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Johnson Introduces Bill to Improve Integrity of Disability Decisions

April 22, 2015

WASHINGTON Today, Social Security Subcommittee Chairman Sam Johnson (R-TX) introduced the Improving the Integrity of Disability Evidence Act of 2015. The bill will ensure that the Social Security Administration (SSA) uses medical evidence only from reputable sources when making a disability determination.

Hardworking American taxpayers expect that honest information is used when making disability determinations, Chairman Johnson said. Its just common sense to say if you cant participate in Medicare, Social Security cant consider your medical evidence. Americans want, need, and deserve a fraud-free disability program.

According to a 2013 report released by the Senate Committee on Homeland Security and Governmental Affairs, some claimant representatives seek out doctors who will provide medical opinions leading to a disability-benefit award without question. The report gives an example of a lawyer who sought out doctors with licensure problems to provide medical opinions to support benefit claims.

The SSAs regulations already prohibit the agency from purchasing consultative exams from medical providers whose license has been suspended or revoked because of concerns with professional competence or conduct. However, the SSA does not have any similar restrictions on medical opinions provided by a claimant. In addition, to protect beneficiaries and federal health care programs, the Center for Medicare and Medicaid Services is authorized to bar a provider from receiving payment from federal health care programs due to certain actions. By law, doctors who have been convicted of program-related crimes, abused patients, committed health care fraud, or have a felony related to a controlled substance cannot participate in Medicare.

This legislation would prohibit the SSA from considering medical evidence from doctors who are barred from participating in Medicare or who were assessed a civil monetary penalty for submitting false evidence by the SSA.

A similar provision was included in Chairman Johnsons Stop Disability Fraud Act of 2014 (H.R. 5260) from the 113th Congress, and in Social Security Subcommittee Ranking Member Xavier Becerras recently reintroduced Social Security Fraud and Error Prevention Act of 2015 (H.R. 1419).