P.L. 114–074, Approved November 2, 2015 (129 Stat. 584)

Bipartisan Budget Act of 2015

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SEC. 1. [42U.S.C. 1305 note] SHORT TITLE

An Act to amend the Internal Revenue Code of 1986 to provide for a right to an administrative appeal relating to adverse determinations of tax-exempt status of certain organizations. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled. This Act may be cited as the “Bipartisan Budget Act of 2015”.

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SEC. 601. MAINTAINING 2016 MEDICARE PART B PREMIUM AND DEDUCTIBLE LEVELS CONSISTENT WITH ACTUARIALLY FAIR RATES.

(a)  2016 Premium and Deductible and Repayment Through Future Premiums.—Section 1839(a) of the Social Security Act (42 U.S.C. 1395r(a)) is amended—

(1)  in the second sentence of paragraph (1), by striking “Such” and inserting “Subject to paragraphs (5) and (6), such”; and

(2)  by adding at the end the following:

“(5)(A)  In applying this part (including subsection (i) and section 1833(b)), the monthly actuarial rate for enrollees age 65 and over for 2016 shall be determined as if subsection (f) did not apply.

“(B)  Subsection (f) shall continue to be applied to paragraph (6)(A) (during a repayment month, as described in paragraph (6)(B)) and without regard to the application of subparagraph (A).

“(6)(A)  With respect to a repayment month (as described in subparagraph (B)), the monthly premium otherwise established under paragraph (3) shall be increased by, subject to subparagraph (D), $3.

“(B)  For purposes of this paragraph, a repayment month is a month during a year, beginning with 2016, for which a balance due amount is computed under subparagraph (C) as greater than zero.

“(C)  For purposes of this paragraph, the balance due amount computed under this subparagraph, with respect to a month, is the amount estimated by the Chief Actuary of the Centers for Medicare & Medicaid Services to be equal to ;

“(i)  the amount transferred under section 1844(d)(1); plus

“(ii)  the amount that is equal to the aggregate reduction, for all individuals enrolled under this part, in the income related monthly adjustment amount as a result of the application of paragraph (5); minus

“(iii)  the amounts payable under this part as a result of the application of this paragraph for preceding months.

“(D)  If the balance due amount computed under subparagraph (C), without regard to this subparagraph, for December of a year would be less than zero, the Chief Actuary of the Centers for Medicare & Medicaid Services shall estimate, and the Secretary shall apply, a reduction to the dollar amount increase applied under subparagraph (A) for each month during such year in a manner such that the balance due amount for January of the subsequent year is equal to zero.".

(b)  Transitional Government Contribution.—Section 1844 of the Social Security Act (42 U.S.C. 1395w) is amended —

(1)  in subsection (a), by adding at the end the following:

“In applying paragraph (1), the amounts transferred under subsection (d)(1) with respect to enrollees described in subparagraphs (A) and (B) of such subsection shall be treated as premiums payable and deposited in the Trust Fund under subparagraphs (A) and (B), respectively, of paragraph (1).”; and

(2)  by adding at the end the following:

“(d)(1)  For 2016, there shall be transferred from the General Fund to the Trust Fund an amount, as estimated by the Chief Actuary of the Centers for Medicare & Medicaid Services, equal to the reduction in aggregate premiums payable under this part for a month in such year (excluding any changes in amounts collected under section 1839(i)) that is attributable to the application of section 1839(a)(5)(A) with respect to —

“(A)  enrollees age 65 and over; and

“(B)  enrollees under age 65.

“Such amounts shall be transferred from time to time as appropriate.

“(2)  Premium increases affected under section 1839(a)(6) shall not be taken into account in applying subsection (a). "(3) There shall be transferred from the Trust Fund to the General Fund of the Treasury amounts equivalent to the additional premiums payable as a result of the application of section 1839(a)(6), excluding the aggregate payments attributable to the application of section 1839(i)(3)(A)(ii)(II).”.

(c)  Conforming Application of High Income Adjustments to Increased Monthly Premium in Same Manner as for Regular Medicare Premiums.—Section 1839(i)(3)(A)(ii) of the Social Security Act (42 U.S.C. 1395r(i)(3)(A)(ii)) is amended —

(1)  by striking “amount.— 200 percent” and inserting the following: “amount.—

“(I)  200 percent”; and

(2)  by striking the period at the end and inserting “; plus”; and

(3)  by adding at the end the following new subclause:

“(II)  4 times the amount of the increase in the monthly premium under subsection (a)(6) for a month in the year.”.

(d)  Conditional Application to 2017 if No Social Security COLA for 2017.—If there is no increase in the monthly insurance benefits payable under title II with respect to December 2016 pursuant to section 215(i), then the amendments made by this section shall be applied as if—

(1)  the reference to “2016” in paragraph (5)(A) of section 1839(a) of the Social Security Act (42 U.S.C. 1395r(a)), as added by subsection (a)(2), was a reference to “2016 and 2017”;

(2)  the reference to “a month during a year, beginning with 2016” in paragraph (6)(B) of section 1839 of such Act , as added by subsection (a)(2), was a reference to “a month in a year, beginning with 2016 and beginning with 2017, respectively’;

(3)  the reference to “2016” in subsection (d)(1) of section 1844 of such Act, as added by subsection (b)(2), was a reference to “each of 2016 and 2017”.

Any increase in premiums effected under this subsection shall be in addition to the increase effected by the amendments made by subsection (a).

(e)  Construction Regarding No Authority to Initiate Application to Years After 2017.—Nothing in subsection (d) or the amendments made by this section shall be construed as authorizing the Secretary of Health and Human Services to initiate application of such subsection or amendments for a year after 2017.

SEC. 602. APPLYING THE MEDICAID ADDITIONAL REBATE REQUIREMENT TO GENERIC DRUGS.

(a)  In General.—Section 1927(c)(3) of the Social Security Act (42 U.S.C. 1396r-8(c)(3)) is amended —

(1)  in subparagraph (A), by striking “The amount” and inserting “Except as provided in subparagraph (C), the amount”; and

(2)  by adding at the end the following new subparagraph:

“(C) Additional rebate.—

“(i)  In general.—The amount of the rebate specified in this paragraph for a rebate period, with respect to each dosage form and strength of a covered outpatient drug other than a single source drug or an innovator multiple source drug of a manufacturer, shall be increased in the manner that the rebate for a dosage form and strength of a single source drug or an innovator multiple source drug is increased under subparagraphs (A) and (D) of paragraph (2), except as provided in clause (ii).

“(ii)  Special rules for application of provision.—In applying subparagraphs (A) and (D) of paragraph (2) under clause (i)

“(I)  the reference in subparagraph (A)(i) of such paragraph to ‘1990’ shall be deemed a reference to ‘2014’

“(II)  subject to clause (iii), the reference in subparagraph (A)(ii) of such paragraph to ‘the calendar quarter beginning July 1, 1990’ shall be deemed a reference to ‘the calendar quarter beginning July 1, 2014’; and

“(III)  subject to clause (iii), the reference in subparagraph (A)(ii) of such paragraph to ‘September 1990’ shall be deemed a reference to ‘September 2014’;

“(IV)  the references in subparagraph (D) of such paragraph to ‘paragraph (1)(A)(ii)’, ‘this paragraph’, and ‘December 31, 2009’ shall be deemed references to ‘subparagraph (A)’, ‘this subparagraph’, and ‘December 31, 2014’ respectively; and

“(V)  any reference in such paragraph to a `single source drug or an innovator multiple source drug' shall be deemed to be a reference to a drug to which clause (i) applies.

“(iii)  Special rule for certain noninnovator multiple source drugs.—In applying paragraph (2)(A)(ii)(II) under clause (i) with respect to a covered outpatient drug that is first marketed as a drug other than a single source drug or an innovator multiple source drug after April 1, 2013, such paragraph shall be applied —

“(I)  by substituting ‘the applicable quarter’ for ‘the calendar quarter beginning July 1, 1990’; and

“(II)  by substituting ‘the last month in such applicable quarter’ for ‘September 1990’.

“(iv)  Applicable quarter defined.—In this subsection, the term ‘applicable quarter’ means, with respect to a drug described in clause (iii), the fifth full calendar quarter after which the drug is marketed as a drug other than a single source drug or an innovator multiple source drug.”.

(b)  Effective Date.—The amendments made by subsection (a) shall apply to rebate periods beginning after the date that is one year after the date of the enactment of this Act.

SEC. 603. TREATMENT OF OFF-CAMPUS OUTPATIENT DEPARTMENTS OF A PROVIDER.

Section 1833(t) of the Social Security Act (42 U.S.C. 1395l(t)) is amended—

(1)  in paragraph (1)(B)—

(A)  in clause (iii), by striking "but" at the end;

(B)  in clause (iv), by striking the period at the end and inserting “; and”; and

(C)  by adding at the end the following new clause:

“(v)  does not include applicable items and services (as defined in subparagraph (A) of paragraph (21)) that are furnished on or after January 1, 2017, by an off-campus outpatient department of a provider (as defined in subparagraph (B) of such paragraph).”; and

(2)  by adding at the end the following new paragraph:

“(21) Services furnished by an off-campus outpatient department of a provider.—

“(A)  Applicable items and services.—For purposes of paragraph (1)(B)(v) and this paragraph, the term ‘applicable items and services’ means items and services other than items and services furnished by a dedicated emergency department (as defined in section 489.24(b) of title 42 of the Code of Federal Regulations).

“(B) Off-campus outpatient department of a provider.—

“(i)  In general.—For purposes of paragraph (1)(B)(v) and this paragraph, subject to clause (ii), the term ‘off- campus outpatient department of a provider’ means a department of a provider (as defined in section 413.65(a)(2) of title 42 of the Code of Federal Regulations, as in effect as of the date of the enactment of this paragraph) that is not located—

“(I)  on the campus (as defined in such section 413.65(a)(2)) of such provider; or

“(II)  within the distance (described in such definition of campus) from a remote location of a hospital facility (as defined in such section 413.65(a)(2)).

“(ii)  Exception.—For purposes of paragraph (1)(B)(v) and this paragraph, the term `off-campus outpatient department of a provider' shall not include a department of a provider (as so defined) that was billing under this subsection with respect to covered OPD services furnished prior to the date of the enactment of this paragraph.

“(C)  Availability of payment under other payment systems.—Payments for applicable items and services furnished by an off-campus outpatient department of a provider that are described in paragraph (1)(B)(v) shall be made under the applicable payment system under this part (other than under this subsection) if the requirements for such payment are otherwise met.

“(D)  Information needed for implementation.—Each hospital shall provide to the Secretary such information as the Secretary determines appropriate to implement this paragraph and paragraph (1)(B)(v) (which may include reporting of information on a hospital claim using a code or modifier and reporting information about off-campus outpatient departments of a provider on the enrollment form described in section 1866(j)).

“(E)  Limitations.—There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of the following:

“(i)  The determination of the applicable items and services under subparagraph (A) and applicable payment systems under subparagraph (C).

“(ii)  The determination of whether a department of a provider meets the term described in subparagraph (B).

“(ii)  Any information that hospitals are required to report pursuant to subparagraph (D).".

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SEC. 812. EXCLUSION OF CERTAIN MEDICAL SOURCES OF EVIDENCE.

(a)  In General.—Section 223(d)(5) of the Social Security Act (42 U.S.C. 423(d)(5)) is amended by adding at the end the following:

“(C) (i)  In making any determination with respect to whether an individual is under a disability or continues to be under a disability, the Commissioner of Social Security may not consider (except for good cause as determined by the Commissioner) any evidence furnished by —

“(I)  any individual or entity who has been convicted of a felony under section 208 or under section 1632;

“(II)  any individual or entity who has been excluded from participation in any Federal health care program under section 1128; or

“(III)  any person with respect to whom a civil money penalty or assessment has been imposed under section 1129 for the submission of false evidence.

“(ii)  To the extent and at such times as is necessary for the effective implementation of clause (i) of this subparagraph—

“(I)  the Inspector General of the Social Security Administration shall transmit to the Commissioner information relating to persons described in subclause (I) or (III) of clause (i);

“(II)  the Secretary of Health and Human Services shall transmit to the Commissioner information relating to persons described in subclause (II) of clause (i); and”.

(b)  Regulations.—Not later than 1 year after the date of the enactment of this Act, the Commissioner of Social Security shall issue regulations to carry out the amendment made by subsection (a).

(c)  Effective Date.—The amendment made by subsection (a) shall apply with respect to determinations of disability made on or after the earlier of—

(1)  the effective date of the regulations issued by the Commissioner under subsection (b); or

(2)  one year after the date of the enactment of this Act.

SEC. 813. NEW AND STRONGER PENALTIES.

(a) Conspiracy to Commit Social Security Fraud.—

(1)  Amendment to title ii.—Section 208(a) of the Social Security Act (42 U.S.C. 408(a)) is amended —

(A)  in paragraph (7)(C), by striking “or” at the end;

(B)  in paragraph (8), by adding "or" at the end; and

(C)  by inserting after paragraph (8) the following:

“(9) conspires to commit any offense described in any of paragraphs (1) through (4),”

(2)  Amendment to title viii.—Section 811(a) of such Act (42 U.S.C. 1011(a)) is amended—

(A)  in paragraph (3), by striking “or” at the end;

(B)  in paragraph (4), by striking the comma and adding “; or” at the end; and

(C)  by inserting after paragraph (4) the following: “(5) conspires to commit any offense described in any of paragraphs (1) through (3),”.

(3)  Amendment to title xvi.—Section 1632(a) of such Act (42 U.S.C. 1383a(a)) is amended—

(A)  in paragraph (3), by striking “or” at the end;

(B)  in paragraph (4), by adding “or” at the end; and

(C)  by inserting after paragraph (4) the following: “(5) conspires to commit any offense described in any of paragraphs (1) through (3),”.

(b) Increased Criminal Penalties for Certain Individuals Violating Positions of Trust.—

(1)  Amendment to title ii.—Section 208(a) of the Social Security Act (42 U.S.C. 408(a)), as amended by subsection (a), is further amended by striking the period at the end and inserting “, except that in the case of a person who receives a fee or other income for services performed in connection with any determination with respect to benefits under this title (including a claimant representative, translator, or current or former employee of the Social Security Administration), or who is a physician or other health care provider who submits, or causes the submission of, medical or other evidence in connection with any such determination, such person shall be guilty of a felony and upon conviction thereof shall be fined under title 18, United States Code, or imprisoned for not more than ten years, or both.”.

(2)  Amendment to title viii.—Section 811(a) of such Act (42 U.S.C. 1011(a)), as amended by subsection (a), is further amended by striking the period at the end and inserting “, except that in the case of a person who receives a fee or other income for services performed in connection with any determination with respect to benefits under this title (including a claimant representative, translator, or current or former employee of the Social Security Administration), or who is a physician or other health care provider who submits, or causes the submission of, medical or other evidence in connection with any such determination, such person shall be guilty of a felony and upon conviction thereof shall be fined under title 18, United States Code, or imprisoned for not more than ten years, or both.”.

(3)  Amendment to title xvi.—Section 1632(a) of such Act (42 U.S.C. 1383a(a)), as amended by subsection (a), is further amended by striking the period at the end and inserting “, except that in the case of a person who receives a fee or other income for services performed in connection with any determination with respect to benefits under this title (including a claimant representative, translator, or current or former employee of the Social Security Administration), or who is a physician or other health care provider who submits, or causes the submission of, medical or other evidence in connection with any such determination, such person shall be guilty of a felony and upon conviction thereof shall be fined under title 18, United States Code, or imprisoned for not more than ten years, or both.”.

(c)  Increased Civil Monetary Penalties for Certain Individuals Violating Positions of Trust.—Section 1129(a)(1) of the Social Security Act (42 U.S.C. 1320a-8(a)(1)) is amended, in the matter following subparagraph (C), by inserting after “withholding disclosure of such fact” the following: “, except that in the case of such a person who receives a fee or other income for services performed in connection with any such determination (including a claimant representative, translator, or current or former employee of the Social Security Administration) or who is a physician or other health care provider who submits, or causes the submission of, medical or other evidence in connection with any such determination, the amount of such penalty shall be not more than $7,500”.

(d)  No Benefits Payable to Individuals for Whom a Civil Monetary Penalty Is Imposed for Fraudulently Concealing Work Activity.—Section 222(c)(5) of the Social Security Act (42 U.S.C. 422(c)(5)) is amended by inserting after “conviction by a Federal court” the following: “, or the imposition of a civil monetary penalty under section 1129,”.

SEC. 814 REFERENCES TO SOCIAL SECURITY AND MEDICARE IN ELECTRONIC COMMUNICATIONS

(a)  In General.—Section 1140(a)(1) of the Social Security Act (42 U.S.C. 1320b-10(a)(1)) is amended by inserting “(including any Internet or other electronic communication)” after “or other communication”.

(b)  Each Communication Treated as Separate Violation.—Section 1140(b) of such Act (42 U.S.C. 1320b-10(b)) is amended by inserting after the second sentence the following: “In the case of any items referred to in subsection (a)(1) consisting of Internet or other electronic communications, each dissemination, viewing, or accessing of such a communication which contains one or more words, letters, symbols, or emblems in violation of subsection (a) shall represent a separate violation”.

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SEC. 821 TEMPORARY REAUTHORIZATION OF DISABILITY INSURANCE DEMONSTRATION PROJECT AUTHORITY

(a)  Termination Date.—Section 234(d)(2) of the Social Security Act (42 U.S.C. 434(d)(2)) is amended by striking “December 18, 2005” and inserting “December 31, 2021, and the authority to carry out such projects shall terminate on December 31, 2022”.

(b)  Authority to Waive Compliance With Benefits Requirements.—Section 234(c) of such Act is amended by striking “December 17, 2005” and inserting “December 30, 2021”.

SEC.822 MODIFICATION OF DEMONSTRATION PROJECT AUTHORITY.

(a)  In General.—Section 234(a)(1) of the Social Security Act (42 U.S.C. 434(a)(1)) is amended in the matter preceding subparagraph (A) by inserting “to promote attachment to the labor force and” after “designed”.

(b)  Congressional Review Period.—Section 234(c) of the Social Security Act (42 U.S.C. 434(c)), as amended by section 821(b) of this Act, is further amended by inserting “including the objectives of the experiment or demonstration project, the expected annual and total costs, and the dates on which the experiment or demonstration project is expected to start and finish,” after “thereof,”

(c)  Additional Requirements.—Section 234 of the Social Security Act (42 U.S.C. 434), as amended by subsection (b), is further amended by adding at the end the following:

“(e)  Additional Requirements.—In developing and carrying out any experiment or demonstration project under this section, the Commissioner may not require any individual to participate in such experiment or demonstration project and shall ensure—

“(1)  that the voluntary participation of individuals in such experiment or demonstration project is obtained through informed written consent which satisfies the requirements for informed consent established by the Commissioner for use in such experiment or demonstration project in which human subjects are at risk;

“(2)  that any individual's voluntary agreement to participate in any such experiment or demonstration project may be revoked by such individual at any time; and

“(3)  that such experiment or demonstration project is expected to yield statistically significant results.".

(d)  Annual Reporting Deadline.—Section 234(d)(1) of such Act is amended by striking “June 9” and inserting “September 30”.

SEC. 823 PROMOTING OPPORTUNITY DEMONSTRATION PROJECT.

Section 234 of the Social Security Act (42 U.S.C. 434), as amended by section 822 of this Act, is further amended by adding at the end the following:

“(f) Promoting Opportunity Demonstration Project.—

“(1)  In general.—The Commissioner shall carry out a demonstration project under this subsection as described in paragraph (2) during a 5-year period beginning not later than January 1, 2017.

“(2)  Benefit offset.—Under the demonstration project described in this paragraph, with respect to any individual participating in the project who is otherwise entitled to a benefit under section 223(a)(1) for a month—

“(A)  any such benefit otherwise payable to the individual for such month (other than a benefit payable for any month prior to the 1st month beginning after the date on which the individual's entitlement to such benefit is determined) shall be reduced by $1 for each $2 by which the individual's earnings derived from services paid during such month exceeds an amount equal to the individual's impairment-related work expenses for such month (as determined under paragraph (3)), except that such benefit may not be reduced below $0;

“(B)  no benefit shall be payable under section 202 on the basis of the wages and self-employment income of the individual for any month for which the benefit of such individual under section 223(a)(1) is reduced to $0 pursuant to subparagraph (A);

“(C)  entitlement to any benefit described in subparagraph (A) or (B) shall not terminate due to earnings derived from services except following the first month for which such benefit has been reduced to $0 pursuant to subparagraph (A) (and the trial work period (as defined in section 222(c)) and extended period of eligibility shall not apply to any such individual for any such month); and

“(D)  in any case in which such an individual is entitled to hospital insurance benefits under part A of title XVIII by reason of section 226(b) and such individual's entitlement to a benefit described in subparagraph (A) or (B) or status as a qualified railroad retirement beneficiary is terminated pursuant to subparagraph (C), such individual shall be deemed to be entitled to such benefits or to occupy such status (notwithstanding the termination of such entitlement or status) for the period of consecutive months throughout all of which the physical or mental impairment, on which such entitlement or status was based, continues, and throughout all of which such individual would have been entitled to monthly insurance benefits under title II or as a qualified railroad retirement beneficiary had such termination of entitlement or status not occurred, but not in excess of 93 such months.

“(3) Impairment-related work expenses.—

“(A)  In general.—For purposes of paragraph (2)(A) and except as provided in subparagraph (C), the amount of an individual's impairment-related work expenses for a month is deemed to be the minimum threshold amount.

“(B)  Minimum threshold amount.—In this paragraph, the term ‘minimum threshold amount’ means an amount, to be determined by the Commissioner, which shall not exceed the amount sufficient to demonstrate that an individual has rendered services in a month, as determined by the Commissioner under section 222(c)(4)(A). The Commissioner may test multiple minimum threshold amounts.

“(C) Exception for itemized impairment-related work expenses.—

“(i)  In general.—Notwithstanding subparagraph (A), in any case in which the amount of such an individual's itemized impairment- related work expenses (as defined in clause (ii)) for a month is greater than the minimum threshold amount, the amount of the individual's impairment- related work expenses for the month shall be equal to the amount of the individual's itemized impairment-related work expenses (as so defined) for the month.

“(ii)  Definition.—In this subparagraph, the term ‘itemized impairment-related work expenses’ means the amount excluded under section 223(d)(4)(A) from an individual's earnings for a month in determining whether an individual is able to engage in substantial gainful activity by reason of such earnings in such month, except that such amount does not include the cost to the individual of any item or service for which the individual does not provide to the Commissioner a satisfactory itemized accounting.

“(D)  Limitation.— Notwithstanding the other provisions of this paragraph, for purposes of paragraph (2)(A), the amount of an individual's impairment-related work expenses for a month shall not exceed the amount of earnings derived from services, prescribed by the Commissioner under regulations issued pursuant to section 223(d)(4)(A), sufficient to demonstrate an individual's ability to engage in substantial gainful activity.”.

SEC. 824 USE OF ELECTRONIC PAYROLL DATA TO IMPROVE PROGRAM ADMINISTRATION.

(a)  In General.—Title XI of the Social Security Act (42 U.S.C. 1301 et seq.) is amended by inserting after section 1183 the following:

(a) " information exchange with payroll data providers

“Sec. 1184. (a)  In General.—The Commissioner of Social Security may enter into an information exchange with a payroll data provider for purposes of—

“(1)  efficiently administering—

“(A)  monthly insurance benefits under subsections (d)(1)(B)(ii), (d)(6)(A)(ii), (d)(6)(B), (e)(1)(B)(ii), and (f)(1)(B)(ii) of section 202 and subsection (a)(1) of section 223; and

“(B)  supplemental security income benefits under title XVI; and

“(2)  preventing improper payments of such benefits without the need for verification by independent or collateral sources.

“(b)  Notification Requirements.—Before entering into an information exchange pursuant to subsection (a), the Commissioner shall publish in the Federal Register a notice describing the information exchange and the extent to which the information received through such exchange is—

“(1)  relevant and necessary to—

“(A)  accurately determine entitlement to, and the amount of, benefits described under subparagraph (A) of subsection (a)(1);

“(B)  accurately determine eligibility for, and the amount of, benefits described in subparagraph (B) of such subsection; and

“(C)  prevent improper payment of such benefits; and

“(2)  sufficiently accurate, up-to-date, and complete.

“(c)  Definitions.—For purposes of this section:

“(1)  Payroll data provider.—The term ‘payroll data provider’ means payroll providers, wage verification companies, and other commercial or non-commercial entities that collect and maintain data regarding employment and wages, without regard to whether the entity provides such data for a fee or without cost.

“(2)  Information exchange.—The term ‘information exchange’ means the automated comparison of a system of records maintained by the Commissioner of Social Security with records maintained by a payroll data provider.”.

(b) Authorization to Access Information Held by Payroll Data Providers.—

(1)  Amendment to title ii.—Section 225 of the Social Security Act (42 U.S.C. 425) is amended by adding at the end the following:

“(c) Access to Information Held by Payroll Data Providers.—

“(1)  The Commissioner of Social Security may require each individual who applies for or is entitled to monthly insurance benefits under subsections (d)(1)(B)(ii), (d)(6)(A)(ii), (d)(6)(B), (e)(1)(B)(ii), and (f)(1)(B)(ii) of section 202 and subsection (a)(1) of section 223 to provide authorization by the individual for the Commissioner to obtain from any payroll data provider (as defined in section 1184(c)(1)) any record held by the payroll data provider with respect to the individual whenever the Commissioner determines the record is needed in connection with a determination of initial or ongoing entitlement to such benefits.

“(2)  An authorization provided by an individual under this subsection shall remain effective until the earliest of—

“(A)  the rendering of a final adverse decision on the individual's application or entitlement to benefits under this title;

“(B)  the termination of the individual's entitlement to benefits under this title; or

“(C)  the express revocation by the individual of the authorization, in a written notification to the Commissioner.

“(3)  The Commissioner of Social Security is not required to furnish any authorization obtained pursuant to this subsection to the payroll data provider.

“(4)  The Commissioner shall inform any person who provides authorization pursuant to this clause of the duration and scope of the authorization.

“(5)  If an individual who applies for or is entitled to benefits under this title refuses to provide, or revokes, any authorization under this subsection, subsection (d) shall not apply to such individual beginning with the first day of the first month in which he or she refuses or revokes such authorization.”.

(2)  Title xvi.—Section 1631(e)(1)(B) of the Social Security Act (42 U.S.C. 1383(e)(1)(B)) is amended by adding at the end the following:

“(iii)(I)  The Commissioner of Social Security may require each applicant for, or recipient of, benefits under this title to provide authorization by the applicant, recipient or legal guardian (or by any other person whose income or resources are material to the determination of the eligibility of the applicant or recipient for such benefits) for the Commissioner to obtain from any payroll data provider (as defined in section 1184(c)(1)) any record held by the payroll data provider with respect to the applicant or recipient (or any such other person) whenever the Commissioner determines the record is needed in connection with a determination of initial or ongoing eligibility or the amount of such benefits.

“(II)  An authorization provided by an applicant, recipient or legal guardian (or any other person whose income or resources are material to the determination of the eligibility of the applicant or recipient) under this clause shall remain effective until the earliest of—

“(aa)  the rendering of a final adverse decision on the applicant's application for eligibility for benefits under this title;

“(bb)  the cessation of the recipient's eligibility for benefits under this title;

“(cc)  the express revocation by the applicant, or recipient (or such other person referred to in subclause (I)) of the authorization, in a written notification to the Commissioner; or

“(dd)  the termination of the basis upon which the Commissioner considers another person's income and resources available to the applicant or recipient.

“(III)  The Commissioner of Social Security is not required to furnish any authorization obtained pursuant to this clause to the payroll data provider.

“(IV)  The Commissioner shall inform any person who provides authorization pursuant to this clause of the duration and scope of the authorization.

“(V)  If an applicant for, or recipient of, benefits under this title (or any such other person referred to in subclause (I)) refuses to provide, or revokes, any authorization required by subclause (I), paragraph (2)(B) and paragraph (10) shall not apply to such applicant or recipient beginning with the first day of the first month in which he or she refuses or revokes such authorization.”.

(c) Reporting Responsibilities for Beneficiaries Subject to Information Exchange With Payroll Data Provider.—

(1)  Amendment to title ii.—Section 225 of the Social Security (42 U.S.C. 425), as amended by subsection (b)(1), is further amended by adding at the end the following:

“(d)  An individual who has authorized the Commissioner of Social Security to obtain records from a payroll data provider under subsection (c) shall not be subject to a penalty under section 1129A for any omission or error with respect to such individual's wages as reported by the payroll data provider.”.

(2)  Amendment to title xvi.—Section 1631(e)4 of the Social Security Act (42 U.S.C. 1383(e)) is amended—

(A)  in paragraph (2)

(i)  by striking “In the case of the failure” and inserting “(A) In the case of the failure”;

(ii)  by redesignating subparagraphs (A) through (C) as clauses (i) through (iii), respectively; and

(iii)  by adding at the end the following:

“(B)  For purposes of subparagraph (A), the Commissioner of Social Security shall find that good cause exists for the failure of, or delay by, an individual in submitting a report of an event or change in circumstances relevant to eligibility for or amount of benefits under this title in any case where—

“(i)  the individual (or another person referred to in paragraph (1)(B)(iii)(I)) has provided authorization to the Commissioner to access payroll data records related to the individual; and

“(ii)  the event or change in circumstance is a change in the individual's employer.”; and

(B)  by adding at the end the following:

“(10)  An individual who has authorized the Commissioner of Social Security to obtain records from a payroll data provider under paragraph (1)(B)(iii) (or on whose behalf another person described in subclause (I) of such paragraph has provided such authorization) shall not be subject to a penalty under section 1129A for any omission or error with respect to such individual's wages as reported by the payroll data provider.”.

(d)  Regulations.—Not later than 1 year after the date of the enactment of this Act, the Commissioner of Social Security shall prescribe by regulation procedures for implementing the Commissioner's access to and use of information held by payroll providers, including—

(1)  guidelines for establishing and maintaining information exchanges with payroll providers, pursuant to section 1184 of the Social Security Act;

(2)  beneficiary authorizations;

(3)  reduced wage reporting responsibilities for individuals who authorize the Commissioner to access information held by payroll data providers through an information exchange; and

(4)  procedures for notifying individuals in writing when they become subject to such reduced wage reporting requirements and when such reduced wage reporting requirements no longer apply to them.

(e)  Effective Date.—The amendments made by this section shall take effect on the date that is 1 year after the date of the enactment of this Act.

SEC. 825 TREATMENT OF EARNINGS DERIVED FROM SERVICES

(a)  In General.—Section 223(d)(4) of the Social Security Act (42 U.S.C. 423(d)(4)) is amended by adding at the end the following:

“(C) (i)  Subject to clause (ii), in determining when earnings derived from services demonstrate an individual's ability to engage in substantial gainful activity, such earnings shall be presumed to have been earned—

“(I)  in making a determination of initial entitlement on the basis of disability, in the month in which the services were performed from which such earnings were derived; and

“(II)  in any other case, in the month in which such earnings were paid.

“(ii)  A presumption made under clause (i) shall not apply to a determination described in such clause if

“(I)  the Commissioner can reasonably establish, based on evidence readily available at the time of such determination, that the earnings were earned in a different month than when paid; or

“(II)  in any case in which there is a determination that no benefit is payable due to earnings, after the individual is notified of the presumption made and provided with an opportunity to submit additional information along with an explanation of what additional information is needed, the individual shows to the satisfaction of the Commissioner that such earnings were earned in another month.”.

(b)  Effective Date.—The amendment made by subsection (a) shall take effect upon the date of the enactment of this Act, or as soon as practicable thereafter.

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SEC. 831 CLOSURE OF UNINTENDED LOOPHOLES.

(a) Presumed Filing of Application by Individuals Eligible for Old- Age Insurance Benefits and for Wife's or Husband's Insurance Benefits.—

(1)  In general.—Section 202(r) of the Social Security Act (42 U.S.C. 402(r)) is amended by striking paragraphs (1) and (2) and inserting the following:

“(1)  If an individual is eligible for a wife's or husband's insurance benefit (except in the case of eligibility pursuant to clause (ii) of subsection (b)(1)(B) or subsection (c)(1)(B), as appropriate), in any month for which the individual is entitled to an old-age insurance benefit, such individual shall be deemed to have filed an application for wife's or husband's insurance benefits for such month.

“(2)  If an individual is eligible (but for section 202(k)(4)) for an old-age insurance benefit in any month for which the individual is entitled to a wife's or husband's insurance benefit (except in the case of entitlement pursuant to clause (ii) of [[Page 129 STAT. 612]] subsection (b)(1)(B) or subsection (c)(1)(B), as appropriate), such individual shall be deemed to have filed an application for old-age insurance benefits—

“(A)  for such month, or

“(B)  if such individual is also entitled to a disability insurance benefit for such month, in the first subsequent month for which such individual is not entitled to a disability insurance benefit.”.

(2)  Conforming amendment.—Section 202 of the Social Security Act (42 U.S.C. 402) is amended—

(A)  in subsection (b)(1), by striking subparagraph (B) and inserting the following:

“(B) (i)  has attained age 62, or

“(ii)  in the case of a wife, has in her care (individually or jointly with such individual) at the time of filing such application a child entitled to a child's insurance benefit on the basis of the wages and self-employment income of such individual,”; and

(B)  in subsection (c)(1), by striking subparagraph (B) and inserting the following:

“(B) (i)  has attained age 62, or

“(ii)  in the case of a husband, has in his care (individually or jointly with such individual) at the time of filing such application a child entitled to a child's insurance benefit on the basis of the wages and self-employment income of such individual,”.

(3)  Effective date.—The amendments made by this subsection shall apply with respect to individuals who attain age 62 in any calendar year after 2015.

(b) Voluntary Suspension of Benefits.—

(1)  In general.—Section 202 of the Social Security Act (42 U.S.C. 402) is amended by adding at the end the following:

“(z) Voluntary Suspension.—

“(1) (A)  Except as otherwise provided in this subsection, any individual who has attained retirement age (as defined in section 216(l)) and is entitled to old-age insurance benefits may request that payment of such benefits be suspended—

“(i)  beginning with the month following the month in which such request is received by the Commissioner, and

“(ii)  ending with the earlier of the month following the month in which a request by the individual for a resumption of such benefits is so received or the month following the month in which the individual attains the age of 70.

“(2)  An individual may not suspend such benefits under this subsection, and any suspension of such benefits under this subsection shall end, effective with respect to any month in which the individual becomes subject to—

“(A)  mandatory suspension of such benefits under section 202(x);

“(B)  termination of such benefits under section 202(n);

“(C)  a penalty under section 1129A imposing nonpayment of such benefits; or

“(D)  any other withholding, in whole or in part, of such benefits under any other provision of law that authorizes recovery of a debt by withholding such benefits.

“(3)  In the case of an individual who requests that such benefits be suspended under this subsection, for any month during the period in which the suspension is in effect—

“(A)  no retroactive benefits (as defined in subsection (j)(4)(B)(iii)) shall be payable to such individual;

“(B)  no monthly benefit shall be payable to any other individual on the basis of such individual's wages and self- employment income; and

“(C)  no monthly benefit shall be payable to such individual on the basis of another individual's wages and self-employment income.”.

(2)  Conforming amendment.—Section 202(w)(2)(B)(ii) of the Social Security Act (42 U.S.C. 402(w)(2)(B)(ii)) is amended by inserting “under section 202(z)” after “request”.

(3)  Effective date.—The amendments made by this subsection shall apply with respect to requests for benefit suspension submitted beginning at least 180 days after the date of the enactment of this Act.

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SEC. 832. REQUIREMENT FOR MEDICAL REVIEW.

(a)  In General.—Section 221(h) of the Social Security Act (42 U.S.C. 421(h)) is amended to read as follows:

“(h)  An initial determination under subsection (a), (c), (g), or (i) shall not be made until the Commissioner of Social Security has made every reasonable effort to ensure—

“(1)  in any case where there is evidence which indicates the existence of a mental impairment, that a qualified psychiatrist or psychologist has completed the medical portion of the case review and any applicable residual functional capacity assessment; and

“(2)  in any case where there is evidence which indicates the existence of a physical impairment, that a qualified physician has completed the medical portion of the case review and any applicable residual functional capacity assessment.”.

(b)  Effective Date.—The amendment made by subsection (a) shall apply with respect to determinations of disability made on or after the date that is 1 year after the date of the enactment of this Act.

SEC. 833. REALLOCATION OF PAYROLL TAX REVENUE.

(1)  Wages.—Section 201(b)(1) of the Social Security Act (42 U.S.C. 401(b)(1)) is amended by striking “and (R) 1.80 per centum of the wages (as so defined) paid after December 31, 1999, and so reported” and inserting “(R) 1.80 per centum of the wages (as so defined) paid after December 31, 1999, and before January 1, 2016, and so reported, (S) 2.37 per centum of the wages (as so defined) paid after December 31, 2015, and before January 1, 2019, and so reported, and (T) 1.80 per centum of the wages (as so defined) paid after December 31, 2018, and so reported,”.

(2)  Self-employment income.—Section 201(b)(2) of such Act (42 U.S.C. 401(b)(2)) is amended by striking “and (R) 1.80 per centum of the amount of self-employment income (as so defined) so reported for any taxable year beginning after December 31, 1999” and inserting “(R) 1.80 per centum of the amount of self-employment income (as so defined) so reported for any taxable year beginning after December 31, 1999, and before January 1, 2016, (S) 2.37 per centum of the amount of self-employment income (as so defined) so reported for any taxable year beginning after December 31, 2015, and before January 1, 2019, and (T) 1.80 per centum of the amount of self-employment income (as so defined) so reported for any taxable year beginning after December 31, 2018”.

(3)  Effective date.—The amendments made by this section shall apply with respect to wages paid after December 31, 2015, and self-employment income for taxable years beginning after such date.

SEC. 834 ACCESS TO FINANCIAL INFORMATION FOR WAIVERS AND ADJUSTMENTS OF RECOVERY.

(a)  Access to Financial Information for Old-age, Survivors, and Disability Insurance Waivers.—Section 204(b) of the Social Security Act (42 U.S.C. 404(b)) is amended to read as follows:

“(b) (1)  In any case in which more than the correct amount of payment has been made, there shall be no adjustment of payments to, or recovery by the United States from, any person who is without fault if such adjustment or recovery would defeat the purpose of this title or would be against equity and good conscience.

“(2)  In making for purposes of this subsection any determination of whether any individual is without fault, the Commissioner of Social Security shall specifically take into account any physical, mental, educational, or linguistic limitation such individual may have (including any lack of facility with the English language).

“(3) (A)  In making for purposes of this subsection any determination of whether such adjustment or recovery would defeat the purpose of this title, the Commissioner of Social Security shall require an individual to provide authorization for the Commissioner to obtain (subject to the cost reimbursement requirements of section 1115(a) of the Right to Financial Privacy Act) from any financial institution (within the meaning of section 1101(1) of such Act) any financial record (within the meaning of section 1101(2) of such Act) held by the institution with respect to such individual whenever the Commissioner determines the record is needed in connection with a determination with respect to such adjustment or recovery.

“(B)  Notwithstanding section 1104(a)(1) of the Right to Financial Privacy Act, an authorization provided by an individual pursuant this paragraph shall remain effective until the earlier of—

“(i)  the rendering of a final decision on whether adjustment or recovery would defeat the purpose of this title; or

“(ii)  the express revocation by the individual of the authorization, in a written notification to the Commissioner.

“(C) (i)  An authorization obtained by the Commissioner of Social Security pursuant this paragraph shall be considered to meet the requirements of the Right to Financial Privacy Act for purposes of section 1103(a) of such Act, and need not be furnished to the financial institution, notwithstanding section 1104(a) of such Act.

“(ii)  The certification requirements of section 1103(b) of the Right to Financial Privacy Act shall not apply to requests by the Commissioner of Social Security pursuant to an authorization provided under this paragraph.

“(iii)  A request by the Commissioner pursuant to an authorization provided under this paragraph is deemed to meet the requirements of section 1104(a)(3) of the Right to Financial Privacy Act and the flush language of section 1102 of such Act.

“(D)  The Commissioner shall inform any person who provides authorization pursuant to this paragraph of the duration and scope of the authorization.

“(E)  If an individual refuses to provide, or revokes, any authorization for the Commissioner of Social Security to obtain from any financial institution any financial record, the Commissioner may, on that basis, determine that adjustment or recovery would not defeat the purpose of this title.”.

(b) Access to Financial Information for Supplemental Security Income Waivers.—

(1)  In general.—Section 1631(b)(1)(B) of the Social Security Act (42 U.S.C. 1383(b)(1)(B)) is amended by adding at the end the following:

“In making for purposes of this subparagraph a determination of whether an adjustment or recovery would defeat the purpose of this title, the Commissioner of Social Security shall require an individual to provide authorization for the Commissioner to obtain (subject to the cost reimbursement requirements of section 1115(a) of the Right to Financial Privacy Act) from any financial institution (within the meaning of section 1101(1) of such Act) any financial record (within the meaning of section 1101(2) of such Act) held by the institution with respect to such individual whenever the Commissioner determines that the record is needed in connection with a determination with respect to such adjustment or recovery, under the terms and conditions established under subsection (e)(1)(B).”.

(2)  Conforming amendment.—Section 1631(e)(1)(B)(ii)(V) of such Act (42 U.S.C. 1383(e)(1)(B)(ii)(V)) is amended by inserting

“, determine that adjustment or recovery on account of an overpayment with respect to the applicant or recipient would not defeat the purpose of this title, or both”

before the period at the end.

(c)  Effective Date.—The amendments made by this section shall apply with respect to determinations made on or after the date that is 3 months after the date of the enactment of this section.

SEC. 841. INTERAGENCY COORDINATION TO IMPROVE PROGRAM ADMINISTRATION.

(a)  In General.—Title XI of the Social Security Act (42 U.S.C. 1301 et seq.) is amended by inserting after section 1127 the following:

“Sec. 1127A INTERAGENCY COORDINATION TO IMPROVE PROGRAM ADMINISTRATION.

“(a)  Coordination Agreement.—Notwithstanding any other provision of law, including section 207 of this Act, the Commissioner of Social Security (referred to in this section as ‘the Commissioner’) and the Director of the Office of Personnel Management (referred to in this section as ‘the Director’) shall enter into an agreement under which a system is established to carry out the following procedure:

“(1)  The Director shall notify the Commissioner when any individual is determined to be entitled to a monthly disability annuity payment pursuant to subchapter V of chapter 84 of subpart G of part III of title 5, United States Code, and shall certify that such individual has provided the authorization described in subsection (f).

“(2)  If the Commissioner determines that an individual described in paragraph (1) is also entitled to past-due benefits under section 223, the Commissioner shall notify the Director of such fact.

“(3)  Not later than 30 days after receiving a notification described in paragraph (2) with respect to an individual, the Director shall provide the Commissioner with the total amount of any disability annuity overpayments made to such individual, as well as any other information (in such form and manner as the Commissioner shall require) that the Commissioner determines is necessary to carry out this section.

“(4)  If the Director provides the Commissioner with the information described in paragraph (3) in a timely manner, the Commissioner may withhold past-due benefits under section 223 to which such individual is entitled and may pay the amount described in paragraph (3) to the Office of Personnel Management for any disability annuity overpayments made to such individual.

“(5)  The Director shall credit any amount received under paragraph (4) with respect to an individual toward any disability annuity overpayment owed by such individual.

“(b) Limitations.—

“(1)  Priority of Other Reductions.—Benefits shall only be withheld under this section after any other reduction applicable under this Act, including sections 206(a)(4), 224, and 1127(a).

“(2)  Timely Notification Required.—The Commissioner may not withhold benefits under this section if the Director does not provide the notice described in subsection (a)(3) within the time period described in such subsection.

“(c)  Delayed Payment of Past-Due Benefits.—If the Commissioner is required to make a notification described in subsection (a)(2) with respect to an individual, the Commissioner shall not make any payment of past-due benefits under section 223 to such individual until after the period described in subsection (a)(3).

“(d)  Review.—Notwithstanding section 205 or any other provision of law, any determination regarding the withholding of past-due benefits under this section shall only be subject to adjudication and review by the Director under section 8461 of title 5, United States Code.

“(e)  Disability Annuity Overpayment Defined.—For purposes of this section, the term ‘disability annuity overpayment’ means the amount of the reduction under section 8452(a)(2) of title 5, United States Code, applicable to a monthly annuity payment made to an individual pursuant to subchapter V of chapter 84 of subpart G of part III of such title due to the individual’s concurrent entitlement to a disability insurance benefit under section 223 during such month.

“(f)  Authorization to Withhold Benefits.—The authorization described in this subsection, with respect to an individual, is written authorization provided by the individual to the Director which authorizes the Commissioner to withhold past-due benefits under section 223 to which such individual is entitled in order to pay the amount withheld to the Office of Personnel Management for any disability overpayments made to such individual.

“(g)  Expenses.—The Director shall pay to the Social Security Administration an amount equal to the amount estimated by the Commissioner as the total cost incurred by the Social Security Administration in carrying out this section for each calendar quarter.”.

(b)  Effective Date.—The amendment made by this section shall apply to past-due disability insurance benefits payable on or after the date that is 1 year after the date of the enactment of this section.

SEC. 842 ELIMINATION OF QUINQUENNIAL DETERMINATIONS RELATING TO WAGE CREDITS FOR MILITARY SERVICE PRIOR TO 1957.

Section 217(g)(2) of the Social Security Act (42 U.S.C. 417(g)(2)) is amended—

“(1)  by inserting “through 2010” after “each fifth year thereafter”; and

“(2)  by inserting after the first sentence the following:

“The Secretary of Health and Human Services shall revise the amount determined under paragraph (1) with respect to the Federal Hospital Insurance Trust Fund under title XVIII in 2015 and each fifth year thereafter through such date, and using such data, as the Secretary determines appropriate on the basis of the amount of benefits and administrative expenses actually paid from such Trust Fund under title XVIII and the relevant actuarial assumptions set forth in the report of the Board of Trustees of such Trust Fund for such year under section 1817(b).”.

SEC. 843. CERTIFICATION OF BENEFITS PAYABLE TO A DIVORCED SPOUSE OF A RAILROAD WORKER TO THE RAILROAD RETIREMENT BOARD.

Section 205(i) of the Social Security Act (42 U.S.C. 405(i)) is amended by inserting “or divorced wife or divorced husband” after “the wife or husband”.

SEC. 844. TECHNICAL AMENDMENTS TO ELIMINATE OBSOLETE PROVISIONS.

(a)  Elimination of Reference in Section 226 to a Repealed Provision.—Section 226 of the Social Security Act (42 U.S.C. 426) is amended—

(1)  by striking subsection (i); and

(2)  by redesignating subsection (j) as subsection (i).

(b)  Elimination of Reference in Section 226A to a Repealed Provision.—Section 226A of such Act (42 U.S.C. 426-1) is amended by striking the second subsection (c).

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