[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1288 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 1288

To amend title XVIII of the Social Security Act to provide for coverage 
 under part B of cost-effective, medically necessary dental procedures.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 10, 1997

   Mr. Hoyer (for himself, Mr. Cardin, and Mr. Stark) introduced the 
following bill; which was referred to the Committee on 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 amend title XVIII of the Social Security Act to provide for coverage 
 under part B of cost-effective, medically necessary dental procedures.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Medically Necessary Dental 
Care Act of 1997''.

SEC. 2. COST-EFFECTIVE MEDICARE COVERAGE OF MEDICALLY NECESSARY DENTAL 
              PROCEDURES.

    (a) In General.--Section 1862 of the Social Security Act (42 U.S.C. 
1395y) is amended--
            (1) in subsection (a)(12)--
                    (A) by inserting ``(A)'' after ``except that'', and
            (B) by inserting before the semicolon at the end the 
        following: ``, and (B) payment may be made under part B for the 
        provision of such dental services that are medically necessary 
        as a direct result of, or will have a direct impact on, an 
        underlying medical condition if the coverage of such services 
        is cost-effective, as determined under subsection (j)''; and
            (2) by adding at the end the following new subsection:
    ``(j) For purposes of subsection (a)(12)(B)--
            ``(1) Dental services shall be considered to be cost-
        effective if furnished in connection with treatment of an 
        individual with any of the following diagnoses: congenital or 
        acquired valvular heart disease, cancer of the head or neck, 
        lymphoma, leukemia, and organ transplantation.
            ``(2) If the Secretary determines that the coverage (under 
        the exception provided in section 1862(a)(12)(B)) of dental 
        services furnished in connection with treatment of an 
        individual with a diagnosis not listed in paragraph (1) will 
        result in reductions in expenditures under this title that 
        exceed the expenditures resulting from such coverage, coverage 
        shall be available under such exception with respect to such an 
        individual with such diagnosis unless (and until) the Secretary 
        makes a determination to the contrary.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to procedures performed on or after January 1, 1998.
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