,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #dfej  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,july #bb1 #bjba ,ms4 
,kelly ( ,ill9ois 7= h]self1 ,mr4       
,hors=d1 ,mr4 ,butt]field1 ,mr4 ,payne1 
& ,mr4 ,wel*7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce1 & 9 addition to ! ,committee 
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
provide = d5tal & oral heal? c>e b5efits
 "u ! ,m$ic>e program4  #a4 ,%ort title 
,?is ,act may be cit$ z ! ,m$ic>e ,d5tal
 ,cov]age ,act ( #bjba4  #b4 ,d5tal &   
oral heal? c>e  7a7 ,cov]age ,section   
#ahfa7s77#b7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #aciex7s77#b77 is am5d$--
  7#a7 9 subp>agraph 7,,gg71 by /rik+ & 
aft] ! semicolon at ! end2  7#b7 9      
subp>agraph 7,,hh71 by /rik+ ! p]iod at 
! end & add+ 2 &2 &  7#c7 by add+ at !  

end ! foll[+ new subp>agraph3  7,,ii7   
d5tal & oral heal? s]vices 7z def9$ 9   
subsection 7lll772  4  7b7 ,d5tal & oral
 heal? s]vices def9$ ,section #ahfa ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7 is am5d$ by add+ at ! end !     
foll[+ new subsection3  7lll7 ,d5tal &  
oral heal? s]vices  7#a7 ,9 g5]al ,! t]m
 d5tal & oral heal? s]vices means items 
& s]vices 7o!r ?an su* items & s]vices =
 :i* paym5t may be made "u "p ,a z      
inpati5t hospital s]vices7 t are furni%$
 dur+ #bjbe or a subsequ5t ye>1 = :i*   
cov]age 0 n provid$ "u "p ,b z ( ! date 
( ! enactm5t ( ?is subsection1 & t are--
  7,a7 ! prev5tive & scre5+ s]vices     
describ$ 9 p>agraph 7#b7 furni%$ by a   
doctor ( d5tal surg]y or ( d5tal m$ic9e 
7z describ$ 9 subsection 7r77#b77 or an 
oral heal? pr(essional 7z def9$ 9       
p>agraph 7#d772 or  7,b7 ! basic        
treatm5ts specifi$ = su* ye> by !       
,secret>y pursuant to p>agraph 7#c77;,a7
 & ! major treatm5ts specifi$ = su* ye> 
by ! ,secret>y pursuant to p>agraph     

7#c77;,b7 furni%$ by su* a doctor or su*
 a pr(essional4  7#b7 ,prev5tive &      
scre5+ s]vices ,! prev5tive & scre5+    
s]vices describ$ 9 ?is p>agraph are !   
foll[+3 7,a7 ,oral exams4  7,b7 ,d5tal  
clean+s4  7,c7 ,d5tal x-rays p]=m$ 9 !  
(fice ( a doctor or pr(essional describ$
 9 p>agraph 7#a77;,a74  7,d7 ,fluoride  
treatm5ts4  7#c7 ,basic & major         
treatm5ts ,= #bjbe & ea* subsequ5t ye>1 
! ,secret>y %all specify--  7,a7 basic  
treatm5ts 7:i* may include basic too?   
re/orations1 basic p]iodontic s]vices1  
too? extractions1 & oral disease        
managem5t s]vices72 &  7,b7 major       
treatm5ts 7:i* may include major too?   
re/orations1 major p]iodontic s]vices1  
bridges1 cr[ns1 & root canals72  t %all 
be includ$ z d5tal & oral heal? s]vices 
= su* ye>4  7#d7 ,oral heal? pr(essional
 ,! t]m oral heal? pr(essional means1 ) 
respect to d5tal & oral heal? s]vices1 a
 heal? pr(essional :o is lic5s$ to      
furni% su* s]vices1 act+ )9 ! scope (   
su* lic5se1 by ! ,/ate 9 :i* su* s]vices

 are furni%$4  4  7c7 ,paym5t2          
co9surance2 & limitations  7#a7 ,9 g5]al
 ,section #ahcc7;a77#a7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#aciel7a77#a77 is am5d$--  7,a7 9       
subp>agraph 7,n71 by ins]t+ & d5tal &   
oral heal? s]vices 7z def9$ 9 section   
#ahfa7lll77 aft] section                
#ahfa7;hhh77#a772  7,b7 by /rik+ & be=e 
7,,dd72 &  7,c7 by ins]t+ be=e !        
semicolon at ! end ! foll[+3 1 & 7,,ee7 
) respect to d5tal & oral heal? s]vices 
7z def9$ 9 section #ahfa7lll771 ! am\nt 
paid %all be ! paym5t am\nt specifi$ "u 
section #ahcd7z74  7#b7 ,paym5t & limits
 specifi$ ,section #ahcd ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #aciem7 is
 am5d$ by add+ at ! end ! foll[+ new    
subsection3  7z7 ,paym5t & limits =     
d5tal & oral heal? s]vices  7#a7 ,9     
g5]al ,! paym5t am\nt "u ?is "p = d5tal 
& oral heal? s]vices 7z def9$ 9 section 
#ahfa7lll77 %all be1 subject to p>agraph
 7#c71 ! applicable p]c5t 7specifi$ 9   
p>agraph 7#b77 ( ! less] ( ! actual *>ge

 = ! s]vices or ! am\nt det]m9$ "u !    
paym5t basis det]m9$ "u section #ahdh4  
,9 det]m9+ su* am\nts det]m9$ "u su*    
paym5t basis1 ! ,secret>y %all consid]  
paym5t rates paid to d5ti/s = comp>able 
s]vices "u ,/ate plans "u title ,,xix1  
"u ! ,,tric>e program "u *apt] #ee (    
title #aj ( ! ,unit$ ,/ates ,code1 & by 
o!r heal? c>e pay]s1 su* z ,m$ic>e      
,advantage plans "u "p ,c4  7#b7        
,applicable p]c5t ,= purposes ( p>agraph
 7#a71 ! applicable p]c5t specifi$ 9 ?is
 p>agraph is1 ) respect to d5tal & oral 
heal? s]vices 7z def9$ 9 section        
#ahfa7lll77 furni%$ 9 a ye>--  7,a7 t   
are prev5tive & scre5+ s]vices describ$ 
9 p>agraph 7#b7 or basic treatm5ts      
specifi$ = su* ye> pursuant to p>agraph 
7#c77;,a7 ( su* section1 #hj p]c5t2 &   
7,b7 t are major treatm5ts specifi$ =   
su* ye> pursuant to p>agraph 7#c77;,b7 (
 su* section--  7i7 9 ! case su* s]vices
 are furni%$ dur+ #bjbe1 #aj p]c5t2     
7ii7 9 ! case su* s]vices are furni%$   
dur+ #bjbf or a subsequ5t ye> be=e      

#bjbi1 ! applicable p]c5t specifi$ "u   
?is subp>agraph = ! previ\s ye>1        
increas$ by #aj p]c5tage po9ts2 &  7iii7
 9 ! case su* s]vices are furni%$ dur+  
#bjbi or a subsequ5t ye>1 #ej p]c5t4    
7#c7 ,limitations ,) respect to d5tal & 
oral heal? s]vices t are--  7,a7        
prev5tive & scre5+ oral exams1 paym5t   
may be made "u ?is "p = n m ?an two su* 
exams dur+ a #ab-mon? p]iod2  7,b7 d5tal
 clean+s1 paym5t may be made "u ?is "p =
 n m ?an two su* clean+s dur+ a #ab-mon?
 p]iod2 &  7,c7 n describ$ 9 subp>agraph
 7,a7 or 7,b71 paym5t may be made "u ?is
 "p only at su* frequ5cies & "u su*     
circum/ances det]m9$ appropriate by !   
,secret>y4  4  7d7 ,paym5t "u physician 
fee s*$ule  7#a7 ,9 g5]al ,section      
#ahdh7;j77#c7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciew-#d7;j77#c77 is   
am5d$ by ins]t+ 7#b77;,,ii71 be=e 7#c74 
7#b7 ,exclusion f ,,mips ,section       
#ahdh7q77#a77;,c77ii7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7q77#a77;,c77ii77 is am5d$--   

7,a7 9 subclause 7,,ii71 by /rik+ or at 
! end2  7,b7 9 subclause 7,,iii71 by    
/rik+ ! p]iod at ! end & ins]t+ 2 or2 & 
7,c7 by add+ at ! end ! foll[+ new      
subclause3  7,,iv7 ) respect to #bjbe & 
ea* subsequ5t ye>1 is a doctor ( d5tal  
surg]y or ( d5tal m$ic9e 7z describ$ 9  
section #ahfa7r77#b77 or is an oral     
heal? pr(essional 7z def9$ 9 section    
#ahfa7lll77#d774  4  7#c7 ,inclusion (  
oral heal? pr(essionals z c]ta9         
practition]s ,section                   
#ahdb7;b77#ah77;,c7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#acieu7b77#ah77;,c77 is am5d$ by add+ at
 ! end ! foll[+ new clause3  7vii7 ,)   
respect to #bjbe & ea* subsequ5t ye>1 an
 oral heal? pr(essional 7z def9$ 9      
section #ahfa7lll77#d774  4  7e7        
,d5tures  7#a7 ,9 g5]al ,section        
#ahfa7s77#h7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #aciex7s77#h77 is am5d$--
  7,a7 by /rik+ 7o!r ?an d5tal72 &  7,b7
 by ins]t+ & exclud+ d5tal1 except = a  
full or p>tial set ( d5tures furni%$ on 

or aft] ,janu>y #a1 #bjbe aft] colo/omy 
c>e4  7#b7 ,special paym5t rules  7,a7  
,limitations ,section #ahcd7;h7 ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#aciem7h77 is am5d$ by add+ at ! end !  
foll[+ new p>agraph3  7#f7 ,special     
paym5t rule = d5tures ,paym5t may be    
made "u ?is "p ) respect to an          
individual = d5tures--  7,a7 n m ?an    
once dur+ any #e-ye> p]iod 7except 9 !  
case t a doctor or pr(essional describ$ 
9 section #ahfa7lll77#a77;,a7 det]m9es  
su* d5tures d n fit ! individual72 &    
7,b7 only to ! ext5t t su* d5tures are  
furni%$ pursuant to a writt5 ord] ( su* 
a doctor or pr(essional4  4  7,b7       
,application ( competitive acquisition  
7i7 ,9 g5]al ,section #ahcd7;h77#a77;,h7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #aciem7h77#a77;,h77 is am5d$--
 7,i7 9 ! subp>agraph head+1 by ins]t+ 1
 d5tures aft] or?otics2  7,,ii7 by      
ins]t+ 1 ( d5tures describ$ 9 p>agraph  
7#b77;,d7 ( su* section1 aft] #bjaa12 & 
7,,iii7 9 clause 7i71 by ins]t+ 1 su*   

d5tures aft] or?otics4  7ii7 ,con=m+    
am5dm5t ,section #ahdg7;a77#b7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#c7;a77#b77 is am5d$ by add+ at !
 end ! foll[+ new subp>agraph3  7,d7    
,d5tures ,d5tures describ$ 9 section    
#ahfa7s77#h7 = :i* paym5t w\ld o!rwise  
be made "u section #ahcd7;h74  4  7iii7 
,exemption ( c]ta9 items f competitive  
acquisition ,section #ahdg7;a77#g7 ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#c7;a77#g77 is am5d$ by add+ at !
 end ! foll[+ new subp>agraph3  7,c7    
,c]ta9 d5tures ,^? items & s]vices      
describ$ 9 p>agraph 7#b77;,d7 if furni%$
 by a physician or o!r practition] 7z   
def9$ by ! ,secret>y7 to ! physician's  
or practition]'s own pati5ts z "p ( !   
physician's or practition]'s pr(essional
 s]vice4  4  7f7 ,exclusion             
modifications ,section #ahfb7;a7 ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#aciey7a77 is am5d$-- 7#a7 9 p>agraph   
7#a7--  7,a7 9 subp>agraph 7,o71 by     
/rik+ & at ! end2  7,b7 9 subp>agraph   

7,p71 by /rik+ ! semicolon at ! end &   
ins]t+ 1 &2 &  7,c7 by add+ at ! end !  
foll[+ new subp>agraph3  7,q7 9 ! case (
 d5tal & oral heal? s]vices 7z def9$ 9  
section #ahfa7lll77 t are prev5tive &   
scre5+ s]vices describ$ 9 p>agraph 7#b7 
( su* section1 :i* are furni%$ m        
frequ5tly ?an provid$ "u section        
#ahcd7z77#c7 & "u circum/ances o!r ?an  
circum/ances det]m9$ appropriate "u su* 
section2  2 &  7#b7 9 p>agraph 7#ab71 by
 ins]t+ be=e ! semicolon at ! end !     
foll[+3 & except t paym5t may be made "u
 "p ,b = d5tal & oral heal? s]vices t   
are cov]$ "u section                    
#ahfa7s77#b77;,,ii74  7g7 ,c]ta9        
non-,application  7#a7 ,9 g5]al         
,p>agraphs 7#a7 & 7#d7 ( section        
#ahci7;a7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acier7a77 are am5d$ by  
add+ at ! end ( ea* su* p>agraphs !     
foll[+3 ,9 apply+ ?is p>agraph !re %all 
n be tak5 into acc\nt b5efits &         
adm9i/rative co/s attributable to !     
am5dm5ts made by section #b 7o!r ?an    

subsection 7g77 ( ! ,m$ic>e ,d5tal      
,cov]age ,act ( #bjba & ! ,gov]nm5t     
contribution "u section #ahdd7;a77#e744 
7#b7 ,paym5t ,section #ahdd7;a7 ( su*   
,act 7#db ,u4,s4,c4 #aciew7a77 is       
am5d$-- 7,a7 9 p>agraph 7#d71 by /rik+ !
 p]iod at ! end & ins]t+ 2 plus2 &  7,b7
 by add+ at ! end ! foll[+ new p>agraph3
  7#e7 a ,gov]nm5t contribution equal to
 ! am\nt t is e/imat$ to be payable =   
b5efits & relat$ adm9i/rative co/s      
incurr$ t are attributable to ! am5dm5ts
 made by section #b 7o!r ?an subsection 
7g77 ( ! ,m$ic>e ,d5tal ,cov]age ,act ( 
#bjba4  4  7h7 ,implem5tation fund+     
7#a7 ,9 g5]al ,! ,secret>y ( ,heal? &   
,human ,s]vices 79 ?is subsection ref]r$
 to z ! ,secret>y7 %all provide = !     
transf] f ! ,f$]al ,supplem5t>y ,m$ical 
,insurance ,tru/ ,fund "u section #ahda 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #aciet7 to ! ,c5t]s = ,m$ic>e 
,m$icaid ,s]vices ,program ,managem5t   
,acc\nt (-- 7,a7 #bj1jjj1jjj = ea* (    
fiscal ye>s #bjbb ?r\gh #bjbg = purposes

 ( implem5t+ ! am5dm5ts made by ?is     
section2 &  7,b7 su* sums z det]m9$     
appropriate by ! ,secret>y = ea*        
subsequ5t fiscal ye> = purposes (       
adm9i/]+ ! provisions ( su* am5dm5ts4   
7#b7 ,availability ,funds transf]r$     
pursuant to p>agraph 7#a7 %all rema9    
available until exp5d$4