Foster Youth Dental Act of 2021

To amend title XIX of the Social Security Act to strengthen coverage under the Medicaid program for certain foster youth individuals. 1. Short title This Act may be cited as the Foster Youth Dental Act of 2021 2. Strengthening coverage under the Medicaid program for certain foster youth individuals (a) Expansion of EPSDT services to certain individuals aged 21–25 (1) In general Section 1905(a) of the Social Security Act ( 42 U.S.C. 1396d(a) (A) in paragraph (4)(B), by inserting (or, in the case of a specified individual (as defined in the matter at the end of this subsection), under the age of 26) 21 (B) by adding at the end the following new sentence: For purposes of paragraph (4)(B), the term specified individual (2) Provision of information with respect to dental services Section 1902(a)(43)(A) of the Social Security Act ( 42 U.S.C. 1396a(a)(43)(A) (A) by inserting (or, in the case of a specified individual (as defined in the matter at the end of section 1905(a)), under the age of 26) 21 (B) by inserting (including dental services) treatment services (C) by striking and the need , the need (D) by striking the comma at the end and inserting , and the importance of maintaining good oral health, (3) Effective date (A) Extension of coverage The amendments made by paragraph (1) shall apply with respect to medical assistance furnished during calendar quarters beginning on or after the date that is 80 days after the date of the enactment of this Act. (B) Provision of information The amendment made by paragraph (2) shall apply to information provided under section 1902(a)(43)(A) of the Social Security Act ( 42 U.S.C. 1396a(a)(43)(A) (b) Incentive for the provision of dental services to certain individuals (1) In general Section 1902(a) of the Social Security Act ( 42 U.S.C. 1396a(a) (A) in paragraph (13)— (i) in subparagraph (B), by striking and (ii) in subparagraph (C), by adding and (iii) by adding at the end the following new subparagraph: (D) for payment for dental services furnished on or after the first day of the first calendar quarter beginning on or after the date that is 80 days after the date of the enactment of this subparagraph by a dentist to a specified individual (as defined in the matter at the end of section 1905(a)) under the age of 26 at a rate not less than the specified average rate (as defined in subsection (tt)) for such services. ; and (B) by adding at the end the following new subsection: (tt) Specified average rate defined (1) In general For purposes of subsection (a)(13)(D), the term specified average rate (A) for such service furnished in such State (as determined by the State); or (B) for such service furnished in the United States (as determined by the Secretary); as selected by such State. (2) Contracted rate defined (A) In general For purposes of paragraph (1), the term contracted rate (B) Exclusion of self-insured group health plan rates For purposes of subparagraph (A), the term contracted rate . (2) Medicaid managed care plans Section 1932(f) of the Social Security Act ( 42 U.S.C. 1396u–2(f) (A) in the header, by striking primary care services certain services (B) by inserting or dental services primary care services (C) by striking section 1902(a)(13)(C) subparagraph (C) or (D), respectively, of section 1902(a)(13) (D) by striking such section such subparagraph (C) or (D), as applicable (3) Increased FMAP for increased expenses Section 1905 of the Social Security Act ( 42 U.S.C. 1396d (gg) Increased FMAP for additional expenditures for dental services Notwithstanding subsection (b), with respect to the portion of the amounts expended for medical assistance for services described in section 1902(a)(13)(D) furnished on or after the first day of the first calendar quarter beginning on or after the date that is 80 days after the date of the enactment of this subsection furnished to an individual described in such section by a dentist that is attributable to the amount by which the minimum payment rate required under such section (or, by application, section 1932(f)) exceeds the payment rate applicable to such services under the State plan as of January 1, 2021, the Federal medical assistance percentage for a State that is one of the 50 States or the District of Columbia shall be equal to 100 percent. The preceding sentence does not prohibit the payment of Federal financial participation based on the Federal medical assistance percentage for amounts in excess of those specified in such sentence. . (c) Outreach efforts for enrollment of former foster children Section 1902(a) of the Social Security Act ( 42 U.S.C. 1396a(a) (1) in paragraph (85), by striking ; and (2) in paragraph (86), by striking the period at the end and inserting ; and (3) by inserting after paragraph (86) the following new paragraph: (87) not later than 6 months after the date of the enactment of this paragraph— (A) establish an outreach and enrollment program, in coordination with the State agency responsible for administering the State plan under part E of title IV and any other appropriate or interested agencies, designed to increase the enrollment of individuals who are eligible for medical assistance under the State plan under paragraph (10)(A)(i)(IX) in accordance with best practices established by the Secretary; and (B) establish an outreach program to dentists practicing in such State to encourage enrollment by such dentists in such plan as participating providers under such plan. . (d) Providing for immediate eligibility for former foster youth Section 1002(a)(2) of the SUPPORT for Patients and Communities Act ( Public Law 115–271 January 1, 2023 the date of enactment of the Foster Youth Dental Act of 2021

Summary: Foster Youth Dental Act of 2021 This bill expands Medicaid coverage of current and former foster youth, particularly with respect to dental services. Specifically, the bill requires state Medicaid programs to cover early and periodic screening, diagnostic, and treatment services, including dental services, for current and former foster youth under the age of 26. States must set a special payment rate, based on rates in the private sector, for dental services provided to such individuals; the bill provides an enhanced Federal Medical Assistance Percentage (i.e., federal matching rate) for excess expenses that result from such payments. The bill's requirements take effect 80 days after the date of enactment of the bill. The bill also accelerates the application of certain provisions that require a state Medicaid program to cover former foster youth from other states until the age of 26; such provisions currently apply to former foster youth who reach the age of 18 on or after January 1, 2023. The bill instead applies these provisions to former foster youth who reach the age of 18 on or after the date of enactment of the bill.