THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY GINGRICH, BARRAR, CAUSER, D. COSTA, CUTLER, DENLINGER, EVERETT, FAIRCHILD, GEIST, GIBBONS, GRELL, GROVE, HALUSKA, HARRIS, HENNESSEY, HESS, HICKERNELL, HUTCHINSON, M. KELLER, MARSICO, MILLARD, MILLER, MOUL, MUSTIO, OBERLANDER, O'NEILL, PAYNE, PEIFER, PETRI, PICKETT, REED, SAYLOR, S. H. SMITH, STERN, STEVENSON, TRUE, TURZAI, VULAKOVICH AND WHEATLEY, MARCH 9, 2009

REFERRED TO COMMITTEE ON HEALTH AND HUMAN SERVICES, MARCH 9, 2009  

AN ACT

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

act to consolidate, editorially revise, and codify the public

welfare laws of the Commonwealth," providing for income

eligibility verification system and for fraud detection

system.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

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

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

read:

Section 414.1.  Income Eligibility Verification System.--(a)

The department shall establish a computerized income eligibility

verification system in order to eliminate duplication of

assistance and deter fraud.

(b)  The department shall require that as a condition of

receiving assistance applicants and recipients supply their

social security numbers. The department shall match the social

security number of each applicant and recipient with the

following:

(1)  Unearned income information maintained by the Internal

Revenue Service.

(2)  Employer quarterly reports of income and unemployment

insurance benefit payment information maintained by the State

Wage Information Collection Agency.

(3)  Earned income information maintained by the Social

Security Administration.

(4)  Immigration status information maintained by the

Citizenship and Immigration Services.

(5)  Death register information maintained by the Social

Security Administration.

(6)  Prisoner information maintained by the Social Security

Administration.

(7)  Public housing and section 8 payment information

maintained by the Department of Housing and Urban Development.

(8)  National fleeing felon information maintained by the

Federal Bureau of Investigation.

(9)  Wage reporting and similar information maintained by

states contiguous to this Commonwealth.

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

maintained by the Social Security Administration.

(11)  Beneficiary Earnings Exchange Report (BEER) database

maintained by the Social Security Administration.

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

(13)  National New Hire database maintained by the Federal

Government.

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

Social Security Administration.

(15)  Veterans Benefits and Veterans Medical (PARIS)

maintained by the Department of Veterans Affairs with

coordination through the Department of Health and Human

Services.

(16)  Day care subsidy payments maintained by the

Commonwealth.

(17)  Low-Income Energy Assistance Program Reporting Utility

Expenses maintained by the Commonwealth.

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

successor of a database set forth in this subsection.

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

license, permit or certificate from a Commonwealth agency the

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

(c)  Notwithstanding any provision of law to the contrary,

the income eligibility verification system shall be utilized for

an applicant at the time of application for assistance and for a

recipient on a quarterly basis.

(d)  The department shall notify each applicant and recipient

of the requirement of providing a social security number at the

time of application for assistance and as otherwise required

under the provisions of this section.

(e)  If a significant discrepancy results between the

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

more of the databases set forth in subsection (b), the

department shall review the applicant's or recipient's case, as

appropriate, and shall investigate the circumstances to confirm

eligibility of the applicant or recipient utilizing the

procedure set forth in subsection (f).

(f)  The department shall institute the following procedure

to investigate the circumstances of a significant discrepancy:

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

not result in ineligibility or modification of the amount or

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

(2)  If paragraph (1) does not apply and a significant

discrepancy results from the match between the applicant's or

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

databases in subsection (b), the applicant or the recipient, as

appropriate, shall be given an opportunity to explain the

discrepancy. The department shall provide written notice to the

applicant or recipient which shall describe in sufficient detail

the circumstances of the discrepancy, the opportunity to resolve

it, the manner in which it may be resolved and the consequences

of failing to take action. The explanation of the recipient or

applicant may be given over the telephone, as set forth in

subsection (i), in person or in writing. After receiving the

explanation, the department may request additional documentation

if it determines that there is a substantial risk of fraud.

(3)  If the applicant or recipient, as appropriate, does not

respond to the notice, the department may deny assistance for

failure to cooperate, in which case the department shall provide

notice of intent to discontinue assistance. Eligibility for

assistance shall not be reestablished until the significant

discrepancy has been resolved.

(4)  If an applicant or recipient disagrees with the findings

of the match between his or her social security number and one

or more database, the department shall reinvestigate the matter,

and if the department finds that there has been an error, the

department shall take immediate action to correct it and no

further action shall be taken. If, after investigation, the

department determines that there is no error, the department

shall determine the effect on the applicant's or recipient's

case and take appropriate action. Written notice of the

department's action shall be given to the applicant or

recipient.

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

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

security number and one or more database, the department shall

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

take appropriate action. Written notice of the department's

action shall be given to the applicant or recipient.

(6)  If the findings of a match between the applicant's or

recipient's social security number and one or more database

result in no change in eligibility or overpayment, the

department shall take no further action.

(g)  The department may review and investigate a case when

there is a match between the social security number and one or

more database which does not result in a significant

discrepancy. In such a case, the department shall utilize the

procedure in subsection (f).

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

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

between the applicant's or recipient's social security number

and one or more database. Nothing in this subsection shall be

construed to limit the right of appeal provided by law.

(i)  The department shall establish a single Statewide toll-

free telephone number and call center to be used by applicants

and recipients in order to resolve discrepancies. The call

center shall have sufficient capacity and staff to promptly

handle incoming telephone calls, and the department shall assign

sufficient numbers of case workers to enable the department to

make prompt eligibility determinations under this section.

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

section and every year thereafter, the department shall provide

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

Inspector General detailing the results achieved under this

section and the amount of case closures and savings that

resulted.

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

shall have the meanings given to them in this subsection:

"Significant discrepancy"  means information regarding

assets, income, resources or status of an applicant or recipient

of assistance, derived from one or more of the databases in

subsection (b), which gives the department grounds to suspect

that either:

(i)  an applicant or recipient is ineligible to receive

assistance under Federal or State law; or

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

recipient are at least, in terms of a dollar amount, twenty-five

percent greater than the dollar amount reflected in the

information the department possesses about the applicant or

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

income or resources.

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

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

or jail or is a fleeing felon.

Section 422.1.  Fraud Detection System.--Within one year of

the effective date of this section, each county shall establish

procedures to identify, investigate and resolve potential cases

of fraud, misrepresentation or inadequate documentation prior to

determining an applicant's eligibility for assistance and submit

to the department a plan describing its antifraud procedures.

The plan shall ensure that every case is reviewed and include

utilization of the income eligibility verification system

established in section 414.1.

Section 2.  This act shall take effect immediately.