,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #hca  ,,9 ,,! ,,h\se ,,(            
,,repres5tatives  ,febru>y #f1 #bjbc,mr4
 ,coh5 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 = cov]age "u "p ,b ( ! ,m$ic>e  
program = m$ically necess>y d5tal       
proc$ures4  #a4 ,%ort title2 f9d+s  7a7 
,%ort ,title ,?is ,act may be cit$ z !  
,m$ic>e ,m$ically ,necess>y ,d5tal ,c>e 
,act ( #bjbc4  7b7 ,f9d+s ,congress f9ds
 ! foll[+3 7#a7 ,oral & g5]al heal?s are
 insep>able1 & good d5tal c>e is        
critical to our ov]all physical heal? & 
well-be+4  7#b7 ,a #aiii ,in/itute (    
,m$ic9e /udy f\nd t ! prev5tion &       
managem5t ( oral infection h significant
 heal? implications :5 su* infection has

 ! pot5tial to increase morbidity 9     
,m$ic>e pati5ts :o are at risk ( adv]se 
outcomes f und]ly+ heal? problems4  7#c7
 ,improv$ oral heal? c>e may r$uce      
mortality & morbidity rates ( ,m$ic>e   
pati5ts suff]+ f head & neck canc]1     
leukemia1 lymphoma1 organ               
transplantation1 & he>t valve disease4  
7#d7 ,! ,m$ic>e program1 f its          
inception1 has exclud$ cov]age = s]vices
 9 connection ) ! c>e1 treatm5t1 fill+1 
removal1 or replacem5t ( tee? or        
/ructures directly support+ ! tee?4     
7#e7 ,! ,c5t]s = ,m$ic>e  ,m$icaid      
,s]vices has approv$ cov]age exceptions 
= limit$ d5tal s]vices & propos$        
additional exceptions bas$ on ! argum5t 
t oral heal? s]vices w\ld r$uce ! risk (
 infection & o!r complications ( m$ical 
c>e4  7#f7 ,! ,in/itute ( ,m$ic9e /udy  
conclud$ t x is reasonable = ,congress  
to update ! /atutory language relat+ to 
cov]age ( d5tal s]vices = ,m$ic>e       
b5efici>ies s t x cle>ly cov]s d5tal c>e
 t is effective 9 prev5t+ or r$uc+ oral 

& sy/emic complications associat$ )     
s]i\s m$ical conditions & treatm5ts4    
#b4 ,m$ic>e cov]age ( m$ically necess>y 
d5tal proc$ures  7a7 ,9 g5]al ,section  
#ahfb ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #aciey7 is am5d$-- 7#a7 9     
subsection 7a77#ab7-- 7,a7 by ins]t+    
7,a7 aft] except t2 &  7,b7 by ins]t+   
be=e ! semicolon at ! end ! foll[+3 1 & 
7,b7 paym5t may be made "u "p ,b = !    
provision ( su* d5tal s]vices t are     
m$ically necess>y z a direct result (1  
or w h a direct impact on1 an und]ly+   
m$ical condition if ! cov]age ( su*     
s]vices is m$ically necess>y1 z det]m9$ 
"u subsection 7p72 &  7#b7 by add+ at ! 
end ! foll[+ new subsection3  7p7 ,=    
purposes ( subsection 7a77#ab77;,b71    
d5tal s]vices %all be consid]$ to be    
m$ically necess>y if furni%$-- 7#a7 9   
conjunction ) treatm5t ( an individual )
 a pro/hetic he>t valve replacem5t or a 
diagnosis ( canc] ( ! head or neck1     
lymphoma1 leukemia1 & organ             
transplantation2 &  7#b7 n lat] ?an "o  

ye> aft] ! lat] (-- 7,a7 ! date ( su*   
diagnosis2 or  7,b7 ! date ( ! relat$   
surgical or m$ical treatm5t = t         
diagnosis4  4  7b7 ,effective date ,!   
am5dm5ts made by subsection 7a7 %all    
apply to proc$ures p]=m$ on or aft]     
,janu>y #a1 #bjbd4