I 

117TH CONGRESS 

1ST SESSION H. R. 1794 

To amend title XIX of the Social Security Act to strengthen coverage under 

the Medicaid program for certain foster youth individuals. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 11, 2021 

Ms. BASS (for herself, Mr. BACON, Mr. LANGEVIN, Mrs. LAWRENCE, and Mr. 

HASTINGS) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to strengthen 

coverage under the Medicaid program for certain foster 

youth individuals. 

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. 

4 This Act may be cited as the ‘‘Foster Youth Dental 

5 Act of 2021’’. 


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1 SEC. 2. STRENGTHENING COVERAGE UNDER THE MED2 ICAID PROGRAM FOR CERTAIN FOSTER 

3 YOUTH INDIVIDUALS. 

4 (a) EXPANSION OF EPSDT SERVICES TO CERTAIN

5 INDIVIDUALS AGED 21–25.— 

6 (1) IN GENERAL.—Section 1905(a) of the So7 cial Security Act (42 U.S.C. 1396d(a)) is amend8 ed— 

9 (A) in paragraph (4)(B), by inserting ‘‘(or, 

10 in the case of a specified individual (as defined 

11 in the matter at the end of this subsection), 

12 under the age of 26)’’ after ‘‘21’’; and 

13 (B) by adding at the end the following new 

14 sentence: ‘‘For purposes of paragraph (4)(B), 

15 the term ‘specified individual’ means an indi16 vidual who is in foster care under the responsi17 bility of a State (or was in foster care under the 

18 responsibility of the State on the date of attain19 ing 18 years of age or such higher age as the 

20 State has elected under section 475(8)(B)(iii) 

21 and was enrolled in a State plan under this title 

22 or under a waiver of a plan while in such foster 

23 care).’’. 

24 (2) PROVISION OF INFORMATION WITH RE25 SPECT TO DENTAL SERVICES.—Section 


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1 1902(a)(43)(A) of the Social Security Act (42 

2 U.S.C. 1396a(a)(43)(A)) is amended— 

3 (A) by inserting ‘‘(or, in the case of a spec4 ified individual (as defined in the matter at the 

5 end of section 1905(a)), under the age of 26)’’ 

6 after ‘‘21’’; 

7 (B) by inserting ‘‘(including dental serv8 ices)’’ after ‘‘treatment services’’; 

9 (C) by striking ‘‘and the need’’ and insert10 ing ‘‘, the need’’; and 

11 (D) by striking the comma at the end and 

12 inserting ‘‘, and the importance of maintaining 

13 good oral health,’’. 

14 (3) EFFECTIVE DATE.— 

15 (A) EXTENSION OF COVERAGE.—The 

16 amendments made by paragraph (1) shall apply 

17 with respect to medical assistance furnished 

18 during calendar quarters beginning on or after 

19 the date that is 80 days after the date of the 

20 enactment of this Act. 

21 (B) PROVISION OF INFORMATION.—The 

22 amendment made by paragraph (2) shall apply 

23 to information provided under section 

24 1902(a)(43)(A) of the Social Security Act (42 

25 U.S.C. 1396a(a)(43)(A)) beginning with the 


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1 first calendar quarter beginning on or after the 

2 date that is 80 days after the date of the enact3 ment of this Act. 

4 (b) INCENTIVE FOR THE PROVISION OF DENTAL

5 SERVICES TO CERTAIN INDIVIDUALS.— 

6 (1) IN GENERAL.—Section 1902(a) of the So7 cial Security Act (42 U.S.C. 1396a(a)) is amend8 ed— 

9 (A) in paragraph (13)— 

10 (i) in subparagraph (B), by striking 

11 ‘‘and’’ at the end; 

12 (ii) in subparagraph (C), by adding 

13 ‘‘and’’ at the end; and 

14 (iii) by adding at the end the fol15 lowing new subparagraph: 

16 ‘‘(D) for payment for dental services fur17 nished on or after the first day of the first cal18 endar quarter beginning on or after the date 

19 that is 80 days after the date of the enactment 

20 of this subparagraph by a dentist to a specified 

21 individual (as defined in the matter at the end 

22 of section 1905(a)) under the age of 26 at a 

23 rate not less than the specified average rate (as 

24 defined in subsection (tt)) for such services.’’; 

25 and 


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1 (B) by adding at the end the following new 

2 subsection: 

3 ‘‘(tt) SPECIFIED AVERAGE RATE DEFINED.— 

4 ‘‘(1) IN GENERAL.—For purposes of subsection 

5 (a)(13)(D), the term ‘specified average rate’ means, 

6 with respect to a dental service furnished in a State, 

7 the average of the contracted rates (as defined in 

8 paragraph (2)) in effect during the 5-year period 

9 ending on the date such service is so furnished— 

10 ‘‘(A) for such service furnished in such 

11 State (as determined by the State); or 

12 ‘‘(B) for such service furnished in the 

13 United States (as determined by the Secretary); 

14 as selected by such State. 

15 ‘‘(2) CONTRACTED RATE DEFINED.— 

16 ‘‘(A) IN GENERAL.—For purposes of para17 graph (1), the term ‘contracted rate’ means, 

18 with respect to a dental service, a rate in effect 

19 between a health insurance issuer offering 

20 group or individual health insurance coverage 

21 or a group health plan (as such terms are de22 fined in section 2791 of the Public Health Serv23 ice Act) and a dentist with a contractual rela24 tionship in effect with such issuer or plan (as 

25 applicable) for furnishing such service under 


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1 such coverage or plan (as applicable) that rep2 resents the total amount payable (including cost 

3 sharing) under such coverage or plan (as appli4 cable) for such service so furnished. 

5 ‘‘(B) EXCLUSION OF SELF-INSURED

6 GROUP HEALTH PLAN RATES.—For purposes of 

7 subparagraph (A), the term ‘contracted rate’ 

8 shall not include a rate described in such sub9 paragraph that is in effect between a self-in10 sured group health plan and a dentist.’’. 

11 (2) MEDICAID MANAGED CARE PLANS.—Section 

12 1932(f) of the Social Security Act (42 U.S.C. 

13 1396u–2(f)) is amended— 

14 (A) in the header, by striking ‘‘PRIMARY

15 CARE SERVICES’’ and inserting ‘‘CERTAIN

16 SERVICES’’; 

17 (B) by inserting ‘‘or dental services’’ after 

18 ‘‘primary care services’’; 

19 (C) by striking ‘‘section 1902(a)(13)(C)’’ 

20 and inserting ‘‘subparagraph (C) or (D), re21 spectively, of section 1902(a)(13)’’; and 

22 (D) by striking ‘‘such section’’ and insert23 ing ‘‘such subparagraph (C) or (D), as applica24 ble’’. 


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1 (3) INCREASED FMAP FOR INCREASED EX2 PENSES.—Section 1905 of the Social Security Act 

3 (42 U.S.C. 1396d) is amended by adding at the end 

4 the following new subsection: 

5 ‘‘(gg) INCREASED FMAP FOR ADDITIONAL EXPEND6 ITURES FOR DENTAL SERVICES.—Notwithstanding sub7 section (b), with respect to the portion of the amounts ex8 pended for medical assistance for services described in sec9 tion 1902(a)(13)(D) furnished on or after the first day 

10 of the first calendar quarter beginning on or after the date 

11 that is 80 days after the date of the enactment of this 

12 subsection furnished to an individual described in such 

13 section by a dentist that is attributable to the amount by 

14 which the minimum payment rate required under such 

15 section (or, by application, section 1932(f)) exceeds the 

16 payment rate applicable to such services under the State 

17 plan as of January 1, 2021, the Federal medical assist18 ance percentage for a State that is one of the 50 States 

19 or the District of Columbia shall be equal to 100 percent. 

20 The preceding sentence does not prohibit the payment of 

21 Federal financial participation based on the Federal med22 ical assistance percentage for amounts in excess of those 

23 specified in such sentence.’’. 


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1 (c) OUTREACH EFFORTS FOR ENROLLMENT OF

2 FORMER FOSTER CHILDREN.—Section 1902(a) of the So3 cial Security Act (42 U.S.C. 1396a(a)) is amended— 

4 (1) in paragraph (85), by striking ‘‘; and’’ and 

5 inserting a semicolon; 

6 (2) in paragraph (86), by striking the period at 

7 the end and inserting ‘‘; and’’; and 

8 (3) by inserting after paragraph (86) the fol9 lowing new paragraph: 

10 ‘‘(87) not later than 6 months after the date of 

11 the enactment of this paragraph— 

12 ‘‘(A) establish an outreach and enrollment 

13 program, in coordination with the State agency 

14 responsible for administering the State plan 

15 under part E of title IV and any other appro16 priate or interested agencies, designed to in17 crease the enrollment of individuals who are eli18 gible for medical assistance under the State 

19 plan under paragraph (10)(A)(i)(IX) in accord20 ance with best practices established by the Sec21 retary; and 

22 ‘‘(B) establish an outreach program to 

23 dentists practicing in such State to encourage 

24 enrollment by such dentists in such plan as par25 ticipating providers under such plan.’’. 


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1 (d) PROVIDING FOR IMMEDIATE ELIGIBILITY FOR

2 FORMER FOSTER YOUTH.—Section 1002(a)(2) of the 

3 SUPPORT for Patients and Communities Act (Public 

4 Law 115–271) is amended by striking ‘‘January 1, 2023’’ 

5 and inserting ‘‘the date of enactment of the Foster Youth 

6 Dental Act of 2021’’. 

Æ 


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