I 
118TH CONGRESS 
1ST SESSION H. R. 1422 
To amend title XIX of the Social Security Act to improve oral health care 
and dental benefits under the Medicaid program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 7, 2023 
Mr. SIMPSON introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to improve 
oral health care and dental benefits under the Medicaid 
program, and for other purposes. 
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 ‘‘Strengthening Med-
icaid Incentives for Licensees Enrolled in Dental Act’’ or 
the ‘‘SMILED Act’’. 
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SEC. 2. SUPPORT FOR ENSURING INDIVIDUALS ENROLLED 
IN MEDICAID HAVE DENTAL SERVICES AC-
CESS EQUAL TO THE POPULATION OF THE 
STATE. 
Section 1903 of the Social Security Act (42 U.S.C. 
1396b) is amended by adding at the end the following new 
subsection: 
‘‘(cc) EQUAL ACCESS
TO ORAL HEALTH CARE 
PLAN.— 
‘‘(1) PROVIDER
PARTICIPATION
AND
ACCESS 
REQUIREMENTS.—Not later than 1 year after the 
date of enactment of this paragraph, a State shall 
provide the Secretary with assurances that adminis-
trative barriers to the participation of licensed den-
tists under this title will be addressed, by— 
‘‘(A) improving eligibility verification; 
‘‘(B) ensuring that any such dentist may 
participate in a publicly funded plan without 
also having to participate in any other plan; 
‘‘(C) simplifying claims forms processing; 
and 
‘‘(D) assigning a single plan administrator 
for the dental program. 
‘‘(2) STUDY ON DENTIST PARTICIPATION.—Not 
later than 3 years after the date on which the assur-
ance under paragraph (1) is submitted, each State 
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shall conduct a study to determine whether the par-
ticipation of licensed dentists have increased fol-
lowing the assurance provided under paragraph 
(1).’’. 
SEC. 3. DENTAL AND ORAL HEALTH SERVICES DEFINED; 
AUDIT REQUIREMENT. 
(a) DENTAL
AND ORAL HEALTH SERVICES DE-
FINED.—Section 1905 of the Social Security Act (42 
U.S.C. 1396d) is amended— 
(1) in subsection (a)(10), by inserting ‘‘and 
dental and oral health services (as defined in sub-
section (jj))’’ after ‘‘dental services’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(jj) DENTAL AND ORAL HEALTH SERVICES.— 
‘‘(1) IN GENERAL.—For purposes of subsection 
(a)(10), the term ‘dental and oral health services’ 
means dentures and denture services, implants and 
implant services, and services necessary to prevent 
oral disease and promote oral health, restore oral 
structures to health and function, reduce oral pain, 
and treat emergency oral conditions, that are fur-
nished by a provider who— 
‘‘(A) is legally authorized to furnish such 
items and services under State law (or the 
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State regulatory mechanism provided by State 
law); 
‘‘(B) is initially credentialed by a State 
Medicaid program (or the designated entity of 
such program) through an integrated data col-
lection system, as described in paragraph (3); 
and 
‘‘(C) is, as applicable, re-credentialed 
through such integrated data collection system 
by a State Medicaid program (or the designated 
entity of such program). 
‘‘(2) SELECTION
OF
DATA
COLLECTION
SYS-
TEM.—Not later than one year after the date of en-
actment of this subsection, the State Medicaid Di-
rector shall select an integrated data collection sys-
tem (as defined in paragraph (3) that— 
‘‘(A) minimizes provider paperwork bur-
den; and 
‘‘(B) communicates final credentialing de-
cisions to providers within 90 days of receipt of 
a completed application. 
‘‘(3) INTEGRATED DATA COLLECTION SYSTEM 
DEFINED.—For purposes of this subsection, the 
term ‘integrated data collection system’ means an 
electronic system maintained by a State and used 
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for 
purposes 
of 
enrolling, 
screening, 
and 
credentialing dentists under a State Medicaid pro-
gram.’’. 
(b) DENTAL AND ORAL HEALTH SERVICES AUDIT 
REQUIREMENT.—Not later than 90 days after the date 
of enactment of this Act, a State Medicaid program, in-
cluding a program offered by a sponsor of a Medicaid 
managed care plan, that offers dental and oral health serv-
ices audits a claim for such dental and oral health services 
shall— 
(1) utilize a licensed health care professional 
from the dental specialty area of practice being au-
dited to establish relevant audit methodology con-
sistent with— 
(A) established practice guidelines, stand-
ards of care, and State-issued dental Medicaid 
provider handbooks; and 
(B) established clinical practice guidelines 
and acceptable standards of care established by 
the dental professional or specialty organiza-
tions responsible for setting such standards of 
care; 
(2) develop and implement, in consultation with 
the Centers for Medicare & Medicaid Services, a pro-
cedure in which an improper payment identified by 
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