II 

113TH CONGRESS 

1ST SESSION S. 1586 

To amend title 38, United States Code, to improve dental health care for 

veterans, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 28, 2013 

Mr. SANDERS introduced the following bill; which was read twice and referred 

to the Committee on Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to improve dental 

health care for veterans, and for other purposes. 

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 ‘‘Enhanced Dental Care 

5 for Veterans Act of 2013’’. 

6 SEC. 2. RESTORATIVE DENTAL SERVICES FOR VETERANS. 

7 Section 1710(c) of title 38, United States Code, is 

8 amended— 

9 (1) in the second sentence— 


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1 (A) by redesignating subparagraphs (A) 

2 and (B) as clauses (i) and (ii), respectively; and 

3 (B) by redesignating paragraphs (1) and 

4 (2) as subparagraphs (A) and (B), respectively; 

5 (2) by inserting ‘‘(1)’’ after ‘‘(c)’’; 

6 (3) by striking ‘‘The Secretary’’ and inserting 

7 the following: 

8 ‘‘(2) The Secretary’’; and 

9 (4) by adding at the end the following new 

10 paragraph: 

11 ‘‘(3) In addition to the dental services, treatment, 

12 and appliances authorized to be furnished by paragraph 

13 (2), the Secretary may furnish dental services and treat14 ment, and dental appliances, needed to restore functioning 

15 in a veteran that is lost as a result of any services or treat16 ment furnished under this subsection.’’. 

17 SEC. 3. PILOT PROGRAM ON EXPANSION OF FURNISHING 

18 OF DENTAL CARE TO ALL ENROLLED VET19 ERANS. 

20 (a) PILOT PROGRAM REQUIRED.—Commencing not 

21 later than 180 days after the date of the enactment of 

22 this Act, the Secretary of Veterans Affairs shall carry out 

23 a pilot program to assess the feasibility and advisability 

24 of furnishing dental care to veterans enrolled in the system 

25 of patient enrollment under section 1705 of title 38, 


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1 United States Code, who are not eligible for dental serv2 ices and treatment, and related dental appliances, under 

3 current authorities. 

4 (b) DURATION OF PILOT PROGRAM.—The pilot pro5 gram shall be carried out during the three-year period be6 ginning on the date of the commencement of the pilot pro7 gram. 

8 (c) LOCATIONS.— 

9 (1) IN GENERAL.—The Secretary shall carry 

10 out the pilot program at not fewer than 16 locations 

11 as follows: 

12 (A) Four Department of Veterans Affairs 

13 medical centers with an established dental clin14 ic. 

15 (B) Four Department medical centers with 

16 a current contract for the furnishing of dental 

17 care. 

18 (C) Four Community-Based Outpatient 

19 Clinics (CBOCs) with space available for the 

20 furnishing of services and treatment under the 

21 pilot program. 

22 (D) Four facilities selected from among 

23 Federally Qualified Health Centers (FQHCs) 

24 and Indian Health Service facilities with estab25 lished dental clinics, of which— 


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1 (i) at least one facility shall be such 

2 an Indian Health Service facility; and 

3 (ii) any Indian Health Service facility 

4 so selected shall be selected in consultation 

5 with the Secretary of Health and Human 

6 Services. 

7 (2) CONSIDERATIONS.—In selecting locations 

8 for the pilot program, the Secretary shall consider 

9 the feasibility and advisability of selecting locations 

10 in each of the following: 

11 (A) Rural areas. 

12 (B) Areas that are not in close proximity 

13 to an active duty military installation. 

14 (C) Areas representing different geo15 graphic locations, such as census tracts estab16 lished by the Bureau of Census. 

17 (d) SCOPE OF SERVICES.—The dental services and 

18 treatment furnished to veterans under the pilot program 

19 shall be consistent with the dental services and treatment 

20 furnished by the Secretary to veterans with service-con21 nected disabilities rated 100 percent disabling under the 

22 laws administered by the Secretary. 

23 (e) VOLUNTARY PARTICIPATION.—The participation 

24 of a veteran in the pilot program shall be at the election 

25 of the veteran. 


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1 (f) LIMITATION ON AMOUNT OF SERVICES.— 

2 (1) IN GENERAL.—Except as provided in para3 graph (3), the total amount the Secretary may ex4 pend furnishing dental services and treatment to any 

5 veteran participating in the pilot program during 

6 any one-year period may not exceed such amount as 

7 the Secretary determines appropriate. The amount 

8 so determined may not be less than $1,000. 

9 (2) CONSULTATION.—The Secretary shall make 

10 the determination under paragraph (1)— 

11 (A) in consultation with the Director of the 

12 Indian Health Service; and 

13 (B) in consultation with the Director of 

14 the Centers for Medicare and Medicaid Services 

15 if one or more Federally Qualified Health Cen16 ters is selected as a location for the pilot pro17 gram under subsection (c)(1)(D). 

18 (3) SERVICES IN EXCESS OF LIMITATION

19 AMOUNT.—The total amount expended by the Sec20 retary in furnishing dental services and treatment to 

21 a particular veteran participating in the pilot pro22 gram during a one-year period may exceed the 

23 amount determined under paragraph (1) if the Sec24 retary determines, before furnishing such services 

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1 eran by a dentist participating in the pilot program 

2 that the furnishing of such services and treatment is 

3 necessary. Any determination under this paragraph 

4 shall be made on a case-by-case basis. 

5 (g) COPAYMENTS.—The Secretary may collect copay6 ments for dental services and treatment furnished under 

7 the pilot program in accordance with authorities on the 

8 collection of copayments for medical care of veterans 

9 under chapter 17 of title 38, United States Code. 

10 (h) PROGRAM ADMINISTRATION.— 

11 (1) NOTICE TO COVERED VETERANS ON PILOT

12 PROGRAM.—In carrying out the pilot program, the 

13 Secretary shall inform all veterans eligible to partici14 pate in the pilot program of the services and treat15 ment available under the pilot program. 

16 (2) CONTRACTS.—In carrying out the pilot pro17 gram, the Secretary may enter into contracts with 

18 appropriate entities for the provision of dental serv19 ices and treatment under the pilot program. Each 

20 such contract shall specify performance standards 

21 and metrics and processes for ensuring compliance 

22 of the contractor concerned with such performance 

23 standards. 

24 (i) REPORTS.— 

25 (1) PRELIMINARY REPORTS.— 


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1 (A) IN GENERAL.—Not later than each of 

2 one year and three years after the date of the 

3 commencement of the pilot program, the Sec4 retary shall submit to the Committee on Vet5 erans’ Affairs of the Senate and the Committee 

6 on Veterans’ Affairs of the House of Represent7 atives a report on the pilot program. 

8 (B) CONTENTS.—Each report under sub9 paragraph (A) shall include the following: 

10 (i) A description of the implementa11 tion and operation of the pilot program. 

12 (ii) The number of veterans receiving 

13 services and treatment under the pilot pro14 gram, and a description of the dental serv15 ices and treatment furnished to such vet16 erans. 

17 (iii) An analysis of the costs and bene18 fits of the pilot program, including a com19 parison of costs and benefits by location 

20 type. 

21 (iv) The current findings and conclu22 sions of the Secretary with respect to the 

23 pilot program. 

24 (v) Such recommendations for the 

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1 gram as the Secretary considers appro2 priate. 

3 (2) FINAL REPORT.— 

4 (A) IN GENERAL.—Not later than 180 

5 days after the completion of the pilot program, 

6 the Secretary shall submit to the Committee on 

7 Veterans’ Affairs of the Senate and the Com8 mittee on Veterans’ Affairs of the House of 

9 Representatives a report on the pilot program. 

10 (B) CONTENTS.—The report under sub11 paragraph (A) shall include the following: 

12 (i) The findings and conclusions of 

13 the Secretary with respect to the pilot pro14 gram. 

15 (ii) Such recommendations for the 

16 continuation or expansion of the pilot pro17 gram as the Secretary considers appro18 priate. 

19 SEC. 4. PROGRAM ON EDUCATION TO PROMOTE DENTAL 

20 HEALTH IN VETERANS. 

21 (a) PROGRAM REQUIRED.— 

22 (1) IN GENERAL.—The Secretary of Veterans 

23 Affairs shall carry out a program of education to 

24 promote dental health for veterans who are enrolled 

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1 ment of Veterans Affairs under section 1705 of title 

2 38, United States Code. 

3 (2) CONSTRUCTION.—Nothing in the program 

4 shall be deemed to alter or revise the eligibility of 

5 any veteran for dental care under the laws adminis6 tered by the Secretary. 

7 (b) ELEMENTS.—The program required by sub8 section (a) shall provide education for veterans on the fol9 lowing: 

10 (1) The association between dental health and 

11 overall health and well-being. 

12 (2) Proper techniques for dental care. 

13 (3) Signs and symptoms of commonly occurring 

14 dental issues, including caries. 

15 (4) Treatment options for commonly occurring 

16 dental issues. 

17 (5) Options for obtaining access to dental care, 

18 including information on eligibility for dental care 

19 through the Department and on purchasing private 

20 dental insurance. 

21 (6) Options for obtaining low or no-cost dental 

22 care, including through dental schools and Federally 

23 Qualified Health Centers. 

24 (7) Such other matters relating to dental health 

25 as the Secretary considers appropriate. 


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1 (c) DELIVERY OF EDUCATIONAL MATERIALS.— 

2 (1) IN GENERAL.—The Secretary shall provide 

3 educational materials to veterans under the program 

4 required by subsection (a) through a variety of 

5 mechanisms, including the following: 

6 (A) The availability and distribution of 

7 print materials at Department facilities, includ8 ing medical centers, clinics, Vet Centers, and 

9 readjustment counseling centers. 

10 (B) The availability and distribution of 

11 materials over the Internet, including through 

12 webinars and My HealtheVet. 

13 (C) Presentations of information, including 

14 both small group and large group presentations. 

15 (2) SELECTION OF MECHANISMS.—In selecting 

16 mechanisms for purposes of this subsection, the Sec17 retary shall select mechanisms designed to maximize 

18 the number of veterans who receive education under 

19 the program. 

20 SEC. 5. INFORMATION ON DENTAL SERVICES FOR INCLU21 SION IN ELECTRONIC MEDICAL RECORDS 

22 UNDER DENTAL INSURANCE PILOT PRO23 GRAM. 

24 (a) IN GENERAL.—Commencing not later than 180 

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1 retary of Veterans Affairs shall expand the dental insur2 ance pilot program established by section 17.169 of title 

3 38, Code of Federal Regulations, to establish a mechanism 

4 by which private sector dental care providers may forward 

5 to the Department of Veterans Affairs information on 

6 dental care furnished to individuals under the pilot pro7 gram for inclusion in the electronic medical records of the 

8 Department with respect to such individuals. 

9 (b) CONSTRUCTION WITH CURRENT PILOT PROGRAM

10 REQUIREMENTS.— 

11 (1) IN GENERAL.—Nothing in this section shall 

12 be construed to revise eligibility for participation in, 

13 or the locations of, the pilot program referred to in 

14 subsection (a). 

15 (2) DURATION.—The Secretary may continue 

16 the pilot program for two years in addition to the 

17 duration otherwise provided for the pilot program in 

18 section 17.169 of title 38, Code of Federal Regula19 tions, if the Secretary determines that the continu20 ation is needed to assess the mechanism required by 

21 subsection (a). 

22 (3) VOLUNTARY PARTICIPATION IN MECHA23 NISM.—The participation in the mechanism required 

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1 pating in the pilot program shall be at the election 

2 of the individual. 

3 (c) INCLUSION OF INFORMATION ON MECHANISM IN

4 REPORTS.—Each report to Congress on the pilot program 

5 after the date of the commencement of the mechanism re6 quired by subsection (a) shall include information on the 

7 mechanism, including a current assessment of the feasi8 bility and advisability of using the mechanism to include 

9 information on dental care furnished to individuals in the 

10 electronic medical records of the Department with respect 

11 to such individuals. 

Æ 


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