‘‘(aa) EQUAL ACCESS
TO ORAL HEALTH CARE 
PLAN.— 
‘‘(1) INCREASE IN FMAP FOR STATES IMPLE-
MENTING
APPROVED
EQUAL
ACCESS
REQUIRE-
MENTS.—In order to ensure adequate provider par-
ticipation in the plan under this title and to ensure 
that individuals covered by the plan have access to 
oral health care services to the same extent as such 
services are available to the population of the State, 
subject to paragraph (3), in the case of a State that 
obtains the Secretary’s approval for its plan under 
this title to incorporate, and to implement, the re-
quirements specified in paragraph (2), notwith-
standing section 1905(b), the Federal medical assist-
ance percentage applied under the plan with respect 
to expenditures for dental and oral health services 
for individuals covered under the plan shall be in-
creased by 25 percentage points, but not to exceed 
90 percent, at the time the approved plan is imple-
mented. 
‘‘(2) PROVIDER
PARTICIPATION
AND
ACCESS 
REQUIREMENTS.—The requirements specified in this 
paragraph for a State are that the State provides 
the Secretary with assurances regarding each of the 
following: 
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‘‘(A) Individuals covered by the State plan 
have access to oral health care services to the 
same extent as such services are available to the 
population of the State. 
‘‘(B) Payment for dental services for indi-
viduals covered by the State plan is made at 
levels consistent with market-based rates. 
‘‘(C) No fewer than 35 percent of the prac-
ticing dentists (including a reasonable mix of 
general dentists, pediatric dentists, and oral 
and maxillofacial surgeons) in the State partici-
pate (whether directly or through a plan pro-
viding dental services) under the State plan and 
there is reasonable distribution of such dentists 
serving the covered population. 
‘‘(D) Administrative barriers under this 
title are addressed to facilitate such provider 
participation, including improving eligibility 
verification, ensuring that any licensed dentist 
may participate in a publicly funded plan with-
out also having to participate in any other plan, 
simplifying claims forms processing, assigning a 
single plan administrator for the dental pro-
gram, and employing case managers to reduce 
the number of missed appointments. 
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‘‘(E) Demand for services barriers under 
this title is addressed, such as educating care-
givers regarding the need to seek dental serv-
ices and addressing oral health care literacy 
issues. 
‘‘(3) 3-YEAR REVIEW.—Beginning 3 years after 
the date of the enactment of this section and every 
3 years thereafter the Secretary shall evaluate the 
impact of the increase in the Federal medical assist-
ance percentage under this subsection on the rate of 
participation of dentists and the use of dental serv-
ices under the State plan. If the Secretary deter-
mines that the increase in such percentage has not 
resulted in a commensurate increase in such partici-
pation and use rate, as determined in consultation 
with the State involved, paragraph (1) shall no 
longer apply in such State.’’ 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to expenditures in calendar quar-
ters beginning on or after October 1, 2009. 
Æ 
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