I 
118TH CONGRESS 
1ST SESSION 
H. R. 33 
To amend title XVIII of the Social Security Act to provide for coverage 
of dental, vision, and hearing care under the Medicare program. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 9, 2023 
Mr. DOGGETT (for himself, Mrs. BEATTY, Mr. BEYER, Mr. BISHOP of Geor-
gia, Mr. BLUMENAUER, Mr. BOWMAN, Ms. BUSH, Mr. CARSON, Mr. CAR-
TER of Louisiana, Mr. CARTWRIGHT, Mr. CASAR, Mr. CASTRO of Texas, 
Ms. CHU, Mr. CLEAVER, Mr. COHEN, Mr. CONNOLLY, Mr. COURTNEY, 
Mr. CUELLAR, Ms. DELAURO, Mr. DESAULNIER, Mrs. DINGELL, Ms. 
ESCOBAR, Mr. ESPAILLAT, Mr. EVANS, Ms. LEGER FERNANDEZ, Mr. 
GARAMENDI, Mr. GARCI´A of Illinois, Ms. GARCIA of Texas, Mr. VICENTE 
GONZALEZ of Texas, Mr. GOTTHEIMER, Mr. GREEN of Texas, Mr. GRI-
JALVA, Mrs. HAYES, Mr. HIGGINS of New York, Ms. JACKSON LEE, Ms. 
JAYAPAL, Mr. JOHNSON of Georgia, Ms. KAPTUR, Mr. KHANNA, Mr. KIM 
of New Jersey, Mr. LARSON of Connecticut, Ms. LEE of California, Mr. 
LIEU, Ms. MCCOLLUM, Mr. MCGOVERN, Ms. MENG, Mr. MFUME, Ms. 
MOORE of Wisconsin, Mr. NADLER, Mr. NEGUSE, Mr. NORCROSS, Ms. 
NORTON, Ms. OCASIO-CORTEZ, Ms. OMAR, Mr. PASCRELL, Mr. PAYNE, 
Ms. PINGREE, Mr. POCAN, Ms. PORTER, Ms. PRESSLEY, Ms. BLUNT 
ROCHESTER, Mr. RUIZ, Mr. RUPPERSBERGER, Ms. SCHAKOWSKY, Mr. 
SCHIFF, Mr. DAVID SCOTT of Georgia, Mr. SHERMAN, Mr. SWALWELL, 
Mr. TAKANO, Mr. THOMPSON of California, Ms. TITUS, Ms. TLAIB, Mr. 
TONKO, Mr. TORRES of New York, Mrs. TRAHAN, Mr. TRONE, Mr. 
VEASEY, Mrs. WATSON COLEMAN, and Ms. WILLIAMS of Georgia) intro-
duced the following bill; which was referred to the Committee on Energy 
and Commerce, and in addition to the Committee on Ways and Means, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of the 
committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
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for coverage of dental, vision, and hearing care under 
the Medicare program. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Dental, Vi-
sion, and Hearing Benefit Act of 2023’’. 
SEC. 2. DENTAL AND ORAL HEALTH CARE. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)) is amended— 
(1) in subparagraph (II), by striking ‘‘and’’ 
after the semicolon at the end; 
(2) in subparagraph (JJ), by adding ‘‘and’’ 
after the semicolon at the end; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(KK) dental and oral health services (as de-
fined in subsection (nnn));’’. 
(b) DENTAL
AND ORAL HEALTH SERVICES DE-
FINED.—Section 1861 of the Social Security Act (42 
U.S.C. 1395x) is amended by adding at the end the fol-
lowing new subsection: 
‘‘Dental and Oral Health Services 
‘‘(nnn) The term ‘dental and oral health services’ 
means— 
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‘‘(1) preventative and screening services, such 
as oral exams, dental cleanings, dental x-rays, and 
fluoride treatments; 
‘‘(2) basic dental services, such as tooth res-
torations, basic periodontics services, tooth extrac-
tions, and oral disease management services; 
‘‘(3) major dental services, such as major tooth 
restorations, major periodontics services, bridges, 
crowns, root canals, and extractions; 
‘‘(4) emergency dental care; and 
‘‘(5) other necessary services related to dental 
or oral health (as defined by the Secretary).’’. 
(c) PAYMENT; COINSURANCE; AND LIMITATIONS.— 
(1) IN GENERAL.—Section 1833(a)(1) of the 
Social Security Act (42 U.S.C. 1395l(a)(1)) is 
amended— 
(A) by striking ‘‘and’’ before ‘‘(GG)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (HH) with respect 
to dental and oral health services (as defined in 
section 1861(lll)), the amount paid shall be the 
payment 
amount 
specified 
under 
section 
1834(aa)’’. 
(2) PAYMENT AND LIMITS SPECIFIED.—Section 
1834 of the Social Security Act (42 U.S.C. 1395m) 
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is amended by adding at the end the following new 
subsection: 
‘‘(aa) PAYMENT AND LIMITS FOR DENTAL AND ORAL 
HEALTH SERVICES.— 
‘‘(1) IN
GENERAL.—The payment amount 
under this part for dental and oral health services 
(as defined in section 1861(nnn)) shall be, subject to 
paragraph (3), the applicable percent (specified in 
paragraph (2)) of the lesser of the actual charge for 
the services or the amount determined under the 
payment basis determined under section 1848. 
‘‘(2) APPLICABLE PERCENT.— 
‘‘(A) IN GENERAL.—For purposes of para-
graph (1), except as provided in subparagraph 
(B), the applicable percent specified in this 
paragraph is— 
‘‘(i) with respect to services described 
in section 1861(nnn)(1) furnished during 
2024 or a subsequent year, 100 percent; 
and 
‘‘(ii) with respect to services not de-
scribed in clause (i)— 
‘‘(I) for a year before 2025, 0 
percent; 
‘‘(II) for 2025, 30 percent; 
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‘‘(III) for 2026, 60 percent; and 
‘‘(IV) for 2027 and each subse-
quent year, 80 percent. 
‘‘(B) SPECIAL RULE FOR CERTAIN LOW-IN-
COME
INDIVIDUALS.—For purposes of para-
graph (1), the applicable percent specified in 
this paragraph is, with respect to services fur-
nished to an individual who is a subsidy eligible 
individual (as defined in section 1860D– 
14(a)(3)), or who would be a subsidy eligible in-
dividual if the individual were enrolled in a pre-
scription drug plan or MA–PD plan— 
‘‘(i) with respect to services described 
in section 1861(nnn)(1), for 2024 and 
each subsequent year, 100 percent; and 
‘‘(ii) with respect to services not de-
scribed in clause (i), for 2025 and each 
subsequent year, 80 percent. 
‘‘(3) LIMITATIONS AND SECRETARIAL AUTHOR-
ITY.— 
‘‘(A) FREQUENCY.—With respect to dental 
and oral health services that are— 
‘‘(i) routine dental cleanings, payment 
may be made under this part for only two 
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such cleanings during a 12-month period; 
and 
‘‘(ii) routine exams, payment may be 
made under this part for only two such 
exams during a 12-month period. 
‘‘(B) SECRETARIAL AUTHORITY.— 
‘‘(i) AUTHORITY
TO
APPLY
ADDI-
TIONAL LIMITATIONS.—The Secretary may 
apply such other reasonable limitations on 
the extent to which dental and oral services 
are covered under this part, including 
through application of a prior authoriza-
tion requirement. 
‘‘(ii) AUTHORITY
TO
MODIFY
COV-
ERAGE.—Notwithstanding any other provi-
sion of this title, if the Secretary deter-
mines appropriate, the Secretary may mod-
ify the coverage under this part of dental 
and oral health services to the extent that 
such modification is consistent with the 
recommendations of the United States Pre-
ventive Services Task Force. 
‘‘(iii) AUTHORITY
TO
WAIVE
FRE-
QUENCY
LIMITATIONS.—Notwithstanding 
subparagraph (A), the Secretary may 
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waive any frequency limitation under such 
subparagraph for an individual (or cat-
egory of individuals) if determined appro-
priate by the Secretary.’’. 
(d) PAYMENT UNDER PHYSICIAN FEE SCHEDULE.— 
Section 1848(j)(3) of the Social Security Act (42 U.S.C. 
1395w–4(j)(3)) is amended by inserting ‘‘(2)(KK),’’ be-
fore ‘‘(3)’’. 
(e) DENTURES.— 
(1) IN
GENERAL.—Section 1861(s)(8) of the 
Social Security Act (42 U.S.C. 1395x(s)(8)) is 
amended— 
(A) by striking ‘‘(other than dental)’’ and 
inserting ‘‘(including dentures)’’; and 
(B) by striking ‘‘internal body’’. 
(2) 
SPECIAL
PAYMENT
RULES.—Section 
1834(a) of the Social Security Act (42 U.S.C. 
1395m(a)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(23) PAYMENT AND LIMITS FOR DENTURES.— 
‘‘(A) IN GENERAL.—The payment amount 
under this part for dentures shall be, subject to 
subparagraph (C), the applicable percent (speci-
fied in subparagraph (B)) of the amount other-
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wise payable for such dentures under this sec-
tion. 
‘‘(B) APPLICABLE
PERCENT.—For pur-
poses of subparagraph (A), the applicable per-
cent specified in this subparagraph is— 
‘‘(i) for a year before 2025, 0 percent; 
and 
‘‘(ii) for 2025 and each subsequent 
year, 80 percent. 
‘‘(C) LIMITATIONS AND SECRETARIAL AU-
THORITY.— 
‘‘(i) IN GENERAL.—Payment may be 
made under this part for an individual 
for— 
‘‘(I) not more than one full upper 
and one full lower denture once every 
five years; and 
‘‘(II) not more than one partial 
upper denture and one partial lower 
denture once every five years. 
‘‘(ii) SECRETARIAL AUTHORITY.— 
‘‘(I) AUTHORITY TO APPLY ADDI-
TIONAL LIMITATIONS.—The Secretary 
may apply such other reasonable limi-
tations on the extent to which den-
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tures are covered under this part, in-
cluding through application of a prior 
authorization requirement. 
‘‘(II) AUTHORITY
TO
MODIFY 
COVERAGE.—Notwithstanding 
any 
other provision of this title, if the Sec-
retary determines appropriate, the 
Secretary may modify the coverage 
under this part of dentures to the ex-
tent that such modification is con-
sistent with the recommendations of 
the United States Preventive Services 
Task Force. 
‘‘(III) AUTHORITY
TO
WAIVE 
FREQUENCY
LIMITATIONS.—Notwith-
standing clause (i), the Secretary may 
waive any frequency limitation under 
such clause for an individual (or cat-
egory of individuals) if determined ap-
propriate by the Secretary.’’. 
(f) REPEAL OF GROUND FOR EXCLUSION.—Section 
1862(a) of the Social Security Act (42 U.S.C. 1395y) is 
amended by striking paragraph (12). 
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(g) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2024. 
SEC. 3. VISION CARE. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)), as amended by section 
2, is further amended— 
(1) in subparagraph (JJ), by striking ‘‘and’’ 
after the semicolon at the end; 
(2) in subparagraph (KK), by adding ‘‘and’’ 
after the semicolon at the end; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(LL) vision services (as defined in subsection 
(ooo));’’. 
(b) VISION SERVICES DEFINED.—Section 1861 of 
the Social Security Act (42 U.S.C. 1395x), as amended 
by section 2, is further amended by adding at the end the 
following new subsection: 
‘‘Vision Services 
‘‘(ooo) The term ‘vision services’ means— 
‘‘(1) routine eye examinations and procedures 
performed (during the course of any eye examina-
tion) to determine the refractive state of the eyes; 
and 
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‘‘(2) other necessary services related to eye and 
vision health (as defined by the Secretary).’’. 
(c) PAYMENT; COINSURANCE; AND LIMITATIONS.— 
(1) IN GENERAL.—Section 1833(a)(1) of the 
Social Security Act (42 U.S.C. 1395l(a)(1)), as 
amended by section 2, is further amended— 
(A) by striking ‘‘and’’ before ‘‘(HH)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (II) with respect 
to vision services (as defined in section 
1861(mmm)), the amount paid shall be the 
payment 
amount 
specified 
under 
section 
1834(bb)’’. 
(2) PAYMENT AND LIMITS SPECIFIED.—Section 
1834 of the Social Security Act (42 U.S.C. 1395m), 
as amended by section 2, is further amended by add-
ing at the end the following new subsection: 
‘‘(bb) PAYMENT
AND LIMITS
FOR VISION SERV-
ICES.— 
‘‘(1) IN
GENERAL.—The payment amount 
under this part for vision services (as defined in sec-
tion 1861(ooo)) shall be, subject to paragraph (2), 
80 percent of the lesser of the actual charge for the 
services or the amount determined under the pay-
ment basis determined under section 1848. 
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‘‘(2) LIMITATIONS AND SECRETARIAL AUTHOR-
ITY.— 
‘‘(A) FREQUENCY.—With respect to rou-
tine eye exams, payment may be made under 
this part for only one such exam during a 12- 
month period. 
‘‘(B) SECRETARIAL AUTHORITY.— 
‘‘(i) AUTHORITY
TO
APPLY
ADDI-
TIONAL LIMITATIONS.—The Secretary may 
apply other reasonable limitations on the 
extent to which vision services are covered 
under this part, including through applica-
tion of a prior authorization requirement. 
‘‘(ii) AUTHORITY
TO
MODIFY
COV-
ERAGE.—Notwithstanding any other provi-
sion of this title, if the Secretary deter-
mines appropriate, the Secretary may mod-
ify the coverage under this part of vision 
services to the extent that such modifica-
tion is consistent with the recommenda-
tions of the United States Preventive Serv-
ices Task Force. 
‘‘(iii) AUTHORITY
TO
WAIVE
FRE-
QUENCY
LIMITATIONS.—Notwithstanding 
subparagraph (A), the Secretary may 
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