2110(b)(5), the conditions described in this para-
graph are the following: 
‘‘(A) INCOME
ELIGIBILITY.—The State 
child health plan (whether implemented under 
title XIX or this title)— 
‘‘(i) has the highest income eligibility 
standard permitted under this title as of 
January 1, 2008; 
‘‘(ii) subject to subparagraph (B), 
does not limit the acceptance of applica-
tions for children; and 
‘‘(iii) provides benefits to all children 
in the State who apply for and meet eligi-
bility standards. 
‘‘(B) NO WAITING LIST IMPOSED.—With 
respect to all targeted low-income children, the 
State does not impose any numerical limitation, 
waiting list, or similar limitation on the eligi-
bility of such children for child health assist-
ance under such State plan. 
‘‘(C) NO MORE FAVORABLE TREATMENT.— 
The State child health plan may not provide 
more favorable coverage of dental services to 
the children covered under section 2110(b)(5) 
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than to children otherwise covered under this 
title.’’. 
(C) STATE OPTION TO WAIVE WAITING PE-
RIOD.—Section 2102(b)(1)(B) of the Social Se-
curity Act (42 U.S.C. 1397bb(b)(1)(B)) is 
amended— 
(i) in clause (i), by striking ‘‘and’’ at 
the end; 
(ii) in clause (ii), by striking the pe-
riod and inserting ‘‘; and’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(iii) at State option, may not apply 
a waiting period in the case of a child de-
scribed in section 2110(b)(5), if the State 
satisfies 
the 
requirements 
of 
section 
2105(c)(8).’’. 
(2) APPLICATION OF ENHANCED MATCH UNDER 
MEDICAID.—Section 1905 of the Social Security Act 
(42 U.S.C. 1396d) is amended— 
(A) in subsection (b), in the fourth sen-
tence, by striking ‘‘or subsection (u)(3)’’ and 
inserting ‘‘(u)(3), or (u)(4)’’; and 
(B) in subsection (u)— 
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(i) by redesignating paragraph (4) as 
paragraph (5); and 
(ii) by inserting after paragraph (3) 
the following: 
‘‘(4) For purposes of subsection (b), the ex-
penditures described in this paragraph are expendi-
tures for items and services for children described in 
section 2110(b)(5), but only in the case of a State 
that 
satisfies 
the 
requirements 
of 
section 
2105(c)(8).’’. 
(3) APPLICATION OF SECONDARY PAYER PROVI-
SIONS.—Section 2107(e)(1) of the Social Security 
Act (42 U.S.C. 1397gg(e)(1)) is amended— 
(A) by redesignating subparagraphs (B) 
through (D) as subparagraphs (C) through (E), 
respectively; and 
(B) by inserting after subparagraph (A) 
the following: 
‘‘(B) Section 1902(a)(25) (relating to co-
ordination of benefits and secondary payer pro-
visions) with respect to children covered under 
a waiver described in section 2110(b)(5).’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect on January 1, 2008, and 
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shall apply to child health assistance and medical assist-
ance provided on or after that date. 
TITLE 
II—CORRECTING 
GME 
PAYMENTS 
FOR 
DENTAL 
RESIDENCY TRAINING PRO-
GRAMS 
SEC. 201. LIMITATION ON THE APPLICATION OF THE 1- 
YEAR LAG IN THE INDIRECT MEDICAL EDU-
CATION RATIO (IME) CHANGES AND THE 3- 
YEAR ROLLING AVERAGE FOR COUNTING IN-
TERNS AND RESIDENTS FOR IME AND DI-
RECT GRADUATE MEDICAL EDUCATION (D– 
GME) PAYMENTS UNDER THE MEDICARE 
PROGRAM. 
(a) IME RATIO AND ROLLING AVERAGE.—Section 
1886(d)(5)(B)(vi) of the Social Security Act (42 U.S.C. 
1395ww(d)(5)(B)(vi)) is amended by adding at the end 
the following new sentence: ‘‘For cost reporting periods 
beginning during fiscal years beginning on or after Octo-
ber 1, 2007, subclauses (I) and (II) shall be applied only 
with respect to a hospital’s approved medical residency 
training program in the fields of allopathic medicine and 
osteopathic medicine.’’. 
(b) 
D–GME 
ROLLING
AVERAGE.—Section 
1886(h)(4)(G) of the Social Security Act (42 U.S.C. 
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1395ww(h)(4)(G)) is amended by adding at the end the 
following new clause: 
‘‘(iv) APPLICATION FOR FY 2008 AND 
SUBSEQUENT YEARS.—For cost reporting 
periods beginning during fiscal years be-
ginning on or after October 1, 2007, 
clauses (i) through (iii) shall be applied 
only with respect to a hospital’s approved 
medical residency training program in the 
fields of allopathic medicine and osteo-
pathic medicine.’’. 
TITLE 
III—IMPROVING 
DELIV-
ERY OF PEDIATRIC DENTAL 
SERVICES 
UNDER 
COMMU-
NITY HEALTH CENTERS, PUB-
LIC HEALTH DEPARTMENTS, 
AND 
THE 
INDIAN 
HEALTH 
SERVICE 
SEC. 301. GRANTS TO IMPROVE THE PROVISION OF DENTAL 
HEALTH SERVICES THROUGH COMMUNITY 
HEALTH CENTERS AND PUBLIC HEALTH DE-
PARTMENTS. 
Subpart I of part D of title III of the Public Health 
Service Act (42 U.S.C. 254b et seq.) is amended by adding 
at the end the following: 
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‘‘SEC. 330M. GRANT PROGRAM TO EXPAND THE AVAIL-
ABILITY OF SERVICES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Health Resources and Services Administration, shall 
establish a program under which the Secretary may award 
grants to eligible entities and eligible individuals to expand 
the availability of primary dental care services in dental 
health professional shortage areas and medically under-
served areas. 
‘‘(b) ELIGIBILITY.— 
‘‘(1) ENTITIES.—To be eligible to receive a 
grant under this section an entity— 
‘‘(A) shall be— 
‘‘(i) a health center receiving funds 
under section 330 or designated as a Fed-
erally qualified health center; 
‘‘(ii) a county or local public health 
department, if located in a federally-des-
ignated dental health professional shortage 
area; 
‘‘(iii) an Indian tribe or tribal organi-
zation (as defined in section 4 of the In-
dian Self-Determination and Education 
Assistance Act (25 U.S.C. 450b)); 
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‘‘(iv) a dental education program ac-
credited by the Commission on Dental Ac-
creditation; or 
‘‘(v) a community-based program the 
child service population of which is made 
up of at least 33 percent of children who 
are eligible children, including at least 25 
percent of such children being children 
with mental retardation or related develop-
mental disabilities, unless specific docu-
mentation of a lack of need for access by 
this sub-population is established; and 
‘‘(B) shall prepare and submit to the Sec-
retary an application at such time, in such 
manner, and containing such information as the 
Secretary may require, including information 
concerning dental provider capacity to serve in-
dividuals with developmental disabilities. 
‘‘(2) INDIVIDUALS.—To be eligible to receive a 
grant under this section an individual shall— 
‘‘(A) be a dental health professional li-
censed or certified in accordance with the laws 
of State in which such individual provides den-
tal services; 
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‘‘(B) prepare and submit to the Secretary 
an application at such time, in such manner, 
and containing such information as the Sec-
retary may require; and 
‘‘(C) provide assurances that— 
‘‘(i) the individual will practice in a 
federally-designated dental health profes-
sional shortage area; or 
‘‘(ii) not less than 25 percent of the 
patients of such individual are— 
‘‘(I) receiving assistance under a 
State plan under title XIX of the So-
cial Security Act (42 U.S.C. 1396 et 
seq.); 
‘‘(II) receiving assistance under a 
State plan under title XXI of the So-
cial Security Act (42 U.S.C. 1397aa 
et seq.); or 
‘‘(III) uninsured. 
‘‘(c) USE OF FUNDS.— 
‘‘(1) ENTITIES.—An entity shall use amounts 
received under a grant under this section to provide 
for the increased availability of primary dental serv-
ices in the areas described in subsection (a). Such 
amounts may be used to supplement the salaries of-
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fered for individuals accepting employment as den-
tists in such areas. 
‘‘(2) INDIVIDUALS.—A grant to an individual 
under subsection (a) shall be in the form of a 
$1,000 bonus payment for each month in which such 
individual is in compliance with the eligibility re-
quirements of subsection (b)(2)(C). 
‘‘(d) PRIMARY DENTAL CARE SERVICES DEFINED.— 
For purposes of this section, the term ‘primary dental care 
services’ means dental services necessary to prevent dis-
ease and promote oral health, restore oral structures to 
health and function, and treat emergency conditions, and 
includes dental services described in section 1905(r)(3) of 
the Social Security Act (42 U.S.C. 1396d(r)(3)). 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—Notwithstanding any other 
amounts appropriated under section 330 for health 
centers, there is authorized to be appropriated 
$40,000,000 for each of fiscal years 2008 through 
2012 to hire and retain dental health care providers 
under this section. 
‘‘(2) USE OF FUNDS.—Of the amount appro-
priated for a fiscal year under paragraph (1), the 
Secretary shall use— 
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‘‘(A) not less than 65 percent of such 
amount to make grants to eligible entities; and 
‘‘(B) not more than 35 percent of such 
amount to make grants to eligible individuals.’’. 
SEC. 302. DENTAL OFFICER MULTIYEAR RETENTION BONUS 
FOR THE INDIAN HEALTH SERVICE. 
(a) TERMS AND DEFINITIONS.—In this section: 
(1) CREDITABLE
SERVICE.—The term ‘‘cred-
itable service’’ includes all periods that a dental offi-
cer spent in graduate dental educational (GDE) 
training programs while not on active duty in the In-
dian Health Service and all periods of active duty in 
the Indian Health Service as a dental officer. 
(2) DENTAL OFFICER.—The term ‘‘dental offi-
cer’’ means an officer of the Indian Health Service 
designated as a dental officer. 
(3) DIRECTOR.—The term ‘‘Director’’ means 
the Director of the Indian Health Service. 
(4) RESIDENCY.—The term ‘‘residency’’ means 
a graduate dental educational (GDE) training pro-
gram of at least 12 months leading to a specialty, 
including general practice residency (GPR) or an ad-
vanced education general dentistry (AEGD). 
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(5) SPECIALTY.—The term ‘‘specialty’’ means a 
dental specialty for which there is an Indian Health 
Service specialty code number. 
(b) REQUIREMENTS FOR BONUS.— 
(1) IN GENERAL.—An eligible dental officer of 
the Indian Health Service who executes a written 
agreement to remain on active duty for 2, 3, or 4 
years after the completion of any other active duty 
service commitment to the Indian Health Service 
may, upon acceptance of the written agreement by 
the Director, be authorized to receive a dental officer 
multiyear retention bonus under this section. The 
Director may, based on requirements of the Indian 
Health Service, decline to offer such a retention 
bonus to any specialty that is otherwise eligible, or 
to restrict the length of such a retention bonus con-
tract for a specialty to less than 4 years. 
(2) LIMITATIONS.—Each annual dental officer 
multiyear retention bonus authorized under this sec-
tion shall not exceed the following: 
(A) $50,000 for a 4-year written agree-
ment. 
(B) $10,000 for a 3-year written agree-
ment. 
(C) $8,000 for a 2-year written agreement. 
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(c) ELIGIBILITY.— 
(1) IN GENERAL.—In order to be eligible to re-
ceive a dental officer multiyear retention bonus 
under this section, a dental officer shall— 
(A) be at or below such grade as the Di-
rector shall determine; 
(B) have completed any active duty service 
commitment of the Indian Health Service in-
curred for dental education and training or 
have 8 years of creditable service; 
(C) have completed initial residency train-
ing, or be scheduled to complete initial resi-
dency training before September 30 of the fiscal 
year in which the officer enters into a dental of-
ficer multiyear retention bonus written service 
agreement under this section; and 
(D) have a recognized dental specialty. 
(2) EXTENSION TO OTHER OFFICERS.—The Di-
rector may extend the retention bonus to dental offi-
cers other than officers with a dental specialty in pe-
diatric dentistry, as well as to other dental hygien-
ists with a minimum of a baccalaureate degree, 
based on demonstrated need. 
(d) TERMINATION
OF ENTITLEMENT
TO SPECIAL 
PAY.—The Director may terminate, with cause, at any 
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time a dental officer’s multiyear retention bonus contract 
under this section. If such a contract is terminated, the 
unserved portion of the retention bonus contract shall be 
recouped on a pro rata basis. The Director shall establish 
regulations that specify the conditions and procedures 
under which termination may take place. The regulations 
and conditions for termination shall be included in the 
written service contract for a dental officer multiyear re-
tention bonus under this section. 
(e) REFUNDS.— 
(1) IN GENERAL.—Prorated refunds shall be re-
quired for sums paid under a retention bonus con-
tract under this section if a dental officer who has 
received the retention bonus fails to complete the 
total period of service specified in the contract, as 
conditions and circumstances warrant. 
(2) DEBT TO UNITED STATES.—An obligation 
to reimburse the United States imposed under para-
graph (1) is a debt owed to the United States. 
(3) NO DISCHARGE IN BANKRUPTCY.—Notwith-
standing any other provision of law, a discharge in 
bankruptcy under title 11, United States Code, that 
is entered less than 5 years after the termination of 
a retention bonus contract under this section does 
not discharge the dental officer who signed such a 
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contract from a debt arising under the contract or 
under paragraph (1). 
SEC. 303. DEMONSTRATION PROJECTS TO INCREASE AC-
CESS TO PEDIATRIC DENTAL SERVICES IN 
UNDERSERVED AREAS. 
(a) AUTHORITY TO CONDUCT PROJECTS.—The Sec-
retary of Health and Human Services, through the Admin-
istrator of the Health Resources and Services Administra-
tion and the Director of the Indian Health Service, shall 
establish demonstration projects that are designed to in-
crease access to dental services for children in underserved 
areas, as determined by the Secretary. 
(b) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated such sums as may be nec-
essary to carry out this section. 
SEC. 304. TECHNICAL CORRECTION. 
Section 340G(b)(1)(B) of the Public Health Service 
Act (42 U.S.C. 256g(b)(1)(B)) is amended by striking 
‘‘and’’ at the end and inserting ‘‘or’’. 
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TITLE 
IV—IMPROVING 
ORAL 
HEALTH 
PROMOTION 
AND 
DISEASE PREVENTION PRO-
GRAMS 
SEC. 401. ORAL HEALTH INITIATIVE. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services shall establish an oral health initiative 
to reduce the profound disparities in oral health by im-
proving the health status of vulnerable populations, par-
ticularly low-income children, children with developmental 
disabilities, and ethnic and racial minority populations 
that experience a disproportionate level of dental disease, 
to the level of health status that is enjoyed by the majority 
of people in the United States. 
(b) ACTIVITIES.—The Secretary of Health and 
Human Services shall, through the oral health initiative— 
(1) carry out activities to improve intra-agency 
and inter-agency collaborations, including activities 
to identify, engage, and encourage existing Federal 
and State programs to maximize their potential to 
address oral health; 
(2) carry out activities to encourage public-pri-
vate partnerships to engage private sector commu-
nities of interest (including health professionals, 
educators, State policymakers, foundations, business, 
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and the public) in partnerships that promote oral 
health and dental care, in addition to allowing for 
contractual relationships between federally qualified 
health centers and private dental providers to in-
crease access to dental care for adults and children; 
(3) carry out activities to reduce the disease 
burden in high risk populations through the applica-
tion of best-science in oral health, including pro-
grams such as community water fluoridation and 
dental sealants; 
(4) carry out activities to improve the oral 
health literacy of the public through school-based 
education programs; and 
(5) provide for the development, implementa-
tion, or integration of outreach and education pro-
grams to families of children enrolled in Medicaid or 
SCHIP, particularly such children who are members 
of populations that experience oral health disparities, 
that increase awareness of dental coverage, when to 
seek dental services, and how to obtain such serv-
ices. 
(c) COORDINATION.—The Secretary of Health and 
Human Services shall— 
(1) through the Administrator of the Centers 
for Medicare and Medicaid Services, establish the 
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