PRINTER'S NO. 2221
No. 1687 Session of 2007
INTRODUCED BY GINGRICH, ADOLPH, ARGALL, BAKER, BARRAR, BEAR,
BENNINGHOFF, BOYD, BROOKS, CALTAGIRONE, CAPPELLI, CAUSER,
CLYMER, COX, CREIGHTON, CUTLER, DALLY, DENLINGER, ELLIS,
D. EVANS, EVERETT, FAIRCHILD, FLECK, GEIST, GILLESPIE,
GODSHALL, GRELL, HALUSKA, HARHAI, HARRIS, HERSHEY, HESS,
HICKERNELL, HUTCHINSON, KAUFFMAN, M. KELLER, KILLION,
KIRKLAND, MACKERETH, MAJOR, MANTZ, MARSHALL, MARSICO,
McILHATTAN, MENSCH, METCALFE, MILLARD, R. MILLER, MILNE,
MOUL, MURT, MUSTIO, NAILOR, NICKOL, O'NEILL, PAYNE, PEIFER,
PERRY, PERZEL, PETRI, PHILLIPS, PICKETT, QUIGLEY, RAPP, REED,
REICHLEY, ROAE, ROCK, ROHRER, RUBLEY, SAYLOR, SCAVELLO,
S. H. SMITH, SONNEY, STAIRS, STEIL, STERN, R. STEVENSON,
SWANGER, J. TAYLOR, TRUE, TURZAI, VEREB, VULAKOVICH AND
WATSON, JULY 3, 2007
REFERRED TO COMMITTEE ON HEALTH AND HUMAN SERVICES, JULY 3, 2007
AN ACT
1 Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
2 act to consolidate, editorially revise, and codify the public
3 welfare laws of the Commonwealth," providing for income
4 eligibility verification system and for fraud detection
5 system.
6 The General Assembly of the Commonwealth of Pennsylvania
7 hereby enacts as follows:
8 Section 1. The act of June 13, 1967 (P.L.31, No.21), known
9 as the Public Welfare Code, is amended by adding sections to
10 read:
11 Section 414.1. Income Eligibility Verification System.--(a)
12 The department shall establish a computerized income eligibility
13 verification system in order to eliminate duplication of
1 assistance and deter fraud.
2 (b) The department shall require that as a condition of
3 receiving assistance applicants and recipients supply their
4 social security numbers. The department shall match the social
5 security number of each applicant and recipient with the
6 following:
7 (1) Unearned income information maintained by the Internal
8 Revenue Service.
9 (2) Employer quarterly reports of income and unemployment
10 insurance benefit payment information maintained by the State
11 Wage Information Collection Agency.
12 (3) Earned income information maintained by the Social
13 Security Administration.
14 (4) Immigration status information maintained by the
15 Citizenship and Immigration Services.
16 (5) Death register information maintained by the Social
17 Security Administration.
18 (6) Prisoner information maintained by the Social Security
19 Administration.
20 (7) Public housing and section 8 payment information
21 maintained by the Department of Housing and Urban Development.
22 (8) National fleeing felon information maintained by Federal
23 Bureau of Investigation.
24 (9) Wage reporting and similar information maintained by
25 states contiguous to this Commonwealth.
26 (10) Beneficiary Data Exchange (BENDEX) Title H database
27 maintained by the Social Security Administration.
28 (11) Beneficiary Earnings Exchange Report (BEER) database
29 maintained by the Social Security Administration.
30 (12) State New Hire database maintained by the Commonwealth.
20070H1687B2221 - 2 -
1 (13) National New Hire database maintained by the Federal
2 government.
3 (14) State Data Exchange (SDX) database maintained by the
4 Social Security Administration.
5 (15) Veterans Benefits and Veterans Medical (PARIS)
6 maintained by the Department of Veterans Affairs with
7 coordination through the Department of Health and Human
8 Services.
9 (16) Day care subsidy payments maintained by the
10 Commonwealth.
11 (17) Low Income Energy Assistance Program Reporting Utility
12 Expenses maintained by the Commonwealth.
13 (18) A database which is substantially similar to or a
14 successor of a database set forth in this subsection.
15 (19) The database of all persons who currently hold a
16 license, permit or certificate from a Commonwealth agency the
17 cost of which exceeds one thousand dollars ($1,000).
18 (c) Notwithstanding any provision of law to the contrary,
19 the income eligibility verification system shall be utilized for
20 an applicant at the time of application for assistance and for a
21 recipient on a quarterly basis.
22 (d) The department shall notify each applicant and recipient
23 of the requirement of providing a social security number at the
24 time of application for assistance and as otherwise required
25 under the provisions of this section.
26 (e) If a significant discrepancy results between the
27 applicant's or a recipient's social security number and one or
28 more of the databases set forth in subsection (b), the
29 department shall review the applicant's or recipient's case, as
30 appropriate, and shall investigate the circumstances to confirm
20070H1687B2221 - 3 -
1 eligibility of the applicant or recipient utilizing the
2 procedure set forth in subsection (f).
3 (f) The department shall institute the following procedure
4 to investigate the circumstances of a significant discrepancy:
5 (1) If the information discovered under subsection (b) does
6 not result in ineligibility or modification of the amount or
7 type of assistance, the department shall take no further action.
8 (2) If paragraph (1) does not apply and a significant
9 discrepancy results from the match between the applicant's or
10 recipient's social security number and one or more of the
11 databases in subsection (b), the applicant or the recipient, as
12 appropriate, shall be given an opportunity to explain the
13 discrepancy. The department shall provide written notice to the
14 applicant or recipient which shall describe in sufficient detail
15 the circumstances of the discrepancy, the opportunity to resolve
16 it, the manner in which it may be resolved and the consequences
17 of failing to take action. The explanation of the recipient or
18 applicant may be given over the telephone, as set forth in
19 subsection (i), in person or in writing. After receiving the
20 explanation, the department may request additional documentation
21 if it determines that there is a substantial risk of fraud.
22 (3) If the applicant or recipient, as appropriate, does not
23 respond to the notice, the department may deny assistance for
24 failure to cooperate, in which case the department shall
25 provide notice of intent to discontinue assistance. Eligibility
26 for assistance shall not be reestablished until the significant
27 discrepancy has been resolved.
28 (4) If an applicant or recipient disagrees with the findings
29 of the match between his or her social security number and one
30 or more database, the department shall reinvestigate the matter,
20070H1687B2221 - 4 -
1 and if the department finds that there has been an error, the
2 department shall take immediate action to correct it and no
3 further action shall be taken. If, after investigation, the
4 department determines that there is no error, the department
5 shall determine the effect of the match on the applicant's or
6 recipient's case and take subsection (b), the department shall
7 determine the effect on the applicant's or recipient's case and
8 take appropriate action. Written notice of the department's
9 action shall be given to the applicant or recipient.
10 (5) If the applicant or recipient agrees with the findings
11 of the match between the applicant's or recipient's social
12 security number and one or more database, the department shall
13 determine the effect on the applicant's or recipient's case and
14 take appropriate action. Written notice of the department's
15 action shall be given to the applicant or recipient.
16 (6) If the findings of a match between the applicant's or
17 recipient's social security number and one or more database
18 result in no change in eligibility or overpayment, the
19 department shall take no further action.
20 (g) The department may review and investigate a case when
21 there is a match between the social security number and one or
22 more database which does not result in a significant
23 discrepancy. In such a case, the department shall utilize the
24 procedure in subsection (f).
25 (h) In no case shall the department discontinue or modify
26 the amount or type of assistance solely as a result of a match
27 between the applicant's or recipient's social security number
28 and one or more database. Nothing in this subsection shall be
29 construed to limit the right of appeal provided by law.
30 (i) The department shall establish a single Statewide toll-
20070H1687B2221 - 5 -
1 free telephone number and call center to be used by applicants
2 and recipients in order to resolve discrepancies. The call
3 center shall have sufficient capacity and staff to promptly
4 handle incoming telephone calls and the department shall assign
5 sufficient numbers of case workers to enable the department to
6 make prompt eligibility determinations under this section.
7 (j) No later than one year after the effective date of this
8 section and every year thereafter, the department shall provide
9 a written report to the Governor, the General Assembly and the
10 Inspector General detailing the results achieved under this
11 section and the amount of case closures and savings that
12 resulted.
13 (k) As used in this section, the following words and phrases
14 shall have the meanings given to them in this subsection:
15 "Significant discrepancy" means information regarding
16 assets, income, resources or status of an applicant or recipient
17 of assistance, derived from one or more of the databases in
18 subsection (b), which gives the department grounds to suspect
19 that either:
20 (i) an applicant or recipient is ineligible to receive
21 assistance, under Federal or State law; or
22 (ii) the assets, income or resources of an applicant or
23 recipient are at least, in terms of a dollar amount, twenty-five
24 percent greater than the dollar amount reflected in the
25 information the department possesses about the applicant or
26 recipient with respect to the applicant's or recipient's assets,
27 income or resources.
28 "Status" means the applicant or recipient is in the United
29 States illegally, is no longer living, is an inmate in a prison
30 or jail or is a fleeing felon.
20070H1687B2221 - 6 -
1 Section 422.1. Fraud Detection System.--Within one year of
2 the effective date of this section, each county shall establish
3 procedures to identify, investigate and resolve potential cases
4 of fraud, misrepresentation or inadequate documentation prior to
5 determining an applicant's eligibility for assistance and submit
6 to the department a plan describing its antifraud procedures.
7 The plan shall ensure that every case is reviewed and include
8 utilization of the income eligibility verification system
9 established in section 414.1.
10 Section 2. This act shall take effect immediately.
F12L67VDL/20070H1687B2221 - 7 -