Oct 30, 2015

New Fraud Provision In The Grand Deal

     Let's take a closer look at some of the Social Security portions of the grand deal which is likely to be approved by Congress in the next few days. I'll start out with the fraud provision that I said earlier looked to me as if it makes it a crime to submit medical evidence in support of a disability claim. I didn't mean to suggest that was going to happen. I know this isn't the intent. This looks like a drafting error to me. Here's the statute involved as it will read after this is enacted, with the new portion bolded:
42 U.S.C. §1011 (a)  In general Whoever—
     (1) knowingly and willfully makes or causes to be made any false statement or representation of a material fact in an application for benefits under this subchapter; 
     (2) at any time knowingly and willfully makes or causes to be made any false statement or representation of a material fact for use in determining any right to the benefits; 
     (3) having knowledge of the occurrence of any event affecting—
          (A) his or her initial or continued right to the benefits; or
         (B) the initial or continued right to the benefits of any other individual in whose behalf he or she has applied for or is receiving the benefit,
conceals or fails to disclose the event with an intent fraudulently to secure the benefit either in a greater amount or quantity than is due or when no such benefit is authorized; or  
     (4) having made application to receive any such benefit for the use and benefit of another and having received it, knowingly and willfully converts the benefit or any part thereof to a use other than for the use and benefit of the other individual, shall be fined under title 18, imprisoned not more than 5 years, or both; or
      (5) conspires to commit any offense described in any of paragraphs (1) through (3) except that in the case of a person who receives a fee or other income for services performed in connection with any determination with respect to benefits under this title (including a claimant representative, translator, or current or former employee of the Social Security Administration), or who is a physician or other health care provider who submits, or causes the submission of, medical or other evidence in connection with any such determination, such person shall be guilty of a felony and upon conviction thereof shall be fined under title 18, United States Code, or imprisoned for not more than ten years, or both.’’.
     This doesn't make sense. The new language seems to make it illegal to submit evidence without specifying that it's only illegal to knowingly submit false or misleading evidence which was almost certainly the intent. I don't think anyone is going to be prosecuted under this even if they're guilty as sin because the language is so confusing.
     The right wing extremists in the Freedom Caucus have been demanding "regular order" in the House of Representatives, meaning that they want bills to progress from Subcommittee to Committee to the House floor with members having the opportunity to carefully study the bills and offer amendments. I agree with them on this if nothing else. Regular order helps prevent this sort of problem. Members of Congress, their staffs or outside individuals have a chance to study a bill and point out problems, including drafting errors. The problems can be sorted out before a bill becomes law. However, I've seen plenty of problems like this one in legislation signed by the President even when there is "regular order." Such problems are typically cleaned up with technical corrections acts but the Congressional sclerosis has gotten so bad that it's now difficult to even pass technical corrections acts.

13 comments:

Anonymous said...

It's not a drafting error.

5 applies to a conspiracy to commit 1 through 3; you're a felon if you do this while receiving a fee for submitting evidence.

Anonymous said...

I think your edited version is incorrect. The addition of "; or (5) conspires to commit any offense described in any of paragraphs (1) through (3)" should be before "shall be fined under title 18, imprisoned not more than 5 years, or both" (which is a new paragraph describing penalties for all sections), and the rest (starting with "except that...") goes after that phrase, and so adds the possibility of additional penalties (and felony charges) for the individuals described. This is the part of the law describing penalties, so obviously it only applies to individuals who have committed any of the proscribed acts listed [although I don't think it only applies to conspiracy, since it should be in the section at the end describing penalties for all acts listed under (1)-(5).]

Anonymous said...

http://www.thefiscaltimes.com/2015/10/27/Here-s-New-Plan-Crack-Down-Social-Security-Fraud

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Anonymous said...

This could actually be amazing to use against agency employees who commit this fraud. Like fraudulent consultative examinations. Everybody who touches that file from the inside will committing a felony.

Anonymous said...

Making something illegal does not make it stop. Punishment will be increased but if you don't think you will be caught or if you think it is worth the risk you will still break the law. I doubt those involved in the most egregious cases will take the time to review the Social Security Act before they decide to commit the offense.

Deborah Garland said...

The whole problem with Social Security is that a person commits a felony and goes to prison, benefits stop until the day he is released and then he picks up his benefits again. Why? If your addicted to drugs you can get disability but you are not mandated to go to a rehab and clean up. Why not? If you enter this country illegally you get benefits, even if you have not paid in. Why?You have to fix the problems here first, then start new regulations.

Anonymous said...

why he conservative congress doesn't mind giving anyone who comes here , one who have not worked in this country can receive social security benefits immediately but those that worked and were taxed via FICA WHO THEN get disabled have to go through an extensive menagerie of rules for evidence to prove they are disabled which can take up to at least two years. Congress talks out of both sides of it's mouth when it comes to giving to those who never put in to the SSA, (those who Congress rails against for coming here) and treat those who did, who are legitimate in their need for their disability benefits... as automatic criminals or frauds.
What is even worse is that those who have given for decades not only have to wait too long, bu who also do not get but maybe 1/2 to 1/3 because the other part of their benefits are going to those who never worked in this country. So who are the real frauds that congress should imprison and fine, may it should be congress itself?!?

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Ahsan Awan said...


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Ahsan Awan said...


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Anonymous 42 said...

Maybe they are trying to find a way to deal with people like Conn when state bars won't act.