[Federal Register Volume 79, Number 113 (Thursday, June 12, 2014)]
[Rules and Regulations]
[Pages 33681-33683]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-13802]


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SOCIAL SECURITY ADMINISTRATION

20 CFR Parts 404 and 416

[Docket No. SSA-2011-0099]
RIN 0960-AH44


Obtaining Evidence Beyond the Current ``Special Arrangement 
Sources''

AGENCY: Social Security Administration (SSA).

ACTION: Interim final rules with request for comments.

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SUMMARY: We are amending our regulations to state that we will obtain 
evidence from any appropriate source. Our current regulations provide 
that we will obtain information from ``special arrangement sources'' 
for those infrequent situations when we are in a better position than 
our State agency partners to obtain evidence. Due to improved evidence 
collection through our increased use of health information technology 
(health IT), we are obtaining evidence electronically with increasing 
frequency. We expect that, over time, the electronic exchange of 
medical records will become our primary means for obtaining medical 
evidence. As we increase our use of health IT, the designation of 
``special arrangement sources'' will no longer adequately describe from 
whom we collect evidence.

DATES: Effective Date: This interim final rule is effective June 12, 
2014.
    Comment Date: To ensure that your comments are considered, we must 
receive them no later than August 11, 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-2011-0099 so 
that we can 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 that you submit your comments 
via the Internet. Please visit the Federal eRulemaking portal at http://www.regulations.gov. Use the Search function to find docket number 
SSA-2011-0099. The system will issue a tracking number to confirm your 
submission. You will not be able to view your comment immediately 
because we must post each comment manually. 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, 3100 West High Rise 
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: Cheryl Elksnis, Office of Disability 
Programs, Social Security Administration, 6401 Security Boulevard, 
Baltimore, MD 21235-6401, 410-966-0497. 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

    We need medical and other evidence to determine whether you are 
disabled. We need your permission to request your medical records from 
your medical sources. You can also submit medical evidence to us. We 
request close to 15 million medical records from almost 500,000 
providers to make decisions on approximately 3 million disability 
claims annually.
    Our regulations define the roles and responsibilities of both the 
State agency and us in obtaining evidence and carrying out the 
disability determination function. The State agency has the primary 
responsibility to secure any evidence it needs to make a disability 
determination. Traditionally, the State agency collects this evidence 
through a variety of paper-based processes such as mail and fax. In 
most disability claims, the State agency converts paper records to 
electronic format and adds them to an electronic folder, which the 
State agency uses when it makes a disability determination. If we 
secure evidence from you or other ``special arrangement sources,'' we 
provide that evidence to the State agency for use in making a 
disability determination.
    The United States (U.S.) healthcare system is undergoing a major 
technological shift, with medical providers adopting electronic health 
records in place of paper medical records. In 2008, to improve the 
disability determination process, we started an initiative enabling the 
electronic exchange of health information rather than using a mostly 
manual process to request, receive paper records, and then convert them 
to electronic format. We can now use a fully automated process to 
obtain electronic medical records nearly instantaneously. Using health 
IT, we dramatically increase our efficiency in gathering medical 
evidence. We receive medical evidence via health IT in a matter of 
minutes or hours, as opposed to days or weeks via traditional channels 
such as fax and mail.
    We currently are in a better position than a State agency to obtain 
medical evidence via health IT. We developed an application that allows 
us to request and receive electronic medical records in a fully 
automated manner through a standards-based electronic transaction. We 
obtain the evidence via health IT nearly instantaneously, and then we 
provide it electronically to the State agency that makes the disability 
determination. This collaborative process allows us to gather medical 
evidence faster than we can using the traditional paper process and in 
most cases leads to quicker disability determinations.
    With health IT, we increased the frequency at which we, rather than 
the State agency, request records. As the U.S. healthcare system 
continues its transition toward health IT, we expect health IT to 
become the primary means by which we request and receive medical 
evidence. We anticipate that our requests for medical evidence will 
continue to increase and that they will no longer only be to ``special 
arrangement sources.'' In recognition of these changes to the U.S. 
healthcare system and our increasing use of health

[[Page 33682]]

IT to obtain medical records, we are eliminating the ``special 
arrangement sources'' language from our rules. This revision only 
changes who will obtain evidence; it does not change the State agency's 
role in making disability determinations or in requesting evidence 
through traditional channels, when appropriate.
    While we anticipate obtaining increasing amounts of medical records 
from health IT sources, we also expect that the State agency will 
continue to obtain evidence, when appropriate. For example, if your 
medical provider does not use electronic health records and does not 
participate in health IT, the State agency is better positioned than us 
to obtain your medical records through traditional channels.

Clarity of These Interim Final 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 interim final 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, e.g. grouping and order of sections, use of headings, 
paragraphing?

When will we start to use these rules?

    We will start to use these interim final rules on the date shown 
under the ``Effective Date'' section earlier in this preamble.
    We also invite public comments on the changes made by the rules. We 
will consider any relevant comments we receive. If appropriate, we will 
publish a final rule to respond to any such comments we receive, and to 
make any changes to the rules based on the comments.

Regulatory Procedures

Justification for Issuing Interim Final Rules Without Notice and 
Comment

    We follow the Administrative Procedure Act (APA) rulemaking 
procedures specified in 5 U.S.C. 553 when we develop regulations.\1\ 
Generally, the APA requires that an agency provide prior notice and 
opportunity for public comment before issuing interim final rules. The 
APA provides exceptions to its notice and public comment procedures 
when an agency finds there is good cause for dispensing with such 
procedures because they are impracticable, unnecessary, or contrary to 
the public interest.\2\
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    \1\ Section 702(a)(5) of the Social Security Act, 42 U.S.C. 
902(a)(5).
    \2\ 5 U.S.C. 553(b)(B).
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    We find that there is good cause under 5 U.S.C. 553(b)(B) for 
dispensing with the notice and public comment procedures for these 
rules. We find that prior public comment is unnecessary because these 
rules only change our internal administrative procedures that govern 
the situations in which we, rather than the State agency, request 
evidence from some medical providers. The changes we are making to our 
rules do not affect the rights or benefits of the public or make any 
changes in the standards that the State agency uses to determine 
disability. Our current rules describe certain circumstances when we 
secure evidence. These interim final rules reflect that our evidence 
collection will become more routine than it traditionally has been, in 
recognition of the advent of health IT. Because we are not making any 
substantive changes to our current disability determination rules at 
this time, we find that prior public comment is unnecessary. However, 
we are inviting public comment on these interim final rules and will 
consider any substantive comments we receive within 60 days of the 
publication of these rules.
    In addition, we find good cause for dispensing with the 30-day 
delay in the effective date of these rules provided for in 5 U.S.C. 
553(d)(3). For the reasons stated above, we find it unnecessary to 
delay the effective date of the changes we are making in these interim 
final rules. Accordingly, we are making them effective upon 
publication.

Executive Order 12866 as Supplemented by Executive Order 13563

    We consulted with the Office of Management and Budget (OMB) and 
determined that these interim final rules do not meet the criteria for 
a significant regulatory action under Executive Order 12866, as 
supplemented by Executive Order 13563. Thus, OMB did not review the 
interim final rules.

Regulatory Flexibility Act

    We certify that these interim final rules will not have a 
significant economic impact on a substantial number of small entities 
because the rules affect our internal procedures for handling claims 
for individuals only. Therefore, the Regulatory Flexibility Act, as 
amended, does not require us to prepare a regulatory flexibility 
analysis.

Paperwork Reduction Act

    These interim final rules do not create any new or affect any 
existing collections and, therefore, do not require OMB approval under 
the Paperwork Reduction Act.

(Catalog of Federal Domestic Assistance Program Nos. 96.001, Social 
Security--Disability Insurance; 96.002, Social Security--Retirement 
Insurance; 96.004, Social Security--Survivors Insurance; and 96.006, 
Supplemental Security Income)

List of Subjects

20 CFR Part 404

    Administrative practice and procedure; Blind; Disability benefits; 
Old-Age, Survivors, and Disability Insurance; Reporting and 
recordkeeping requirements; Social security.

20 CFR Part 416

    Administrative practice and procedure; Aged, Blind, Disability 
benefits, Public Assistance programs; Reporting and recordkeeping 
requirements; Supplemental Security Income (SSI).

Carolyn W. Colvin,
Acting Commissioner of Social Security.

    For the reasons set out in the preamble, we are amending 20 CFR 
chapter III, parts 404 and 416, as set forth below:

PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE 
(1950--)

Subpart Q--[Amended]

0
1. The authority citation for subpart Q of part 404 continues to read 
as follows:

    Authority: Secs. 205(a), 221, and 702(a)(5) of the Social 
Security Act (42 U.S.C. 405(a), 421, and 902(a)(5)).


0
2. Amend Sec.  404.1614 by revising paragraph (a), removing paragraph 
(b), and re-designating paragraph (c) as paragraph (b).
    The revision reads as follows:


Sec.  404.1614  Responsibilities for obtaining evidence to make 
disability determinations.

    (a) We or the State agency will secure from the claimant or other 
sources any

[[Page 33683]]

evidence the State agency needs to make a disability determination. 
When we secure the evidence, we will furnish it to the State agency for 
use in making the disability determination.
* * * * *

PART 416--SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND 
DISABLED

Subpart J--[Amended]

0
3. The authority citation for subpart J of part 416 continues to read 
as follows:

    Authority: Secs. 702(a)(5), 1614, 1631, and 1633 of the Social 
Security Act (42 U.S.C. 902(a)(5), 1382c, 1383, and 1383b).

0
4. Amend Sec.  416.1014 by revising paragraph (a), removing paragraph 
(b), and re-designating paragraph (c) as paragraph (b).
    The revision reads as follows:


Sec.  416.1014  Responsibilities for obtaining evidence to make 
disability determinations.

    (a) We or the State agency will secure from the claimant or other 
sources any evidence the State agency needs to make a disability 
determination. When we secure the evidence, we will furnish it to the 
State agency for use in making the disability determination.
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[FR Doc. 2014-13802 Filed 6-11-14; 8:45 am]
BILLING CODE 4191-02-P