I 111th CONGRESS 2d Session H. R. 4731 IN THE HOUSE OF REPRESENTATIVES March 2, 2010 Ms. Watson introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend title XIX of the Social Security Act to ensure access to resin-based dental fillings that, at a minimum, is equal to the level of access to mercury-based dental fillings under such title.

1.

Short title

This Act may be cited as the Medicaid Options for Dental Fillings Act of 2010.

2.

Changes to Medicaid to ensure equal access to resin-based dental fillings

(a)

Changes to Medicaid cost-Sharing rules for dental fillings

(1)

In general

Section 1916 of the Social Security Act (42 U.S.C. 1396o) is amended by adding at the end the following new subsection: (k)

Dental fillings

With respect to an individual, the amount of cost-sharing charged under this section or under section 1916A for a resin-based dental filling— (1)shall not exceed the amount charged in the State for a mercury-based dental filling on January 1, 2010; and (2)in the case that the State charges an amount for a mercury-based dental filling and such amount is less than the amount under paragraph (1), shall not exceed the amount that the State charges for a mercury-based dental filling. . (2)

Conforming change

Section 1916A(a)(1) of such Act (42 U.S.C. 1396o–1(a)(1)) is amended— (A)by striking Notwithstanding sections 1916 and 1902(a)(10)(B) and inserting Notwithstanding section 1902(a)(10)(B) and subsections (a) through (j) of section 1916; and (B)by inserting and section 1916(k) after paragraph (2). (b)

Changes in Medicaid reimbursement rates for resin-Based dental fillings

Section 1903 of the Social Security Act (42 U.S.C. 1396b) is amended by adding at the end the following new subsection: (aa)In order to receive payments under subsection (a) for dental fillings, a State must reimburse providers for resin-based dental fillings at a rate that is the greater of— (1)a rate set by the State; or (2)a rate for such fillings that is proportional, relative to the cost of such fillings, to the greater of— (A)the rate at which the State reimburses providers for mercury-based dental fillings, relative to the cost of such fillings; or (B)the rate at which the State reimbursed providers for mercury-based dental fillings, relative to the cost of such fillings, on January 1, 2010. . (c)

Effective date

The amendments made by this section shall be effective for dental fillings provided on or after the date that is 60 days after the date of the enactment of this section. (d)

Exception for State legislation

In the case of a State plan under title XIX or State child health plan under XXI of the Social Security Act, which the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet one or more additional requirements imposed by amendments made by this section, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this section. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.