Library / Laws / 113th / s / S. 1586 / Introduced in Senate
II
113th CONGRESS
1st Session
S. 1586
IN THE SENATE OF THE UNITED STATES
October 28, 2013Mr. Sanders introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs
A BILL
To amend title 38, United States Code, to improve dental
health care for veterans, and for other purposes.
1.
Short
title
This Act may be cited as
the Enhanced Dental Care for Veterans Act of 2013.
2.
Restorative
dental services for veterans
Section 1710(c) of title 38, United States
Code, is amended—
(1) in the second
sentence—
(A) by redesignating
subparagraphs (A) and (B) as clauses (i) and (ii), respectively; and
(B) by redesignating
paragraphs (1) and (2) as subparagraphs (A) and (B), respectively;
(2) by inserting
(1) after (c);
(3) by striking
The Secretary and inserting the following:
(2) The
Secretary
;
and
(4) by adding at the
end the following new paragraph:
(3) In addition to the dental services,
treatment, and appliances authorized to be furnished by paragraph (2), the
Secretary may furnish dental services and treatment, and dental appliances,
needed to restore functioning in a veteran that is lost as a result of any
services or treatment furnished under this
subsection.
.
3.
Pilot program on expansion of furnishing of dental care to all enrolled veterans
(a)
Pilot program required
Commencing not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall carry out a pilot program to assess the feasibility and advisability of furnishing dental care to veterans enrolled in the system of patient enrollment under section 1705 of title 38, United States Code, who are not eligible for dental services and treatment, and related dental appliances, under current authorities.
(b)
Duration of pilot program
The pilot program shall be carried out during the three-year period beginning on the date of the commencement of the pilot program.
(c)
Locations
(1)
In general
The Secretary shall carry out the pilot program at not fewer than 16 locations as follows:
(A) Four Department of Veterans Affairs medical centers with an established dental clinic.
(B) Four Department medical centers with a current contract for the furnishing of dental care.
(C) Four Community-Based Outpatient Clinics (CBOCs) with space available for the furnishing of services and treatment under the pilot program.
(D) Four facilities selected from among Federally Qualified Health Centers (FQHCs) and Indian Health Service facilities with established dental clinics, of which—
(i) at least one facility shall be such an Indian Health Service facility; and
(ii) any Indian Health Service facility so selected shall be selected in consultation with the Secretary of Health and Human Services.
(2)
Considerations
In selecting locations for the pilot program, the Secretary shall consider the feasibility and advisability of selecting locations in each of the following:
(A) Rural areas.
(B) Areas that are not in close proximity to an active duty military installation.
(C) Areas representing different geographic locations, such as census tracts established by the Bureau of Census.
(d)
Scope of
services
The dental services and treatment furnished to veterans under
the pilot program shall be consistent with the dental services and treatment
furnished by the Secretary to veterans with service-connected disabilities rated
100 percent disabling under the laws administered by the Secretary.
(e)
Voluntary
participation
The participation of a veteran in the pilot
program shall be at the election of the veteran.
(f)
Limitation on amount of services
(1)
In general
Except as provided in paragraph (3), the total amount the Secretary may expend furnishing dental services and treatment to any veteran participating in the pilot program during any one-year period may not exceed such amount as the Secretary determines appropriate. The amount so determined may not be less than $1,000.
(2)
Consultation
The Secretary shall make the determination under paragraph (1)—
(A) in consultation with the Director of the Indian Health Service; and
(B) in consultation with the Director of the Centers for Medicare and Medicaid Services if one or more Federally Qualified Health Centers is selected as a location for the pilot program under subsection (c)(1)(D).
(3)
Services in excess of limitation amount
The total amount expended by the Secretary in furnishing dental services and treatment to a particular veteran participating in the pilot program during a one-year period may exceed the amount determined under paragraph (1) if the Secretary determines, before furnishing such services and treatment, based on an examination of the veteran by a dentist participating in the pilot program that the furnishing of such services and treatment is necessary. Any determination under this paragraph shall be made on a case-by-case basis.
(g)
Copayments
The Secretary may collect copayments for dental services and treatment furnished under the pilot program in accordance with authorities on the collection of copayments for medical care of veterans under chapter 17 of title 38, United States Code.
(h)
Program
administration
(1)
Notice to
covered veterans on pilot program
In carrying out the pilot
program, the Secretary shall inform all veterans eligible to participate in the pilot program of the services
and treatment available under the pilot program.
(2)
Contracts
In
carrying out the pilot program, the Secretary may enter into contracts with
appropriate entities for the provision of dental services and treatment under the pilot
program. Each such contract shall specify performance standards and metrics and
processes for ensuring compliance of the contractor concerned with such
performance standards.
(i)
Reports
(1)
Preliminary
reports
(A)
In
general
Not later than each of one year and three years after the date of the
commencement of the pilot program, the Secretary shall submit to the Committee
on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of
the House of Representatives a report on the pilot program.
(B)
Contents
Each
report under subparagraph (A) shall include the following:
(i) A
description of the implementation and operation of the pilot program.
(ii) The number of
veterans receiving services and treatment under the pilot program, and a description
of the dental services and treatment furnished to such veterans.
(iii) An analysis of
the costs and benefits of the pilot program, including a comparison of costs
and benefits by location type.
(iv) The current
findings and conclusions of the Secretary with respect to the pilot
program.
(v) Such
recommendations for the continuation or expansion of the pilot program as the
Secretary considers appropriate.
(2)
Final
report
(A)
In
general
Not later than 180 days after the completion of the pilot
program, the Secretary shall submit to the Committee on Veterans’ Affairs of
the Senate and the Committee on Veterans’ Affairs of the House of
Representatives a report on the pilot program.
(B)
Contents
The
report under subparagraph (A) shall include the following:
(i) The
findings and conclusions of the Secretary with respect to the pilot
program.
(ii) Such
recommendations for the continuation or expansion of the pilot program as the
Secretary considers appropriate.
4.
Program on
education to promote dental health in veterans
(a)
Program
required
(1)
In
general
The Secretary of Veterans Affairs shall carry out a
program of education to promote dental health for veterans who are enrolled in
the system of patient enrollment of the Department of Veterans Affairs under
section 1705 of title 38, United States Code.
(2)
Construction
Nothing
in the program shall be deemed to alter or revise the eligibility of any
veteran for dental care under the laws administered by the Secretary.
(b)
Elements
The
program required by subsection (a) shall provide education for veterans on the
following:
(1) The association
between dental health and overall health and well-being.
(2) Proper techniques
for dental care.
(3) Signs and
symptoms of commonly occurring dental issues, including caries.
(4) Treatment options
for commonly occurring dental issues.
(5) Options for
obtaining access to dental care, including information on eligibility for
dental care through the Department and on purchasing private dental
insurance.
(6) Options for
obtaining low or no-cost dental care, including through dental schools and
Federally Qualified Health Centers.
(7) Such other
matters relating to dental health as the Secretary considers
appropriate.
(c)
Delivery of
educational materials
(1)
In
general
The Secretary shall provide educational materials to
veterans under the program required by subsection (a) through a variety of
mechanisms, including the following:
(A) The availability
and distribution of print materials at Department facilities, including medical
centers, clinics, Vet Centers, and readjustment counseling centers.
(B) The availability
and distribution of materials over the Internet, including through webinars and
My HealtheVet.
(C) Presentations of
information, including both small group and large group presentations.
(2)
Selection of
mechanisms
In selecting mechanisms for purposes of this
subsection, the Secretary shall select mechanisms designed to maximize the
number of veterans who receive education under the program.
5.
Information on
dental services for inclusion in electronic medical records under dental
insurance pilot program
(a)
In
general
Commencing not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall expand the
dental insurance pilot program established by section 17.169 of title 38, Code
of Federal Regulations, to establish a mechanism by which private sector dental
care providers may forward to the Department of Veterans Affairs information on
dental care furnished to individuals under the pilot program for inclusion in
the electronic medical records of the Department with respect to such
individuals.
(b)
Construction
with current pilot program requirements
(1)
In
general
Nothing in this section shall be construed to revise
eligibility for participation in, or the locations of, the pilot program
referred to in subsection (a).
(2)
Duration
The
Secretary may continue the pilot program for two years in addition to the
duration otherwise provided for the pilot program in section 17.169 of title
38, Code of Federal Regulations, if the Secretary determines that the
continuation is needed to assess the mechanism required by subsection
(a).
(3)
Voluntary
participation in mechanism
The participation in the mechanism
required by subsection (a) of an individual otherwise participating in the
pilot program shall be at the election of the individual.
(c)
Inclusion of
information on mechanism in reports
Each report to Congress on
the pilot program after the date of the commencement of the
mechanism required by subsection (a) shall include information on the
mechanism, including a current assessment of the feasibility and advisability
of using the mechanism to include information on dental care furnished
to individuals in the electronic medical records of the Department with respect to
such individuals.