Home > 106th Congressional Bills > H.R. 4623 (ih) To amend title XVIII of the Social Security Act to revise the calculation of base payment rates for the prospective payment system for home health services furnished under the medicare program. [Introduced in House] ...H.R. 4623 (ih) To amend title XVIII of the Social Security Act to revise the calculation of base payment rates for the prospective payment system for home health services furnished under the medicare program. [Introduced in House] ...
108th CONGRESS
2d Session
H. R. 4622
To provide disadvantaged children with access to dental services.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 18, 2004
Mr. Simpson (for himself, Mr. Dingell, Mr. Pallone, Mr. Waxman, Mr.
Norwood, Ms. Roybal-Allard, Mr. Cramer, Mr. McNulty, Mr. Blunt, Mr.
Linder, Mr. Boucher, Mr. Pastor, Mrs. Christensen, Mr. Towns, Mr.
Dicks, Mr. Andrews, Mr. Meehan, Mr. Kennedy of Rhode Island, Mr.
Serrano, Mr. McIntyre, Mr. Matsui, Mr. Larsen of Washington, Mr. Engel,
Mr. Conyers, Mr. Cunningham, Mrs. McCarthy of New York, Mr. Kildee, Mr.
Pascrell, Ms. Bordallo, Mr. Shuster, Mr. Ferguson, Mr. LoBiondo, Mr.
Turner of Texas, Mr. Brown of Ohio, Mr. Stupak, Mr. Strickland, Mr.
Simmons, and Mr. Allen) 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 dental services.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Children's Dental
Health Improvement Act of 2004''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
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. 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 graduate medical education (D-GME)
payments under the medicare program.
TITLE III--IMPROVING DELIVERY OF PEDIATRIC DENTAL SERVICES 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 SERVICES 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:
``SEC. 511. GRANTS TO IMPROVE THE PROVISION OF DENTAL 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 requirements 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 Secretary 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
administrative case management, improving collection and
reporting of claims data, and providing incentives, 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 enlist providers to treat children in need of dental
services.
``(3) Ensured access.--The State shall ensure it will make
dental services available to children enrolled in the State
plans to the same extent as such services are available to the
general population of the State.
``(c) Use of Funds.--
``(1) In general.--Funds provided under this section may be
used to provide administrative resources (such as program
development, provider training, data collection and analysis,
and research-related tasks) to assist States in providing and
assessing services that include preventive and therapeutic
dental care regimens.
``(2) Limitation.--Funds provided under this section may
not be used for payment of direct dental, medical, or other
services or to obtain Federal matching funds under any Federal
program.
``(d) Application.--A State shall submit an application to the
Secretary for a grant under this section in such form and manner and
containing such information as the Secretary may require.
``(e) Authorization of Appropriations.--There are authorized to be
appropriated to make grants under this section $50,000,000 for fiscal
year 2005 and each fiscal year thereafter.
``(f) Application of Other Provisions of Title.--
``(1) In general.--Except as provided in paragraph (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 subsection (a) to the same
extent and in the same manner as such provisions apply to
allotments made under section 502(c):
``(A) Section 504(b)(6) (relating to prohibition 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 limitation 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.
``(E) Section 507 (relating to penalties for false
statements).
``(F) Section 508 (relating to nondiscrimination).
``(G) Section 509 (relating to the administration
of the grant program).''.
SEC. 102. 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 following:
``(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
satisfies the conditions described in subsection (c)(8). The
State may waive such requirement in order to provide--
``(A) dental services;
``(B) cost-sharing protection; or
``(C) all services.
In waiving such requirement, a State may limit the application
of the waiver to children whose family income 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 2110(b)(5), the conditions described in
this paragraph are the following:
``(A) Income eligibility.--The State child health
plan (whether implemented under title XIX or this
XXI)--
``(i) has the highest income eligibility
standard permitted under this title as of
January 1, 2004;
``(ii) subject to subparagraph (B), does
not limit the acceptance of applications for
children; and
``(iii) provides benefits to all children
in the State who apply for and meet eligibility
standards.
``(B) No waiting list imposed.--With respect to
children whose family income is at or below 200 percent
of the poverty line, the State does not impose any
numerical limitation, waiting list, or similar
limitation on the eligibility of such children for
child health assistance under such State plan.
``(C) No more favorable treatment.--The State child
health plan may not provide more favorable coverage of
dental services to the children covered under section
2110(b)(5) than to children otherwise covered under
this title.''.
(C) State option to waive waiting period.--Section
2102(b)(1)(B) of the Social Security Act (42 U.S.C.
1397bb(b)(1)(B)) is amended--
(i) in clause (i), by striking ``and'' at
the end;
(ii) in clause (ii), by striking the period
and inserting ``; and''; and
(iii) by adding at the end the following:
``(iii) at State option, may not apply a
waiting period in the case of a child described
in section 2110(b)(5), if the State satisfies
the requirements of section 2105(c)(8).''.
(2) Application of enhanced match under medicaid.--Section
1905 of the Social Security Act (42 U.S.C. 1396d) is amended--
(A) in subsection (b), in the fourth sentence, by
striking ``or subsection (u)(3)'' and inserting
``(u)(3), or (u)(4)''; and
(B) in subsection (u)--
(i) by redesignating paragraph (4) as
paragraph (5); and
(ii) by inserting after paragraph (3) the
following:
``(4) For purposes of subsection (b), the expenditures
described in this paragraph are expenditures for items and
services for children described in section 2110(b)(5), but only
in the case of a State that satisfies the requirements of
section 2105(c)(8).''.
(3) Application of secondary payor provisions.--Section
2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1))
is amended--
(A) by redesignating subparagraphs (B) through (D)
as subparagraphs (C) through (E), respectively; and
(B) by inserting after subparagraph (A) the
following:
``(B) Section 1902(a)(25) (relating to coordination
of benefits and secondary payor provisions) with
respect to children covered under a waiver described in
section 2110(b)(5).''.
(b) Effective Date.--The amendments made by subsection (a) shall
take effect on January 1, 2004, and shall apply to child health
assistance and medical assistance provided on or after that date.
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 GRADUATE MEDICAL EDUCATION (D-GME)
PAYMENTS UNDER THE MEDICARE PROGRAM.
(a) IME Ratio and Rolling Average.--Section 1886(d)(5)(B)(vi) of
the Social Security Act (42 U.S.C. 1395ww(d)(5)(B)(vi)) is amended by
adding at the end the following new sentence: ``For cost reporting
periods beginning during fiscal years beginning on or after October 1,
2004, subclauses (I) and (II) shall be applied only with respect to a
hospital's approved medical residency training program in the fields of
allopathic medicine and osteopathic medicine.''.
(b) D-GME Rolling Average.--Section 1886(h)(4)(G) of the Social
Security Act (42 U.S.C. 1395ww(h)(4)(G)) is amended by adding at the
end the following new clause:
``(iv) Application for fy 2005 and
subsequent years.--For cost reporting periods
beginning during fiscal years beginning on or
after October 1, 2004, clauses (i) through
(iii) shall be applied only with respect to a
hospital's approved medical residency training
program in the fields of allopathic medicine
and osteopathic medicine.''.
TITLE III--IMPROVING DELIVERY OF PEDIATRIC DENTAL SERVICES 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.
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