appropriate agencies or organizations of the ability 
to provide fee reimbursements for oral health serv-
ices through applied income adjustments for facility 
residents and of the procedural requirements related 
to such reimbursements. 
‘‘(5) NOTICE OF AVAILABILITY OF SERVICES.— 
The State shall notify residents of nursing facilities 
or skilled nursing facilities under title XVIII (or rep-
resentatives of such residents) of— 
‘‘(A) the availability of oral health services; 
and 
‘‘(B) in the case of each such resident who 
is an aged, blind, or disabled individual de-
scribed in subsection (b), the amount of applied 
income available each month to such resident to 
purchase such services concurrent with the first 
determination of the applied income of such 
resident. 
‘‘(6) DIRECT PAYMENT TO PROVIDERS.—If the 
State has a signed assignment of benefits from a 
resident of a nursing facility or a skilled nursing fa-
cility under title XVIII who is an aged, blind, or dis-
abled individual described in subsection (b) or a 
legal representative of such a resident, the State 
shall pay a provider of oral health services directly
for such services from the resident’s applied income 
adjustments not later than 25 days after the date on 
which the State received the assignment. 
‘‘(7) ASSURANCE
OF
TREATMENT
OF
IN-
COME.—If the State pays a nursing facility or a 
skilled nursing facility under title XVIII on a pro-
spective basis for oral health services, the State shall 
assure— 
‘‘(A) that Pre-Eligiblity Treatment of In-
come matches all rules and regulations that 
apply to Post-Eligibility Treatment of Income; 
and 
‘‘(B) access through applied income. 
‘‘(8) PROHIBITION ON LIMITATIONS ON FEES 
FOR CERTAIN SERVICES.—A State may not set a fee 
limit or a fee schedule for oral health services pur-
chased by residents of a nursing facility or a skilled 
nursing facility under title XVIII who is an aged, 
blind, or disabled individual described in subsection 
(b) or a legal representative of such a resident 
through applied income provisions. 
‘‘(9) 
PROVIDER
REIMBURSEMENT
SELEC-
TION.— 
‘‘(A) IN GENERAL.—A State shall permit a 
provider of oral health services to children who
are eligible for medical assistance under the 
State program under this title or aged, blind, or 
disabled individuals described in subsection (b) 
to choose on a patient-by-patient basis and on 
a provider-by-provider basis, when to seek reim-
bursement for the provision of such services 
under this title or title XVIII, a program oper-
ated under a waiver described in subsection 
(a)(3), or through post-eligibility treatment of 
income procedures in accordance with the provi-
sions of paragraph (1). 
‘‘(B) REQUIREMENTS.—A State shall en-
sure that the procedures established for pro-
vider reimbursement selection in accordance 
with this paragraph— 
‘‘(i) comply with the requirements of 
subsection (a)(4) (prohibiting any prior au-
thorization requirement for the provision 
of, or reimbursement for, oral health serv-
ices); and 
‘‘(ii) do not permit a provider to ob-
tain reimbursement for the same procedure 
under more than 1 of the reimbursement 
options described in subparagraph (A).