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<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>113 S1586 IS: Enhanced Dental Care for Veterans Act of 2013</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2013-10-28</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">II</distribution-code><congress>113th CONGRESS</congress><session>1st Session</session><legis-num>S. 1586</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20131028">October 28, 2013</action-date><action-desc><sponsor name-id="S313">Mr. Sanders</sponsor> introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSVA00">Committee on Veterans' Affairs</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>To amend title 38, United States Code, to improve dental
		  health care for veterans, and for other purposes.</official-title></form><legis-body><section id="S1" section-type="section-one"><enum>1.</enum><header>Short
			 title</header><text display-inline="no-display-inline">This Act may be cited as
			 the <quote><short-title>Enhanced Dental Care for Veterans Act of 2013</short-title></quote>.</text></section><section id="idFBA27391E9DB4E58AF6CE00BC97DF741"><enum>2.</enum><header>Restorative
			 dental services for veterans</header><text display-inline="no-display-inline"><external-xref legal-doc="usc" parsable-cite="usc/38/1710">Section 1710(c)</external-xref> of title 38, United States
			 Code, is amended—</text><paragraph id="id4A0196E1CC1F4B52B68002B153F83B31"><enum>(1)</enum><text>in the second
			 sentence—</text><subparagraph id="idF7DEBB6414224D5588B03E507EF2ADB9"><enum>(A)</enum><text>by redesignating
			 subparagraphs (A) and (B) as clauses (i) and (ii), respectively; and</text></subparagraph><subparagraph id="id2CF7FFCDB7BF49609F40009E663E4535"><enum>(B)</enum><text>by redesignating
			 paragraphs (1) and (2) as subparagraphs (A) and (B), respectively;</text></subparagraph></paragraph><paragraph id="id7E3ECBC7B3FD4D25A5588356C8D087FD"><enum>(2)</enum><text>by inserting
			 <quote>(1)</quote> after <quote>(c)</quote>;</text></paragraph><paragraph id="id257CFE40A5D64E2F807B5374817B9C5B"><enum>(3)</enum><text>by striking
			 <quote>The Secretary</quote> and inserting the following:</text><quoted-block display-inline="no-display-inline" id="idDBC81A75EB9A4C2C9093FA6635A14B8E" style="OLC"><paragraph id="idE9A0869158254251ACF9349ACFBC2387" indent="up1"><enum>(2)</enum><text>The
				Secretary</text></paragraph><after-quoted-block>;
				and</after-quoted-block></quoted-block></paragraph><paragraph id="id10033F4A94FF45179C320637C6AAE195"><enum>(4)</enum><text>by adding at the
			 end the following new paragraph:</text><quoted-block display-inline="no-display-inline" id="idC400265A587749CC8B044A50BDB81BF0" style="OLC"><paragraph id="id39C6C3EC647040948B7661DF9C16BC23" indent="up1"><enum>(3)</enum><text>In addition to the dental services,
				treatment, and appliances authorized to be furnished by paragraph (2), the
				Secretary may furnish dental services and treatment, and dental appliances,
				needed to restore functioning in a veteran that is lost as a result of any
				services or treatment furnished under this
				subsection.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="id00402F03B2B5406CAC753332DDFB9FB5"><enum>3.</enum><header>Pilot program on expansion of furnishing of dental care to all enrolled veterans</header><subsection id="ide4f9725836d0477ab9ade3573cdb9355"><enum>(a)</enum><header>Pilot program required</header><text>Commencing not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall carry out a pilot program to assess the feasibility and advisability of furnishing dental care to veterans enrolled in the system of patient enrollment under <external-xref legal-doc="usc" parsable-cite="usc/38/1705">section 1705</external-xref> of title 38, United States Code, who are not eligible for dental services and treatment, and related dental appliances, under current authorities.</text></subsection><subsection id="id494a2b72378f48e9ae0f29f26a0d1225"><enum>(b)</enum><header>Duration of pilot program</header><text>The pilot program shall be carried out during the three-year period beginning on the date of the commencement of the pilot program.</text></subsection><subsection id="id1886DEBC2B0D459A9BF7DC735D22BFDB"><enum>(c)</enum><header>Locations</header><paragraph id="id06D5FEA8A71C4BCA805A59ECEA41ECBE"><enum>(1)</enum><header>In general</header><text>The Secretary shall carry out the pilot program at  not fewer than 16 locations as follows:</text><subparagraph id="ide6f13da10e5346e2b0257b62d1f6a53e"><enum>(A)</enum><text>Four Department of Veterans Affairs medical centers with an established dental clinic.</text></subparagraph><subparagraph id="id5f5772c84726429cbf772b43791c5aea"><enum>(B)</enum><text>Four Department medical centers with a current contract for the furnishing of dental care.</text></subparagraph><subparagraph id="id296ab50d4145493c9cfe54bc184d3c4f"><enum>(C)</enum><text>Four Community-Based Outpatient Clinics (CBOCs) with space available for the furnishing of services and treatment under the pilot program.</text></subparagraph><subparagraph id="idfbb32377a39040569cf1ab899b4dd008"><enum>(D)</enum><text>Four facilities selected from among Federally Qualified Health Centers (FQHCs) and Indian Health Service facilities with established dental clinics, of which—</text><clause id="id12AB7AEAF181409D9F2F037EBA7A71D7"><enum>(i)</enum><text>at least one facility shall be such an Indian Health Service facility; and</text></clause><clause id="id61868D88878945BA81AB08DEB3FF843F"><enum>(ii)</enum><text>any Indian Health Service facility so selected shall be selected in consultation with the Secretary of Health and Human Services.</text></clause></subparagraph></paragraph><paragraph id="idF6809E586D884BEF9436CD431C6C452D"><enum>(2)</enum><header>Considerations</header><text>In selecting locations for the pilot program, the Secretary shall consider the feasibility and advisability of selecting locations in each of the following:</text><subparagraph id="id86bc41980a5c4b91b77f55a545efea5e"><enum>(A)</enum><text>Rural areas.</text></subparagraph><subparagraph id="idb4ecf56b31c342378e0ce65a9889421c"><enum>(B)</enum><text>Areas that are not in close proximity to an active duty military installation.</text></subparagraph><subparagraph id="id97cc40a526544af2a8c0e572b749c293"><enum>(C)</enum><text>Areas representing different geographic locations, such as census tracts established by the Bureau of Census.</text></subparagraph></paragraph></subsection><subsection id="id6F5DE36DF757411D981F231716C529E3"><enum>(d)</enum><header>Scope of
			 services</header><text>The dental services and treatment furnished to veterans under
			 the pilot program shall be consistent with the dental services and treatment
			 furnished by the Secretary to veterans with service-connected disabilities rated
			 100 percent disabling under the laws administered by the Secretary.</text></subsection><subsection id="id5DAF9B141880424B8FC7CF80F7258C0A"><enum>(e)</enum><header>Voluntary
			 participation</header><text>The participation of a veteran in the pilot
			 program shall be at the election of the veteran.</text></subsection><subsection commented="no" id="id8E26B04662F047FDA53C0D325242295E"><enum>(f)</enum><header>Limitation on amount of services</header><paragraph commented="no" id="id20BDE18B78BA4E66AD57A71941959281"><enum>(1)</enum><header>In general</header><text>Except as provided in paragraph (3), the total amount the Secretary may expend furnishing dental services and treatment to any veteran participating in the pilot program during any one-year period may not exceed such amount as the Secretary determines appropriate. The amount so determined may not be less than $1,000.</text></paragraph><paragraph commented="no" id="id5D1E1586F9384BC497B8B8474B00341F"><enum>(2)</enum><header>Consultation</header><text>The Secretary shall make the determination under paragraph (1)—</text><subparagraph commented="no" id="id7AA182EE65A648FEB3E9D95DA6574AD4"><enum>(A)</enum><text>in consultation with the Director of the Indian Health Service; and</text></subparagraph><subparagraph commented="no" id="id720E564A92664CB1AA71F3CF6FF328B3"><enum>(B)</enum><text>in consultation with the Director of the Centers for Medicare and Medicaid Services if one or more Federally Qualified Health Centers is selected as a location for the pilot program under subsection (c)(1)(D).</text></subparagraph></paragraph><paragraph commented="no" id="id8CCB54BC8BAE49C2BC041A599200079B"><enum>(3)</enum><header>Services in excess of limitation amount</header><text>The total amount expended by the Secretary in furnishing dental services and treatment to a particular veteran participating in the pilot program during a one-year period may exceed the amount determined under paragraph (1) if the Secretary determines, before furnishing such services and treatment, based on an examination of the veteran by a dentist participating in the pilot program that the furnishing of such services and treatment is necessary. Any determination under this paragraph shall be made on a case-by-case basis.</text></paragraph></subsection><subsection commented="no" id="idAD15D674716F4FD8A4C98F50AB0E5351"><enum>(g)</enum><header>Copayments</header><text>The Secretary may collect copayments for dental services and treatment furnished under the pilot program in accordance with authorities on the collection of copayments for medical care of veterans under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/17">chapter 17</external-xref> of title 38, United States Code.</text></subsection><subsection id="idA9911D43D4FD49B5BB4EE533F80C4BF0"><enum>(h)</enum><header>Program
			 administration</header><paragraph id="id28DB1354ECFD4951B9D25C3F3D46FA91"><enum>(1)</enum><header>Notice to
			 covered veterans on pilot program</header><text>In carrying out the pilot
			 program, the Secretary shall inform all veterans eligible to participate in the pilot program of the services
			 and treatment available under the pilot program.</text></paragraph><paragraph id="id50AC032923A2492980FD445FDC56DD00"><enum>(2)</enum><header>Contracts</header><text>In
			 carrying out the pilot program, the Secretary may enter into contracts with
			 appropriate entities for the provision of dental services and treatment under the pilot
			 program. Each such contract shall specify performance standards and metrics and
			 processes for ensuring compliance of the contractor concerned with such
			 performance standards.</text></paragraph></subsection><subsection id="idD2CE1A4E62B14AEFBBB56725C4682636"><enum>(i)</enum><header>Reports</header><paragraph id="idB29A88C0A8CF4F8C95EF2E0DA0378D3E"><enum>(1)</enum><header>Preliminary
			 reports</header><subparagraph id="idC216967372B64E6D9E73490F20BB0716"><enum>(A)</enum><header>In
			 general</header><text>Not later than each of one year and three years after the date of the
			 commencement of the pilot program, the Secretary shall submit to the Committee
			 on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of
			 the House of Representatives a report on the pilot program.</text></subparagraph><subparagraph id="idE6A292930FC84585AA565347EFF7647D"><enum>(B)</enum><header>Contents</header><text>Each
			 report under subparagraph (A) shall include the following:</text><clause id="idAE21FD1439AB4654A7CBF866388CFE50"><enum>(i)</enum><text>A
			 description of the implementation and operation of the pilot program.</text></clause><clause id="idDA6CB5A8A8A44EE184EE0C1608050E3C"><enum>(ii)</enum><text>The number of
			 veterans receiving services and treatment under the pilot program, and a description
			 of the dental services and treatment furnished to such veterans.</text></clause><clause id="id4705AA0F5ACF4D149F9F1F083F70BC76"><enum>(iii)</enum><text>An analysis of
			 the costs and benefits of the pilot program, including a comparison of costs
			 and benefits by location type.</text></clause><clause id="idDE92320EB6FC4972B0E47D5C4EBD4F64"><enum>(iv)</enum><text>The current
			 findings and conclusions of the Secretary with respect to the pilot
			 program.</text></clause><clause id="id90DFB7A16A664558A303674EAFA17518"><enum>(v)</enum><text>Such
			 recommendations for the continuation or expansion of the pilot program as the
			 Secretary considers appropriate.</text></clause></subparagraph></paragraph><paragraph id="id04CBB22C496248B989449594E6CAED94"><enum>(2)</enum><header>Final
			 report</header><subparagraph id="id82F8213B72A74641AC60A78A48170818"><enum>(A)</enum><header>In
			 general</header><text>Not later than 180 days after the completion of the pilot
			 program, the Secretary shall submit to the Committee on Veterans’ Affairs of
			 the Senate and the Committee on Veterans’ Affairs of the House of
			 Representatives a report on the pilot program.</text></subparagraph><subparagraph id="id1BDD1AAA861D47FEA700A27A7BE79239"><enum>(B)</enum><header>Contents</header><text>The
			 report under subparagraph (A) shall include the following:</text><clause id="id027342344922479BBA0E92620E554D81"><enum>(i)</enum><text>The
			 findings and conclusions of the Secretary with respect to the pilot
			 program.</text></clause><clause commented="no" display-inline="no-display-inline" id="id53AF792556F04EC695D982B925CE7752"><enum>(ii)</enum><text>Such
			 recommendations for the continuation or expansion of the pilot program as the
			 Secretary considers appropriate.</text></clause></subparagraph></paragraph></subsection></section><section id="id89d69a54acc542b98db91bdb034c2a86"><enum>4.</enum><header>Program on
			 education to promote dental health in veterans</header><subsection id="idc238757e7f904e16a7613daa1dca804f"><enum>(a)</enum><header>Program
			 required</header><paragraph id="id0DA65E609D0D47E38CA0DBB8FC4103C5"><enum>(1)</enum><header>In
			 general</header><text>The Secretary of Veterans Affairs shall carry out a
			 program of education to promote dental health for veterans who are enrolled in
			 the system of patient enrollment of the Department of Veterans Affairs under
			 <external-xref legal-doc="usc" parsable-cite="usc/38/1705">section 1705</external-xref> of title 38, United States Code.</text></paragraph><paragraph id="idAD9D7E48EA2841FF89F703E440F4BE3A"><enum>(2)</enum><header>Construction</header><text>Nothing
			 in the program shall be deemed to alter or revise the eligibility of any
			 veteran for dental care under the laws administered by the Secretary.</text></paragraph></subsection><subsection id="id6a46da4749894671948b1ca806cf0605"><enum>(b)</enum><header>Elements</header><text>The
			 program required by subsection (a) shall provide education for veterans on the
			 following:</text><paragraph id="id62b5abc5f8ab4da4b2263b6dcf5faaa7"><enum>(1)</enum><text>The association
			 between dental health and overall health and well-being.</text></paragraph><paragraph id="ide05083ee93f04ea2855adf2350fdcc40"><enum>(2)</enum><text>Proper techniques
			 for dental care.</text></paragraph><paragraph id="id7e45281a918a45099bd9d0c6959b7cde"><enum>(3)</enum><text>Signs and
			 symptoms of commonly occurring dental issues, including caries.</text></paragraph><paragraph id="id382748292bcb4f59bc8f51df1bbd5daf"><enum>(4)</enum><text>Treatment options
			 for commonly occurring dental issues.</text></paragraph><paragraph id="ide2ccca9621c849b7a400e1716da85a79"><enum>(5)</enum><text>Options for
			 obtaining access to dental care, including information on eligibility for
			 dental care through the Department and on purchasing private dental
			 insurance.</text></paragraph><paragraph id="id0b4a274a7e994c348d519fe560c8c94e"><enum>(6)</enum><text>Options for
			 obtaining low or no-cost dental care, including through dental schools and
			 Federally Qualified Health Centers.</text></paragraph><paragraph id="id2bc4c434100346f5823815edc3afd569"><enum>(7)</enum><text>Such other
			 matters relating to dental health as the Secretary considers
			 appropriate.</text></paragraph></subsection><subsection id="id3dd9c585e38b4b55b7f58c0002310154"><enum>(c)</enum><header>Delivery of
			 educational materials</header><paragraph id="idEF40D501281A435C9E0813D6CECF304B"><enum>(1)</enum><header>In
			 general</header><text>The Secretary shall provide educational materials to
			 veterans under the program required by subsection (a) through a variety of
			 mechanisms, including the following:</text><subparagraph id="id37FBB51971964CE4B5A7269EE4F91B1A"><enum>(A)</enum><text>The availability
			 and distribution of print materials at Department facilities, including medical
			 centers, clinics, Vet Centers, and readjustment counseling centers.</text></subparagraph><subparagraph id="id3E7574A95106476A85217F7F2C765A04"><enum>(B)</enum><text>The availability
			 and distribution of materials over the Internet, including through webinars and
			 My HealtheVet.</text></subparagraph><subparagraph id="idAA019196F24F47A28178E64C47CC6C0D"><enum>(C)</enum><text>Presentations of
			 information, including both small group and large group presentations.</text></subparagraph></paragraph><paragraph id="id240585F808C6443BB812EA2532205EE3"><enum>(2)</enum><header>Selection of
			 mechanisms</header><text>In selecting mechanisms for purposes of this
			 subsection, the Secretary shall select mechanisms designed to maximize the
			 number of veterans who receive education under the program.</text></paragraph></subsection></section><section id="idb1c128302d50416e8a1892ced6dc4f2c"><enum>5.</enum><header>Information on
			 dental services for inclusion in electronic medical records under dental
			 insurance pilot program</header><subsection id="idc5bf8a3991074686b880dbd369afac40"><enum>(a)</enum><header>In
			 general</header><text>Commencing not later than 180 days after the date of the
			 enactment of this Act, the Secretary of Veterans Affairs shall expand the
			 dental insurance pilot program established by <external-xref legal-doc="usc" parsable-cite="usc/38/17">section 17.169</external-xref> of title 38, Code
			 of Federal Regulations, to establish a mechanism by which private sector dental
			 care providers may forward to the Department of Veterans Affairs information on
			 dental care furnished to individuals under the pilot program for inclusion in
			 the electronic medical records of the Department with respect to such
			 individuals.</text></subsection><subsection id="id956F6F7382434CF18006EA39E2A1F3FA"><enum>(b)</enum><header>Construction
			 with current pilot program requirements</header><paragraph id="idd8576f1fbe424e90a280fab1b87f4251"><enum>(1)</enum><header>In
			 general</header><text>Nothing in this section shall be construed to revise
			 eligibility for participation in, or the locations of, the pilot program
			 referred to in subsection (a).</text></paragraph><paragraph id="idF7050B56E90E47B4A42115123BC626B2"><enum>(2)</enum><header>Duration</header><text>The
			 Secretary may continue the pilot program for two years in addition to the
			 duration otherwise provided for the pilot program in section 17.169 of title
			 38, Code of Federal Regulations, if the Secretary determines that the
			 continuation is needed to assess the mechanism required by subsection
			 (a).</text></paragraph><paragraph id="idA66618BF62DD4BDFA6AC6A33F5F81184"><enum>(3)</enum><header>Voluntary
			 participation in mechanism</header><text>The participation in the mechanism
			 required by subsection (a) of an individual otherwise participating in the
			 pilot program shall be at the election of the individual.</text></paragraph></subsection><subsection id="idc69250c7e6ac4068af87c0d93b6c3a9b"><enum>(c)</enum><header>Inclusion of
			 information on mechanism in reports</header><text>Each report to Congress on
			 the pilot program after the date of the commencement of the
			 mechanism required by subsection (a) shall include information on the
			 mechanism, including a current assessment of the feasibility and advisability
			 of using the mechanism to include information on dental care furnished
			 to individuals in the electronic medical records of the Department with respect to
			 such individuals.</text></subsection></section></legis-body></bill>


