II 

112TH CONGRESS 

2D SESSION S. 3272 

To improve access to oral health care for vulnerable and underserved 

populations. 

IN THE SENATE OF THE UNITED STATES 

JUNE 7, 2012 

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

to the Committee on Finance 

A BILL 

To improve access to oral health care for vulnerable and 

underserved populations. 

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 ‘‘Comprehensive Dental 

5 Reform Act of 2012’’. 

6 SEC. 2. TABLE OF CONTENTS. 

7 The table of contents of this Act is as follows: 

Sec. 1. Short title. 

Sec. 2. Table of contents. 

Sec. 3. Findings. 

TITLE I—MEDICARE AND MEDICAID 

Subtitle A—Medicare 


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Sec. 101. Coverage of dental services under the Medicare program. 

Subtitle B—Medicaid 

Sec. 111. Coverage of dental services under the Medicaid program. 

Subtitle C—Grant Programs 

Sec. 121. Case management grant program. 

TITLE II—PUBLIC HEALTH PROGRAMS 

Subtitle A—National Health Service Corps 

Sec. 201. National Health Service Corps. 

Subtitle B—Oral Health Education 

Sec. 211. Authorization of appropriations for oral health education for medical 

providers. 

Sec. 212. Oral health education for other non-health professionals. 

Sec. 213. Dental education. 

Sec. 214. Oral health professional student loans. 

Subtitle C—Other Oral Health Programs 

Sec. 221. Access points. 

Sec. 222. Dental clinics in schools. 

Sec. 223. Emergency room care coordination. 

Sec. 224. Research funding. 

Sec. 225. Mobile and portable dental services. 

TITLE III—DEPARTMENT OF VETERANS AFFAIRS AND 

DEPARTMENT OF DEFENSE MATTERS 

Subtitle A—Department of Veterans Affairs Matters 

Sec. 301. Requiring Secretary of Veterans Affairs to furnish dental care in 

same manner as any other medical service. 

Sec. 302. Demonstration program on training and employment of alternative 

dental health care providers for dental health care services for 

veterans in rural and other underserved communities. 

Subtitle B—Department of Defense Matters 

Sec. 311. Demonstration program on training and employment of alternative 

dental health care providers for dental health care services for 

members of the Armed Forces and dependents lacking ready 

access to such services. 

TITLE IV—FEDERAL BUREAU OF PRISONS 

Sec. 401. Demonstration program on training and employment of alternative 

dental health care providers for dental health care services for 

prisoners within the custody of the Bureau of Prisons. 

TITLE V—INDIAN HEALTH SERVICE 


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Sec. 501. Demonstration program on training and employment of alternative 

dental health care providers for dental health care services 

under the Indian Health Service. 

TITLE VI—REPORTS TO CONGRESS 

Sec. 601. Evaluation of expansion of coverage for dental services. 

TITLE VII—FUNDING 

Sec. 701. Transaction tax. 

1 SEC. 3. FINDINGS. 

2 Congress makes the following findings: 

3 (1) The United States must establish a nation4 wide and comprehensive approach to address the 

5 lack of access to needed dental care and reduce oral 

6 health disparities. 

7 (2) Since 2000, when the Surgeon General of 

8 the United States called dental disease a ‘‘silent epi9 demic’’, there has been increasing but still insuffi10 cient attention given to addressing oral health 

11 issues. The Healthy People 2020 initiative includes 

12 oral health as a leading health indicator for the first 

13 time in the history of the Healthy People program, 

14 and in 2011, the Institute of Medicine published 2 

15 reports, ‘‘Improving Access to Oral Health Care for 

16 Vulnerable and Underserved Populations’’ and ‘‘Ad17 vancing Oral Health in America’’, that focused on 

18 oral health. 

19 (3) Dental caries, commonly known as cavities, 

20 are the most common chronic disease for children in 


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1 the United States, affecting nearly 60 percent of 

2 children between 5 and 17 years of age. Addition3 ally, 25 percent of American adults who have at4 tained 65 years of age have lost all of their teeth. 

5 (4) Untreated oral health problems contribute 

6 to an increased risk for serious medical conditions 

7 such as diabetes, hospital-acquired pneumonia, and 

8 poor birth outcomes. 

9 (5) More than 47,000,000 individuals reside in 

10 areas where it is difficult to access dental care. Only 

11 45 percent of Americans over 2 years of age have 

12 had a dental visit in the preceding 12 months, and 

13 approximately 17,000,000 low-income children go 

14 each year without seeing a dentist. 

15 (6) While the lack of access to oral health serv16 ices is a national problem, those who are most likely 

17 to remain underserved are individuals with low in18 comes, racial and ethnic minorities, pregnant 

19 women, older adults, individuals with special needs, 

20 and individuals living in rural communities. 

21 (7) Nearly 9,500 additional dental providers are 

22 needed in order to meet this Nation’s current oral 

23 health needs, especially to work in areas where the 

24 need for dental care is the greatest. Only 20 percent 

25 of practicing dentists in the United States provide 


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1 care to individuals enrolled in Medicaid, and a very 

2 small percentage of dentists devote a substantial 

3 part of their practice towards caring for individuals 

4 who are underserved. 

5 (8) Over 40 percent of the total expenditures on 

6 dental care in the United States are out-of-pocket 

7 payments by individuals. 

8 (9) The Medicare program and the Department 

9 of Veterans Affairs do not provide dental coverage to 

10 the majority of their beneficiaries, and States can 

11 elect whether to provide dental coverage to adults 

12 under the Medicaid program. 

13 (10) The number of individuals without dental 

14 health insurance is 3 times higher than the number 

15 of individuals who lack general health insurance. 

16 (11) The lack of access to oral health services 

17 can be extremely costly, resulting in higher health 

18 care expenditures. In 2009, there were over 830,000 

19 visits to emergency rooms across the United States 

20 for preventable dental conditions, which is 16 per21 cent higher than in 2006. 

22 (12) According to a report by the Surgeon Gen23 eral of the United States, students miss more than 

24 51,000,000 hours of school and employed adults lose 


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1 more than 164,000,000 hours of work each year due 

2 to dental disease and dental visits. 

3 TITLE I—MEDICARE AND 

4 MEDICAID 

5 Subtitle A—Medicare 

6 SEC. 101. COVERAGE OF DENTAL SERVICES UNDER THE 

7 MEDICARE PROGRAM. 

8 (a) COVERAGE.—Section 1861(s)(2) of the Social Se9 curity Act (42 U.S.C. 1395x(s)(2)) is amended— 

10 (1) in subparagraph (EE), by striking ‘‘and’’ 

11 after the semicolon at the end; 

12 (2) in subparagraph (FF), by adding ‘‘and’’ 

13 after the semicolon at the end; and 

14 (3) by adding at the end the following new sub15 paragraph: 

16 ‘‘(GG) dental services (as defined in subsection 

17 (iii));’’. 

18 (b) DENTAL SERVICES DEFINED.—Section 1861(s) 

19 of the Social Security Act (42 U.S.C. 1395x(s)) is amend20 ed by adding at the end the following new subsection: 

21 ‘‘Dental Services 

22 ‘‘(iii)(1) The term ‘dental services’ means oral health 

23 services (as defined by the Secretary) provided by a li24 censed oral health care provider that are necessary to pre25 vent disease and promote oral health, restore oral strucVerDate Mar 15 2010 01:27 Jun 09, 2012 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3272.IS S3272

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1 tures to health and function, and treat emergency condi2 tions. 

3 ‘‘(2) For purposes of paragraph (1), such term shall 

4 include mobile and portable oral health services (as de5 fined by the Secretary) that— 

6 ‘‘(A) are provided for the purpose of over7 coming mobility, transportation, and access barriers 

8 for individuals; and 

9 ‘‘(B) satisfy the standards and certification re10 quirements established under section 1902(a)(84)(B) 

11 for the State in which the services are provided.’’. 

12 (c) PAYMENT AND COINSURANCE.—Section 

13 1833(a)(1) of the Social Security Act (42 U.S.C. 

14 1395l(a)(1)) is amended— 

15 (1) by striking ‘‘and’’ before ‘‘(Z)’’; and 

16 (2) by inserting before the semicolon at the end 

17 the following: ‘‘, and (AA) with respect to dental 

18 services (as defined in section 1861(iii)), the amount 

19 paid shall be (i) in the case of such services that are 

20 dental health preventive services described in para21 graph (1)(D) of such section, 100 percent of the 

22 lesser of the actual charge for the services or the 

23 amount determined under the payment basis deter24 mined under section 1848, and (ii) in the case of all 

25 other such services, 80 percent of the lesser of the 


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1 actual charge for the services or the amount deter2 mined under the payment basis determined under 

3 section 1848’’. 

4 (d) PAYMENT UNDER PHYSICIAN FEE SCHEDULE.— 

5 Section 1848(j)(3) of the Social Security Act (42 U.S.C. 

6 1395w–4(j)(3)) is amended by inserting ‘‘(2)(GG),’’ after 

7 ‘‘risk assessment),’’. 

8 (e) DENTURES.—Section 1861(s)(8) of the Social Se9 curity Act (42 U.S.C. 1395x(s)(8)) is amended— 

10 (1) by striking ‘‘(other than dental)’’ and in11 serting ‘‘(including dentures)’’; and 

12 (2) by striking ‘‘internal body’’. 

13 (f) REPEAL OF GROUND FOR EXCLUSION.—Section 

14 1862(a) of the Social Security Act (42 U.S.C. 1395y) is 

15 amended by striking paragraph (12). 

16 (g) EFFECTIVE DATE.—The amendments made by 

17 this section shall apply to services furnished on or after 

18 January 1, 2013. 

19 Subtitle B—Medicaid 

20 SEC. 111. COVERAGE OF DENTAL SERVICES UNDER THE 

21 MEDICAID PROGRAM. 

22 (a) IN GENERAL.—Section 1905 of the Social Secu23 rity Act (42 U.S.C. 1396d) is amended— 


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1 (1) in subsection (a)(10), by adding ‘‘(as de2 scribed in subsection (ee)(1))’’ after ‘‘dental serv3 ices’’; and 

4 (2) by adding at the end the following: 

5 ‘‘(ee)(1) Subject to paragraphs (2) and (3), for pur6 poses of this title, the term ‘dental services’ means oral 

7 health services (as defined by the Secretary) provided by 

8 a licensed oral health care provider that are necessary to 

9 prevent disease and promote oral health, restore oral 

10 structures to health and function, and treat emergency 

11 conditions. 

12 ‘‘(2) For purposes of paragraph (1), such term shall 

13 include mobile and portable oral health services (as de14 fined by the Secretary) that— 

15 ‘‘(A) are provided for the purpose of over16 coming mobility, transportation, and access barriers 

17 for individuals; and 

18 ‘‘(B) satisfy the standards and certification re19 quirements established under section 1902(a)(84)(B) 

20 for the State in which the services are provided. 

21 ‘‘(3) For purposes of paragraph (1), such term shall 

22 not apply to dental care or services provided to individuals 

23 under the age of 21 under subsection (r)(3).’’. 

24 (b) CONFORMING AMENDMENTS.—Section 1902(a) 

25 of such Act (42 U.S.C. 1396a(a)) is amended— 


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1 (1) in paragraph (10)(A), in the matter pre2 ceding clause (i), by inserting ‘‘(10),’’ after ‘‘(5),’’; 

3 (2) in paragraph (82)(C), by striking ‘‘and’’ at 

4 the end; 

5 (3) in paragraph (83), by striking the period at 

6 the end and inserting ‘‘; and’’; and 

7 (4) by inserting after paragraph (83) the fol8 lowing: 

9 ‘‘(84) provide for— 

10 ‘‘(A) informing, in writing, all individuals 

11 who have been determined to be eligible for 

12 medical assistance of the availability of dental 

13 services (as defined in section 1905(ee)(1)); and 

14 ‘‘(B) establishing and maintaining stand15 ards for and certification of mobile and portable 

16 oral health services (as described in subsections 

17 (r)(3)(C) and (ee)(2) of section 1905).’’. 

18 (c) MOBILE AND PORTABLE ORAL HEALTH SERV19 ICES UNDER EPSDT.—Section 1905(r)(3) of the Social 

20 Security Act (42 U.S.C. 1396d(r)(3)) is amended— 

21 (1) in subparagraph (A)(ii), by striking ‘‘; and’’ 

22 and inserting a semicolon; 

23 (2) in subparagraph (B), by striking the period 

24 at the end and inserting ‘‘; and’’; and 


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1 (3) by adding at the end the following new sub2 paragraph: 

3 ‘‘(C) which shall include mobile and portable 

4 oral health services (as defined by the Secretary) 

5 that— 

6 ‘‘(i) are provided for the purpose of over7 coming mobility, transportation, or access bar8 riers for children; and 

9 ‘‘(ii) satisfy the standards and certification 

10 requirements established under section 

11 1902(a)(84)(B) for the State in which the serv12 ices are provided.’’. 

13 (d) INCREASED FEDERAL FUNDING FOR DENTAL

14 SERVICES.— 

15 (1) IN GENERAL.—Section 1905 of the Social 

16 Security Act (42 U.S.C. 1396d), as amended by sub17 section (a), is amended— 

18 (A) in subsection (b), in the first sentence, 

19 by striking ‘‘and (aa)’’ and inserting ‘‘(aa), and 

20 (ff)’’; and 

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

22 subsection: 

23 ‘‘(ff) INCREASED FMAP FOR DENTAL SERVICES.— 

24 ‘‘(1) IN GENERAL.—Notwithstanding subsection 

25 (b) and section 1903(a)(7) and subject to the reVerDate Mar 15 2010 01:27 Jun 09, 2012 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S3272.IS S3272

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1 quirements described in paragraphs (3) and (4), 

2 with respect to amounts expended on or after Octo3 ber 1, 2012, for covered dental expenses (as de4 scribed in paragraph (2)), the Federal medical as5 sistance percentage for a State that is one of the 50 

6 States or the District of Columbia for such expenses 

7 shall be equal to the Federal medical assistance per8 centage that would otherwise apply to the State for 

9 the fiscal year, as determined under subsection (b) 

10 or section 1903(a)(7), increased by 10 percentage 

11 points. 

12 ‘‘(2) COVERED DENTAL EXPENSES.—For pur13 poses of paragraph (1), the term ‘covered dental ex14 penses’ means the amounts expended for medical as15 sistance for dental services (as described in sub16 section (ee)(1)) and amounts expended for the prop17 er and efficient administration of the provision of 

18 such dental services under the State plan. 

19 ‘‘(3) REQUIREMENTS.—For purposes of para20 graph (1), the Federal medical assistance percentage 

21 applicable to covered dental expenses under this sub22 section shall not apply to a State unless— 

23 ‘‘(A) the State plan for medical assistance 

24 provides payment for dental services (as so de25 fined) furnished by a dental provider at a rate 


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1 that is not less than 70 percent of the usual 

2 and customary fee for such services in the 

3 State; and 

4 ‘‘(B) the State satisfies such additional re5 quirements as are established by the Secretary, 

6 which shall include— 

7 ‘‘(i) streamlining of administrative 

8 procedures for purposes of ensuring ade9 quate provider participation and increasing 

10 patient utilization of dental services; and 

11 ‘‘(ii) the provision of technical assist12 ance to dental providers designed to reduce 

13 the number of missed patient appoint14 ments and eliminate other barriers to the 

15 provision of oral health services. 

16 ‘‘(4) LIMITATION.—For purposes of amounts 

17 expended for covered dental services, in no case shall 

18 any increase under this subsection result in a Fed19 eral medical assistance percentage that exceeds 100 

20 percent.’’. 

21 (2) CONFORMING AMENDMENT.—Section 

22 1903(a)(7) of the Social Security Act (42 U.S.C. 

23 1396b(a)(7)) is amended by striking ‘‘section 

24 1919(g)(3)(B)’’ and inserting ‘‘sections 1905(ff) and 

25 1919(g)(3)(B)’’. 


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1 (e) EFFECTIVE DATE.— 

2 (1) IN GENERAL.—Except as provided in para3 graph (2), the amendments made by this section 

4 shall apply to calendar quarters beginning on or 

5 after January 1, 2013, without regard to whether or 

6 not final regulations to carry out such amendments 

7 have been promulgated by such date. 

8 (2) DELAY PERMITTED FOR STATE PLAN

9 AMENDMENT.—In the case of a State plan for med10 ical assistance under title XIX of the Social Security 

11 Act which the Secretary of Health and Human Serv12 ices determines requires State legislation (other than 

13 legislation appropriating funds) in order for the plan 

14 to meet the additional requirements imposed by the 

15 amendments made by this section, the State plan 

16 shall not be regarded as failing to comply with the 

17 requirements of such title solely on the basis of its 

18 failure to meet these additional requirements before 

19 the first day of the first calendar quarter beginning 

20 after the close of the first regular session of the 

21 State legislature that begins after the date of enact22 ment of this Act. For purposes of the previous sen23 tence, in the case of a State that has a 2-year legis24 lative session, each year of such session shall be 


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1 deemed to be a separate regular session of the State 

2 legislature. 

3 Subtitle C—Grant Programs 

4 SEC. 121. CASE MANAGEMENT GRANT PROGRAM. 

5 (a) ESTABLISHMENT.—The Secretary shall award 

6 grants to States and eligible entities for the purpose of 

7 developing case management programs that— 

8 (1) identify eligible individuals who are in need 

9 of dental services, with a particular focus on preg10 nant women, individuals with disabilities, and older 

11 adults, and provide them with information regarding 

12 dental providers in proximity to their residence; 

13 (2) determine the coverage status of an eligible 

14 individual or whether such individual is eligible for 

15 free dental services; 

16 (3) recruit licensed dental providers and coordi17 nate the voluntary provision of medically rec18 ommended dental services by such providers to eligi19 ble individuals described in subsection (f)(2)(E) with 

20 no fee or charge to such individuals and in a manner 

21 consistent with State licensing laws; 

22 (4) provide community-level oral health edu23 cation, with a focus on oral health literacy and pre24 vention, and resource information to eligible individ25 uals; and 


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1 (5) identify and coordinate transportation for 

2 eligible individuals in need of dental services as nec3 essary to overcome mobility impairments and trans4 portation barriers. 

5 (b) APPLICATION.—A State or eligible entity that de6 sires to participate in the grant program under this sec7 tion shall submit to the Secretary an application at such 

8 time, in such manner, and containing such information as 

9 the Secretary may require. 

10 (c) DURATION AND SCOPE.—From any amounts ap11 propriated to carry out this section, the Secretary shall 

12 award grants to a total of 10 States and eligible entities, 

13 with the amount of each grant to be determined at the 

14 discretion of the Secretary. 

15 (d) EVALUATION.—Not later than January 1, 2016, 

16 the Secretary shall— 

17 (1) conduct an evaluation of the grant program 

18 under this section for purposes of determining if 

19 case management programs established by partici20 pating States and eligible entities sufficiently in21 creased access to dental services; and 

22 (2) determine whether case management pro23 grams should be made available on a nationwide 

24 basis. 


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1 (e) AUTHORIZATION.—To carry out the grant pro2 gram under this section, there are authorized to be appro3 priated such sums as may be necessary for each of fiscal 

4 years 2013 through 2015. 

5 (f) DEFINITIONS.—In this section: 

6 (1) ELIGIBLE ENTITY.—The term ‘‘eligible enti7 ty’’ means an organization that is described in sec8 tion 501(c)(3) of the Internal Revenue Code of 1986 

9 and exempt from tax under section 501(a) of such 

10 Code. 

11 (2) ELIGIBLE INDIVIDUAL.—The term ‘‘eligible 

12 individual’’ means an individual who is— 

13 (A) entitled to, or enrolled for, benefits 

14 under part A of title XVIII of the Social Secu15 rity Act or enrolled for benefits under part B 

16 of such title; 

17 (B) eligible to receive medical assistance 

18 under a State plan under title XIX of the So19 cial Security Act or any waiver approved with 

20 respect to such plan; 

21 (C) eligible to receive child health assist22 ance under a State child health plan under title 

23 XXI of the Social Security Act or any waiver 

24 approved with respect to such plan; 


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1 (D) entitled to receive medical benefits 

2 under the laws administered by the Secretary of 

3 Veterans Affairs; or 

4 (E) has an income below 200 percent of 

5 the Federal poverty level and does not otherwise 

6 have any dental insurance coverage. 

7 (3) SECRETARY.—The term ‘‘Secretary’’ means 

8 the Secretary of Health and Human Services. 

9 (4) STATE.—The term ‘‘State’’ means the 50 

10 States and the District of Columbia. 

11 TITLE II—PUBLIC HEALTH 

12 PROGRAMS 

13 Subtitle A—National Health 

14 Service Corps 

15 SEC. 201. NATIONAL HEALTH SERVICE CORPS. 

16 (a) IN GENERAL.—Section 331 of the Public Health 

17 Service Act (42 U.S.C. 254d) is amended— 

18 (1) in subsection (a)(3), by adding at the end 

19 the following: 

20 ‘‘(F) The term ‘dental therapist’ means, 

21 with respect to a State that licenses such dental 

22 therapists, a mid-level dental practitioner who is 

23 licensed to practice under the law of the State 

24 and who provides preventive and restorative 


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1 services directly to the public, commensurate 

2 with the scope of the practice.’’; and 

3 (2) in subsection (b)— 

4 (A) in paragraph (1), by inserting ‘‘, den5 tal therapy,’’ after ‘‘dental’’; and 

6 (B) in paragraph (2), by inserting ‘‘dental 

7 therapists,’’ after ‘‘dentists,’’. 

8 (b) FACILITATION OF EFFECTIVE PROVISION OF

9 CORPS SERVICES.—Section 336(f)(3) of the Public Health 

10 Service Act (42 U.S.C. 254h–1(f)(3)) is amended by in11 serting ‘‘dental therapists’’ after ‘‘midwives,’’. 

12 (c) SCHOLARSHIP PROGRAM AND LOAN REPAYMENT

13 PROGRAM.— 

14 (1) SCHOLARSHIP PROGRAM.—Section 338A of 

15 the Public Health Service Act (42 U.S.C. 254l) is 

16 amended— 

17 (A) in subsection (a)(1), by inserting ‘‘den18 tal therapists,’’ after ‘‘dentists,’’; and 

19 (B) in subsection (b)(1), by inserting ‘‘in20 cluding dental therapy,’’ after ‘‘or other health 

21 profession,’’. 

22 (2) LOAN REPAYMENT PROGRAM.—Section 

23 338B of the Public Health Service Act (42 U.S.C. 

24 254l–1) is amended— 


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1 (A) in subsection (a)(1), by inserting ‘‘den2 tal therapists,’’ after ‘‘dentists,’’; and 

3 (B) in subsection (b)(1)— 

4 (i) in subparagraph (A), by inserting 

5 ‘‘dental therapist,’’ after ‘‘nurse practi6 tioner,’’; 

7 (ii) in subparagraph (B), by inserting 

8 ‘‘dental therapy,’’ after ‘‘mental health,’’; 

9 and 

10 (iii) in subparagraph (C)(ii), by in11 serting ‘‘, including dental therapy,’’ after 

12 ‘‘health profession’’. 

13 (3) AUTHORIZATION OF APPROPRIATIONS.— 

14 Section 338H of the Public Health Service Act (42 

15 U.S.C. 254q) is amended— 

16 (A) in subsection (a), by striking ‘‘this sec17 tion’’ and inserting ‘‘this subpart’’; and 

18 (B) by adding at the end the following: 

19 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS WITH

20 RESPECT TO ORAL HEALTH PROFESSIONALS.—To carry 

21 out this subpart with respect to dentists, dental therapists, 

22 and dental hygienists, in addition to the amounts author23 ized under subsection (a), there is authorized to be appro24 priated such sums as may be necessary for fiscal years 


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1 2013 through 2016, which shall be used to provide schol2 arships to such oral health professionals.’’. 

3 Subtitle B—Oral Health Education 

4 SEC. 211. AUTHORIZATION OF APPROPRIATIONS FOR ORAL 

5 HEALTH EDUCATION FOR MEDICAL PRO6 VIDERS. 

7 Section 747(c) of the Public Health Service Act (42 

8 U.S.C. 293k(c)) is amended by adding at the end the fol9 lowing: 

10 ‘‘(4) ORAL HEALTH EDUCATION.—In addition 

11 to other amounts authorized under this subsection 

12 for purposes of carrying out this section, there is au13 thorized to be appropriated such sums as may be 

14 necessary for fiscal years 2013 through 2016 for the 

15 purpose of educating nondental medical profes16 sionals, including physicians, nurses, and phar17 macists, about oral health, including issues such as 

18 oral hygiene instruction, topical application of fluo19 ride, and oral health screenings, with the goal of in20 tegrating oral health care into overall health care.’’. 

21 SEC. 212. ORAL HEALTH EDUCATION FOR OTHER NON22 HEALTH PROFESSIONALS. 

23 Subpart I of part C of title VII of the Public Health 

24 Service Act (42 U.S.C. 293k et seq.) is amended by insert25 ing after section 748 the following: 


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1 ‘‘SEC. 748A. ORAL HEALTH EDUCATION FOR OTHER NON2 ORAL HEALTH PROFESSIONALS. 

3 ‘‘(a) IN GENERAL.—The Secretary may make grants 

4 to, or enter into contracts with, an accredited public or 

5 nonprofit private hospital, an educational institution, or 

6 a public or private nonprofit entity which the Secretary 

7 has determined is capable of carrying out such grant or 

8 contract to educate individuals, such as community health 

9 workers, social workers, nutritionists, health educators, 

10 occupational therapists, and psychologists, to promote oral 

11 health education and to provide support for behavior 

12 change and assistance with care coordination with respect 

13 to oral health. 

14 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—To 

15 carry out this section, there is authorized to be appro16 priated such sums as may be necessary for fiscal years 

17 2013 through 2016.’’. 

18 SEC. 213. DENTAL EDUCATION. 

19 (a) TRAINING IN GENERAL, PEDIATRIC, AND PUBLIC

20 HEALTH DENTISTRY.—Section 748 of the Public Health 

21 Service Act (42 U.S.C. 293k–2) is amended— 

22 (1) in subsection (a)(1)(H), by striking ‘‘pedi23 atric training programs’’ and inserting ‘‘pediatric 

24 dental training programs’’; and 

25 (2) in subsection (c)— 


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1 (A) by striking the subsection heading and 

2 inserting ‘‘REQUIREMENTS FOR AWARD.—’’; 

3 (B) by amending the matter preceding 

4 paragraph (1) to read as follows: ‘‘With respect 

5 to training provided for under this section, the 

6 Secretary shall award grants or contracts only 

7 to eligible entities that meet at least 7 of the 

8 following criteria:’’; 

9 (C) in paragraph (2), by striking ‘‘have a 

10 record of training the greatest percentage of 

11 providers, or that have demonstrated significant 

12 improvements in the percentage of providers, 

13 who enter and’’ and inserting ‘‘train significant 

14 numbers of providers who’’; 

15 (D) in paragraph (3)— 

16 (i) by striking ‘‘have a record of train17 ing’’ and inserting ‘‘intent to train’’; and 

18 (ii) by striking the period at the end 

19 and inserting ‘‘and have faculty with expe20 rience in treating underserved popu21 lations.’’; 

22 (E) in paragraph (8), by inserting ‘‘or 

23 have established’’ after ‘‘establish’’; and 

24 (F) by adding at the end the following: 


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1 ‘‘(9) Qualified applicants that require not less 

2 than 200 hours of community-based education rota3 tions.’’. 

4 (b) DENTAL RESIDENCY PROGRAMS.—Part B of title 

5 III of the Public Health Service Act (42 U.S.C. 243 et 

6 seq.) is amended by adding at the end the following: 

7 ‘‘SEC. 320B. DENTAL RESIDENCY PROGRAMS. 

8 ‘‘As a condition for receiving Federal funds, dental 

9 training residency programs shall require individuals en10 rolled in such residency programs to provide dental serv11 ices— 

12 ‘‘(1) in hospital emergency rooms; or 

13 ‘‘(2) in community settings, in addition to the 

14 dental training otherwise required by such residency 

15 program.’’. 

16 SEC. 214. ORAL HEALTH PROFESSIONAL STUDENT LOANS. 

17 Part F of title VII of the Public Health Service Act 

18 (42 U.S.C. 295j) is amended by adding at the end the 

19 following: 

20 ‘‘SEC. 799C. ORAL HEALTH PROFESSIONAL STUDENT 

21 LOANS. 

22 ‘‘(a) IN GENERAL.—The Secretary shall establish 

23 and operate a student loan fund for oral health profes24 sional students, including dental hygienists, dental thera25 pists, and dentists. 


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1 ‘‘(b) CONTENT.—The Secretary shall establish and 

2 operate the student loan fund program under subsection 

3 (a) in the same manner and subject to the same terms 

4 as the loan fund program established with schools of nurs5 ing under section 835. 

6 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—To 

7 carry out this section, there are authorized to be appro8 priated such sums as may be necessary for fiscal years 

9 2013 through 2016.’’. 

10 Subtitle C—Other Oral Health 

11 Programs 

12 SEC. 221. ACCESS POINTS. 

13 Subpart X of part D of title III of the Public Health 

14 Service Act (42 U.S.C. 256f et seq.) is amended by adding 

15 at the end the following: 

16 ‘‘SEC. 340G–2. FUNDING FOR ORAL HEALTH SERVICES. 

17 ‘‘(a) IN GENERAL.—The Secretary, acting through 

18 the Administrator of the Health Resources and Services 

19 Administration, shall establish a program to award grants 

20 to eligible entities to provide oral health services, or to con21 tract with private dental practices to provide comprehen22 sive oral health services, to low income individuals and in23 dividuals who are underserved with respect to oral health 

24 care. 


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1 ‘‘(b) TECHNICAL ASSISTANCE.—The Secretary shall 

2 provide technical assistance to entities receiving grants 

3 under subsection (a) to provide technical assistance to 

4 such entities in order to— 

5 ‘‘(1) with respect to oral health care services, 

6 increase efficiency and minimize missed appoint7 ments, contract with offsite providers, recruit pro8 viders (including oral health specialists), and operate 

9 programs outside the physical facilities to take ad10 vantage of new systems to improve access to oral 

11 health services; or 

12 ‘‘(2) contract with private dental practices that 

13 will provide oral health services other than preven14 tive oral health care, including restoration and main15 tenance of oral health, in order to meet the need for 

16 oral health services in the community. 

17 ‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive 

18 a grant under subsection (a), an entity shall— 

19 ‘‘(1) be— 

20 ‘‘(A) a Federally qualified health center 

21 (as defined in section 1861(aa) of the Social 

22 Security Act); 

23 ‘‘(B) a safety net clinic or a free clinic (as 

24 defined by the Secretary); 


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1 ‘‘(C) a health care clinic that provides 

2 services to tribal organizations or urban Indian 

3 organizations (as such terms are defined in sec4 tion 4 of the Indian Health Care Improvement 

5 Act); or 

6 ‘‘(D) any other interested public or private 

7 sector health care provider or organization that 

8 the Secretary determines has a demonstrated 

9 history in serving a high number of uninsured 

10 and or low-income individuals or those who lack 

11 ready access to oral health services; and 

12 ‘‘(2) demonstrate a clear need to expand oral 

13 health care services beyond preventive oral health 

14 care. 

15 ‘‘(d) ALLOCATION FOR HIRING ORAL HEALTH CARE

16 SPECIALISTS.—A portion of the funds available under this 

17 section shall be allocated toward hiring oral health care 

18 specialists, such as oral surgeons, at entities receiving 

19 grants under this section. 

20 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 

21 carry out this section, there is authorized to be appro22 priated such sums as may be necessary for each of fiscal 

23 years 2013 through 2016.’’. 


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1 SEC. 222. DENTAL CLINICS IN SCHOOLS. 

2 Part Q of title III of the Public Health Service Act 

3 (42 U.S.C. 280h et seq.) is amended by adding at the end 

4 the following: 

5 ‘‘SEC. 399Z–2. DENTAL CLINICS IN SCHOOLS. 

6 ‘‘(a) IN GENERAL.—The Secretary shall award 

7 grants to qualified entities for the purpose of funding the 

8 building, operation, or expansion of dental clinics in 

9 schools. 

10 ‘‘(b) QUALIFIED ENTITIES.—To receive a grant 

11 under this section, a qualified entity shall submit an appli12 cation to the Secretary at such time, in such manner, and 

13 containing such information as the Secretary may require. 

14 ‘‘(c) REQUIREMENTS.—An entity receiving a grant 

15 under this section shall— 

16 ‘‘(1) provide comprehensive oral health services 

17 at a dental clinic based at a school, including oral 

18 health education, oral screening, fluoride application, 

19 prophylaxis, and sealants; 

20 ‘‘(2) refer patients to an available qualified oral 

21 health provider in the community for any required 

22 oral health services not provided in the dental clinic 

23 in the school, to ensure that all the oral health needs 

24 of students are met; and 

25 ‘‘(3) maintain clinic hours that extend beyond 

26 school hours. 


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1 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For 

2 purposes of carrying out this section, there is authorized 

3 to be appropriated such sums as may be necessary for fis4 cal years 2013 through 2016.’’. 

5 SEC. 223. EMERGENCY ROOM CARE COORDINATION. 

6 Part B of title III of the Public Health Service Act 

7 (42 U.S.C. 243 et seq.), as amended by section 213(b), 

8 is further amended by adding at the end the following: 

9 ‘‘SEC. 320C. EMERGENCY ROOM CARE COORDINATION WITH 

10 RESPECT TO DENTAL CARE. 

11 ‘‘(a) IN GENERAL.—The Secretary, acting through 

12 the Administrator of the Health Resources and Services 

13 Administration, shall establish a grant program to enable 

14 individuals to receive dental care at a facility operated by 

15 a grant recipient rather than at a hospital emergency 

16 room. 

17 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 

18 a grant under this section, an entity shall be— 

19 ‘‘(1) a hospital in partnership with a Federally 

20 qualified health center; 

21 ‘‘(2) a Federally qualified health center; 

22 ‘‘(3) a private dental practice; or 

23 ‘‘(4) any other interested public or private sec24 tor health care provider or organization that the 

25 Secretary determines has the capacity to serve a 


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1 high number of individuals who lack access to oral 

2 health services. 

3 ‘‘(c) ORAL HEALTH EDUCATION FOR ER PHYSI4 CIANS.—The Secretary shall allocate a portion of the 

5 amounts appropriated under subsection (e) toward med6 ical education for emergency room physicians to be trained 

7 in oral health. 

8 ‘‘(d) REPORT.—Not later than January 1, 2016, the 

9 Secretary shall submit to Congress a report on the best 

10 practices determined by the program established under 

11 this section to address oral health needs of individuals who 

12 go to emergency rooms in need of oral health care. 

13 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 

14 carry out this section, there is authorized to be appro15 priated such sums as may be necessary for fiscal years 

16 2013 through 2016.’’. 

17 SEC. 224. RESEARCH FUNDING. 

18 For fiscal years 2013 through 2016, there is author19 ized to be appropriated such sums as may be necessary 

20 to each of— 

21 (1) the Centers for Disease Control and Preven22 tion, for the purpose of conducting research on— 

23 (A) the prevention of oral health disease; 

24 and 

25 (B) oral health disease management; 


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1 (2) the Agency for Healthcare Research and 

2 Quality, for the purpose of conducting— 

3 (A) research with respect to oral health 

4 services and the delivery of oral health services; 

5 and 

6 (B) an evaluation of oral health service de7 livery to underserved and vulnerable popu8 lations; 

9 (3) the National Institute of Dental and 

10 Craniofacial Research for the purpose of conducting 

11 research on oral health disease management includ12 ing pharmaceutical-behavioral intervention; and 

13 (4) the Maternal and Child Health Bureau for 

14 the purpose of conducting research on maternal and 

15 child oral health issues. 

16 SEC. 225. MOBILE AND PORTABLE DENTAL SERVICES. 

17 Subpart X of part D of title III of the Public Health 

18 Service Act (42 U.S.C. 256f et seq.), as amended by sec19 tion 221, is further amended by adding at the end the 

20 following: 

21 ‘‘SEC. 340G–3. MOBILE AND PORTABLE DENTAL SERVICES. 

22 ‘‘(a) IN GENERAL.—The Secretary shall award 

23 grants to rural health clinics, as defined in section 

24 1861(aa)(2) of the Social Security Act (42 U.S.C. 

25 1395x(aa)(2)), to provide mobile and portable, comprehenVerDate Mar 15 2010 01:27 Jun 09, 2012 Jkt 019200 PO 00000 Frm 00031 Fmt 6652 Sfmt 6201 E:\BILLS\S3272.IS S3272

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1 sive dental services (including dental services provided by 

2 licensed providers through telehealth-enabled collaboration 

3 and supervision) and outreach for dental services at loca4 tions such as senior centers, nursing homes, assisted living 

5 facilities, schools, licensed day care centers that serve chil6 dren who receive benefits under the State Children’s 

7 Health Insurance Program under title XXI of the Social 

8 Security Act (42 U.S.C. 1397aa et seq.) or the Medicaid 

9 program under title XIX of the Social Security Act (42 

10 U.S.C. 1396 et seq.), and facilities that provide services 

11 under the Special Supplemental Nutrition Program for 

12 Women, Infants, and Children (the WIC program) or the 

13 Head Start Act (42 U.S.C. 9831 et seq.). 

14 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—To 

15 carry out this section, there are authorized to be appro16 priated such sums as may be necessary.’’. 


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1 TITLE III—DEPARTMENT OF 

2 VETERANS AFFAIRS AND DE3 PARTMENT OF DEFENSE MAT4 TERS 

5 Subtitle A—Department of 

6 Veterans Affairs Matters 

7 SEC. 301. REQUIRING SECRETARY OF VETERANS AFFAIRS 

8 TO FURNISH DENTAL CARE IN SAME MANNER 

9 AS ANY OTHER MEDICAL SERVICE. 

10 (a) IN GENERAL.—Title 38, United States Code, is 

11 amended— 

12 (1) in section 1701(6), by striking ‘‘as de13 scribed in sections 1710 and 1712 of this title’’; 

14 (2) in section 1710(c), by striking the second 

15 sentence; 

16 (3) in section 1712— 

17 (A) by striking subsections (a) and (b); 

18 and 

19 (B) by redesignating subsections (c) 

20 through (e) as subsections (a) through (c), re21 spectively; and 

22 (4) by striking section 2062. 

23 (b) CONFORMING AMENDMENTS.—Such title is fur24 ther amended— 


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1 (1) in section 1525(a), by striking ‘‘medicines 

2 under section 1712(d)’’ and inserting ‘‘medicines 

3 under section 1712(b)’’; and 

4 (2) in section 1703(a)(7), by striking ‘‘, for a 

5 veteran described in section 1712(a)(1)(F) of this 

6 title’’. 

7 (c) CLERICAL AMENDMENTS.—Such title is further 

8 amended— 

9 (1) in section 1712, in the heading for such sec10 tion, by striking ‘‘Dental care; drugs’’ and in11 serting ‘‘Drugs’’; 

12 (2) in the table of sections at the beginning of 

13 chapter 17, by striking the item relating to section 

14 1712 and inserting the following new item: 

‘‘1712. Drugs and medicines for certain disabled veterans; vaccines.’’; 

15 and 

16 (3) in the table of sections at the beginning of 

17 chapter 20, by striking the item relating to section 

18 2062. 


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1 SEC. 302. DEMONSTRATION PROGRAM ON TRAINING AND 

2 EMPLOYMENT OF ALTERNATIVE DENTAL 

3 HEALTH CARE PROVIDERS FOR DENTAL 

4 HEALTH CARE SERVICES FOR VETERANS IN 

5 RURAL AND OTHER UNDERSERVED COMMU6 NITIES. 

7 (a) DEMONSTRATION PROGRAM AUTHORIZED.—The 

8 Secretary of Veterans Affairs may carry out a demonstra9 tion program to establish programs to train and employ 

10 alternative dental health care providers in order to in11 crease access to dental health care services for veterans 

12 entitled to such services who reside in rural and other un13 derserved communities. 

14 (b) TELEHEALTH.—For purposes of alternative den15 tal health care providers and any other dental care pro16 viders who are licensed to provide clinical care, dental 

17 services provided under the demonstration program under 

18 this section may be administered by such providers 

19 through telehealth-enabled collaboration and supervision 

20 when deemed appropriate and feasible. 

21 (c) ALTERNATIVE DENTAL HEALTH CARE PRO22 VIDERS DEFINED.—In this section, the term ‘‘alternative 

23 dental health care providers’’ has the meaning given that 

24 term in section 340G–1(a)(2) of the Public Health Service 

25 Act (42 U.S.C. 256g–1(a)(2)). 


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1 (d) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated such sums as are nec3 essary to carry out the demonstration program under this 

4 section. 

5 Subtitle B—Department of Defense 

6 Matters 

7 SEC. 311. DEMONSTRATION PROGRAM ON TRAINING AND 

8 EMPLOYMENT OF ALTERNATIVE DENTAL 

9 HEALTH CARE PROVIDERS FOR DENTAL 

10 HEALTH CARE SERVICES FOR MEMBERS OF 

11 THE ARMED FORCES AND DEPENDENTS 

12 LACKING READY ACCESS TO SUCH SERVICES. 

13 (a) DEMONSTRATION PROGRAM AUTHORIZED.—The 

14 Secretary of Defense may carry out a demonstration pro15 gram to establish programs to train and employ alter16 native dental health care providers in order to increase ac17 cess to dental health care services for members of the 

18 Armed Forces and their dependents who lack ready access 

19 to such services, including the following: 

20 (1) Members and dependents who reside in 

21 rural areas or areas otherwise underserved by dental 

22 health care providers. 

23 (2) Members of the National Guard and Re24 serves in active status who are potentially 

25 deployable. 


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1 (b) TELEHEALTH.—For purposes of alternative den2 tal health care providers and any other dental care pro3 viders who are licensed to provide clinical care, dental 

4 services provided under the demonstration program under 

5 this section may be administered by such providers 

6 through telehealth-enabled collaboration and supervision 

7 when deemed appropriate and feasible. 

8 (c) ALTERNATIVE DENTAL HEALTH CARE PRO9 VIDERS DEFINED.—In this section, the term ‘‘alternative 

10 dental health care providers’’ has the meaning given that 

11 term in section 340G–1(a)(2) of the Public Health Service 

12 Act (42 U.S.C. 256g–1(a)(2)). 

13 (d) AUTHORIZATION OF APPROPRIATIONS.—There 

14 are authorized to be appropriated such sums as are nec15 essary to carry out the demonstration program under this 

16 section. 


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1 TITLE IV—FEDERAL BUREAU OF 

2 PRISONS 

3 SEC. 401. DEMONSTRATION PROGRAM ON TRAINING AND 

4 EMPLOYMENT OF ALTERNATIVE DENTAL 

5 HEALTH CARE PROVIDERS FOR DENTAL 

6 HEALTH CARE SERVICES FOR PRISONERS 

7 WITHIN THE CUSTODY OF THE BUREAU OF 

8 PRISONS. 

9 (a) DEMONSTRATION PROGRAM AUTHORIZED.—The 

10 Attorney General, acting through the Director of the Bu11 reau of Prisons, may carry out a demonstration program 

12 to establish programs to train and employ alternative den13 tal health care providers in order to increase access to den14 tal health services for prisoners within the custody of the 

15 Bureau of Prisons. 

16 (b) TELEHEALTH.—For purposes of alternative den17 tal health care providers and any other dental care pro18 viders who are licensed to provide clinical care, dental 

19 services provided under the demonstration program under 

20 this section may be administered by such providers 

21 through telehealth-enabled collaboration and supervision 

22 when deemed appropriate and feasible. 

23 (c) ALTERNATIVE DENTAL HEALTH CARE PRO24 VIDERS DEFINED.—In this section, the term ‘‘alternative 

25 dental health care providers’’ has the meaning given that 


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1 term in section 340G–1(a)(2) of the Public Health Service 

2 Act (42 U.S.C. 256g–1(a)(2)). 

3 (d) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated such sums as are nec5 essary to carry out the demonstration program under this 

6 section. 

7 TITLE V—INDIAN HEALTH 

8 SERVICE 

9 SEC. 501. DEMONSTRATION PROGRAM ON TRAINING AND 

10 EMPLOYMENT OF ALTERNATIVE DENTAL 

11 HEALTH CARE PROVIDERS FOR DENTAL 

12 HEALTH CARE SERVICES UNDER THE INDIAN 

13 HEALTH SERVICE. 

14 (a) DEMONSTRATION PROGRAM AUTHORIZED.—The 

15 Secretary of Health and Human Services, acting through 

16 the Indian Health Service, may carry out a demonstration 

17 program to establish programs to train and employ alter18 native dental health care providers in order to help elimi19 nate oral health disparities and increase access to dental 

20 services through health programs operated by the Indian 

21 Health Service, Indian tribes, tribal organizations, and 

22 Urban Indian organizations (as those terms are defined 

23 in section 4 of the Indian Health Care Improvement Act 

24 (25 U.S.C. 1603)). 


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1 (b) TELEHEALTH.—For purposes of alternative den2 tal health care providers and any other dental care pro3 viders who are licensed to provide clinical care, dental 

4 services provided under the demonstration program under 

5 this section may be administered by such providers 

6 through telehealth-enabled collaboration and supervision 

7 when deemed appropriate and feasible. 

8 (c) ALTERNATIVE DENTAL HEALTH CARE PRO9 VIDERS DEFINED.—In this section, the term ‘‘alternative 

10 dental health care providers’’ has the meaning given that 

11 term in section 340G–1(a)(2) of the Public Health Service 

12 Act (42 U.S.C. 256g–1(a)(2)). 

13 (d) AUTHORIZATION OF APPROPRIATIONS.—There 

14 are authorized to be appropriated such sums as are nec15 essary to carry out the demonstration program under this 

16 section. 

17 TITLE VI—REPORTS TO 

18 CONGRESS 

19 SEC. 601. EVALUATION OF EXPANSION OF COVERAGE FOR 

20 DENTAL SERVICES. 

21 (a) SECRETARY OF HEALTH AND HUMAN SERV22 ICES.—Not later than October 1, 2016, the Secretary of 

23 Health and Human Services shall submit to Congress a 

24 report that provides a comprehensive cost-benefit analysis 

25 regarding the expansion of coverage for dental services 


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1 pursuant to this Act, including whether the provision of 

2 such services resulted in a reduction in total health care 

3 costs for individuals under the Medicare and Medicaid 

4 programs. 

5 (b) COMPTROLLER GENERAL.— 

6 (1) MEDICAID AND MEDICARE.—Not later than 

7 October 1, 2015, the Comptroller General of the 

8 United States shall submit to Congress a report that 

9 provides a comprehensive analysis and evaluation of 

10 the implementation and utilization of the expanded 

11 coverage for dental services pursuant to this Act for 

12 individuals enrolled in the Medicare and Medicaid 

13 programs. 

14 (2) DEMONSTRATION PROGRAMS.—Not later 

15 than October 1, 2016, the Comptroller General of 

16 the United States shall submit to Congress a report 

17 that provides a comprehensive analysis and evalua18 tion of the demonstration programs described in sec19 tions 302, 311, 401, and 501, including— 

20 (A) the extent to which the programs im21 proved access to oral health care and increased 

22 utilization of oral health services; and 

23 (B) an examination of the training pro24 vided under the programs to alternative dental 


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1 health care providers and the quality of care 

2 provided by such providers. 

3 TITLE VII—FUNDING 

4 SEC. 701. TRANSACTION TAX. 

5 (a) IN GENERAL.—Chapter 36 of the Internal Rev6 enue Code of 1986 is amended by inserting after sub7 chapter B the following new subchapter: 

8 ‘‘Subchapter C—Tax on Trading Transactions 

‘‘Sec. 4475. Tax on trading transactions. 

9 ‘‘SEC. 4475. TAX ON TRADING TRANSACTIONS. 

10 ‘‘(a) IMPOSITION OF TAX.—There is hereby imposed 

11 a tax on each covered transaction with respect to any secu12 rity. 

13 ‘‘(b) RATE OF TAX.—The tax imposed under sub14 section (a) with respect to any covered transaction shall 

15 be 0.025 percent of the specified base amount with respect 

16 to such covered transaction. 

17 ‘‘(c) SPECIFIED BASE AMOUNT.—For purposes of 

18 this section, the term ‘specified base amount’ means— 

19 ‘‘(1) except as provided in paragraph (2), the 

20 fair market value of the security (determined as of 

21 the time of the covered transaction), and 

22 ‘‘(2) in the case of any payment described in 

23 subsection (h), the amount of such payment. 


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1 ‘‘(d) COVERED TRANSACTION.—For purposes of this 

2 section, the term ‘covered transaction’ means— 

3 ‘‘(1) except as provided in paragraph (2), any 

4 purchase if— 

5 ‘‘(A) such purchase occurs or is cleared on 

6 a facility located in the United States, or 

7 ‘‘(B) the purchaser or seller is a United 

8 States person, and 

9 ‘‘(2) any transaction with respect to a security 

10 described in subparagraph (D), (E), or (F) of sub11 section (e)(1), if— 

12 ‘‘(A) such security is traded or cleared on 

13 a facility located in the United States, or 

14 ‘‘(B) any party with rights under such se15 curity is a United States person. 

16 ‘‘(e) SECURITY AND OTHER DEFINITIONS.—For pur17 poses of this section: 

18 ‘‘(1) IN GENERAL.—The term ‘security’ 

19 means— 

20 ‘‘(A) any share of stock in a corporation, 

21 ‘‘(B) any partnership or beneficial owner22 ship interest in a partnership or trust, 

23 ‘‘(C) any note, bond, debenture, or other 

24 evidence of indebtedness, 


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1 ‘‘(D) any evidence of an interest in, or a 

2 derivative financial instrument with respect to, 

3 any security or securities described in subpara4 graph (A), (B), or (C), 

5 ‘‘(E) any derivative financial instrument 

6 with respect to any currency or commodity, and 

7 ‘‘(F) any other derivative financial instru8 ment any payment with respect to which is cal9 culated by reference to any specified index. 

10 ‘‘(2) DERIVATIVE FINANCIAL INSTRUMENT.— 

11 The term ‘derivative financial instrument’ includes 

12 any option, forward contract, futures contract, no13 tional principal contract, or any similar financial in14 strument. 

15 ‘‘(3) SPECIFIED INDEX.—The term ‘specified 

16 index’ means any 1 or more of any combination of— 

17 ‘‘(A) a fixed rate, price, or amount, or 

18 ‘‘(B) a variable rate, price, or amount,

19 which is based on any current objectively deter20 minable information which is not within the control 

21 of any of the parties to the contract or instrument 

22 and is not unique to any of the parties’ cir23 cumstances. 

24 ‘‘(4) TREATMENT OF EXCHANGES.— 


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1 ‘‘(A) IN GENERAL.—An exchange shall be 

2 treated as the sale of the property transferred 

3 and a purchase of the property received by each 

4 party to the exchange. 

5 ‘‘(B) CERTAIN DEEMED EXCHANGES.—In 

6 the case of a distribution treated as an ex7 change for stock under section 302 or 331, the 

8 corporation making such distribution shall be 

9 treated as having purchased such stock for pur10 poses of this section. 

11 ‘‘(f) EXCEPTIONS.— 

12 ‘‘(1) EXCEPTION FOR INITIAL ISSUES.—No tax 

13 shall be imposed under subsection (a) on any cov14 ered transaction with respect to the initial issuance 

15 of any security described in subparagraph (A), (B), 

16 or (C) of subsection (e)(1). 

17 ‘‘(2) EXCEPTION FOR CERTAIN TRADED SHORT18 TERM INDEBTEDNESS.—A note, bond, debenture, or 

19 other evidence of indebtedness which— 

20 ‘‘(A) is traded on a trading facility located 

21 in the United States, and 

22 ‘‘(B) has a fixed maturity of not more 

23 than 100 days, 

24 shall not be treated as described in subsection 

25 (e)(1)(C). 


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1 ‘‘(3) EXCEPTION FOR SECURITIES LENDING AR2 RANGEMENTS.—No tax shall be imposed under sub3 section (a) on any covered transaction with respect 

4 to which gain or loss is not recognized by reason of 

5 section 1058. 

6 ‘‘(g) BY WHOM PAID.— 

7 ‘‘(1) IN GENERAL.—The tax imposed by this 

8 section shall be paid by— 

9 ‘‘(A) in the case of a transaction which oc10 curs or is cleared on a facility located in the 

11 United States, such facility, and 

12 ‘‘(B) in the case of a purchase not de13 scribed in subparagraph (A) which is executed 

14 by a broker (as defined in section 6045(c)(1)) 

15 which is a United States person, such broker. 

16 ‘‘(2) SPECIAL RULES FOR DIRECT, ETC., 

17 TRANSACTIONS.—In the case of any transaction to 

18 which paragraph (1) does not apply, the tax imposed 

19 by this section shall be paid by— 

20 ‘‘(A) in the case of a transaction described 

21 in subsection (d)(1)— 

22 ‘‘(i) the purchaser if the purchaser is 

23 a United States person, and 

24 ‘‘(ii) the seller if the purchaser is not 

25 a United States person, and 


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1 ‘‘(B) in the case of a transaction described 

2 in subsection (d)(2)— 

3 ‘‘(i) the payor if the payor is a United 

4 States person, and 

5 ‘‘(ii) the payee if the payor is not a 

6 United States person. 

7 ‘‘(h) CERTAIN PAYMENTS TREATED AS SEPARATE

8 TRANSACTIONS.—Except as otherwise provided by the 

9 Secretary, any payment with respect to a security de10 scribed in subparagraph (D), (E), or (F) of subsection 

11 (e)(1) shall be treated as a separate transaction for pur12 poses of this section, including— 

13 ‘‘(1) any net initial payment, net final or termi14 nating payment, or net periodical payment with re15 spect to a notional principal contract (or similar fi16 nancial instrument), 

17 ‘‘(2) any payment with respect to any forward 

18 contract (or similar financial instrument), and 

19 ‘‘(3) any premium paid with respect to any op20 tion (or similar financial instrument). 

21 ‘‘(i) ADMINISTRATION.—The Secretary shall carry 

22 out this section in consultation with the Securities and Ex23 change Commission and the Commodity Futures Trading 

24 Commission. 


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48 

•S 3272 IS

1 ‘‘(j) GUIDANCE; REGULATIONS.—The Secretary 

2 shall— 

3 ‘‘(1) provide guidance regarding such informa4 tion reporting concerning covered transactions as the 

5 Secretary deems appropriate, and 

6 ‘‘(2) prescribe such regulations as are necessary 

7 or appropriate to prevent avoidance of the purposes 

8 of this section, including the use of non-United 

9 States persons in such transactions.’’. 

10 (b) CLERICAL AMENDMENT.—The table of sub11 chapters for chapter 36 of the Internal Revenue Code of 

12 1986 is amended by inserting after the item relating to 

13 subchapter B the following new item: 

‘‘Subchapter C. Tax on trading transactions.’’. 

14 (c) EFFECTIVE DATE.—The amendments made by 

15 this section shall apply to transactions after December 31, 

16 2012. 

Æ 


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