,,ii  #aah? ,,congress  #a/ ,session    
,s4 #bjab  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #ae1 #bjbc,mr4   
,c>d9 7= himself1 ,mr4 ,blum5?al1 ,mr4  
,m>key1 ,mr4 ,m]kley1 & ,mr4 ,br[n7     
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
provide = cov]age ( d5tal s]vices "u !  
,m$ic>e program4  #a4 ,%ort title ,?is  
,act may be cit$ z ! ,m$ic>e ,d5tal     
,b5efit ,act ( #bjbc4  #b4 ,cov]age (   
d5tal s]vices "u ! ,m$ic>e program  7a7 
,cov]age ,section #ahfa7s77#b7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7s77#b77 is am5d$-- 7#a7 9        
subp>agraph 7,,ii71 by /rik+ & at ! end2
  7#b7 9 subp>agraph 7,,jj71 by add+ &  
at ! end2 &  7#c7 by add+ at ! end !    
foll[+ new subp>agraph3  7,,kk7 d5tal & 
oral heal? s]vices 7z def9$ 9 subsection
 7nnn772  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  7nnn7 ,d5tal & oral ,heal? 
,s]vices ,! t]m d5tal & oral heal?      
s]vices means s]vices 7z def9$ by !     
,secret>y7 t are necess>y to prev5t     
disease & promote oral heal?1 re/ore    
oral /ructures to heal? & function1     
r$uce oral pa91 & treat em]g5cy         
conditions1 includ+-- 7#a7 r\t9e        
diagno/ic & prev5tive c>e su* z d5tal   
clean+s1 exams1 & x-rays2  7#b7 basic   
d5tal s]vices su* z fill+s &            
extractions2  7#c7 major d5tal s]vices  
su* z root canals1 cr[ns1 & d5tures2    
7#d7 em]g5cy d5tal c>e2 &  7#e7 o!r     
necess>y s]vices relat$ to d5tal & oral 
heal? 7z def9$ by ! ,secret>y74  4  7c7 
,cov]age ( r\t9e diagno/ic & prev5tive  
c>e z a prev5tive s]vice ,section       
#ahfa7;ddd77#c7 ( ! ,social ,security   
,act 7#db ,u4,s4,c4 #aciex7ddd77#c77 is 
am5d$ by add+ at ! end ! foll[+ new     
subp>agraph3  7,d7 ,d5tal & oral heal?  
s]vices describ$ 9 p>agraph 7#a7 (      
subsection 7nnn71 relat+ to r\t9e       

diagno/ic & prev5tive c>e4  4  7d7      
,paym5t2 co9surance2 & limitations  7#a7
 ,9 g5]al ,section #ahcc7;a77#a7 ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#aciel7a77#a77 is am5d$-- 7,a7 by /rik+ 
8&0 be=e 87,,hh702 &  7,b7 by ins]t+    
be=e ! semicolon at ! end ! foll[+3 8&  
7,,ii7 ) respect to d5tal & oral heal?  
s]vices 7z def9$ 9 section #ahfa7nnn71  
o!r ?an ^? s]vices describ$ 9 p>agraph  
7#a7 ( su* section71 ! am\nt paid %all  
be ! paym5t am\nt specifi$ "u section   
#ahcd7;aa7404  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  7aa7 ,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 
#ahfa7nnn71 o!r ?an ^? s]vices describ$ 
9 p>agraph 7#a7 ( su* section7 %all be1 
subject to p>agraph 7#c71 ! applicable  
p]c5tage 7specifi$ 9 p>agraph 7#b77 ( ! 
less] ( ! actual *>ge = ! s]vices or !  

am\nt det]m9$ "u ! paym5t basis det]m9$ 
"u section #ahdh4  7#b7 ,applicable     
p]c5tage  7,a7 ,9 g5]al ,= purposes (   
p>agraph 7#a71 subject to subp>agraph   
7,b71 ! applicable p]c5tage specifi$ 9  
?is p>agraph is-- 7i7 = ! fir/ ye>      
beg9n+ at lea/ #f mon?s aft] ! date ( ! 
enactm5t ( ?is subsection1 #j p]c5t2    
7ii7 = ! ye> foll[+ ! ye> specifi$ 9    
subp>agraph 7,a7 & ea* subsequ5t ye>    
?r\gh ! sev5? ye> foll[+ ! ye> specifi$ 
9 subp>agraph 7,a71 ! applicable p]c5t  
specifi$ 9 ?is p>agraph = ! previ\s ye> 
increas$ by #aj p]c5tage po9ts2 &  7iii7
 = ! eigh? ye> foll[+ ! ye> specifi$ 9  
subp>agraph 7,a7 & ea* subsequ5t ye>1   
#hj p]c5t4  7,b7 ,special rule = c]ta9  
l[-income individuals ,= purposes (     
p>agraph 7#a71 ) respect to d5tal & oral
 heal? s]vices describ$ 9 su* p>agraph t
 are furni%$ to an individual :o is a   
subsidy eligible individual 7z def9$ 9  
section #ahfj;,d-#ad7;a77#c771 or :o    
w\ld be a subsidy eligible individual if
 ! individual 7 enroll$ 9 a prescription

 drug plan or an ,,ma-,,pd plan "u "p   
,d1 = ! fir/ ye> beg9n+ at lea/ #f mon?s
 aft] ! date ( ! enactm5t ( ?is         
subsection & ea* subsequ5t ye>1 !       
applicable p]c5t specifi$ 9 ?is p>agraph
 is #hj p]c5t4  7#c7 ,limitations &     
,secret>ial au?ority  7,a7 ,frequ5cy ,) 
respect to d5tal & oral heal? s]vices t 
are-- 7i7 r\t9e d5tal clean+s1 paym5t   
may be made "u ?is "p = only two su*    
clean+s dur+ a #ab-mon? p]iod2 &  7ii7  
r\t9e exams1 paym5t may be made "u ?is  
"p = only two su* exams dur+ a #ab-mon? 
p]iod4  7,b7 ,secret>ial au?ority  7i7  
,au?ority to apply additional           
limitations ,! ,secret>y may apply su*  
o!r reasonable limitations on ! ext5t to
 :i* d5tal & oral s]vices are cov]$ "u  
?is "p1 includ+ ?r\gh application ( a   
prior au?orization requirem5t4  7ii7    
,au?ority to modify cov]age ,not)/&+ any
 o!r provision ( ?is title1 if !        
,secret>y det]m9es appropriate1 !       
,secret>y may modify ! cov]age "u ?is "p
 ( d5tal & oral heal? s]vices to ! ext5t

 t su* modification is consi/5t ) !     
recomm5dations ( ! ,unit$ ,/ates        
,prev5tive ,s]vices ,task ,=ce4  7iii7  
,au?ority to waive frequ5cy limitations 
,! ,secret>y may waive any frequ5cy     
limitation or o!r limitation z describ$ 
9 ?is p>agraph = an individual 7or      
category ( individuals7 z det]m9$       
appropriate by ! ,secret>y4  4  7e7     
,paym5t "u physician fee s*$ule ,section
 #ahdh7;j77#c7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciew-#d7;j77#c77  
is am5d$ by /rik+ risk assessm5t7 1 &   
ins]t+ risk assessm5t71 7#b77,,kk714    
7f7 ,d5tal pro/heses  7#a7 ,9 g5]al     
,section #ahfa7s77#h7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciex7s77#h77 is am5d$-- 7,a7 by /rik+ 
7o!r ?an d5tal7 & ins]t+ 7includ+       
d5tal72 &  7,b7 by /rik+ int]nal body4  
7#b7 ,special paym5t rules ,section     
#ahcd7;a7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #aciem7a77 is am5d$ by   
add+ at ! end ! foll[+ new p>agraph3    
7#bc7 ,paym5t & limits = d5tal pro/heses

  7,a7 ,9 g5]al ,! paym5t am\nt "u ?is  
"p = d5tal pro/heses %all be1 subject to
 subp>agraph 7,c71 ! applicable p]c5t   
7specifi$ 9 subp>agraph 7,b77 ( ! am\nt 
o!rwise payable = su* d5tal pro/heses "u
 ?is section4  7,b7 ,applicable p]c5t   
7i7 ,9 g5]al ,= purposes ( subp>agraph  
7,a71 subject to clause 7ii71 !         
applicable p]c5t specifi$ 9 ?is         
subp>agraph is-- 7,i7 = ! fir/ ye>      
beg9n+ at lea/ #f mon?s aft] ! date ( ! 
enactm5t ( ?is p>agraph1 #j p]c5t2      
7,,ii7 = ! ye> foll[+ ! ye> specifi$ 9  
clause 7i7 & ea* subsequ5t ye> ?r\gh !  
sev5? ye> foll[+ ! ye> specifi$ 9 clause
 7i71 ! applicable p]c5t specifi$ 9 ?is 
subp>agraph = ! previ\s ye> increas$ by 
#aj p]c5tage po9ts2 &  7,,iii7 = ! eigh?
 ye> foll[+ ! ye> specifi$ 9 clause 7i7 
& ea* subsequ5t ye>1 #hj p]c5t4  7ii7   
,special rule = c]ta9 l[-income         
individuals ,= purposes ( subp>agraph   
7,a71 ) respect to d5tal pro/heses      
furni%$ to an individual :o is a subsidy
 eligible individual 7z def9$ 9 section 

#ahfj;,d-#ad7;a77#c771 or :o w\ld be a  
subsidy eligible individual if !        
individual 7 enroll$ 9 a prescription   
drug plan or an ,,ma-,,pd plan "u "p ,d1
 = ! fir/ ye> beg9n+ at lea/ #f mon?s   
aft] ! date ( ! enactm5t ( ?is p>agraph 
& ea* subsequ5t ye>1 ! applicable p]c5t 
specifi$ 9 ?is subp>agraph is #hj p]c5t4
  7,c7 ,limitations & ,secret>ial       
au?ority  7i7 ,9 g5]al ,paym5t may be   
made "u ?is "p = an individual =-- 7,i7 
n m ?an "o full upp] & "o full l[] d5tal
 pro/heses once e five ye>s2 &  7,,ii7 n
 m ?an "o p>tial upp] d5tal pro/heses & 
"o p>tial l[] d5tal pro/heses once e    
five ye>s4  7ii7 ,secret>ial au?ority   
7,i7 ,au?ority to apply additional      
limitations ,! ,secret>y may apply su*  
o!r reasonable limitations on ! ext5t to
 :i* d5tal pro/heses are cov]$ "u ?is   
"p1 includ+ ?r\gh application ( a prior 
au?orization requirem5t4  7,,ii7        
,au?ority to modify cov]age ,not)/&+ any
 o!r provision ( ?is title1 if !        
,secret>y det]m9es appropriate1 !       

,secret>y may modify ! cov]age "u ?is "p
 ( d5tal pro/heses to ! ext5t t su*     
modification is consi/5t ) !            
recomm5dations ( ! ,unit$ ,/ates        
,prev5tive ,s]vices ,task ,=ce4  7,,iii7
 ,au?ority to waive frequ5cy limitations
 ,! ,secret>y may waive any frequ5cy    
limitation or o!r limitation z describ$ 
9 ?is subp>agraph = an individual 7or   
category ( individuals7 z det]m9$       
appropriate by ! ,secret>y  4  7g7      
,repeal ( gr\nd = exclusion ,section    
#ahfb7;a7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #aciey7 is am5d$ by /rik+
 p>agraph 7#ab74  7h7 ,effective date ,!
 am5dm5ts made by ?is section %all apply
 to s]vices furni%$ on or aft] ,janu>y  
#a1 #bjbe4  #c4 ,increas$ ,,fmap =      
additional exp5ditures = m$ic>e co/-%>+ 
= d5tal & oral heal? s]vices ,section   
#aije ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acif;d7 is am5d$-- 7#a7 9    
subsection 7b71 by /rik+ & 7ii7 & ins]t+
 7ii71 & 7jj72 &  7#b7 by add+ at ! end 
! foll[+ new subsection3  7jj7 ,increas$

 ,,fmap = additional exp5ditures =      
m$ic>e co/-,%>+ = d5tal & oral heal?    
s]vices ,not)/&+ subsection 7b71 )      
respect to ! portion ( ! am\nts exp5d$  
by a ,/ate = m$ical assi/ance = m$ic>e  
co/-%>+ 7z def9$ 9 subsection 7p77#c77 =
 qualifi$ m$ic>e b5efici>ies describ$ 9 
subsection 7p77#a7 t is attributable to 
! cov]age "u "p ,b ( title ,,xviii (    
d5tal & oral heal? s]vices 7z def9$ 9   
section #ahfa7nnn771 z det]m9$ by !     
,secret>y1 ! ,f$]al m$ical assi/ance    
p]c5tage = a ,/ate t is "o ( ! #ej      
,/ates or ! ,di/rict ( ,columbia %all be
 equal to #ajj p]c5t4  4  #d4 ,prev5tive
 ,s]vices ,task=ce  7a7 ,9 g5]al        
,section #iae7;a77#a7 ( ! ,public ,heal?
 ,s]vice ,act 7#db ,u4,s4,c4            
#bii;b-#d7;a77#a77 is am5d$1 9 ! fir/   
s5t5ce1 by ins]t+ 1 includ+ at lea/ #a  
oral heal? pr(essional aft] exp]tise4   
7b7 ,effective date ,! am5dm5t made by  
subsection 7a7 %all take effect ,janu>y 
#a1 #bjbe4