Sec. 512. Integrity and compliance
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Subchapter I of chapter 81 is amended by adding at the end the following: In this section— the term FECA program means the Federal Employees Compensation Program administered under this subchapter; the term improper payment has the meaning given that term in section 2(g) of the Improper Payments Information Act of 2002 ( 31 U.S.C. 3321 note); the term Inspector General — means an Inspector General described in subparagraph (A), (B), or
(I)of section 11(b)(1) of the Inspector General Act of 1978 (5 U.S.C. App.); and does not include the Inspector General of an entity having no employees covered under the FECA program; the term Integrity and Compliance Program means the Integrity and Compliance Program established under subsection (b); the term provider means a provider of medical or other services under the FECA program; the term Secretary means the Secretary of Labor; and the term Task Force means the FECA Integrity and Compliance Task Force established under subsection (c)(2)(A). Not later than 270 days after the date of enactment of this section, the Secretary shall establish an Integrity and Compliance Program for the purpose of preventing, identifying, and recovering fraudulent and other improper payments for the FECA program, which shall include— procedures for identifying potentially improper payments before payment is made to claimants and providers, including, where appropriate, predictive analytics; reviews after payment is made to identify potentially improper payments to claimants and providers; on-going screening and verification procedures to ensure the continued eligibility of medical providers to provide services under the FECA program, including licensure, Federal disbarment, and the existence of relevant criminal convictions; provision of appropriate information, education, and training to claimants and providers on requirements to ensure the integrity of the FECA program, including payments under the FECA program; appropriate controls and audits to ensure that providers adopt internal controls and procedures for compliance with requirements under the FECA program; procedures to ensure— initial and continuing eligibility of claimants for compensation, benefits, or services under the FECA program; and ongoing verification of information in databases relating to claimants to ensure accuracy and completeness; and sharing and accessing data and information with other agencies and instrumentalities of the United States, including the United States Postal Service. In administering the FECA program, including the Integrity and Compliance Program, the Secretary shall cooperate with other agencies and instrumentalities of the United States (including the United States Postal Service) and the Inspectors General of such agencies and instrumentalities to prevent, identify, and recover fraudulent and other improper payments under the FECA program. There is established a task force, which shall be known as the FECA Integrity and Compliance Task Force. The members of the Task Force shall be— the Secretary, who shall serve as the Chairperson of the Task Force; the Postmaster General, who shall serve as the Vice Chairperson of the Task Force; the Attorney General; the Director of the Office of Management and Budget; and other appropriate Federal officials, as determined by the Chairperson and Vice Chairperson of the Task Force. The following officials shall attend meetings of the Task Force and participate as ad hoc, advisory members, to provide technical assistance and guidance to the Task Force with respect to the duties of the Task Force: The Inspector General of the Department of Labor. The Inspector General of the United States Postal Service. The Inspectors General of other appropriate agencies and instrumentalities of the United States that employ a significant number of individuals receiving compensation, benefits, or services under the FECA program, as determined by the Chairperson of the Task Force. The Task Force shall— set forth, in writing, a description of the respective roles and responsibilities in preventing, identifying, recovering, and prosecuting fraud under, and otherwise ensuring integrity and compliance of, the FECA program of— the Secretary (including subordinate officials such as the Director of the Office of Workers’ Compensation Programs); the Inspector General of the Department of Labor; the Inspectors General of agencies and instrumentalities of the United States that employ claimants under the FECA program; the Attorney General; and any other relevant officials; develop procedures for sharing information of possible fraud under the FECA program or other intentional misstatements by claimants or providers under the FECA program, including procedures addressing— notification of appropriate officials of the Department of Labor of potential fraud or other intentional misstatements, including provision of supporting information; timely and appropriate response by officials of the Department of Labor to notifications described in subclause (I); the inclusion of information and evidence relating to fraud and other intentional misstatements in criminal, civil, and administrative proceedings relating to the provision of compensation, benefits, or medical services (including payments to providers) under the FECA program; the coordination of criminal investigations with the administration of the FECA program; and the protection of information relating to an investigation of possible fraud under the FECA program from potential disclosure, including requirements that enable investigative files to be appropriately separated from case management files; and not later than 1 year after the date of enactment of this section, submit to the Committee on Homeland Security and Governmental Affairs of the Senate and the Committee on Oversight and Government Reform and the Committee on Education and the Workforce of the House of Representatives a report that includes the description and procedures required under clauses
(i)and (ii). Nothing in this subsection shall be construed to limit or restrict any authority of an Inspector General. In order to improve compliance with the requirements under and the integrity of the FECA program, or as required to otherwise detect and prevent improper payments under the FECA program (including for purposes of computer matching under subsection (e)(1)(D)), upon written request— the Commissioner of Social Security shall make available to the Secretary, the Postmaster General, and each Inspector General the Social Security earnings information of a living or deceased employee; the Director of the Office of Personnel Management shall make available to the Secretary, the Postmaster General, and each Inspector General the information in the databases of Federal employees and retirees maintained by the Director; and the Secretary of Veterans Affairs shall make available to the Secretary, the Postmaster General, and each Inspector General the information in the database of disabled individuals maintained by the Secretary of Veterans Affairs. Upon written request, the Secretary of Health and Human Services shall make available to the Secretary, the Postmaster General, each Inspector General, and the Comptroller General of the United States the information in the National Directory of New Hires for purposes of carrying out this subchapter, in order to improve compliance with the requirements under and the integrity of the FECA program, or as required to otherwise detect and prevent improper payments under the FECA program (including for purposes of computer matching under subsection (e)(1)(D)). The Comptroller General may obtain information from the National Directory of New Hires for purposes of any audit, evaluation, or investigation, including any audit, evaluation, or investigation relating to program integrity. The Secretary shall establish procedures for correlating the identity and status of recipients of compensation, benefits, or services under this subchapter with Social Security earnings information described in paragraph (1)(A). Information requested under this subsection shall be provided— in a timely manner; at a reasonable cost to the Secretary, the Postmaster General, or an Inspector General; without cost to the Comptroller General of the United States; and in the manner, frequency, and form reasonably specified by the officer making the request, which, upon request, shall include electronic form. The Secretary shall consider and assess procedures for correlating the identity and status of recipients of compensation, benefits, or services under this subchapter with information relating to employees, retirees, and individuals described in subparagraphs
(B)and
(C)of paragraph
(1)and paragraph (2). Not later than 1 year after the date of enactment of this section, the Secretary shall submit to the Committee on Homeland Security and Governmental Affairs of the Senate and the Committee on Oversight and Government Reform and the Committee on Education and the Workforce of the House of Representatives a report on the cost-effectiveness of the use of the databases described in subparagraphs
(B)and
(C)of paragraph
(1)and paragraph
(2)for program compliance and integrity. The report required under this subparagraph may be included as part of the report required under subsection (f). Not later than 180 days after the date of enactment of this section, in order to track, verify, and communicate with the Secretary and other relevant entities, the Postmaster General shall establish an electronic database of information relating to employees of the United States Postal Service who have applied for or are receiving compensation, benefits, or services under this subchapter. Nothing in this subsection shall be construed to limit the authority of the Comptroller General of the United States under section 716 of title 31. In order to ensure strong information security and privacy standards, the Task Force shall establish protocols for the secure transfer and storage of any information provided to an individual or entity under this section. In establishing protocols under subparagraph (A), the Task Force shall consider any recommendations submitted to the Secretary by the Inspector General of the Department of Health and Human Services with respect to the secure transfer and storage of information, and to comply with privacy laws and best practices. The Task Force shall establish protocols and procedures to enable information and materials relating to an active investigation of possible fraud relating to the FECA program to be appropriately kept separate from the files for employees relating to the provision of compensation, benefits, or services under the FECA program. Except as provided in this subparagraph, in accordance with section 552a (commonly known as the Privacy Act of 1974), the Secretary, the Postmaster General, each Inspector General, and the head of each agency may enter into computer matching agreements that allow ongoing data matching (which shall include automated data matching) in order to assist in the detection and prevention of improper payments under the FECA program. Not later than 60 days after a proposal for an agreement under clause
(i)has been presented to a Data Integrity Board established under section 552a(u) for consideration, the Data Integrity Board shall approve or deny the agreement. An agreement under clause (i)— shall have a termination date of less than 3 years; and during the 3-month period ending on the date on which the agreement is scheduled to terminate, may be renewed by the agencies entering the agreement for not more than 3 years. For purposes of this subparagraph, section 552a(o)(1) shall be applied by substituting between the source agency and the recipient agency or non-Federal agency or an agreement governing multiple agencies’ for ‘between the source agency and the recipient agency or non-Federal agency in the matter preceding subparagraph (A). An agreement under clause
(i)may be entered without regard to section 552a(o)(1)(B), relating to a cost-benefit analysis of the proposed matching program. Not later than 6 months after the date of enactment of the Workers' Compensation Reform Act of 2013 , and in consultation with the Council of Inspectors General on Integrity and Efficiency, the Secretary of Health and Human Services, the Commissioner of Social Security, and the head of any other relevant agency, the Director of the Office of Management and Budget shall— issue guidance for agencies regarding implementing this subparagraph, which shall include standards for reimbursement costs, when necessary, between agencies; and establish standards and develop standard matching agreements for the purpose of improving the process for establishing data use or computer matching agreements. The Secretary, the Postmaster General, and each Inspector General shall ensure that any information provided to an individual or entity under this section is provided in accordance with protocols established under paragraph (1). Nothing in this section shall be construed to affect the rights of an individual under section 552a(p). Not later than 1 year after the date of enactment of this section, and annually thereafter for 5 years, the Secretary shall submit a report on the activities of the Secretary under this section, including implementation of the Integrity and Compliance Program, to— the Committee on Homeland Security and Governmental Affairs of the Senate; and the Committee on Oversight and Government Reform and the Committee on Education and the Workforce of the House of Representatives. The Comptroller General of the United States shall— conduct periodic reviews of the Integrity and Compliance Program; and submit reports on the results of the reviews under paragraph
(1)to the Committee on Homeland Security and Governmental Affairs of the Senate and the Committee on Oversight and Government Reform and the Committee on Education and the Workforce of the House of Representatives not later than— 2 years after the date of enactment of this section; and 3 years after submission of the report under subparagraph (A). . The table of sections for chapter 81 is amended by inserting after the item relating to section 8152 the following: 8153. Integrity and Compliance Program. . This section and the amendments made by this section shall take effect on the date of enactment of this Act.
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Sec. 512
Integrity and compliance
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