I 

111TH CONGRESS 

1ST SESSION H. R. 2220 

To amend titles V and XIX of the Social Security Act to improve essential 

oral health care for lower-income individuals under the Maternal and 

Child Health Program and the Medicaid Program. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 30, 2009 

Mr. ROSS (for himself and Mr. SIMPSON) introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

A BILL 

To amend titles V and XIX of the Social Security Act 

to improve essential oral health care for lower-income 

individuals under the Maternal and Child Health Program and the Medicaid Program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Essential Oral Health Care Act of 2009’’. 

6 (b) TABLE OF CONTENTS.—The table of contents of 

7 this Act is as follows: 

Sec. 1. Short title; table of contents. 


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TITLE I—PUBLIC-PRIVATE PARTNERSHIP TO IMPROVE ORAL 

HEALTH ACCESS 

Sec. 101. Grants to support volunteer dental projects. 

TITLE II—STATE OPTION FOR IMPROVING MEDICAID DENTAL 

SERVICES ACCESS 

Sec. 201. Support for ensuring individuals enrolled in Medicaid have dental 

services access equal to the population of the State. 

1 TITLE I—PUBLIC-PRIVATE PART2 NERSHIP TO IMPROVE ORAL 

3 HEALTH ACCESS 

4 SEC. 101. GRANTS TO SUPPORT VOLUNTEER DENTAL 

5 PROJECTS. 

6 Title V of the Social Security Act (42 U.S.C. 701 

7 et seq.) is amended by adding at the end the following 

8 new section: 

9 ‘‘SEC. 511. GRANTS TO SUPPORT VOLUNTEER DENTAL 

10 PROJECTS. 

11 ‘‘(a) AUTHORITY TO MAKE GRANTS.—In addition to 

12 any other payments made under this title to a State, the 

13 Secretary shall award grants to eligible entities as defined 

14 in subsection (b) to purchase portable or mobile dental 

15 equipment and to pay for appropriate operational costs, 

16 including direct health care or service delivery costs, for 

17 the provision of free dental services to underserved popu18 lations that are delivered in a manner consistent with 

19 State licensing laws. 

20 ‘‘(b) ELIGIBLE ENTITY.—An eligible entity under 

21 this subsection is an organization, such as a State or local 


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1 dental association, or a dental education, dental hygiene 

2 education or postdoctoral dental education program ac3 credited by the Commission on Dental Accreditation, or 

4 a community-based organization that partners with an 

5 academic institution, that is exempt from tax under sec6 tion 501(c) of the Internal Revenue Code of 1986 and that 

7 offers a free dental services program for underserved pop8 ulations. 

9 ‘‘(c) APPLICATION.—An institution desiring a grant 

10 under this section shall submit an application to the Sec11 retary in such manner as the Secretary may require. 

12 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

13 are authorized to be appropriated to make grants under 

14 this section $3,000,000 for each of fiscal years 2010 

15 through 2014.’’. 

16 TITLE II—STATE OPTION FOR 

17 IMPROVING MEDICAID DEN18 TAL SERVICES ACCESS 

19 SEC. 201. SUPPORT FOR ENSURING INDIVIDUALS EN20 ROLLED IN MEDICAID HAVE DENTAL SERV21 ICES ACCESS EQUAL TO THE POPULATION OF 

22 THE STATE. 

23 (a) IN GENERAL.—Section 1903 of the Social Secu24 rity Act (42 U.S.C. 1396b) is amended by adding at the 

25 end the following new subsection: 


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1 ‘‘(aa) EQUAL ACCESS TO ORAL HEALTH CARE

2 PLAN.— 

3 ‘‘(1) INCREASE IN FMAP FOR STATES IMPLE4 MENTING APPROVED EQUAL ACCESS REQUIRE5 MENTS.—In order to ensure adequate provider par6 ticipation in the plan under this title and to ensure 

7 that individuals covered by the plan have access to 

8 oral health care services to the same extent as such 

9 services are available to the population of the State, 

10 subject to paragraph (3), in the case of a State that 

11 obtains the Secretary’s approval for its plan under 

12 this title to incorporate, and to implement, the re13 quirements specified in paragraph (2), notwith14 standing section 1905(b), the Federal medical assist15 ance percentage applied under the plan with respect 

16 to expenditures for dental and oral health services 

17 for individuals covered under the plan shall be in18 creased by 25 percentage points, but not to exceed 

19 90 percent, at the time the approved plan is imple20 mented. 

21 ‘‘(2) PROVIDER PARTICIPATION AND ACCESS

22 REQUIREMENTS.—The requirements specified in this 

23 paragraph for a State are that the State provides 

24 the Secretary with assurances regarding each of the 

25 following: 


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1 ‘‘(A) Individuals covered by the State plan 

2 have access to oral health care services to the 

3 same extent as such services are available to the 

4 population of the State. 

5 ‘‘(B) Payment for dental services for indi6 viduals covered by the State plan is made at 

7 levels consistent with market-based rates. 

8 ‘‘(C) No fewer than 35 percent of the prac9 ticing dentists (including a reasonable mix of 

10 general dentists, pediatric dentists, and oral 

11 and maxillofacial surgeons) in the State partici12 pate (whether directly or through a plan pro13 viding dental services) under the State plan and 

14 there is reasonable distribution of such dentists 

15 serving the covered population. 

16 ‘‘(D) Administrative barriers under this 

17 title are addressed to facilitate such provider 

18 participation, including improving eligibility 

19 verification, ensuring that any licensed dentist 

20 may participate in a publicly funded plan with21 out also having to participate in any other plan, 

22 simplifying claims forms processing, assigning a 

23 single plan administrator for the dental pro24 gram, and employing case managers to reduce 

25 the number of missed appointments. 


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1 ‘‘(E) Demand for services barriers under 

2 this title is addressed, such as educating care3 givers regarding the need to seek dental serv4 ices and addressing oral health care literacy 

5 issues. 

6 ‘‘(3) 3-YEAR REVIEW.—Beginning 3 years after 

7 the date of the enactment of this section and every 

8 3 years thereafter the Secretary shall evaluate the 

9 impact of the increase in the Federal medical assist10 ance percentage under this subsection on the rate of 

11 participation of dentists and the use of dental serv12 ices under the State plan. If the Secretary deter13 mines that the increase in such percentage has not 

14 resulted in a commensurate increase in such partici15 pation and use rate, as determined in consultation 

16 with the State involved, paragraph (1) shall no 

17 longer apply in such State.’’ 

18 (b) EFFECTIVE DATE.—The amendment made by 

19 this section shall apply to expenditures in calendar quar20 ters beginning on or after October 1, 2009. 

Æ 


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