Title II — Strengthening Program Protections

H.R. 5260 · 113th Congress · Jul 30, 2014 · Lineage

II Strengthening Program Protections

Sec. 201 Pre-effectuation and post-effectuation quality reviews of hearing dispositions

(a)

Amendments to title II— Section 205(b) of the Social Security Act (42 U.S.C. 405(b)) is amended by adding at the end the following:

“(4)

“(A) The Commissioner of Social Security shall conduct pre-effectuation and post-effectuation quality reviews of hearing dispositions with respect to decisions in connection with applications for benefits under this title, in a sufficient number to ensure compliance with laws, regulations, and other guidance issued by the Commissioner of Social Security.

“(B) The Commissioner of Social Security 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 that includes—

“(i) the total number of cases selected for a quality review as described in paragraph (1);

“(ii) the number of such cases in which a decision is remanded; and

“(iii) the number of such cases in which a decision is modified or reversed.”

(b)

Amendment to title XVI— Section 1633 of the Social Security Act (42 U.S.C. 1383b) is amended by adding at the end the following:

“(f)

“(1) The Commissioner of Social Security shall conduct pre-effectuation and post-effectuation quality reviews of hearing dispositions with respect to decisions in connection with applications for benefits under this title, in a sufficient number to ensure compliance with laws, regulations, and other guidance issued by the Commissioner of Social Security.

“(2) The Commissioner of Social Security shall annually submit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report that includes—

“(A) the total number of cases selected for a quality review as described in paragraph (1);

“(B) the number of such cases in which a decision is remanded; and

“(C) the number of such cases in which a decision is modified or reversed.”

Sec. 202 Uniform qualification standards for disability determination decision makers

(a)

In general— Section 221(k)(1) of the Social Security Act (42 U.S.C. 421(k)(1)) is amended by inserting at the end before the period the following: “, including standard qualifications for State and Federal decision makers and medical or vocational advisors involved in the disability determination process”.

(b)

Effective date— The regulations required to be issued as a result of the amendment made by paragraph (1) shall become final not later than 1 year after the date of the enactment of this Act.

Sec. 203 Increased transparency

Not later than 180 days after the date of the enactment of this Act and annually thereafter, the Commissioner of Social Security shall produce and make publicly available comprehensive program information to guide disability policy and procedures and to guide accuracy and consistency in decision making, including information relating to productivity, processing time, pending workloads, and decision outcomes with respect to each hearing officer, hearing office, and region and with respect to the disability insurance program as a whole. Such program information shall also include the same data, categorized by office, State, region, and the program as a whole, with respect to each of the following: initial disability determinations; reconsiderations; continuing disability reviews; and reconsiderations of continuing disability reviews.

Sec. 204 Data exchange standardization

(a)

In general— Section 704 of the Social Security Act (42 U.S.C. 904) is amended by adding at the end the following:

“(f) Data exchange standards for improved interoperability

“(1) Designation—The Commissioner shall, in consultation with an interagency work group established by the Office of Management and Budget and considering State and other Federal government perspectives, designate data exchange standards to govern, under titles II, VIII, and XVI—

“(A) necessary categories of information that State agencies operating programs under State plans approved under this part are required under applicable Federal law to electronically exchange with another State agency; and

“(B) Federal reporting and data exchange required under applicable Federal law.

“(2) Requirements—The data exchange standards required by paragraph (1) shall, to the extent practicable—

“(A) incorporate a widely accepted, non-proprietary, searchable, computer-readable format, such as the eXtensible Markup Language;

“(B) contain interoperable standards developed and maintained by intergovernmental partnerships, such as the National Information Exchange Model;

“(C) incorporate interoperable standards developed and maintained by Federal entities with authority over contracting and financial assistance;

“(D) be consistent with and implement applicable accounting principles;

“(E) be implemented in a manner that is cost-effective and improves program efficiency and effectiveness; and

“(F) be capable of being continually upgraded as necessary.

“(3) Rule of construction—Nothing in this subsection shall be construed to require a change to existing data exchange standards found to be effective and efficient.”

(b)

Plan for public comment— The Commissioner shall issue a plan for public comment on its website within 24 months after the date of the enactment of subsection (a). The plan shall—

(1)

identify federally required data exchanges, include specification and timing of exchanges to be standardized, and address the factors used in determining whether and when to standardize data exchanges; and

(2)

specify implementation options and describe future milestones for standardizing data for improved interoperability.