,,ii  #aah? ,,congress  #a/ ,session    
,s4 #hdb  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,m>* #af1 #bjbc,mr4    
,casey 7= himself1 ,mr4 ,c>d91 ,mr4     
,br[n1 ,mr4 ,blum5?al1 ,mr4 ,fett]man1 &
 ,mr4 ,wel*7 introduc$ ! foll[+ bill2   
:i* 0 read twice & ref]r$ to !          
,committee on ,f9ance  ,a ,,bill  ,to   
am5d titles ,,xviii & ,,xix ( ! ,social 
,security ,act to provide = cov]age (   
d5tal & oral heal? s]vices1 vision      
s]vices1 & he>+ s]vices "u ! ,m$ic>e &  
,m$icaid programs4  #a4 ,%ort title ,?is
 ,act may be cit$ z ! ,m$ic>e & ,m$icaid
 ,d5tal1 ,vision1 & ,he>+ ,b5efit ,act (
 #bjbc4  #b4 ,d5tal & oral heal? s]vices
 "u ,m$ic>e  7a7 ,cov]age ,section      
#ahfa7s77#b7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #aciex7s77#b77 is am5d$--
 7#a7 9 subp>agraph 7,,ii71 by /rik+ &  
aft] ! semicolon at ! end2  7#b7 9      
subp>agraph 7,,jj71 by add+ & aft] !    
semicolon 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-- 7#a7 r\t9e   
d5tal clean+s & exams2  7#b7 basic d5tal
 s]vices1 su* z fill+s & cr[ns2  7#c7   
major d5tal s]vices1 su* z root canals1 
& extractions2  7#d7 em]g5cy d5tal c>e2 
&  7#e7 o!r necess>y s]vices relat$ to  
d5tal or oral heal? 7z def9$ by !       
,secret>y74  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$-- 7,a7 by /rik+ & be=e 7,,hh72 &  
7,b7 by ins]t+ be=e ! semicolon at ! end
 ! foll[+3 1 & 7,,ii7 ) respect to d5tal
 & oral heal? s]vices 7z def9$ 9 section
 #ahfa7nnn771 ! am\nt paid %all be !    
paym5t am\nt specifi$ "u section        
#ahcd7;aa74  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 
#ahfa7nnn77 %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  
7#b7 ,applicable p]c5t ,= purposes (    
p>agraph 7#a71 ! applicable p]c5t       
specifi$ 9 ?is p>agraph is-- 7,a7 = !   
fir/ ye> beg9n+ at lea/ #f mon?s aft] ! 
date ( ! enactm5t ( ?is subsection1 #j  
p]c5t2  7,b7 = ! 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 &  7,c7 = ! eigh? ye>   
foll[+ ! ye> specifi$ 9 subp>agraph 7,a7
 & ea* subsequ5t ye>1 #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  4  7d7 
,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 ins]t+ 7#b77,,kk71 be=e     
7#c74  7e7 ,d5tures  7#a7 ,9 g5]al      
,section #ahfa7s77#h7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciex7s77#h77 is am5d$-- 7,a7 by /rik+ 
7o!r ?an d5tal7 & ins]t+ 7includ+       
d5tures72 &  7,b7 by /rik+ int]nal body4
  7#b7 ,special paym5t rules ,section   
#ahcd7;a7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #aciem7a77 is am5d$ by   
add+ at ! end ! foll[+ new p>agraph3    
7#bc7 ,paym5t & limits = d5tures  7,a7  
,9 g5]al ,! paym5t am\nt "u ?is "p =    
d5tures %all be1 subject to subp>agraph 
7,c71 ! applicable p]c5t 7specifi$ 9    
subp>agraph 7,b77 ( ! am\nt o!rwise     
payable = su* d5tures "u ?is section4   
7,b7 ,applicable p]c5t ,= purposes (    
subp>agraph 7,a71 ! applicable p]c5t    
specifi$ 9 ?is subp>agraph is-- 7i7 = ! 
fir/ ye> beg9n+ at lea/ #f mon?s aft] ! 
date ( ! enactm5t ( ?is p>agraph1 #j    
p]c5t2  7ii7 = ! 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 &  7iii7 = ! eigh? ye> foll[+ !  
ye> specifi$ 9 clause 7i7 & ea*         
subsequ5t ye>1 #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[] d5ture once e five  
ye>s2 &  7,,ii7 n m ?an "o p>tial upp]  
d5ture & "o p>tial l[] d5ture 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* d5tures 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
 ( d5tures to ! ext5t t su* modification

 is consi/5t ) ! recomm5dations ( !     
,unit$ ,/ates ,prev5tive ,s]vices ,task 
,=ce4  4  7f7 ,repeal ( gr\nd =         
exclusion ,section #ahfb7;a7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4 #aciey7  
is am5d$ by /rik+ p>agraph 7#ab74  7g7  
,effective date ,! am5dm5ts made by ?is 
section %all apply to s]vices furni%$ on
 or aft] ,janu>y #a ( ! fir/ ye> beg9n+ 
at lea/ six mon?s aft] ! date ( !       
enactm5t ( ?is ,act4  #c4 ,vision       
s]vices "u ,m$ic>e  7a7 ,cov]age        
,section #ahfa7s77#b7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4           
#aciex7s77#b771 z am5d$ by section      
#b7;a71 is am5d$-- 7#a7 9 subp>agraph   
7,,jj71 by /rik+ & aft] ! semicolon at !
 end2  7#b7 9 subp>agraph 7,,kk71 by    
add+ & aft] ! semicolon at ! end2 &     
7#c7 by add+ at ! end ! foll[+ new      
subp>agraph3  7,,ll7 vision s]vices 7z  
def9$ 9 subsection 7mmm772  4  7b7      
,vision s]vices def9$ ,section #ahfa ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciex71 z am5d$ by section #b7;b71 is  

am5d$ by add+ at ! end ! foll[+ new     
subsection3  7ooo7 ,vision ,s]vices ,!  
t]m vision s]vices means-- 7#a7 r\t9e   
eye exam9ations & proc$ures p]=m$ 7dur+ 
! c\rse ( any eye exam9ation7 to det]m9e
 ! refractive /ate ( ! eyes2 &  7#b7 o!r
 necess>y s]vices relat$ to eye & vision
 heal? 7z def9$ by ! ,secret>y74  4  7c7
 ,paym5t2 co9surance2 & limitations     
7#a7 ,9 g5]al ,section #ahcc7;a77#a7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciel7a77#a771 z am5d$ by section      
#b7;c77#a71 is am5d$-- 7,a7 by /rik+ &  
be=e 7,,ii72 &  7,b7 by ins]t+ be=e !   
semicolon at ! end ! foll[+3 1 & 7,,jj7 
) respect to vision s]vices 7z def9$ 9  
section #ahfa7mmm771 ! am\nt paid %all  
be ! paym5t am\nt specifi$ "u section   
#ahcd7;bb74  7#b7 ,paym5t & limits      
specifi$ ,section #ahcd ( ! ,social     
,security ,act 7#db ,u4,s4,c4 #aciem71 z
 am5d$ by section #b7;c77#b71 is am5d$  
by add+ at ! end ! foll[+ new           
subsection3  7bb7 ,paym5t & limits =    
vision s]vices  7#a7 ,9 g5]al ,! paym5t 

am\nt "u ?is "p = vision s]vices 7z     
def9$ 9 section #ahfa7mmm77 %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  7#b7 ,applicable     
p]c5t ,= purposes ( p>agraph 7#a71 !    
applicable p]c5t specifi$ 9 ?is p>agraph
 is-- 7,a7 = ! fir/ ye> beg9n+ at lea/  
#f mon?s aft] ! date ( ! enactm5t ( ?is 
subsection1 #j p]c5t2  7,b7 = ! 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 &  7,c7 = ! eigh? ye>  
foll[+ ! ye> specifi$ 9 subp>agraph 7,a7
 & ea* subsequ5t ye>1 #hj p]c5t4  7#c7  
,limitations & ,secret>ial au?ority     
7,a7 ,frequ5cy ,) respect to r\t9e eye  
exams1 paym5t may be made "u ?is "p =   
only "o su* exam dur+ a #ab-mon? p]iod4 
7,b7 ,secret>ial au?ority  7i7 ,au?ority

 to apply additional limitations ,!     
,secret>y may apply o!r reasonable      
limitations on ! ext5t to :i* vision    
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 ( vision s]vices to ! 
ext5t t su* modification is consi/5t ) !
 recomm5dations ( ! ,unit$ ,/ates       
,prev5tive ,s]vices ,task ,=ce4  4  7d7 
,paym5t "u physician fee s*$ule ,section
 #ahdh7;j77#c7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #aciew-#d7;j77#c771 
z am5d$ by section #b7;d71 is am5d$ by  
ins]t+ 7#b77,,ll71 aft] 7#b77,,kk714    
7e7 ,special paym5t rules = eyeglasses1 
contact l5ses1 & l[ vision devices      
,section #ahcd7;a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciem7a771 z am5d$
 by section #b7;e77#b71 is am5d$ by add+
 at ! end ! foll[+ new p>agraphs3  7#bd7
 ,paym5t & limits = eyeglasses & contact

 l5ses  7,a7 ,9 g5]al ,! paym5t am\nt "u
 ?is "p = eyeglass l5ses1 eyeglass      
frames1 & contact l5ses %all be1 subject
 to subp>agraph 7,c71 ! applicable p]c5t
 7specifi$ 9 subp>agraph 7,b77 ( ! am\nt
 o!rwise payable = su* eyeglass l5ses1  
eyeglass frames1 & contact l5ses1       
respectively1 "u ?is section4  7,b7     
,applicable p]c5t ,= purposes (         
subp>agraph 7,a71 ! applicable p]c5t    
specifi$ 9 ?is subp>agraph is-- 7i7 = ! 
fir/ ye> beg9n+ at lea/ #f mon?s aft] ! 
date ( ! enactm5t ( ?is p>agraph1 #j    
p]c5t2  7ii7 = ! 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 &  7iii7 = ! eigh? ye> foll[+ !  
ye> specifi$ 9 clause 7i7 & ea*         
subsequ5t ye>1 #hj p]c5t4  7,c7         
,limitations & ,secret>ial au?ority  7i7
 ,9 g5]al ,paym5t may be made "u ?is "p 
7o!r ?an = eyewe> describ$ 9 section    

#ahfa7s77#h77 = an individual =-- 7,i7 n
 m ?an "o pair ( eyeglass l5ses dur+ any
 #ab-mon? p]iod2  7,,ii7 n m ?an "o set 
( eyeglass frames dur+ any #bd-mon?     
p]iod2 &  7,,iii7 contact l5ses1 only to
 ! ext5t t ! sum ( su* paym5ts = contact
 l5ses does n exce$ a limitation ( #bjj 
dur+ any #bd-mon? p]iod beg9n+ dur+ !   
fir/ ye> beg9n+ at lea/ six mon?s aft] !
 date ( ! enactm5t ( ?is p>agraph 7or1  
beg9n+ dur+ a subsequ5t ye>1 su*        
limitation = a #bd-mon? p]iod beg9n+ 9 !
 previ\s ye> increase by an appropriate 
inflation adju/m5t specifi$ by !        
,secret>y74  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* eyeglass l5ses1 eyeglass frames1 & 
contact l5ses 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
 ( eyeglass l5ses1 eyeglass frames1 &   
contact l5ses to ! ext5t t su*          
modification is consi/5t ) !            
recomm5dations ( ! ,unit$ ,/ates        
,prev5tive ,s]vices ,task ,=ce4  7#be7  
,paym5t & limits = l[ vision devices    
7,a7 ,9 g5]al ,! paym5t am\nt "u ?is "p 
= l[ vision devices %all be1 subject to 
subp>agraph 7,c71 ! applicable p]c5t    
7specifi$ 9 subp>agraph 7,b77 ( ! am\nt 
o!rwise payable = l[ vision devices "u  
?is section4  7,b7 ,applicable p]c5t ,= 
purposes ( subp>agraph 7,a71 !          
applicable p]c5t specifi$ 9 ?is         
subp>agraph is-- 7i7 = ! fir/ ye> beg9n+
 at lea/ #f mon?s aft] ! date ( !       
enactm5t ( ?is p>agraph1 #j p]c5t2  7ii7
 = ! 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 &  7iii7 = ! eigh?  
ye> foll[+ ! ye> specifi$ 9 clause 7i7 &

 ea* subsequ5t ye>1 #hj p]c5t4  7,c7    
,secret>ial au?ority  7i7 ,au?ority to  
apply limitations ,! ,secret>y may apply
 reasonable limitations on ! ext5t to   
:i* l[ vision devices 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 ( l[ vision  
devices to ! ext5t t su* modification is
 consi/5t ) ! recomm5dations ( ! ,unit$ 
,/ates ,prev5tive ,s]vices ,task ,=ce4  
7,d7 ,l[ vision device def9$ ,9 ?is     
p>agraph1 ! t]m l[ vision device means a
 device1 prescrib$ by a physician1 t    
magnifies1 enhances1 or o!rwise augm5ts 
or int]prets visual images irrespective 
( ! size1 =m1 or te*nological features (
 su* device & does n include ord9>y     
eyeglasses or contact l5ses4 ,9 !       
previ\s s5t5ce1 ! t]m ord9>y eyeglasses 
or contact l5ses means l5ses t are      
int5d$ to fully correct visual acuity or

 fully elim9ate refractive error4  4    
7f7 ,def9ition ( durable m$ical equipm5t
 ,to include eyeglasses1 contact l5ses1 
& l[ vision devices ,section #ahfa7n7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#aciex7n77 is am5d$-- 7#a7 by /rik+ &   
be=e eye track+ & ins]t+ a comma2 &     
7#b7 by ins]t+ 1 & eyeglass l5ses1 l[   
vision devices 7z def9$ 9 section       
#ahcd7;a77#be771 eyeglass frames1 &     
contact l5ses be=e 2 except4  7g7       
,repeal ( gr\nd = exclusion ,section    
#ahfb7;a77#g7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciey7a77#g77 is am5d$ 
by /rik+ 1 eyeglasses 7o!r ?an eyewe>   
describ$ 9 section #ahfa7s77#h77 or eye 
exam9ations = ! purpose ( prescrib+1    
fitt+1 or *ang+ eyeglasses1 proc$ures   
p]=m$ 7dur+ ! c\rse ( any eye           
exam9ation7 to det]m9e ! refractive /ate
 ( ! eyes4  7h7 ,effective date ,!      
am5dm5ts made by ?is section %all apply 
to s]vices furni%$ on or aft] ,janu>y #a
 ( ! fir/ ye> beg9n+ at lea/ six mon?s  
aft] ! date ( ! enactm5t ( ?is ,act4    

#d4 ,he>+ s]vices "u ,m$ic>e  7a7       
,cov]age  7#a7 ,9 g5]al ,section        
#ahfa7s77#b7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #aciex7s77#b771 z am5d$  
by sections #b7;a7 & #c7;a71 is am5d$-- 
7,a7 9 subp>agraph 7,,kk71 by /rik+ &   
aft] ! semicolon at ! end2  7,b7 9      
subp>agraph 7,,ll71 by ins]t+ & aft] !  
semicolon at ! end2 &  7,c7 by add+ at !
 end ! foll[+ new subp>agraph3  7,,mm7  
audiology s]vices 7z def9$ 9 subsection 
7ll77#c77 & he>+ s]vices 7z def9$ 9     
subsection 7ll77#e772  4  7#b7 ,he>+    
s]vices def9$ ,section #ahfa7ll7 ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7ll77 is am5d$-- 7,a7 9 !         
subsection head+1 by ins]t+ 2 ,he>+     
,s]vices aft] ,audiology ,s]vices2 &    
7,b7 by add+ at ! end ! foll[+ new      
p>agraph3  7#e7 ,! t]m he>+ s]vices     
means-- 7,a7 r\t9e he>+ exams & exams = 
he>+ aids2 &  7,b7 o!r necess>y s]vices 
relat$ to he>+ heal? 7z def9$ by !      
,secret>y74  4  7b7 ,paym5t2 co9surance2
 & limitations  7#a7 ,9 g5]al ,section  

#ahcc7;a77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciel7a77#a771 z am5d$ 
by sections #b7;c77#a7 & #c7;c7#ia71 is 
am5d$-- 7,a7 by /rik+ & be=e 7,,jj72 &  
7,b7 by ins]t+ be=e ! semicolon at ! end
 ! foll[+3 1 & 7,,kk7 ) respect to      
audiology s]vices 7z def9$ 9 section    
#ahfa7ll77#c77 & he>+ s]vices 7z def9$ 9
 section #ahfa7ll77#e771 ! am\nt paid   
%all be ! paym5t am\nt specifi$ "u      
section #ahcd7;cc74  7#b7 ,paym5t &     
limits specifi$ ,section #ahcd ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciem71 z am5d$ by sections #b7;c77#b7 
& #c7;c77#b71 is am5d$ by add+ at ! end 
! foll[+ new subsection3  7cc7 ,paym5t &
 limits = he>+ s]vices  7#a7 ,9 g5]al ,!
 paym5t am\nt "u ?is "p = audiology     
s]vices 7z def9$ 9 section              
#ahfa7ll77#c77 & he>+ s]vices 7z def9$ 9
 section #ahfa7ll77#e771 %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  7#b7 ,applicable     
p]c5t ,= purposes ( p>agraph 7#a71 !    
applicable p]c5t specifi$ 9 ?is p>agraph
 is-- 7,a7 = ! fir/ ye> beg9n+ at lea/  
#f mon?s aft] ! date ( ! enactm5t ( ?is 
subsection1 #j p]c5t2  7,b7 = ! 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 &  7,c7 = ! eigh? ye>  
foll[+ ! ye> specifi$ 9 subp>agraph 7,a7
 & ea* subsequ5t ye>1 #hj p]c5t4  7#c7  
,secret>ial au?ority  7,a7 ,au?ority to 
apply limitations ,! ,secret>y may apply
 reasonable limitations on ! ext5t to   
:i* audiology s]vices & he>+ s]vices are
 cov]$ "u ?is "p1 includ+ ?r\gh         
application ( a prior au?orization      
requirem5t4  7,b7 ,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 ( audiology s]vices & 

he>+ s]vices to ! ext5t t su*           
modification is consi/5t ) !            
recomm5dations ( ! ,unit$ ,/ates        
,prev5tive ,s]vices ,task ,=ce4  4  7c7 
,paym5t "u ! physician fee s*$ule       
,section #ahdh7;j77#c7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7;j77#c771 z am5d$ by sections 
#b7;d7 & #c7;d71 is am5d$ by ins]t+     
7#b77,,mm71 aft] 7#b77,,ll714  7d7 ,he>+
 aids  7#a7 ,repeal ( gr\nd = exclusion 
,section #ahfb7;a77#g7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciey7a77#g771 z am5d$ by section      
#c7;g71 is am5d$ by /rik+ 1 he>+ aids or
 exam9ations !re=14  7#b7 ,def9ition (  
durable m$ical equipm5t to include he>+ 
aids ,section #ahfa7n7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciex7n771 z am5d$ by section #c7;f71  
is am5d$ by ins]t+ he>+ aids1 be=e &    
eyeglass l5ses4  7#c7 ,special paym5t   
rules = he>+ aids ,section #ahcd7;a7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciem7a771 z am5d$ by sections         

#b7;e77#b7 & #c7;e71 is am5d$ by add+ at
 ! end ! foll[+ new p>agraph3  7#bf7    
,paym5t & limits = he>+ aids  7,a7 ,9   
g5]al ,! paym5t am\nt "u ?is "p = he>+  
aids %all be1 subject to subp>agraph    
7,c71 ! applicable p]c5t 7specifi$ 9    
subp>agraph 7,b77 ( ! am\nt o!rwise     
payable = he>+ aids "u ?is section4     
7,b7 ,applicable p]c5t ,= purposes (    
subp>agraph 7,a71 ! applicable p]c5t    
specifi$ 9 ?is subp>agraph is-- 7i7 = ! 
fir/ ye> beg9n+ at lea/ #f mon?s aft] ! 
date ( ! enactm5t ( ?is p>agraph1 #j    
p]c5t2  7ii7 = ! 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 &  7iii7 = ! eigh? ye> foll[+ !  
ye> specifi$ 9 clause 7i7 & ea*         
subsequ5t ye>1 #hj p]c5t4  7,c7         
,limitations & ,secret>ial au?ority  7i7
 ,9 g5]al ,paym5t may be made "u ?is "p 
= an individual = n m ?an "o he>+ aid p]

 e> dur+ a #dh-mon? p]iod4  7ii7        
,secret>ial au?ority  7,i7 ,au?ority to 
apply additional limitations ,!         
,secret>y may apply additional          
limitations on ! ext5t to :i* he>+ aids 
are cov]$ "u ?is "p1 includ+ ?r\gh      
application ( a prior au?orization      
requirem5t & ?r\gh application ( crit]ia
 = a m9imum level ( he>+ loss = cov]age 
( an initial or replacem5t he>+ aid4    
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
 ( he>+ aids to ! ext5t t su*           
modification is consi/5t ) !            
recomm5dations ( ! ,unit$ ,/ates        
,prev5tive ,s]vices ,task ,=ce4  4  7e7 
,effective date ,! am5dm5ts made by ?is 
section %all apply to s]vices furni%$ on
 or aft] ,janu>y #a ( ! fir/ ye> beg9n+ 
at lea/ six mon?s aft] ! date ( !       
enactm5t ( ?is ,act4  #e4 ,increas$     
,,fmap = cov]age ( d5tal & oral heal?   
s]vices1 vision s]vices1 & he>+ s]vices 

"u ,m$icaid ,section #aije ( ! ,social  
,security ,act 7#db ,u4,s4,c4 #acif;d7  
is am5d$-- 7#a7 9 subsection 7a7-- 7,a7 
9 p>agraph 7#aj71 by ins]t+ 1 :i* may   
include any d5tal & oral heal? s]vice 7z
 def9$ 9 section #ahfa7nnn77 aft] d5tal 
s]vices2  7,b7 9 p>agraph 7#ac7-- 7i7 9 
subp>agraph 7,b71 by /rik+ 2 & & ins]t+ 
a semicolon2  7ii7 9 subp>agraph 7,c71  
by /rik+ ! semicolon & ins]t+ 2 &2 &    
7iii7 by add+ at ! end ! foll[+ new     
subp>agraph3  7,d7 any s]vice t is a    
vision s]vice 7z def9$ 9 section        
#ahfa7ooo77 or a he>+ s]vice 7z def9$ 9 
section #ahfa7ll77#e72  2  7#b7 9       
subsection 7b71 by /rik+ & 7ii7 & ins]t+
 7ii71 & 7jj72 &  7#c7 by add+ at ! end 
! foll[+ new subsection3  7jj7 ,increas$
 ,,fmap = exp5ditures = d5tal & oral    
heal? s]vices1 vision s]vices1 & he>+   
s]vices  7#a7 ,9 g5]al ,not)/&+         
subsection 7b71 ! ,f$]al m$ical         
assi/ance p]c5tage ) respect to am\nts  
exp5d$ by a ,/ate = m$ical assi/ance =  
s]vices describ$ 9 p>agraph 7#b7 %all be

 equal to #ij p]c5t4  7#b7 ,s]vices     
describ$ ,a s]vice describ$ 9 ?is       
p>agraph is any s]vice t-- 7,a7 is      
furni%$ on or aft] ,janu>y #a ( ! fir/  
cal5d> ye> t beg9s at lea/ #f mon?s aft]
 ! date ( ! enactm5t ( ?is subsection2  
7,b7 is n furni%$ to an individual :o   
is-- 7i7 "u ! age ( #ba2 &  7ii7        
eligible = m$ical assi/ance = ! s]vices 
describ$ 9 subsection 7a77#d77;,b72 &   
7,c7 is-- 7i7 a d5tal & oral heal?      
s]vice 7z def9$ 9 section #ahfa7nnn772  
7ii7 a vision s]vice 7z def9$ 9 section 
#ahfa7ooo772 or  7iii7 a he>+ s]vice 7z 
def9$ 9 section #ahfa7ll77#e774  4