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] ...


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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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