable Evidence.— (1) OASDI programs.— Section 205 of the Social Security Act (42 U.S.C. 405) is amended by adding at the end the following: “(u) (1) (A) The Secretary shall immediately redetermine the entitlement of individuals to monthly insurance benefits under this title if there is reason to believe that fraud or similar fault was involved in the application of the individual for such benefits, unless a United States attorney, or equivalent State prosecutor, with jurisdiction over potential or actual related criminal cases, certifies, in writing, that there is a substantial risk that such action by the Secretary with regard to beneficiaries in a particular investigation would jeopardize the criminal prosecution of a person involved in a suspected fraud. “(B) When redetermining the entitlement, or making an initial determination of entitlement, of an individual under this title, the Secretary shall disregard any evidence if there is reason to believe that fraud or similar fault was involved in the providing of such evidence. “(2) For purposes of paragraph (1), similar fault is involved with respect to a determination if— “(A) an incorrect or incomplete statement that is material to the determination is knowingly made; or “(B) information that is material to the determination is knowingly concealed. “(3) If, after redetermining pursuant to this subsection the entitlement of an individual to monthly insurance benefits, the Secretary determines that there is insufficient evidence to support such entitlement, the Secretary may terminate such entitlement and may treat benefits paid on the basis of such insufficient evidence as overpayments.”. (2) SSI program.— Section 1631(e) of such Act (42 U.S.C. 1383(e)) is amended by adding at the end the following: “(6) (A) (i) The Secretary shall immediately redetermine the eligibility of an individual for benefits under this title if there is reason to believe that fraud or similar fault was involved in the application of the individual for such benefits, unless a United States attorney, or equivalent State prosecutor, with jurisdiction over potential or actual related criminal cases, certifies, in writing, that there is a substantial risk that such action by the Secretary with regard to recipients in a particular investigation would jeopardize the criminal prosecution of a person involved in a suspected fraud. 108 STAT. 1515 “(ii) When redetermining the eligibility, or making an initial determination of eligibility, of an individual for benefits under this title, the Secretary shall disregard any evidence if there is reason to believe that fraud or similar fault was involved in the providing of such evidence. “(B) For purposes of subparagraph (A), similar fault is involved with respect to a determination if— “(i) an incorrect or incomplete statement that is material to the determination is knowingly made; or “(ii) information that is material to the determination is knowingly concealed. “(C) If, after redetermining the eligibility of an individual for benefits under this title, the Secretary determines that there is insufficient evidence to support such eligibility, the Secretary may terminate such eligibility and may treat benefits paid on the basis of such insufficient evidence as overpayments.”. (3) Effective date.— The amendments made by this sub- section shall take effect on October 1, 1994, and shall apply to determinations made before, on, or after such date. (e) AVAILABILITY OF RECIPIENT IDENTIFYING INFORMATION FROM THE INSPECTOR GENERAL.— (1) In general.— Section 1129 of the Social Security Act (added by subsection (b) of this section) is amended by adding at the end the following: “(1) As soon as the Inspector General, Department of Health and Human Services, has reason to believe that fraud was involved in the application of an individual for monthly insurance benefits under title II or for benefits under title XVI, the Inspector General shall make available to the Secretary information identifying the individual, unless a United States attorney, or equivalent State prosecutor, with jurisdiction over potential or actual related criminal cases, certifies, in writing, that there is a substantial risk that making the information so available in a particular investigation or redetermining the eligibility of the individual for such benefits would jeopardize the criminal prosecution of any person who is a subject of the investigation from which the information is derived.”. (2) Effective date.— The amendment made by paragraph (1) shall take effect on October 1, 1994. (f) Authority to Use Available Preadmission Immigrant and Refugee Medical Information.— (1) In general.— Section 1631(e) of the Social Security Act (42 U.S.C. 1383(e)) as amended by subsection (d)(2) of this section, is amended by adding at the end the following: “(7) (A) The Secretary shall request the Immigration and Naturalization Service or the Centers for Disease Control to provide the Secretary with whatever medical information, identification information, and employment history either such entity has with respect to any alien who has applied for benefits under title XVI to the extent that the information is relevant to any determination relating to eligibility for such benefits under title XVI. “(B) Subparagraph (A) shall not be construed to prevent the Secretary from adjudicating the case before receiving such information.”. (2) Effective date.— The amendment made by paragraph (1) shall take effect on October 1, 1994. 108 STAT. 1516 (g) Annual Reports on Reviews of OASDI and SSI Cases.— The Secretary of Health and Human Services shall annually submit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report on the extent to which the Secretary has exercised his authority to review cases of entitlement to monthly insurance benefits under title II of the Social Security Act and supplemental security income cases under title XVI of such Act, and the extent to which the cases reviewed were those that involved a high likelihood or probability of fraud.