blind, or disabled individuals described in sub-
section (b) without providing notice of the pro-
posed decrease to providers of such services and 
provider organizations in the State during the 
preceding 12-month period. 
‘‘(C) CRITERIA.—In establishing payment 
rates and the types of procedures to which such 
rates apply with respect to oral health services 
for children who are eligible for medical assist-
ance under the State program under this title 
or aged, blind, or disabled individuals described 
in subsection (b), a State shall include appro-
priate and necessary procedures for such chil-
dren and individuals, and shall establish pay-
ment rates that promote access to such services 
at a level equal to that of the general popu-
lation. 
‘‘(D) USE
OF
ORAL
HEALTH
MINIMUM 
DATA SET.—In establishing payment rates for 
nursing facilities and skilled nursing facilities 
under title XVIII, the State shall rely on guid-
ance from the Secretary to include the oral 
health section of the Minimum Data Set (com-
monly referred to as ‘MDS’) to establish pay-
ment rates for such facilities.
‘‘(3) PROVIDER CODE SELECTION.—A provider 
of oral health services for children who are eligible 
for medical assistance under the State program 
under this title or aged, blind, or disabled individ-
uals described in subsection (b) shall be allowed to 
bill for the provision of such services, regardless of 
whether the services are to be paid under this title 
or title XVIII, using codes established or recognized 
by the American Dental Association. 
‘‘(e) POST-ELIGIBILITY TREATMENT
OF INCOME 
(PETI) PROVISIONS.— 
‘‘(1) ALLOWANCE
OF
MULTIPLE
MONTH
DE-
DUCTIONS.—A State shall allow a resident of a 
nursing facility or of a skilled nursing facility under 
title XVIII who is an aged, blind, or disabled indi-
vidual described in subsection (b) and who receives 
oral health services multiple month deductions with 
respect to the provision of such services on a par-
ticular date. Except for a resident’s personal month-
ly allowance, fees reimbursed through post-eligibility 
treatment of income procedures under the State pro-
gram under this title shall be paid using the full 
amount of such a resident’s applied income each 
month (shared proportionally between providers if 
multiple bills exist) until the outstanding balance of
any bill for such services is paid in full or otherwise 
eliminated. 
‘‘(2) NOTICE OF AMOUNT OF AVAILABLE IN-
COME.—Upon receipt of a signed release from a 
resident of a nursing facility or skilled nursing facil-
ity under title XVIII who is an aged, blind, or dis-
abled individual described in subsection (b) who has 
requested oral health services, or such resident’s rep-
resentative, the State shall furnish a provider of oral 
health services with the amount of applied income 
available for that resident not later than 5 days 
after receipt of the release. 
‘‘(3) COMPLIANCE
WITH
APPLIED
INCOME 
LAWS.—Each State shall comply with Federal re-
quirements relating to applied income adjustments 
for residents of nursing facilities and skilled nursing 
facilities under title XVIII and shall provide the Sec-
retary with procedural information documenting how 
fee reimbursements are made through applied in-
come adjustments for such residents who reside in 
such facilities in the State. 
‘‘(4) NOTIFICATION OF FEE REIMBURSEMENT 
MECHANISM.—The State annually shall notify nurs-
ing facilities, skilled nursing facilities under title 
XVIII, providers of oral health services, and other