| 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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