I 
110TH CONGRESS 
1ST SESSION H. R. 1781 
To provide disadvantaged children with access to primary dental care services. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 29, 2007 
Mr. DINGELL (for himself, Mr. SIMPSON, Mr. HOYER, Mr. PALLONE, Mr. 
WAXMAN, Mr. CUMMINGS, Mr. WYNN, Mrs. CAPPS, Mr. TOWNS, Mr. 
ROSS, Mr. ENGEL, Ms. ESHOO, Mr. ALLEN, Ms. DEGETTE, and Ms. 
SCHAKOWSKY) introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committee 
on Ways and Means, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To provide disadvantaged children with access to primary 
dental care services. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Children’s Dental Health Improvement Act of 2007’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title. 
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TITLE I—IMPROVING DELIVERY OF PEDIATRIC DENTAL 
SERVICES UNDER MEDICAID AND SCHIP 
Sec. 101. Grants to improve the provision of dental services under Medicaid 
and SCHIP. 
Sec. 102. Guarantee of dental benefits under SCHIP. 
Sec. 103. State option to provide wrap-around SCHIP coverage to children who 
have other health coverage. 
TITLE II—CORRECTING GME PAYMENTS FOR DENTAL 
RESIDENCY TRAINING PROGRAMS 
Sec. 201. Limitation on the application of the 1-year lag in the Indirect Medical 
Education ratio (IME) changes and the 3-year rolling average 
for counting interns and residents for IME and Direct Grad-
uate Medical Education (D–GME) payments under the Medi-
care program. 
TITLE III—IMPROVING DELIVERY OF PEDIATRIC DENTAL SERV-
ICES UNDER COMMUNITY HEALTH CENTERS, PUBLIC 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 departments. 
Sec. 302. Dental officer multiyear retention bonus for the Indian health service. 
Sec. 303. Demonstration projects to increase access to pediatric dental services 
in underserved areas. 
Sec. 304. Technical correction. 
TITLE IV—IMPROVING ORAL HEALTH PROMOTION AND DISEASE 
PREVENTION PROGRAMS 
Sec. 401. Oral health initiative. 
Sec. 402. CDC reports. 
Sec. 403. Early childhood caries. 
Sec. 404. School-based dental sealant program. 
Sec. 405. Basic oral health promotion. 
TITLE I—IMPROVING DELIVERY 
OF PEDIATRIC DENTAL SERV-
ICES UNDER MEDICAID AND 
SCHIP 
SEC. 101. GRANTS TO IMPROVE THE PROVISION OF DENTAL 
SERVICES UNDER MEDICAID AND SCHIP. 
Title V of the Social Security Act (42 U.S.C. 701 
et seq.) is amended by adding at the end the following: 
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‘‘SEC. 511. GRANTS TO IMPROVE THE PROVISION OF DEN-
TAL SERVICES UNDER MEDICAID AND SCHIP. 
‘‘(a) AUTHORITY TO MAKE GRANTS.—In addition to 
any other payments made under this title to a State, the 
Secretary shall award grants to States that satisfy the re-
quirements of subsection (b) to improve the provision of 
dental services to children who are enrolled in a State plan 
under title XIX or a State child health plan under title 
XXI (in this section, collectively referred to as the ‘State 
plans’). 
‘‘(b) REQUIREMENTS.—In order to be eligible for a 
grant under this section, a State shall provide the Sec-
retary with the following assurances: 
‘‘(1) 
IMPROVED
SERVICE
DELIVERY.—The 
State shall have a plan to improve the delivery of 
dental services to children, including children with 
special health care needs, who are enrolled in the 
State plans, including providing outreach and ad-
ministrative case management, improving collection 
and reporting of claims data, and providing incen-
tives, in addition to raising reimbursement rates, to 
increase provider participation. 
‘‘(2) ADEQUATE PAYMENT RATES.—The State 
has provided for payment under the State plans for 
dental services for children at levels consistent with 
the market-based rates and sufficient enough to en-
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list providers to treat children in need of dental serv-
ices. 
‘‘(3) ENSURED ACCESS.—The State shall en-
sure it will make dental services available to children 
enrolled in the State plans to the same extent as 
such services are available to the pediatric popu-
lation of the State. 
‘‘(c) USE OF FUNDS.— 
‘‘(1) IN GENERAL.—Funds provided under this 
section may be used to provide administrative re-
sources (such as program development, provider 
training, data collection and analysis, research-re-
lated tasks, demonstration programs, and technical 
assistance) to assist States in providing and assess-
ing services that include preventive and therapeutic 
dental care regimens. 
‘‘(2) LIMITATION.—Funds provided under this 
section may not be used for payment of direct den-
tal, medical, or other services or to obtain Federal 
matching funds under any Federal program. 
‘‘(d) APPLICATION.—A State shall submit an applica-
tion to the Secretary for a grant under this section in such 
form and manner and containing such information as the 
Secretary may require. 
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‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to make grants under 
this section $50,000,000 for fiscal year 2008 and each fis-
cal year thereafter. 
‘‘(f) APPLICATION
OF
OTHER
PROVISIONS
OF 
TITLE.— 
‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), the other provisions of this title shall not 
apply to a grant made under this section. 
‘‘(2) EXCEPTIONS.—The following provisions of 
this title shall apply to a grant made under sub-
section (a) to the same extent and in the same man-
ner as such provisions apply to allotments made 
under section 502(c): 
‘‘(A) Section 504(b)(6) (relating to prohi-
bition on payments to excluded individuals and 
entities). 
‘‘(B) Section 504(c) (relating to the use of 
funds for the purchase of technical assistance). 
‘‘(C) Section 504(d) (relating to a limita-
tion on administrative expenditures). 
‘‘(D) Section 506 (relating to reports and 
audits), but only to the extent determined by 
the Secretary to be appropriate for grants made 
under this section. 
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‘‘(E) Section 507 (relating to penalties for 
false statements). 
‘‘(F) 
Section 
508 
(relating 
to 
non-
discrimination). 
‘‘(G) Section 509 (relating to the adminis-
tration of the grant program).’’. 
SEC. 102. GUARANTEE OF DENTAL BENEFITS UNDER SCHIP. 
(a) IN GENERAL.—Section 2103(c)(1) of the Social 
Security Act (42 U.S.C. 1397cc(c)(1)) is amended by add-
ing at the end the following new subparagraph: 
‘‘(E) Dental services described in section 
1905(r)(3) and provided in accordance with 
1902(a)(43).’’. 
(b) INFORMATION REPORTING.—Section 2108 of 
such Act (42 U.S.C. 1397hh) is amended by adding at 
the end the following new subsection: 
‘‘(e) INFORMATION ON DENTAL SERVICES.— 
‘‘(1) IN GENERAL.—Each State shall submit to 
the Secretary, not less frequently than annually and 
in a form and manner specified by the Secretary, the 
following information with respect to the provision of 
the care and services described in section 1905(r)(3) 
under the State child health plan to targeted low-in-
come children enrolled in the plan at any time dur-
ing the fiscal year involved: 
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‘‘(A) The number of such enrolled children 
by age grouping. 
‘‘(B) For children within each such age 
grouping, information of the type contained in 
questions 12(a)–(c) of CMS Form 416 that 
consists of the number of enrolled targeted low 
income children who receive any, preventive, or 
restorative care described in such section under 
the State plan. 
‘‘(C) For the age grouping that includes 
age 8, the number of enrolled targeted low-in-
come children who receive a protective sealant 
on at least one permanent molar tooth. 
‘‘(2) PUBLIC DISCLOSURE OF REPORTS.—The 
Secretary shall post on the public website of the Sec-
retary of Health and Human Services the results of 
information most recently reported under paragraph 
(1). The Secretary shall include in such posting in-
formation, by age grouping beginning with dental 
visits occurring by age one, on the estimated na-
tional averages for all States with respect to such in-
formation.’’. 
(c) EFFECTIVE DATES.— 
(1) INCLUSION
OF
DENTAL
BENEFITS.—The 
amendment made by subsection (a) shall take effect 
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on January 1, 2008, and shall apply to child health 
assistance provided on or after that date. 
(2) REPORTING.—The amendment made by 
subsection (b) shall apply to reports for years after 
the effective date described in paragraph (1). 
SEC. 103. STATE OPTION TO PROVIDE WRAP-AROUND 
SCHIP COVERAGE TO CHILDREN WHO HAVE 
OTHER HEALTH COVERAGE. 
(a) IN GENERAL.— 
(1) SCHIP.— 
(A) STATE
OPTION
TO
PROVIDE
WRAP- 
AROUND
COVERAGE.—Section 2110(b) of the 
Social Security Act (42 U.S.C. 1397jj(b)) is 
amended— 
(i) in paragraph (1)(C), by inserting 
‘‘, subject to paragraph (5),’’ after ‘‘under 
title XIX or’’; and 
(ii) by adding at the end the fol-
lowing: 
‘‘(5) STATE OPTION TO PROVIDE WRAP-AROUND 
COVERAGE.—A State may waive the requirement of 
paragraph (1)(C) that a targeted low-income child 
may not be covered under a group health plan or 
under health insurance coverage, if the State satis-
fies the conditions described in section 2105(c)(8). 
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The State may waive such requirement in order to 
provide— 
‘‘(A) dental services described in section 
2103(c)(1)(E); or 
‘‘(B)(i) benefits for items or services that 
are not covered, or are only partially covered, 
under such plan; and 
‘‘(ii) protection against incurring out of- 
pocket costs (including premiums) in excess of 
the limitations otherwise applicable to a tar-
geted low-income child with the same family in-
come. 
In waiving such requirement, a State may limit the 
application of the waiver to children whose family in-
come does not exceed a level specified by the State, 
so long as the level so specified does not exceed the 
maximum income level otherwise established for 
other children under the State child health plan.’’. 
(B) 
CONDITIONS
DESCRIBED.—Section 
2105(c) of the Social Security Act (42 U.S.C. 
1397ee(c)) is amended by adding at the end the 
following: 
‘‘(8) CONDITIONS
FOR
PROVISION
OF
WRAP- 
AROUND
COVERAGE.—For 
purposes 
of 
section 
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