[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8546 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 8546
To require the Commissioner of the Social Security Administration to
take certain actions to improve the processing of claims and appeals
for disability insurance benefits and supplemental security income, and
for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 23, 2024
Mr. Neguse introduced the following bill; which was referred to the
Committee on Ways and Means
_______________________________________________________________________
A BILL
To require the Commissioner of the Social Security Administration to
take certain actions to improve the processing of claims and appeals
for disability insurance benefits and supplemental security income, and
for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Social Security Administration
Processing Claims Improvement Act of 2024''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) A recent Social Security Administration Inspector
General report found that nearly half of the 151,000,000
callers to field offices and the national 800-number went
unanswered.
(2) In 2021, over 9,000,000 people received Social Security
disability insurance benefits.
(3) According to the National Academy of Social Insurance,
over half of all beneficiaries rely on Disability Insurance and
Supplemental Security for 90 percent or more of their income.
(4) Benefits are interrupted following the denial and often
remain paused until a review--which can take anywhere from 14
to 22 months--is complete.
(5) Since 2011, the number of beneficiaries increased by
more than 22 percent while over the same period, Social
Security Administration's operating budget fell by more than 17
percent, after adjusting for inflation.
SEC. 3. SOCIAL SECURITY ADMINISTRATION CLAIMS PROCESSING REVIEW.
Not later than 1 year after the date of enactment of this Act, and
on an annual basis thereafter, the Commissioner shall conduct a review
to--
(1) identify--
(A) processing error trends of claims processors
and the training needs of claims processors and case
managers;
(B) possible improvements to the processing of
claims with respect to covered benefits, including
decision-making of claims processors;
(C) the most common causes of overpayments of
covered benefits; and
(D) the most common reasons for denying an
application for a covered benefit;
(2) evaluate--
(A) any written or verbal instructions or training
given to benefits counselors;
(B) any guidance or regulation promulgated by the
Commissioner that is related to determinations of
eligibility for covered benefits and whether updates to
such guidance are necessary to provide claims
processors with better resources to carry out the
duties of such processors, including any guidance
regarding the processing of claims for a covered
benefit; and
(3) after the training programs under section 4 are
established, identify improvements to the training programs
with regard to--
(A) the processing of claims for a covered benefit;
and
(B) decision-making for claims processors when
reconsidering the eligibility of a claimant for a
covered benefit.
SEC. 4. TRAININGS FOR CLAIMS PROCESSORS.
(a) Annual Training Program.--
(1) Establishment.--Not later than 1 year after the first
review under section 3 is conducted, the Commissioner shall
establish, and update on an ongoing basis, a national training
program for claims processors who review claims for covered
benefits, including appeals of continuing disability reviews.
(2) Participation.--Not later than 180 days after the date
that the annual training program under paragraph (1) is
established, the Commissioner shall require that each claims
processor participates in such program at least once each year,
beginning in the second year in which the claims processor
carries out the duties of a claims processor for the agency.
(3) Required elements.--The training established under
paragraph (1) shall include the following:
(A) Training on the quality assurance standards
established under section 6.
(B) Disability etiquette training for case managers
and claims processors to learn effective communication
and empathy.
(C) Training regarding internal communications to
prevent overpayments and subsequent benefit denials.
(b) Ongoing Training Program.--
(1) Establishment.--Not later than 1 year after the first
review under section 3 is conducted, the Commissioner shall
establish, and update on an ongoing basis, an ongoing training
program for claims processors who review claims for covered
benefits, including appeals of continuing disability reviews.
(2) Participation.--Not later than 180 days after the date
that the ongoing training program under paragraph (1) is
established, the Commissioner shall require each claims
processor to participate in such program on an ongoing basis,
beginning in the second year in which the claims processor
carries out the duties of a claims processor for the agency.
(3) Required elements.--The training program established
under paragraph (1) shall include the following:
(A) Workshops with claims processors every 6
months.
(B) Collaborative review of a complex case by all
claims processors at a field office every 2 months.
(4) Definitions.--In this subsection:
(A) Complex case.--The term ``complex case'' means
a case that--
(i) has its processing time increased
because of a mistake or error that is
attributable to the Social Security
Administration;
(ii) has conflicting evidence from multiple
health care providers; or
(iii) involves an individual with a lapse
for a period of time that is greater than 2
weeks.
(B) Lapse.--The term ``lapse'' means, with respect
to an individual receiving a covered benefit, a
physical or mental impairment, as determined by a
health care provider, that prevents the individual from
providing information required for a continuing
disability review (as defined in section 201(g)(1)(A)
of the Social Security Act (42 U.S.C. 401(g)(1)(A)).
(c) Consultation Required.--When establishing the training programs
described in subsections (a) and (b), the Commissioner shall consult
with an entity that advocates for, and provides resources and
information to, individuals with disabilities to assist such
individuals in overcoming barriers to independent living, including an
entity carrying out a community rehabilitation program (as such term is
defined in section 7 of the Rehabilitation Act of 1973 (29 U.S.C.
705)).
SEC. 5. REPORTS.
(a) Report on Backlogs.--Not later than 180 days after the date
after the date of enactment of this Act, and on an annual basis
thereafter, the Commissioner shall submit to Congress a report on the
status of backlogs for determinations of eligibility for covered
benefits and continuing disability review determinations, including,
with respect to both such determination backlogs--
(1) information on wait times for such determinations; and
(2) recommendations on streamlining and improving the
determination processes.
(b) Report on Accessibility.--Not later than 180 days after the
date of enactment of this Act, and on an annual basis thereafter the
Commissioner shall submit to Congress a report that includes--
(1) a plan to ensure that all services at the Social
Security Administration, including appeals of covered benefit
denials, are in a format that is appropriate for the specific
needs of individuals with disabilities, such as audio versions
of notifications, large print and braille options, and easy-to-
read information; and
(2) the amount of funding needed to carry out the plan
described in subparagraph (A).
SEC. 6. QUALITY ASSURANCE STANDARDS.
Not later than 180 days after the date of enactment of this Act,
the Commissioner shall establish, and update on an ongoing basis,
quality assurance standards to standardize how staff at field offices
assist claimants, which shall include--
(1) guidelines on how to answer questions of claimants in a
timely and polite manner; and
(2) a process for a claimant to submit feedback to the
Commissioner on whether the claims processor who processed the
application of such claimant met such standards.
SEC. 7. DEFINITIONS.
In this Act:
(1) Covered benefit.--The term ``covered benefit'' means--
(A) a disability insurance benefit under section
223 of the Social Security Act (42 U.S.C. 423); and
(B) a supplemental security income benefit under
title XVI of the Social Security Act (42 U.S.C. 1381
et. seq).
(2) Commissioner.--The term ``Commissioner'' means the
Commissioner of the Social Security Administration.
(3) Continuing disability review.--The term ``continuing
disability review'' has the meaning given the term in
subsection (g)(1)(A) of section 201 of the Social Security Act
(42 U.S.C. 401(g)(1)(A)).
SEC. 8. SOCIAL SECURITY ACT AMENDMENTS.
(a) Additional Review.--
(1) Title ii amendment.--Section 205(b)(1) of the Social
Security Act (42 U.S.C. 405(b)(1)) is amended by striking ``Any
such decision by the Commissioner of Social Security which
involves a determination of disability and which is in whole or
in part unfavorable to such individual'' and inserting the
following: ``In the case of any such decision that involves a
determination of disability and that is in whole or in part
unfavorable to such individual, the Commissioner shall require
a person, other than the person who made the initial
unfavorable determination, to review the initial decision and
make a recommendation as to whether the initial decision should
be modified. The Commissioner shall make a final decision in
accordance with such recommendation. Any such final decision
which is in whole or in part unfavorable to such individual''.
(2) Title xvi amendment.--Section 1631(c)(1)(A) of such Act
(42 U.S.C. 1383(c)(1)(A)) is amended by striking ``Any such
decision by the Commissioner of Social Security which involves
a determination of disability and which is in whole or in part
unfavorable to such individual'' and inserting the following:
``In the case of any such decision that involves a
determination of disability and that is in whole or in part
unfavorable to the individual, the Commissioner shall require a
person, other than the person who made the initial unfavorable
determination, to review the initial decision and make a
recommendation as to whether the initial decision should be
modified. The Commissioner shall make a final decision in
accordance with the recommendation. Any such final decision
that is in whole or in part unfavorable to the individual''.
(b) Modernization of Information Submission.--Part A of title XI of
the Social Security Act (42 U.S.C. 1301 et. seq) is amended by
inserting after section 1143 the following:
``SEC. 1143A. MODERNIZATION OF INFORMATION SUBMISSION.
``With respect to any information required to be submitted by an
individual to the Social Security Administration regarding a proceeding
or determination for a benefit under title II or a supplemental
security income benefit under title XVI, the Commissioner shall accept
such information in the following ways:
``(1) Email.
``(2) Fax machine, until December 31, 2045.''.
(c) Social Security Wage Reporting App.--Part A of title XI of the
Social Security Act (42 U.S.C. 1301 et. seq) is amended by adding at
the end the following:
``SEC. 1150D. SOCIAL SECURITY WAGE REPORTING APP.
``The Commissioner of the Social Security Administration shall
ensure that an individual who receives a disability insurance benefit
under section 223 may use the SSA Mobile Wage Reporting App for the
purpose of tracking the wages and employment of such individual.''.
(d) Effective Date.--The amendments made by this section shall take
effect 2 years after the date of enactment of this section.
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