tures to health and function, and treat emergency condi-
tions. 
‘‘(2) For purposes of paragraph (1), such term shall 
include mobile and portable oral health services (as de-
fined by the Secretary) that— 
‘‘(A) are provided for the purpose of over-
coming mobility, transportation, and access barriers 
for individuals; and 
‘‘(B) satisfy the standards and certification re-
quirements established under section 1902(a)(84)(B) 
for the State in which the services are provided.’’. 
(c) 
PAYMENT
AND
COINSURANCE.—Section 
1833(a)(1) of the Social Security Act (42 U.S.C. 
1395l(a)(1)) is amended— 
(1) by striking ‘‘and’’ before ‘‘(Z)’’; and 
(2) by inserting before the semicolon at the end 
the following: ‘‘, and (AA) with respect to dental 
services (as defined in section 1861(iii)), the amount 
paid shall be (i) in the case of such services that are 
dental health preventive services described in para-
graph (1)(D) of such section, 100 percent of the 
lesser of the actual charge for the services or the 
amount determined under the payment basis deter-
mined under section 1848, and (ii) in the case of all 
other such services, 80 percent of the lesser of the 
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actual charge for the services or the amount deter-
mined under the payment basis determined under 
section 1848’’. 
(d) PAYMENT UNDER PHYSICIAN FEE SCHEDULE.— 
Section 1848(j)(3) of the Social Security Act (42 U.S.C. 
1395w–4(j)(3)) is amended by inserting ‘‘(2)(GG),’’ after 
‘‘risk assessment),’’. 
(e) DENTURES.—Section 1861(s)(8) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(8)) is amended— 
(1) by striking ‘‘(other than dental)’’ and in-
serting ‘‘(including dentures)’’; and 
(2) by striking ‘‘internal body’’. 
(f) REPEAL OF GROUND FOR EXCLUSION.—Section 
1862(a) of the Social Security Act (42 U.S.C. 1395y) is 
amended by striking paragraph (12). 
(g) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2013. 
Subtitle B—Medicaid 
SEC. 111. COVERAGE OF DENTAL SERVICES UNDER THE 
MEDICAID PROGRAM. 
(a) IN GENERAL.—Section 1905 of the Social Secu-
rity Act (42 U.S.C. 1396d) is amended— 
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(1) in subsection (a)(10), by adding ‘‘(as de-
scribed in subsection (ee)(1))’’ after ‘‘dental serv-
ices’’; and 
(2) by adding at the end the following: 
‘‘(ee)(1) Subject to paragraphs (2) and (3), for pur-
poses of this title, the term ‘dental services’ means oral 
health services (as defined by the Secretary) provided by 
a licensed oral health care provider that are necessary to 
prevent disease and promote oral health, restore oral 
structures to health and function, and treat emergency 
conditions. 
‘‘(2) For purposes of paragraph (1), such term shall 
include mobile and portable oral health services (as de-
fined by the Secretary) that— 
‘‘(A) are provided for the purpose of over-
coming mobility, transportation, and access barriers 
for individuals; and 
‘‘(B) satisfy the standards and certification re-
quirements established under section 1902(a)(84)(B) 
for the State in which the services are provided. 
‘‘(3) For purposes of paragraph (1), such term shall 
not apply to dental care or services provided to individuals 
under the age of 21 under subsection (r)(3).’’. 
(b) CONFORMING AMENDMENTS.—Section 1902(a) 
of such Act (42 U.S.C. 1396a(a)) is amended— 
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(1) in paragraph (10)(A), in the matter pre-
ceding clause (i), by inserting ‘‘(10),’’ after ‘‘(5),’’; 
(2) in paragraph (82)(C), by striking ‘‘and’’ at 
the end; 
(3) in paragraph (83), by striking the period at 
the end and inserting ‘‘; and’’; and 
(4) by inserting after paragraph (83) the fol-
lowing: 
‘‘(84) provide for— 
‘‘(A) informing, in writing, all individuals 
who have been determined to be eligible for 
medical assistance of the availability of dental 
services (as defined in section 1905(ee)(1)); and 
‘‘(B) establishing and maintaining stand-
ards for and certification of mobile and portable 
oral health services (as described in subsections 
(r)(3)(C) and (ee)(2) of section 1905).’’. 
(c) MOBILE AND PORTABLE ORAL HEALTH SERV-
ICES UNDER EPSDT.—Section 1905(r)(3) of the Social 
Security Act (42 U.S.C. 1396d(r)(3)) is amended— 
(1) in subparagraph (A)(ii), by striking ‘‘; and’’ 
and inserting a semicolon; 
(2) in subparagraph (B), by striking the period 
at the end and inserting ‘‘; and’’; and 
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(3) by adding at the end the following new sub-
paragraph: 
‘‘(C) which shall include mobile and portable 
oral health services (as defined by the Secretary) 
that— 
‘‘(i) are provided for the purpose of over-
coming mobility, transportation, or access bar-
riers for children; and 
‘‘(ii) satisfy the standards and certification 
requirements 
established 
under 
section 
1902(a)(84)(B) for the State in which the serv-
ices are provided.’’. 
(d) INCREASED FEDERAL FUNDING FOR DENTAL 
SERVICES.— 
(1) IN GENERAL.—Section 1905 of the Social 
Security Act (42 U.S.C. 1396d), as amended by sub-
section (a), is amended— 
(A) in subsection (b), in the first sentence, 
by striking ‘‘and (aa)’’ and inserting ‘‘(aa), and 
(ff)’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(ff) INCREASED FMAP FOR DENTAL SERVICES.— 
‘‘(1) IN GENERAL.—Notwithstanding subsection 
(b) and section 1903(a)(7) and subject to the re-
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quirements described in paragraphs (3) and (4), 
with respect to amounts expended on or after Octo-
ber 1, 2012, for covered dental expenses (as de-
scribed in paragraph (2)), the Federal medical as-
sistance percentage for a State that is one of the 50 
States or the District of Columbia for such expenses 
shall be equal to the Federal medical assistance per-
centage that would otherwise apply to the State for 
the fiscal year, as determined under subsection (b) 
or section 1903(a)(7), increased by 10 percentage 
points. 
‘‘(2) COVERED DENTAL EXPENSES.—For pur-
poses of paragraph (1), the term ‘covered dental ex-
penses’ means the amounts expended for medical as-
sistance for dental services (as described in sub-
section (ee)(1)) and amounts expended for the prop-
er and efficient administration of the provision of 
such dental services under the State plan. 
‘‘(3) REQUIREMENTS.—For purposes of para-
graph (1), the Federal medical assistance percentage 
applicable to covered dental expenses under this sub-
section shall not apply to a State unless— 
‘‘(A) the State plan for medical assistance 
provides payment for dental services (as so de-
fined) furnished by a dental provider at a rate 
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that is not less than 70 percent of the usual 
and customary fee for such services in the 
State; and 
‘‘(B) the State satisfies such additional re-
quirements as are established by the Secretary, 
which shall include— 
‘‘(i) streamlining of administrative 
procedures for purposes of ensuring ade-
quate provider participation and increasing 
patient utilization of dental services; and 
‘‘(ii) the provision of technical assist-
ance to dental providers designed to reduce 
the number of missed patient appoint-
ments and eliminate other barriers to the 
provision of oral health services. 
‘‘(4) LIMITATION.—For purposes of amounts 
expended for covered dental services, in no case shall 
any increase under this subsection result in a Fed-
eral medical assistance percentage that exceeds 100 
percent.’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
1903(a)(7) of the Social Security Act (42 U.S.C. 
1396b(a)(7)) is amended by striking ‘‘section 
1919(g)(3)(B)’’ and inserting ‘‘sections 1905(ff) and 
1919(g)(3)(B)’’. 
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(e) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this section 
shall apply to calendar quarters beginning on or 
after January 1, 2013, without regard to whether or 
not final regulations to carry out such amendments 
have been promulgated by such date. 
(2) DELAY
PERMITTED
FOR
STATE
PLAN 
AMENDMENT.—In the case of a State plan for med-
ical assistance under title XIX of the Social Security 
Act which the Secretary of Health and Human Serv-
ices determines requires State legislation (other than 
legislation appropriating funds) in order for the plan 
to meet the additional requirements imposed by the 
amendments made by this section, the State plan 
shall not be regarded as failing to comply with the 
requirements of such title solely on the basis of its 
failure to meet these additional requirements before 
the first day of the first calendar quarter beginning 
after the close of the first regular session of the 
State legislature that begins after the date of enact-
ment of this Act. For purposes of the previous sen-
tence, in the case of a State that has a 2-year legis-
lative session, each year of such session shall be 
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deemed to be a separate regular session of the State 
legislature. 
Subtitle C—Grant Programs 
SEC. 121. CASE MANAGEMENT GRANT PROGRAM. 
(a) ESTABLISHMENT.—The Secretary shall award 
grants to States and eligible entities for the purpose of 
developing case management programs that— 
(1) identify eligible individuals who are in need 
of dental services, with a particular focus on preg-
nant women, individuals with disabilities, and older 
adults, and provide them with information regarding 
dental providers in proximity to their residence; 
(2) determine the coverage status of an eligible 
individual or whether such individual is eligible for 
free dental services; 
(3) recruit licensed dental providers and coordi-
nate the voluntary provision of medically rec-
ommended dental services by such providers to eligi-
ble individuals described in subsection (f)(2)(E) with 
no fee or charge to such individuals and in a manner 
consistent with State licensing laws; 
(4) provide community-level oral health edu-
cation, with a focus on oral health literacy and pre-
vention, and resource information to eligible individ-
uals; and 
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(5) identify and coordinate transportation for 
eligible individuals in need of dental services as nec-
essary to overcome mobility impairments and trans-
portation barriers. 
(b) APPLICATION.—A State or eligible entity that de-
sires to participate in the grant program under this sec-
tion shall submit to the Secretary an application at such 
time, in such manner, and containing such information as 
the Secretary may require. 
(c) DURATION AND SCOPE.—From any amounts ap-
propriated to carry out this section, the Secretary shall 
award grants to a total of 10 States and eligible entities, 
with the amount of each grant to be determined at the 
discretion of the Secretary. 
(d) EVALUATION.—Not later than January 1, 2016, 
the Secretary shall— 
(1) conduct an evaluation of the grant program 
under this section for purposes of determining if 
case management programs established by partici-
pating States and eligible entities sufficiently in-
creased access to dental services; and 
(2) determine whether case management pro-
grams should be made available on a nationwide 
basis. 
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(e) AUTHORIZATION.—To carry out the grant pro-
gram under this section, there are authorized to be appro-
priated such sums as may be necessary for each of fiscal 
years 2013 through 2015. 
(f) DEFINITIONS.—In this section: 
(1) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means an organization that is described in sec-
tion 501(c)(3) of the Internal Revenue Code of 1986 
and exempt from tax under section 501(a) of such 
Code. 
(2) ELIGIBLE INDIVIDUAL.—The term ‘‘eligible 
individual’’ means an individual who is— 
(A) entitled to, or enrolled for, benefits 
under part A of title XVIII of the Social Secu-
rity Act or enrolled for benefits under part B 
of such title; 
(B) eligible to receive medical assistance 
under a State plan under title XIX of the So-
cial Security Act or any waiver approved with 
respect to such plan; 
(C) eligible to receive child health assist-
ance under a State child health plan under title 
XXI of the Social Security Act or any waiver 
approved with respect to such plan; 
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