[Federal Register Volume 78, Number 227 (Monday, November 25, 2013)]
[Proposed Rules]
[Pages 70244-70248]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-28034]
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SOCIAL SECURITY ADMINISTRATION
20 CFR Part 416
[Docket No. SSA-2011-0104]
RIN 0960-AH45
Electronic Interim Assistance Reimbursement Program
AGENCY: Social Security Administration.
ACTION: Notice of proposed rulemaking (NPRM).
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SUMMARY: We reimburse States that provide interim assistance to
Supplemental Security Income (SSI) claimants under our interim
assistance reimbursement (IAR) program. We provide this reimbursement
from the SSI recipient's initial retroactive SSI payment. On November
20, 2010, we began using an electronic Interim Assistance Reimbursement
system (eIAR) to streamline the way we process reimbursements to the
States. The eIAR process replaced our prior paper-based process with an
electronic one, and greatly reduced our and the State's involvement in
manually processing IAR cases. This electronic system did not change
the amount of payments we make to States and SSI recipients. We propose
to revise our rules about how we administer the IAR process to reflect
the electronic process. We also made minor language changes and
reorganized the sections for clarity.
DATES: To ensure that your comments are considered, we must receive
them no later than January 24, 2014.
ADDRESSES: You may submit comments by any one of three methods--
Internet, fax, or mail. Do not submit the same comments multiple times
or by more than one method. Regardless of which method you choose,
please state that your comments refer to Docket No. SSA-2011-0104 so
that we may associate your comments with the correct regulation.
Caution: You should be careful to include in your comments only
information that you wish to make publicly available. We strongly urge
you not to include in your comments any personal information, such as
Social Security numbers or medical information.
1. Internet: We strongly recommend this method for submitting your
comments. Visit the Federal eRulemaking portal at http://www.regulations.gov. Use the Search function of the Web page to find
docket number SSA-2011-0104 and then submit your comment. Once you
submit your comment, the system will issue you a tracking number to
confirm your submission. You will not be able to view your comment
immediately as we must manually post each comment. It may take up to a
week for your comment to be viewable.
2. Fax: Fax comments to (410) 966-2830.
3. Mail: Address your comments to the Office of Regulations and
Reports Clearance, Social Security Administration, 107 Altmeyer
Building, 6401 Security Boulevard, Baltimore, Maryland 21235-6401.
Comments are available for public viewing on the Federal
eRulemaking portal at http://www.regulations.gov or in person, during
regular business hours, by arranging with the contact person identified
below.
FOR FURTHER INFORMATION CONTACT: Tema Friedman, Office of Retirement
and Disability Policy, Social Security Administration, 6401 Security
Boulevard, Baltimore, Maryland 21235-6401, (410) 965-8979. For
information on eligibility or filing for benefits, call our national
toll-free number, 1-800-772-1213, or TTY 1-800-325-0778, or visit our
Internet site, Social Security Online, at http://www.socialsecurity.gov.
SUPPLEMENTARY INFORMATION:
Background
To be eligible for benefits from the SSI program, a person must be
age 65 or older, blind, or disabled; have low
[[Page 70245]]
income; and have limited resources.\1\ We determine who is eligible to
receive SSI benefit payments, and we pay SSI recipients.\2\ If we
determine that a claimant is eligible to receive SSI benefits, we pay
him or her based on the effective date of the application.\3\
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\1\ Sections 1601 and 1611(a) of the Social Security Act (Act).
\2\ Section 1602 of the Act.
\3\ Section 1611(c) of the Act.
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Some States have programs that provide interim assistance payments
to their residents while we review their SSI applications.\4\ The
payments provide immediate financial help to residents with low income
and limited resources to help pay for basic needs, such as food,
clothing, and shelter. Each State that runs an assistance program has
its own requirements that its residents must meet to be eligible to
receive interim assistance.
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\4\ As of December 1, 2012, 34 States and the District of
Columbia participate in the IAR program.
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We reimburse a State for its interim assistance payments to an
eligible claimant if the State has both an IAR agreement with us and a
written authorization from the claimant.\5\ We base the calculation of
the reimbursement amount to the State on IAR rules discussed in these
regulations. For this reason, we do not always repay the State for all
of the interim assistance paid to each claimant. We consider the facts
for each SSI claim and calculate the reimbursement amount based on
those facts. For example, we do not reimburse a State for the interim
assistance it pays to a claimant if we deny the SSI claim, or if the
claimant does not receive both interim assistance and SSI benefit
payments for the same month. We can reimburse the State only up to the
amount of the claimant's initial retroactive SSI benefit payment
available for reimbursement.\6\ In addition, we do not reimburse a
State if the source of the interim assistance is a type of payment that
the Act prohibits us from reimbursing.\7\
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\5\ Section 1631(g) of the Act.
\6\ An initial retroactive SSI benefit payment includes all
retroactive SSI money due the claimant after we compute the first
payments based on an approved SSI claim. Once we have sent an IAR
payment to a State, we cannot send the State any additional
reimbursement from any subsequent retroactive SSI benefit payment
that we may make to the claimant based on a recomputation we might
do for the months in the IAR period. We will send that subsequent
retroactive SSI benefit payment, if any, to the claimant.
\7\ See section 1631(g)(3) of the Act.
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Our IAR agreement with a State must include certain provisions to
be valid.\8\ The IAR agreement affirms that we agree to repay the State
for some or all of the interim assistance the State provides. It
specifies the length of time that the IAR agreement is in effect and
the procedure for how we reimburse the State. This agreement also
includes information that the State must include in the notice that it
sends to recipients of interim assistance within 10 working days of
receiving our reimbursement.
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\8\ See section 1631(g)(4) of the Act.
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A claimant's written authorization allows us to withhold his or her
retroactive SSI benefit payment and reimburse the State for the interim
assistance it paid the claimant. The authorization becomes effective
when we receive it or when we receive an electronic notice from the
State that it received the authorization.\9\ The authorization remains
in effect until we make the first recurring monthly SSI benefit
payment; the State and the claimant both agree to end it or it expires;
or we make a determination or decision about the claim and the claimant
does not file a timely appeal.\10\ If a claimant files a timely appeal
of our determination or decision, the authorization remains in effect
until we make a final determination or decision on the claim.
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\9\ We may consider the date that the authorization is effective
to be the protective filing date if the claimant applies for SSI
benefits within 60 days of the date the State received the
authorization or the date you signed the authorization if later than
the State signed. 20 CFR 416.340.
\10\ The first recurring monthly SSI benefit payment is the
regular monthly payment due to the claimant on a continuing basis.
Usually we send the first recurring monthly SSI benefit payment at
the same time that we send the IAR to a State.
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The IAR provisions also apply to individuals who receive SSI
benefit payments but are suspended or terminated from the program.
Participating States may provide interim assistance to these
individuals while we review their claims. If we reinstate the suspended
or terminated SSI benefit payments, we will reimburse the State in the
same manner described above. The same requirements for the IAR
agreements and authorizations apply as well.
Prior Reimbursement Method
Prior to November 20, 2010, we had two methods of reimbursing the
State and paying the recipient, both of which required manual action.
In most cases, we would send a recipient's entire first SSI retroactive
payment to the State that provided the interim assistance if there was
an IAR agreement and authorization in effect. The State would determine
how much of the first SSI benefit payment it would keep as
reimbursement for its interim assistance payments. The State would then
send the remaining amount of the payment to the SSI recipient.\11\ In
the remaining cases, the State calculated how much we should reimburse
it. After reimbursing the State, we paid any outstanding amount to the
SSI recipient using regular SSI payment rules.\12\ This manual process
was labor-intensive, required many paper forms, and was increasingly
difficult to administer as staff resources diminished.
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\11\ If the State could not pay an SSI beneficiary, such as when
a beneficiary died or could not be located, the State would refund
the excess amount to us. See 20 CFR part 416 subpart E.
\12\ For IAR cases, SSI payment rules may include paying fees to
the beneficiary's attorney, paying some of the beneficiary's
retroactive SSI payments in installments instead of in one lump sum,
or depositing some of an eligible child's retroactive SSI benefit
payments into a dedicated account.
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Prior to November 20, 2010, if a recipient wanted to appeal the
amount of reimbursement sent to the State, the recipient requested a
hearing before the State regarding the amount the State claimed for
reimbursement or the amount the State paid him or her. A recipient
could also appeal to us and receive a hearing regarding the total
amount of retroactive SSI benefit payments we withheld.
Current Reimbursement Method
On November 20, 2010, we began using eIAR to manage the IAR process
more efficiently. Based on input from the State, eIAR automatically
calculates the months a State is due reimbursement from the recipient's
first retroactive SSI payment and the reimbursement amount. eIAR
provides the information we need to make the payments to the State and
the recipient. As part of eIAR, we changed how we reimburse the State
from the SSI recipient's first retroactive payment and how the claimant
receives the remaining SSI benefit payments. We now reimburse the State
directly based on the amount of the recipient's SSI benefits available
for reimbursement. We reimburse the State up to the amount of interim
assistance it paid to the recipient, and we pay the SSI recipient the
rest using regular SSI payment rules. Because eIAR is an automated
process, it significantly reduces the amount of manual work for States
and our employees. We are able to reimburse States and pay SSI
recipients more quickly. However, eIAR did not change the reimbursement
amounts we make to States and SSI claimants.
The eIAR process also changed how we administer the IAR program in
other ways. It changed certain provisions we need in the IAR agreements
we have with States. For example, our IAR agreements now provide that
we will
[[Page 70246]]
send reimbursement for the interim assistance paid in a claim to the
State's designated financial institution.
Proposed Changes
We propose to revise our current rules about the IAR process in 20
CFR part 416 subparts E and S to reflect how we reimburse States and
pay SSI recipients using eIAR. We propose to revise for clarity, Sec.
416.525, which discusses IAR. We propose to reorganize subpart S and
revise the regulatory text for clarity and plain language. We propose
to revise Sec. 416.1902 and add definitions for ``interim assistance
reimbursement agreement,'' ``interim assistance reimbursement
payment,'' and ``interim assistance reimbursement period.'' Under the
definition of ``SSI benefit payment'' we also propose to clarify the
definition of an interim benefit and that we cannot reimburse a state
for interim assistance from provisional benefits as explained in
current 20 CFR 416.999(c). We propose to revise Sec. 416.1904 and
change the name of Sec. 416.1904. We propose to revise Sec. 416.1906.
These changes clarify the regulations based on our experience dealing
with the States. We propose to revise Sec. 416.1910 and change the
name of Sec. 416.1910. We propose to add Sec. 416.1912.
We propose to revise and rename Sec. 416.1920, while removing and
reserving Sec. 416.1922.
Clarity of These Proposed Rules
Executive Order 12866, as supplemented by Executive Order 13563,
requires each agency to write all rules in plain language. In addition
to your substantive comments on these proposed rules, we invite your
comments on how to make them easier to understand.
For example:
Would more, but shorter, sections be better?
Are the requirements in the rules clearly stated?
Have we organized the material to suit your needs?
Could we improve clarity by adding tables, lists, or
diagrams?
What else could we do to make the rules easier to
understand?
Do the rules contain technical language or jargon that is
not clear?
Would a different format make the rules easier to
understand, such as grouping and order of sections, use of headings, or
paragraphing?
Regulatory Procedures
Executive Order 12866, as Supplemented by Executive Order 13563
We consulted with the Office of Management and Budget (OMB) and
determined that this NPRM does not meet the criteria for a significant
regulatory action under Executive Order 12866, as supplemented by
Executive Order 13563. Therefore, OMB did not review it.
Regulatory Flexibility Act
We certify that this NPRM would not have a significant economic
impact on a substantial number of small entities because it would
affect only individuals and those States that voluntarily enter into a
contractual agreement with us. Therefore, the Regulatory Flexibility
Act, as amended, does not require us to prepare a regulatory
flexibility analysis.
Paperwork Reduction Act
This NPRM does not create any new or affect any existing
collections and, therefore, does not require OMB approval under the
Paperwork Reduction Act.
(Catalog of Federal Domestic Assistance Program No. 96.006,
Supplemental Security Income)
List of Subjects in 20 CFR Part 416
Administrative practice and procedure, Aged, Blind, Disability
benefits, Public assistance programs, Reporting and recordkeeping
requirements, Supplemental Security Income (SSI).
Dated: November 15, 2013.
Carolyn W. Colvin,
Acting Commissioner of Social Security.
For the reasons set out in the preamble, we propose to amend title
20 of the Code of Federal Regulations, part 416, subparts E and S as
set forth below:
PART 416--SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND
DISABLED
Subpart E--[Amended]
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1. The authority citation for subpart E of part 416 continues to read
as follows:
Authority: Secs. 702(a)(5), 1147, 1601, 1602, 1611(c) and (e),
and 1631(a)-(d) and (g) of the Social Security Act (42 U.S.C.
902(a)(5), 1320b-17, 1381, 1381a, 1382(c) and (e), and 1383(a)-(d)
and (g)); 31 U.S.C. 3716; 31 U.S.C. 3720A.
0
2. Revise Sec. 416.525 to read as follows:
Sec. 416.525 Reimbursement to States for interim assistance payments.
Notwithstanding Sec. 416.542, and in accordance with subpart S of
this part, we may withhold SSI benefits from an individual and
reimburse a State (or its political subdivision) from the withheld
benefits for the State's interim assistance paid to the individual.
PART 416--SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND
DISABLED
Subpart S--[Amended]
0
3. The authority citation for subpart S of part 416 continues to read
as follows:
Authority: Secs. 702(a)(5) and 1631 of the Social Security Act
(42 U.S.C. 902(a)(5) and 1383).
0
4. Revise Sec. 416.1901 to read as follows:
Sec. 416.1901 Scope of subpart S.
This subpart explains how we administer the interim assistance
reimbursement program. We may pay interim assistance reimbursement to
the State if the State enters into an interim assistance reimbursement
agreement with us and if you authorize us, in writing, to repay the
State. If your State pays you interim assistance, we may withhold your
retroactive SSI benefits, including any Federally administered state
supplementary payments, to reimburse the State. The State must inform
us about the amounts of interim assistance it paid to you. We will
identify the months for which we may reimburse the State, determine how
much of your retroactive SSI benefits to pay the State, and reimburse
the State for that amount. After we reimburse the State, we will pay
you any remaining sum from your retroactive SSI benefits using SSI
payment rules.
0
5. Revise Sec. 416.1902 to read as follows:
Sec. 416.1902 Definitions.
For purposes of this subpart--
Authorization means your written permission, in a form legally
acceptable to us and to the State from which you receive interim
assistance, for us to withhold your retroactive SSI benefit payments
and reimburse the State the amount of interim assistance due the State.
Interim assistance means the assistance a State gives you,
including payments made on your behalf to providers of goods or
services, to meet your basic needs. It does not include assistance the
State gives to or for another person. Interim assistance does not
include assistance payments financed wholly or partly with Federal
funds.
Interim assistance reimbursement agreement means our agreement with
a State to reimburse the State for the
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interim assistance it pays to SSI recipients.
Interim assistance reimbursement payment means the amount of money
we pay the State, which we determine based on the amount of interim
assistance the State paid to you or on your behalf and the amount of
SSI retroactive payments available for the reimbursement. If your
available initial retroactive SSI benefit payment is less than the
total interim assistance the State paid to you or on your behalf, we
will pay the State only a partial amount of the interim assistance the
State paid. Reimbursement to the State takes priority over the
retroactive SSI benefit payments that may be due you.
Interim assistance reimbursement period means the period for which
we may reimburse the State for interim assistance payments the State
made to you or on your behalf.
SSI benefit payment means your Federal SSI benefit and any state
supplementary benefit we make to you on behalf of a State (see subpart
T of this part) under title XVI of the Social Security Act. For
purposes of this subpart, SSI benefit payment does not include an
emergency advance payment (see Sec. 416.520), a payment based upon
presumptive disability or presumptive blindness (see Sec. 416.931), a
provisional benefit (see Sec. 416.999(c)), an interim benefit (see
Sec. 416.1469(d)), or a payment made under the administrative
immediate payment procedure.
State for purposes of an interim assistance agreement, means a
State of the United States, the District of Columbia, and the Northern
Mariana Islands. For all other purposes (e.g., payment, appeals,
notices), State also means a political subdivision of any of these.
We, Us, or Our means the Social Security Administration.
You or Your means someone who has applied for or is already
receiving an SSI benefit payment(s).
0
6. Revise Sec. 416.1904 to read as follows:
Sec. 416.1904 Authorization to withhold SSI benefit payment.
We will withhold your retroactive SSI benefit payment to repay the
State the amount of interim assistance the State paid to you or on your
behalf if:
(a) We have an interim assistance reimbursement agreement with the
State when your authorization goes into effect; and
(b) Your authorization is in effect when we make your first
recurring monthly SSI benefit payment.
0
7. Revise Sec. 416.1906 to read as follows:
Sec. 416.1906 When your authorization is in effect.
(a) When your authorization begins. Your authorization becomes
effective when the earliest of the following events occurs--
(1) We receive the authorization; or
(2) We receive notice from the State that it has received your
authorization.
(b) When your authorization ends. Your authorization remains in
effect until the earliest of the following events occurs--
(1) We make your first recurring monthly SSI benefit payment for
your initial claim or, in the case of an authorization effective for a
period of suspense or termination, when we make your first recurring
monthly SSI payment following the suspension or termination, and
subsequent reinstatement of your SSI benefits;
(2) You and the State agree to end the authorization;
(3) We make a determination or decision on your claim and you do
not timely file an appeal, as described in subpart N of this part; or
(4) You do not file an application for SSI or timely file an appeal
of our determination to suspend or terminate your benefits within 12
months from the authorization begin date described in paragraph (a) of
this section.
(c) When we need a new authorization. If your authorization is no
longer effective because an event in paragraph (b) of this section
occurred, the State must obtain a new authorization from you before we
may reimburse the State for interim assistance it gives you. If you
timely file an appeal of our determination or decision on your claim as
described in subpart N of this part, we do not need a new authorization
from you because your authorization remains in effect until we make a
final determination or decision on your claim.
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8. Revise Sec. 416.1910 to read as follows:
Sec. 416.1910 Requirements for an interim assistance reimbursement
agreement.
(a) The interim assistance reimbursement agreement defines our
obligations and a State's obligations. The agreement says we must repay
the State for the interim assistance the State paid to you based on the
interim assistance amount claimed by the State and the amount of your
retroactive SSI money available to pay the State.
(b) The interim assistance reimbursement agreement must include the
following provisions--
(1) You must have received interim assistance from the State and be
eligible for a SSI payment for the same month as the interim assistance
period as defined in Sec. 416.1905.
(2) We will reimburse the State only from your initial retroactive
payment for your initial claim (see Sec. 416.1930(a)) or
posteligibility claim (see Sec. 416.1930(b)).
(3) When, how much, and under which conditions we will reimburse
the State for the interim assistance it paid you.
(4) We will send any reimbursement for interim assistance to a
State's designated financial institution.
(5) If a State has prepared and cannot stop delivery of its last
interim assistance payment to you, we will include the amount of the
State's last interim assistance payment in the reimbursement payment.
(6) We will specify the beginning date of the agreement and will
automatically renew the agreement for successive periods of one year
beginning October 1 of each year. Either we or the State may terminate
this agreement at any time upon 30 days written notice to the other
party.
(7) When the State must notify us that it has a signed
authorization.
(8) The State will send you a notice within 10 working days of
receiving the reimbursement from us. The notice will provide--
(i) How much interim assistance the State paid to you;
(ii) That we will notify you about how we will pay the remaining
SSI benefit payments, if any, to you; and
(iii) That you have the right to appeal any of the State's actions
about interim assistance reimbursement if you disagree with them.
(9) The State must agree to comply with any other regulations that
we find necessary to administer the interim assistance reimbursement
provisions.
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9. Add Sec. 416.1912 under the undesignated heading ``Interim
Assistance Agreements'' to read as follows:
Sec. 416.1912 When the interim assistance reimbursement period is in
effect.
(a) Initial claims. For initial claims, the interim assistance
reimbursement period begins with the first month for which you are
eligible for SSI benefit payments, and it ends with and includes the
month your recurring monthly SSI benefit payment begins.
(b) Posteligibility claims. If we determine that you were eligible
for SSI benefit payments during a period when we suspended or
terminated your benefits, the interim assistance reimbursement period
begins on the day that you are eligible for reinstatement of SSI
benefits. The interim assistance reimbursement period ends with and
[[Page 70248]]
includes the month we make the first recurring monthly SSI benefit
payment to you following your period of suspension or termination and
subsequent reinstatement of those benefits.
0
10. Revise Sec. 416.1920 to read as follows:
Sec. 416.1920 Your appeal rights under this subpart.
(a) Your appeal rights to the State. You have the right to appeal
to the State if you disagree with any of the State's actions regarding
reimbursement of the interim assistance. You are not entitled to a
Federal hearing to appeal the State's actions regarding reimbursement
for interim assistance.
(b) Your appeal rights to us. You have the right to appeal to us,
in accordance with subpart N of this part--
(1) The amount of your retroactive SSI benefit payments we withheld
from you;
(2) The amount of your retroactive SSI benefit payments we sent to
the State to reimburse the State for interim assistance it paid to you;
and
(3) The amount of your retroactive SSI benefit payments due to you
after we reimbursed the State for interim assistance it paid to you.
Sec. 416.1922 [Removed and Reserved]
0
11. Sec. 416.1922 is removed and reserved.
[FR Doc. 2013-28034 Filed 11-22-13; 8:45 am]
BILLING CODE 4191-02-P