I 
117TH CONGRESS 
2D SESSION 
H. R. 7702 
To provide health insurance benefits for outpatient and inpatient items and 
services related to the diagnosis and treatment of a craniofacial, oral, 
or maxillofacial congenital anomaly or birth defect. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 10, 2022 
Mr. DUNN (for himself and Mr. GRIFFITH) introduced the following bill; which 
was referred to the Committee on Energy and Commerce, and in addition 
to the Committees on Education and Labor, and 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 com-
mittee concerned 
A BILL 
To provide health insurance benefits for outpatient and inpa-
tient items and services related to the diagnosis and 
treatment of a craniofacial, oral, or maxillofacial con-
genital anomaly or birth defect. 
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 ‘‘Ensuring Lasting 
Smiles Act’’. 
VerDate Sep 11 2014 
02:08 May 13, 2022
Jkt 029200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H7702.IH
H7702
kjohnson on DSK79L0C42PROD with BILLS
SEC. 2. COVERAGE OF CRANIOFACIAL, ORAL, OR MAXILLO-
FACIAL CONGENITAL ANOMALY OR BIRTH 
DEFECT. 
(a) PUBLIC HEALTH SERVICE ACT AMENDMENTS.— 
Part D of title XXVII of the Public Health Service Act 
(42 U.S.C. 300gg–111 et seq.) is amended by adding at 
the end the following new section: 
‘‘SEC. 2799A–11. STANDARDS RELATING TO BENEFITS FOR 
CRANIOFACIAL, ORAL, OR MAXILLOFACIAL 
CONGENITAL ANOMALY OR BIRTH DEFECT. 
‘‘(a) REQUIREMENTS FOR CARE AND RECONSTRUC-
TIVE TREATMENT.— 
‘‘(1) IN GENERAL.—A group health plan, and a 
health insurance issuer offering group or individual 
health insurance coverage, shall provide coverage for 
outpatient and inpatient items and services related 
to the diagnosis and treatment of a craniofacial, 
oral, or maxillofacial congenital anomaly or birth de-
fect. 
‘‘(2) REQUIREMENTS.— 
‘‘(A) IN
GENERAL.—Coverage provided 
under paragraph (1) shall include any medically 
necessary item or service to functionally im-
prove, repair, or restore any body part to 
achieve normal body functioning or appearance, 
as determined by the treating physician (as de-
VerDate Sep 11 2014 
02:08 May 13, 2022
Jkt 029200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H7702.IH
H7702
kjohnson on DSK79L0C42PROD with BILLS
fined in section 1861(r) of the Social Security 
Act), due to craniofacial, oral, or maxillofacial 
congenital anomaly or birth defect. 
‘‘(B) 
FINANCIAL
REQUIREMENTS
AND 
TREATMENT
REQUIREMENTS.—Any coverage 
provided under paragraph (1) under a group 
health plan or individual or group health insur-
ance coverage offered by a health insurance 
issuer may be subject to coverage limits (such 
as medical necessity, pre-authorization, or pre- 
certification) and cost-sharing requirements 
(such 
as 
coinsurance, 
copayments, 
and 
deductibles), as required by the plan or issuer, 
that are no more restrictive than the predomi-
nant coverage limits and cost-sharing require-
ments, respectively, applied to substantially all 
medical and surgical benefits covered by the 
plan (or coverage). 
‘‘(3) TREATMENT DEFINED.—In this section: 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), the term ‘treatment’ in-
cludes, with respect to a group health plan or 
group or individual health insurance coverage 
offered by a health insurance issuer, inpatient 
and outpatient items and services performed to 
VerDate Sep 11 2014 
02:08 May 13, 2022
Jkt 029200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H7702.IH
H7702
kjohnson on DSK79L0C42PROD with BILLS