PRINTER'S NO.  1028

  

THE GENERAL ASSEMBLY OF PENNSYLVANIA

  

HOUSE BILL

 

No.

960

Session of

2011

  

  

INTRODUCED BY GINGRICH, AUMENT, BAKER, BARRAR, BEAR, BENNINGHOFF, BOBACK, BOYD, BROOKS, CAUSER, CLYMER, D. COSTA, CREIGHTON, CUTLER, DENLINGER, ELLIS, EVANKOVICH, EVERETT, FLECK, GABLER, GEIST, GIBBONS, GILLEN, GILLESPIE, GODSHALL, GOODMAN, GRELL, GROVE, HAHN, HALUSKA, HARHART, HARPER, HARRIS, HEFFLEY, HESS, HICKERNELL, HUTCHINSON, KAUFFMAN, M.K. KELLER, KNOWLES, KORTZ, KRIEGER, LAWRENCE, MAJOR, MARSHALL, MARSICO, MASSER, METCALFE, MILLARD, MILLER, MILNE, MOUL, MURT, MUSTIO, OBERLANDER, O'NEILL, PAYNE, PERRY, PETRI, PICKETT, PYLE, QUIGLEY, QUINN, RAPP, READSHAW, REED, REICHLEY, ROAE, ROCK, ROSS, SAYLOR, SCAVELLO, SCHRODER, K. SMITH, SONNEY, STERN, STEVENSON, STURLA, SWANGER, TALLMAN, TOBASH, TOEPEL, TOOHIL, VULAKOVICH AND WATSON, MARCH 7, 2011

  

  

REFERRED TO COMMITTEE ON HEALTH, MARCH 7, 2011  

  

  

  

AN ACT

  

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Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An

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act to consolidate, editorially revise, and codify the public

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welfare laws of the Commonwealth," providing for fraud

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detection system and for income eligibility verification

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system.

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The General Assembly of the Commonwealth of Pennsylvania

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hereby enacts as follows:

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Section 1.  The act of June 13, 1967 (P.L.31, No.21), known

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as the Public Welfare Code, is amended by adding sections to

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read:

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Section 422.1.  Fraud Detection System.--Within six months of

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the effective date of this section, the department shall

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establish uniform procedures for each county to use to identify,

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investigate and resolve potential cases of fraud,

 


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misrepresentation or inadequate documentation prior to

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determining an applicant's eligibility for assistance. The

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procedures shall ensure that every case is reviewed. Each review

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shall include utilization of the income eligibility verification

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system established in section 432.23.

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Section 432.23.  Income Eligibility Verification System.--(a)

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The department shall establish a computerized income eligibility

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verification system in order to verify eligibility, eliminate

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duplication of assistance and deter fraud. Prior to awarding

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assistance under section 432.2(b) or continuing assistance under

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section 432.2(c), the department shall match the social security

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number of each applicant and recipient with the following:

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(1)  Unearned income information maintained by the Internal

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Revenue Service.

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(2)  Employer quarterly reports of income and unemployment

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insurance benefit payment information maintained by the State

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Wage Information Collection Agency.

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(3)  Earned income information maintained by the Social

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Security Administration.

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(4)  Immigration status information maintained by the

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Citizenship and Immigration Services.

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(5)  Death register information maintained by the Social

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Security Administration.

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(6)  Prisoner information maintained by the Social Security

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Administration.

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(7)  Public housing and section 8 payment information

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maintained by the Department of Housing and Urban Development.

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(8)  National fleeing felon information maintained by the

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Federal Bureau of Investigation.

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(9)  Wage reporting and similar information maintained by

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states contiguous to this Commonwealth.

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(10)  Beneficiary Data Exchange (BENDEX) Title H database

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maintained by the Social Security Administration.

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(11)  Beneficiary Earnings Exchange Report (BEER) database

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maintained by the Social Security Administration.

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(12)  State New Hire database maintained by the Commonwealth.

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(13)  National New Hire database maintained by the Federal

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Government.

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(14)  State Data Exchange (SDX) database maintained by the

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Social Security Administration.

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(15)  Veterans Benefits and Veterans Medical (PARIS)

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maintained by the Department of Veterans Affairs with

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coordination through the Department of Health and Human

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Services.

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(16)  Day care subsidy payments maintained by the

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Commonwealth.

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(17)  Low-Income Energy Assistance Program Reporting Utility

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Expenses maintained by the Commonwealth.

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(18)  A database which is substantially similar to or a

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successor of a database set forth in this subsection.

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(19)  The database of all persons who currently hold a

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license, permit or certificate from a Commonwealth agency the

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cost of which exceeds one thousand dollars ($1,000).

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(b)  If a discrepancy results between the applicant's or a

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recipient's social security number and one or more of the

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databases set forth in subsection (a), the department shall

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review the applicant's or recipient's case using the following

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procedure:

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(1)  If the information discovered under subsection (a) does

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not result in ineligibility or modification of the amount or

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type of assistance, the department shall take no further action.

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(2)  If the information discovered under subsection (a) would

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result in ineligibility or modification of the amount or type of

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assistance, the applicant or the recipient shall be given an

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opportunity to explain the discrepancy. The department shall

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provide written notice to the applicant or recipient which shall

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describe in sufficient detail the circumstances of the

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discrepancy, the manner in which the applicant or recipient may

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respond and the consequences of failing to take action. The

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applicant or recipient shall have ten business days to respond

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in an attempt to resolve the discrepancy. The explanation of the

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recipient or applicant shall be given in writing. After

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receiving the explanation, the department may request additional

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documentation if it determines that there is a substantial risk

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of fraud.

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(3)  If the applicant or recipient does not respond to the

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notice, the department shall deny assistance for failure to

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cooperate, in which case the department shall provide notice of

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intent to discontinue assistance. Eligibility for assistance

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shall not be reestablished until the significant discrepancy has

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been resolved.

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(4)  If an applicant or recipient responds to the notice and

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disagrees with the findings of the match between his or her

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social security number and one or more database, the department

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shall reinvestigate the matter. If the department finds that

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there has been an error, the department shall take immediate

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action to correct it and no further action shall be taken. If,

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after investigation, the department determines that there is no

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error, the department shall determine the effect on the

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applicant's or recipient's case and take appropriate action.

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Written notice of the department's action shall be given to the

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applicant or recipient.

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(5)  If the applicant or recipient agrees with the findings

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of the match between the applicant's or recipient's social

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security number and one or more database, the department shall

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determine the effect on the applicant's or recipient's case and

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take appropriate action. Written notice of the department's

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action shall be given to the applicant or recipient.

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(c)  In no case shall the department discontinue or modify

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the amount or type of assistance as a result of a match between

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the applicant's or recipient's social security number and one or

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more database until the applicant or recipient has been given

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notice of the discrepancy and the opportunity to respond.

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(d)  No later than one year after the effective date of this

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section and every year thereafter, the department shall provide

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a written report to the Governor, the General Assembly and the

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Inspector General detailing the results achieved under this

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section and the amount of case closures and savings that

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resulted.

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(e)  As used in this section, the following words and phrases

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shall have the meanings given to them in this subsection:

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"Discrepancy" means information regarding assets, income,

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resources or status of an applicant or recipient of assistance,

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derived from one or more of the database in subsection (a),

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which gives the department grounds to suspect that either:

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(i)  an applicant or recipient is ineligible to receive

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assistance under Federal or State law; or

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(ii)  the assets, income or resources of an applicant or

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recipient are at least, in terms of a dollar amount, ten percent

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greater than the dollar amount reflected in the information the

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department possesses about the applicant or recipient with

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respect to the applicant's or recipient's assets, income or

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resources.

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"Status" means the applicant or recipient is in the United

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States illegally, is no longer living, is an inmate in a prison

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or jail or is a fleeing felon.

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Section 2.  This act shall take effect immediately.

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