Bill summaries are authored by CRS.

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Reported to House amended, Part I (10/18/1999)

Ticket to Work and Work Incentives Improvement Act of 1999 - Title I: Ticket to Work and Self-Sufficiency and Related Provisions - Subtitle A: Ticket to Work and Self-Sufficiency - Amends part A (General Provisions) of title XI of the Social Security Act (SSA) to direct the Commissioner of Social Security to establish a Ticket to Work and Self-Sufficiency Program (TWSSP) under which a disabled beneficiary may use a TWSSP ticket issued by the Commissioner to obtain employment, vocational rehabilitation services, or other support services, pursuant to an appropriate individual beneficiary work plan that meets specified requirements. Includes among such requirements goals for earnings and job advancement, at the Commissioner's expense, from a participating employment network, public or private. Allows State agencies administering or supervising the administration of the State plan under title I of the Rehabilitation Act of 1973 to elect to participate as an employment network. Sets forth requirements applicable to agreements between State agencies and employment networks. Describes employment network payment systems.

(Sec. 101) Provides that during any period for which an individual is using a TWSSP ticket, the Commissioner and any applicable State agency may not initiate a continuing disability or similar review to determine whether the individual is or is not disabled.

Requires payments to employment networks: (1) out of the social security trust funds in the case of SSA title II (Old Age, Survivors and Disability Insurance) (OASDI) disability beneficiaries who return to work; or (2) from the appropriation for making Supplemental Security Income (SSI) payments under SSA title XVI, in the case of SSI disability beneficiaries who return to work.

Establishes within the Social Security Administration the Ticket to Work and Work Incentives Advisory Panel to advise the President, the Congress, and the Commissioner with respect to TWSSP work incentive issues, and those issues under OASDI, SSI, Medicare (SSA title XVIII), and Medicaid (SSA title XIX) as well. Authorizes appropriations.

Subtitle B: Elimination of Work Disincentives - Amends SSA titles II and XVI (Procedural and General Provisions) to prescribe specified measures designed to eliminate work disincentives. Prohibits review of an individual's disability status on the basis of work activity. Provides for expedited reinstatement of entitlement to OASDI or of eligibility for SSI disability benefits.

Subtitle C: Work Incentives Planning, Assistance, and Outreach - Amends SSA title XI part A to direct the Commissioner to establish a community-based work incentives outreach program for disabled beneficiaries that includes technical assistance to organizations and entities designed to encourage disabled beneficiaries to return to work.

(Sec. 121) Authorizes appropriations.

(Sec. 122) Authorizes the Commissioner to make certain minimum payments in each State to the protection and advocacy system established under the Developmental Disabilities Assistance and Bill of Rights Act for the purpose of providing services to disabled beneficiaries, which may include advocacy or other services that such a beneficiary may need to secure or regain gainful employment. Authorizes appropriations.

Title II: Expanded Availability of Health Care Services - Amends SSA title XIX to provide for expanding State Medicaid options for workers with disabilities, including options to: (1) eliminate income, assets, and resource limitations for workers with disabilities who buy into Medicaid; and (2) provide opportunity for employed individuals with a medically improved disability to make such a buy. Provides that Federal funds paid to a State for Medicaid payments may not generally be used to supplant the level of State funds expended for a fiscal year for programs to enable working disabled individuals to work.

(Sec. 202) Amends SSA title II to extend the period of Medicare coverage for OASDI disability insurance beneficiaries.

Directs the Comptroller General to report to Congress on specified consequences of such extension.

(Sec. 203) Directs the Secretary of Health and Human Services to: (1) award grants to eligible States to support establishment of State infrastructures to support working disabled individuals as well as to enable State outreach campaigns on infrastructure existence; and (2) submit a recommendation to specified congressional committees on whether such grant program should be continued after FY 2010. Authorizes appropriations.

(Sec. 204) Authorizes State demonstration projects for certain Medicaid coverage of up to a specified maximum number of workers with a potentially severe disability, coverage equal to that afforded under the State option for eliminating income, assets, and resource limitations for disabled workers buying into Medicaid. Authorizes appropriations.

(Sec. 205) Allows disabled Medicare beneficiaries to request the suspension of Medicare supplemental policy (Medigap) insurance when covered under a group health plan.

Title III: Demonstration Projects and Studies - Amends SSA title II to provide for an extension of disability insurance program demonstration project authority. Directs the Commissioner to develop and carry out experiments and demonstration projects, subject to specified guidelines which include the authority to waive compliance with benefits requirements, with regard to various alternative methods of treating the work activity of individuals entitled to OASDI disability benefits, altering other limitations and conditions applicable to such individuals, and implementing sliding scale benefit offsets. Authorizes the Commissioner to: (1) expand the scope of any such experiment or demonstration project to include any group of OASDI benefit applicants with impairments that reasonably may be presumed to be disabling for purposes of such demonstration project; and (2) limit any such demonstration project to any such group of applicants, subject to the terms of such demonstration project which shall define the extent of any such presumption.

(Sec. 302) Directs the Commissioner to conduct certain demonstration projects designed to provide for specified reductions in disability insurance benefits based on earnings. Requires expenditures for such demonstration projects to come out of the social security and Medicare trust funds, as determined appropriate, to the extent provided in advance in appropriation Acts.

(Sec. 303) Directs the Comptroller General to study and report to the Congress on: (1) existing tax credits and other disability-related employment incentives; (2) coordination of the OASDI disability insurance (DI) program and the SSI program as they relate to individuals entering or leaving concurrent entitlement under them; and (3) the impact of the substantial gainful activity limit on return to work.

Directs the Commissioner to report to the Congress on disregards under the DI and SSI programs.

Requires the Comptroller General to study and report to the Congress on the Social Security Administration's efforts to conduct disability demonstrations.

Title IV: Miscellaneous and Technical Amendments - Amends the Contract with America Advancement Act of 1996 with respect to: (1) final adjudication of denied claims by drug addicts and alcoholics for SSA title II disability benefits; and (2) the effective dates of certain requirements concerning representative payees and treatment referrals for such individuals.

(Sec. 402) Amends SSA title II to provide for: (1) payments to State and local prisons for monthly reports on the identities of inmates whose OASDI benefits are determined by the Commissioner not to be payable as a result of such reports; (2) a 50 percent reduction in such payments under SSA titles II and XVI in cases involving a comparable payment under the other title with respect to the same prisoner; (3) transfer from the social security trust funds of any sums necessary to enable the Commissioner to make such payments; (4) provision of inmate identification information to any agency administering a Federal or federally-assisted cash, food, or medical assistance program for eligibility purposes under such program; (5) elimination of the requirement that confinement stem only from a crime punishable by imprisonment for more than one year (thus denying OASDI benefits to individuals confined for any criminal offense); and (5) continued denial of benefits to sex offenders remaining confined to public institutions upon completion of prison term.

(Sec. 403) Provides for a two-year open season for members of the clergy who wish to revoke their exemption from social security coverage.

(Sec. 404) Amends SSA title XI to make a miscellaneous technical amendment relating to cooperative research or development projects under SSA titles II and XVI.

(Sec. 405) Amends SSA title XI to make miscellaneous technical amendments to provisions concerning the requirements of State income and eligibility verification systems, among other changes allowing a State to permit certain employers that make returns with respect to domestic service employment taxes on a calendar year basis to instead make such reports on an annual basis.

(Sec. 406) Amends SSA title II to direct the Commissioner to impose on attorneys who are owed a fee from a claimant's past-due benefits an assessment, determined according to a specified formula, for crediting to the OASDI trust funds. Authorizes appropriations.

(Sec. 407) Amends SSA title XIX to: (1) grant State Medicaid fraud control units the authority to investigate and prosecute violations of all applicable State laws regarding any and all aspects of suspected fraud in connection with any Federal health care program if the Inspector General of the relevant Federal agency approves the unit's involvement; (2) grant an Inspector General who approves such involvement continuing authority to join the case or investigation or to replace the unit as the primary agency assigned to the matter; (3) include within the unit's authority to recoup overpayments made under the State Medicaid plan to health care facilities authority to recoup overpayments made under any Federal health care program; and (4) revise procedures for unit complaint review, among other changes allowing the unit the option of having procedures for reviewing complaints of abuse or neglect of residents in non-Medicaid board and care facilities.

(Sec. 408) Amends SSA title XIX with respect to certain Medicaid payments to States with approved Medicaid plans. Requires a specified payment system approved by the Secretary for the payment of any covered expenditure by, or on behalf of, a local educational agency or school district: (1) in the case of a bundled group of individual items, services, and administrative expenses, in accordance with an actuarially sound payment methodology; or (2) in the case of payment using a fee-for-service methodology, in accordance with reasonable cost reimbursement requirements. Includes among such requirements a competitive bidding process for claims processing contracts and coordination between the local educational agency or school district and Medicaid managed care organization in order for the State to receive Medicaid reimbursement.

Formulates the allowable share of the Federal financial participation amount with respect to payment for items and services furnished in a school setting.

Directs the Administrator of the Health Care Financing Administration to develop and implement a uniform methodology for claims for payment of Medicaid and related administrative expenses furnished by schools.