1614(f)(2)(B), or, in the case of an eligible individual who is a child under the age of 18, receiving payments (with respect to such individual) under any health insurance policy issued by a private provider of such insurance 10 the benefit under this title for such individual for such month shall be payable (subject to subparagraph (E))—

(i) at a rate not in excess of $360 per year (reduced by the amount of any income not excluded pursuant to section 1612(b)) in the case of an individual who does not have an eligible spouse;

(ii) in the case of an individual who has an eligible spouse, if only one of them is in such a facility throughout such month, at a rate not in excess of the sum of

(I) the rate of $360 per year (reduced by the amount of any income, not excluded pursuant to section 1612(b), of the one who is in such 12 facility), and

(II) the applicable rate specified in subsection (b)(1) (reduced by the amount of any income, not excluded pursuant to section 1612(b), of the other); and

(iii) at a rate not in excess of $720 per year (reduced by the amount of any income not excluded pursuant to section 1612(b)) in the case of an individual who has an eligible spouse, if both of them are in such a 13 facility throughout such month.

For purposes of this subsection, a medical treatment facility that provides services described in section 1917(c)(1)(C) 14 shall be considered to be receiving payments with respect to an individual under a State plan approved under title XIX during any period of ineligibility of such individual provided for under the State plan pursuant to section 1917(c).

(C) As used in subparagraph (A), the term "public institution" does not include a publicly operated community residence which serves no more than 16 residents. 15

(D) A person may be an eligible individual or eligible spouse for purposes of this title with respect to any month throughout which he is a resident of a public emergency shelter for the homeless (as defined in regulations which shall be prescribed by the Commissioner of Social Security); except that no person shall be an eligible individual or eligible spouse by reason of this subparagraph more than 6 months in any 9-month period.

(E) Notwithstanding subparagraphs (A) and (B), any individual who

10 P.L. 104-193, §214(a), inserted "or, in the case of an eligible individual who is a child under the age of 18, receiving payments (with respect to such individual) under any health insurance policy issued by a private provider of such insurance", applicable with respect to benefits for months beginning 90 or more days after August 22, 1996, without regard to whether regulations have been issued to implement this amendment.

P.L. 105-33, §5522(c)(1)(B)(i), struck out "hospital, home or", effective as if included in the enactment of title II of P.L. 104-193, August 22, 1996.

12 P.L. 105-33, §5522(c)(1)(B)(ii), struck out "hospital, home, or", effective as if included in the enactment of title II of P.L. 104-193, August 22, 1996.

13 P.L. 105-33, §5522(c)(1)(C), struck out "hospital, home, or", effective as if included in the enactment of title II of P.L. 104-193, August 22, 1996.

14 P.L. 105-33, §5522(c)(1)(D), struck out "hospital, extended care facility, nursing home, or intermediate care facility which is a 'medical institution or nursing facility' within the meaning of section 1917(c)" and substituted "medical treatment facility that provides services described in section 1917(c)(1)(C)", effective as if included in the enactment of title II of P.L. 104-193, August 22, 1996.

15 See Vol. II, P.L. 96-598, §4, with respect to the Boundary County Restorium, Bonner's Ferry, Idaho.

(i)(I) is an inmate of a public institution, the primary purpose of which is the provision of medical or psychiatric care, through-out any month as described in subparagraph (A), or (II) is in a medical treatment facility 16 throughout any month as described in subparagraph (B),

(ii) was eligible under section 1619(a) or (b) for the month preceding such month, and

(iii) under an agreement of the public institution or the medical treatment facility 17 is permitted to retain any benefit payable by reason of this subparagraph,

may be an eligible individual or eligible spouse for purposes of this title (and entitled to a benefit determined on the basis of the rate applicable under subsection (b)) for the month referred to in subclause (I) or (II) of clause (i) and, if such subclause still applies, for the succeeding month.

(F) An individual who is an eligible individual or an eligible spouse for a month by reason of subparagraph (E) shall not be treated as being eligible under section 1619(a) or (b) for such month for purposes of clause (ii) of such subparagraph.

(G) A person may be an eligible individual or eligible spouse for purposes of this title, and subparagraphs (A) and (B) shall not apply, with respect to any particular month throughout which he or she is an inmate of a public institution the primary purpose of which is the provision of medical or psychiatric care, or is in a medical treatment 18 facility receiving payments (with respect to such individual or spouse) under a State plan approved under title XIX or, in the case of an individual who is a child under the age of 18, under any health insurance policy issued by a private provider of such insurance 19, if it is determined in accordance with subparagraph (H) that—

(i) such person's stay in that institution or facility (or in that institution or facility and one or more other such institutions or facilities during a continuous period of institutionalization) is likely (as certified by a physician) not to exceed 3 months, and the particular month involved is one of the first 3 months throughout which such person is in such an institution or facility during a continuous period of institutionalization; and

(ii) such person needs to continue to maintain and provide for the expenses of the home or living arrangement to which he or she may return upon leaving the institution or facility. The benefit of any person under this title (including State supplementation if any) for each month to which this subparagraph applies shall be payable, without interruption of benefit payments and on the date the benefit involved is regularly due, at the rate that was applicable to such person in the month prior to the first month throughout which he or she is in the institution or facility.

16 P.L. 105–33, §5522(c)(2)(A), struck out "hospital, extended care facility, nursing home, or intermediate care facility" and substituted "medical treatment facility", effective as if included in the enactment of title II of P.L. 104-193, August 22, 1996.

17 P.L. 105-33, §5522(c)(2)(B), struck out "hospital, extended care facility, nursing home, or intermediate care facility" and substituted "medical treatment facility", effective as if included in the enactment of title II of P.L. 104-193, August 22, 1996.

18 P.L. 105-33, §5522(c)(3)(A), struck out "or which is a hospital, extended care facility, nursing home, or intermediate care" and substituted "or is in a medical treatment", effective as if included in the enactment of title II of P.L. 104-193, August 22, 1996.

19 P.L. 105-33, §5522(c)(3)(B), inserted “or, in the case of an individual who is a child under the age of 18, under any health insurance policy issued by a private provider of such insurance", effective as if included in the enactment of title II of P.L. 104-193, August 22, 1996.

(H) The Commissioner of Social Security shall establish procedures for the determinations required by clauses (i) and (ii) of subparagraph (G), and may enter into agreements for making such determinations (or for providing information or assistance in connection with the making of such determinations) with appropriate State and local public and private agencies and organizations. Such procedures and agreements shall include the provision of appropriate assistance to individuals who, because of their physical or mental condition, are limited in their ability to furnish the information needed in connection with the making of such determinations.

(I)(i) The Commissioner shall enter into an agreement, with any interested State or local institution described in clause (i) or (ii) of section 202(x)(1)(A) the primary purpose of which is to confine individuals as described in section 202(x)(1)(A), under which

(I) the institution shall provide to the Commissioner, on a monthly basis and in a manner specified by the Commissioner, the names, social security account numbers, dates of birth, confinement commencement dates, and, to the extent available to the institution, such other identifying information concerning the inmates of the institution as the Commissioner may require for the purpose of carrying out this paragraph 20; and

(II) the Commissioner shall pay to any such institution, with respect to each individual who receives in the month preceding the first month throughout which such individual is an inmate of the jail, prison, penal institution, or correctional facility that furnishes information respecting such individual pursuant to subclause (I), or is confined in the institution (that so furnishes such information) as described in section 202(x)(1)(A)(ii), a benefit under this title for such preceding month, and who is determined by the Commissioner to be ineligible for benefits under this title by reason of confinement based on the information provided by such institution 21, $400 if the institution furnishes the information described in subclause (I) to the Commissioner within 30 days after the date such individual becomes an inmate of such institution, or $200 if the institution furnishes such information after 30 days after such date but within 90 days after such date.

(ii)(I) The provisions of section 552a of title 5, United States Code 22, shall not apply to any agreement entered into under clause (i) or to information exchanged pursuant to such agreement.

(II) The Commissioner is authorized to provide, on a reimbursable basis, information obtained pursuant to agreements entered into under clause (i) to any Federal or federally-assisted cash, food, or medical assistance program for eligibility

purposes.

20 P.L. 105-33, §5521(c), struck out "paragraph (1)” and substituted "this paragraph".

21 P.L. 105-33, §5521(b), struck out "inmate of the institution who is eligible for a benefit under this title for the month preceding the first month throughout which such inmate is in such institution and becomes ineligible for such benefit as a result of the application of this subparagraph" and substituted "individual who receives in the month preceding the first month throughout which such individual is an inmate of the jail, prison, penal institution, or correctional facility that furnishes information respecting such individual pursuant to subclause (I), or is confined in the institution (that so furnishes such information) as described in section 202(x)(1)(A)(ii), a benefit under this title for such preceding month, and who is determined by the Commissioner to be ineligible for benefits under this title by reason of confinement based on the information provided by such institution", effective as if included in the enactment of title II of P.L. 104-193, August 22, 1996.

22 See Vol. II, Title 5, §552a.

(iii) Payments to institutions required by clause (i)(II) shall be made from funds otherwise available for the payment of benefits under this title and shall be treated as direct spending for purposes of the Balanced Budget and Emergency Deficit Control Act of 1985.23

(2) No person shall be an eligible individual or eligible spouse for purposes of this title if, after notice to such person by the Commissioner of Social Security that it is likely that such person is eligible for any payments of the type enumerated in section 1612(a)(2)(B), such person fails within 30 days to take all appropriate steps to apply for and (if eligible) obtain any such payments.

(3)24 Notwithstanding anything to the contrary in the criteria being used by the Commissioner of Social Security in determining when a husband and wife are to be considered two eligible individuals for purposes of this title and when they are to be considered an eligible individual with an eligible spouse, the State agency administering or supervising the administration of a State plan under any other program under this Act may (in the administration of such plan) treat a husband and wife living in the same medical treatment facility 25 described in paragraph (1)(B) as though they were an eligible individual with his or her eligible spouse for purposes of this title (rather than two eligible individuals), after they have continuously lived in the same such facility 26 for 6 months, if treating such husband and wife as two eligible individuals would prevent either of them from receiving benefits or assistance under such plan or reduce the amount thereof.

(4)(A) No person shall be considered an eligible individual or eligible spouse for purposes of this title during the 10-year period that begins on the date the person is convicted in Federal or State court of having made a fraudulent statement or representation with respect to the place of residence of the person in order to receive assistance simultaneously from 2 or more States under programs that are funded under title IV, title XIX, or the Food Stamp Act of 197727, or benefits in 2 or more States under the supplemental security income program under this title.

(B) As soon as practicable after the conviction of a person in a Federal or State court as described in subparagraph (A), an official of such court shall notify the Commissioner of such conviction. 28

(5) No person shall be considered an eligible individual or eligible spouse for purposes of this title with respect to any month if during such month the person is

(A) fleeing to avoid prosecution, or custody or confinement after conviction, under the laws of the place from which the

23 P.L. 104-193, §203(a)(1), added subparagraph (I), applicable with respect to individuals whose period of confinement in an institution commences on or after March 1, 1997.

24 P.L. 104-121, §105(b)(4)(A), struck out the former paragraph (3). For the effective date, see Vol. II, P.L. 104-121, §105(b)(5)(A). For paragraph (3) as it formerly read, see Vol. II, Superseded Provisions, P.L. 104-121.

P.L. 104-193, $201(a), redesignated the former paragraph (5) as paragraph (3), effective August 22, 1996.

25 P.L. 105-33, §5522(c)4XA), struck out "same hospital, home, or facility" and substituted "same medical treatment facility", effective as if included in the enactment of title II of P.L. 104-193, August 22, 1996.

26 P.L. 105-33, §5522(c)(4)(B), struck out "same such hospital, home, or facility" and substituted "same such facility", effective as if included in the enactment of title II of P.L. 104193, August 22, 1996.

27 P.L. 88-525.

28 P.L. 104-193, §201(a), added paragraph (4), effective August 22, 1996.

person flees, for a crime, or an attempt to commit a crime, which is a felony under the laws of the place from which the person flees, or which, in the case of the State of New Jersey, is a high misdemeanor under the laws of such State; or

(B) violating a condition of probation or parole imposed under Federal or State law. 29

(6) Notwithstanding any other provision of law (other than section 6103 of the Internal Revenue Code of 1986 30 and section 1106(c) of this Act 31), the Commissioner shall furnish any Federal, State, or local law enforcement officer, upon the written request of the officer, with the current address, Social Security number, and photograph (if applicable) of any recipient of benefits under this title, if the officer furnishes the Commissioner with the name of the recipient, and other identifying information as reasonably required by the Commissioner to establish the unique identity of the recipient, and notifies the Commissioner that

(A) the recipient

(i) is described in subparagraph (A) or (B) of paragraph (5); and

(ii) has information that is necessary for the officer to conduct the officer's official duties; and

(B) the location or apprehension of the recipient is within the officer's official duties. 32

Suspension of Payments to Individuals Who Are Outside the
United States

(f)(1) Notwithstanding any other provision of this title, no individual (other than a child described in section 1614(a)(1)(B)(ii)) shall be considered an eligible individual for purposes of this title for any month during all of which such individual is outside the United States (and no person shall be considered the eligible spouse of an individual for purposes of this title with respect to any month during all of which such person is outside the United States). For purposes of the preceding sentence, after an individual has been outside the United States for any period of 30 consecutive days, he shall be treated as remaining outside the United States until he has been in the United States for a period of 30 consecutive days.

(2) For a period of not more than 1 year, the first sentence of paragraph (1) shall not apply to any individual who

(A) was eligible to receive a benefit under this title for the month immediately preceding the first month during all of which the individual was outside the United States; and

(B) demonstrates to the satisfaction of the Commissioner of Social Security that the absence of the individual from the United States will be

(i) for not more than 1 year; and

(ii) for the purposes of conducting studies as part of an educational program that is—

(I) designed to substantially enhance the ability of the individual to engage in gainful employment;

29 P.L. 104-193, §202(a), added subparagraph (5), effective August 22, 1996. 30 See Vol. II, P.L. 83-591.

31 P.L. 105-33, §5521(a), inserted "and section 1106(c) of this Act", effective as if included in the enactment of title II of P.L. 104-193, August 22, 1996.

32 P.L. 104-193, §202(b), added subparagraph (6), effective August 22, 1996.