Supporting Statement for
Evidence From Statutorily Excluded Medical Sources (RIN 0960-AH92)
20 C.F.R. 404.1503b, 416.903b
OMB No. 0960-NEW
Justification
Introduction/Authoring Laws and Regulations
The Bipartisan Budget Act of 2015 (BBA), Section 812 (“Exclusion of certain medical sources of evidence”) mandates that the Social Security Administration (SSA) exclude evidence in disability decisions from certain medical sources. BBA Section 812 will amend section 223(d)(5) of the Social Security Act (Act) by adding a subsection “C.”
Section 223(d)(5)(C) of the Act, as amended, requires SSA to exclude evidence (except for good cause) from medical sources: (1) convicted of a felony under sections 208 or 1632 of the Act; (2) excluded from participating in any Federal health care program under section 1128 of the Act; or (3) imposed with a civil monetary penalty (CMP), assessment, or both, for submitting false evidence, under section 1129 of the Act.
Pursuant to its broad authority to regulate under sections 205(a), 702(a)(5), and 1631(d)(1) of the Act, SSA proposes to implement section 223(d)(5)(C), as amended, through new regulations, 20 CFR 404.1503b and 416.903b. These proposed, new regulations will require statutorily excluded medical sources to self-report their excluded status in writing each time they submit evidence related to a claim for benefits under Titles II or XVI of the Act. Statutorily excluded medical sources’ duty to self-report their excluded status will apply to evidence they submitted to SSA directly or through a representative, claimant, or other individual or entity.
This information collection request (ICR) is for the information collection requirements of BBA Section 812, as explained in a Notice of Proposed Rulemaking for BBA 812, published on June 10, 2016 at 81 FR 37557.
Per the BBA, SSA must finalize the regulation, and implement the provision by November 2, 2016. We are submitting this ICR for preliminary review now, post‑publication of the NPRM. We will resubmit for OMB approval after the publication of the Final Rule.
Description of Collection
The Revisions to Rules Regarding the Evidence From Statutorily Excluded Medical Sources, RIN 0960-AH92, contains the following public reporting burdens:
20 CFR 404.1503b – This regulatory section requires sources excluded by section 223(d)(5)(C) of the Act, as amended, to self-report their exclusion, in writing, each time they submit evidence related to a claim for benefits under Titles II or XVI of the Act. This duty applies to evidence submitted to SSA directly or through a representative, claimant, or other individual or entity. In their written self-report, all excluded medical sources must include: (1) the heading, “WRITTEN STATEMENT REGARDING SECTION 223(d)(5)(C) OF THE SOCIAL SECURITY ACT – DO NOT REMOVE[,]” (2) their name and title, and (3) the applicable excluding event (i.e., felony conviction under sections 208 or 1632, section 1128 exclusion, or CMP or assessment (or both) under section 1129 for submitting false evidence). Felons must also include their date of conviction. Those imposed with a CMP, assessment, or both, must provide the date(s) of imposition. Sources excluded under section 1128 must include: (1) the basis of their exclusion, (2) its effective date and anticipated length, and (3) whether the Department of Health & Human Services’ Office of Inspector General (HHS’ OIG) waived it. There is no form for this request. Statutorily excluded medical sources create their own writing, within the regulatory parameters, and submit it to SSA or State agency (DDS) employees. They do not need information from someone else to create the writing. No one may remove a statutorily excluded medical source’s written report of exclusion. SSA may also ask statutorily excluded medical sources to provide additional information or clarify already‑provided information.
20 CFR 416.903b – This regulatory section requires sources excluded by section 223(d)(5)(C) of the Act, as amended, to self-report their exclusion, in writing, each time they submit evidence related to a claim for benefits under Titles II or XVI of the Act. This duty applies to evidence submitted to SSA directly or through a representative, claimant, or other individual or entity. In their written self-report, all excluded medical sources must include: (1) the heading, “WRITTEN STATEMENT REGARDING SECTION 223(d)(5)(C) OF THE SOCIAL SECURITY ACT – DO NOT REMOVE[,]” (2) their name and title, and (3) the applicable excluding event (i.e., felony conviction under sections 208 or 1632, section 1128 exclusion, or CMP or assessment (or both) under section 1129 for submitting false evidence). Felons must also include their date of conviction. Those imposed with a CMP, assessment, or both, must provide the date(s) of imposition. Sources excluded under section 1128 must include: (1) the basis of their exclusion, (2) its effective date and anticipated length, and (3) whether the Department of Health & Human Services’ Office of Inspector General (HHS’ OIG) waived it. There is no form for this request. Statutorily excluded medical sources create their own writing, within the regulatory parameters, and submit it to SSA or State agency (DDS) employees. They do not need information from someone else to create the writing. No one may remove a statutorily excluded medical source’s written report of exclusion. SSA may also ask statutorily excluded medical sources to provide additional information or clarify already‑provided information.
We will inform the public of these requirements through a Fact Sheet we send to them (submitted for approval as part of this ICR), or through our Website. In addition, we will provide a sample statement as a template the affected medical sources can use to create their own written statements. The respondents for this collection are medical sources that (1) meet one of the exclusionary categories set forth in section 223(d)(5)(C) of the Act, as amended, and (2) furnish evidence related to a claim for benefits under Titles II or XVI of the Act.
Use of Information Technology to Collect the Information
Given the low number of expected respondents (approximately 50 per year), SSA has no printed form and plans to collect this information via paper only (i.e., through the written self‑report of medical sources excluded under section 223(d)(5)(C) of the Act, as amended). SSA did not create an electronic version of the written, self-report under its Government Paperwork Elimination Act (GPEA) plan because it estimates only 50 respondents (approximately) will create the written, self-reports annually. This is less than the GPEA cut-off of 50,000.
Why We Cannot Use Duplicate Information
The nature of the information SSA collects and the manner in which we collect it precludes duplication. SSA does not use another collection instrument to obtain similar data.
Minimizing Burden on Small Respondents
The collection does not significantly affect small businesses or other small entities.
Consequences of Not Colleting Information or Collecting it Less Frequently
Without providing the information requested in 20 CFR 404.1503b and 416.903b, medical sources excluded under section 223(d)(5)(C) of the Act, as amended, will not meet their regulatory requirement to self-report their excluded status, in writing, each time they submit evidence related to a claim for benefits under Titles II or XVI of the Act. Additionally, because we have no other feasible way to collect the information, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction.
Special Circumstances
Because we have no other feasible way to collect the information, we require medical sources excluded under section 223(d)(5)(C) of the Act, as amended, to self-report their excluded status, in writing, each time they submit evidence related to a claim for benefits under Titles II or XVI of the Act. As such, we may require affected medical sources to self-report their excluded status more often than on a quarterly basis. We may also require these affected medical sources to prepare a written response to this information collection (IC) in fewer than 30 days after receipt of it.
Solicitation of Public Comment and Other Consultations with the Public
SSA published a notice of proposed rulemaking (NPRM) in the Federal Register on June 10, 2016, at 81 FR 37557. If we receive any comments in response to the NPRM, we will forward them to OMB. When we publish the Final Rule, we will re-submit this ICR for formal approval of the information collection requirements described within.
Payment or Gifts to Respondents
SSA does not provide payments or gifts to the respondents.
Assurances of Confidentiality
SSA protects and holds confidential the information it collects in accordance with 42 USC 1306, 20 CFR parts 401 and 402, 5 USC 552 (Freedom of Information Act), 5 USC 552a (Privacy Act of 1974), and OMB Circular No. A-130.
Justification for Sensitive Questions
This information collection does not contain any questions of a sensitive nature.
Estimates of Public Reporting Burden
Regulation Section(s) |
Number of Respondents |
Frequency of Response |
Average Burden Per Response (minutes) |
Estimated Annual Burden (hours) |
404.1503b(c) 416.903b(c) |
50 |
60 |
20 |
1,000 |
The total annual burden for this information collection is 1,000 hours. This figure represents burden hours and we did not calculate a separate cost burden.
Annual Cost to Respondents
Any cost burden this information collection imposes (e.g., postal costs for mailing in the required information) is negligible.
Annual Cost to Federal Government
The annual cost to the Federal Government is negligible.
Program Changes or Adjustments to the Information Collection Request
This new information collection increases the public reporting burden. See #12 above for updated burden figures.
Plans for Publication of Information Collection Results
SSA will not publish the results of the information collection.
Displaying the OMB Approval Expiration Date
Regarding the IC for 20 CFR 404.1503b and 416.903b, for the paper fact sheet SSA intends to send to statutorily excluded medical sources upon the occurrence of their exclusion, we will not publish the OMB approval expiration date. OMB granted an exemption from the requirement to print the OMB expiration date on its program forms. SSA produces millions of public-use forms with life cycles exceeding those of an OMB approval. Since SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis), OMB granted this exemption so SSA would not have to destroy stocks of otherwise useable forms with expired OMB dates, avoiding Government waste.
For the public webpage containing information related to section 223(d)(5)(C) of the Act, as amended, SSA is not requesting an exception to the requirement to display the OMB approval expiration date.
Exception to Certification Statement
SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).
Collections of Information Employing Statistical Methods
SSA does not use statistical methods for this IC.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | ALC |
| File Modified | 0000-00-00 |
| File Created | 2021-01-23 |