[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3701 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 3701
To amend title XIX of the Social Security Act to strengthen coverage
under the Medicaid program for certain foster youth individuals.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 25, 2023
Ms. Kamlager-Dove (for herself, Ms. Moore of Wisconsin, and Mr.
Cleaver) 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 strengthen coverage
under the Medicaid program for certain foster youth individuals.
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 ``Foster Youth Dental Act of 2023''.
SEC. 2. STRENGTHENING COVERAGE UNDER THE MEDICAID PROGRAM FOR CERTAIN
FOSTER YOUTH INDIVIDUALS.
(a) Expansion of EPSDT Services to Certain Individuals Aged 21-
25.--
(1) In general.--Section 1905(a) of the Social Security Act
(42 U.S.C. 1396d(a)) is amended--
(A) in paragraph (4)(B), by inserting ``(or, in the
case of a specified individual (as defined in the
matter at the end of this subsection), under the age of
26)'' after ``21''; and
(B) by adding at the end the following new
sentence: ``For purposes of paragraph (4)(B), the term
`specified individual' means an individual who is in
foster care under the responsibility of a State (or was
in foster care under the responsibility of the State on
the date of attaining 18 years of age or such higher
age as the State has elected under section
475(8)(B)(iii) and was enrolled in a State plan under
this title or under a waiver of a plan while in such
foster care).''.
(2) Provision of information with respect to dental
services.--Section 1902(a)(43)(A) of the Social Security Act
(42 U.S.C. 1396a(a)(43)(A)) is amended--
(A) by inserting ``(or, in the case of a specified
individual (as defined in the matter at the end of
section 1905(a)), under the age of 26)'' after ``21'';
(B) by inserting ``(including dental services)''
after ``treatment services'';
(C) by striking ``and the need'' and inserting ``,
the need''; and
(D) by striking the comma at the end and inserting
``, and the importance of maintaining good oral
health,''.
(3) Effective date.--
(A) Extension of coverage.--The amendments made by
paragraph (1) shall apply with respect to medical
assistance furnished during calendar quarters beginning
on or after the date that is 80 days after the date of
the enactment of this Act.
(B) Provision of information.--The amendment made
by paragraph (2) shall apply to information provided
under section 1902(a)(43)(A) of the Social Security Act
(42 U.S.C. 1396a(a)(43)(A)) beginning with the first
calendar quarter beginning on or after the date that is
80 days after the date of the enactment of this Act.
(b) Incentive for the Provision of Dental Services to Certain
Individuals.--
(1) In general.--Section 1902(a) of the Social Security Act
(42 U.S.C. 1396a(a)) is amended--
(A) in paragraph (13)--
(i) in subparagraph (B), by striking
``and'' at the end;
(ii) in subparagraph (C), by adding ``and''
at the end; and
(iii) by adding at the end the following
new subparagraph:
``(D) for payment for dental services furnished on
or after the first day of the first calendar quarter
beginning on or after the date that is 80 days after
the date of the enactment of this subparagraph by a
dentist to a specified individual (as defined in the
matter at the end of section 1905(a)) under the age of
26 at a rate not less than the specified average rate
(as defined in subsection (uu)) for such services.'';
and
(B) by adding at the end the following new
subsection:
``(uu) Specified Average Rate Defined.--
``(1) In general.--For purposes of subsection (a)(13)(D),
the term `specified average rate' means, with respect to a
dental service furnished in a State, the average of the
contracted rates (as defined in paragraph (2)) in effect during
the 5-year period ending on the date such service is so
furnished--
``(A) for such service furnished in such State (as
determined by the State); or
``(B) for such service furnished in the United
States (as determined by the Secretary);
as selected by such State.
``(2) Contracted rate defined.--
``(A) In general.--For purposes of paragraph (1),
the term `contracted rate' means, with respect to a
dental service, a rate in effect between a health
insurance issuer offering group or individual health
insurance coverage or a group health plan (as such
terms are defined in section 2791 of the Public Health
Service Act) and a dentist with a contractual
relationship in effect with such issuer or plan (as
applicable) for furnishing such service under such
coverage or plan (as applicable) that represents the
total amount payable (including cost sharing) under
such coverage or plan (as applicable) for such service
so furnished.
``(B) Exclusion of self-insured group health plan
rates.--For purposes of subparagraph (A), the term
`contracted rate' shall not include a rate described in
such subparagraph that is in effect between a self-
insured group health plan and a dentist.''.
(2) Medicaid managed care plans.--Section 1932(f) of the
Social Security Act (42 U.S.C. 1396u-2(f)) is amended--
(A) in the header, by striking ``Primary Care
Services'' and inserting ``Certain Services'';
(B) by inserting ``or dental services'' after
``primary care services'';
(C) by striking ``section 1902(a)(13)(C)'' and
inserting ``subparagraph (C) or (D), respectively, of
section 1902(a)(13)''; and
(D) by striking ``such section'' and inserting
``such subparagraph (C) or (D), as applicable''.
(3) Increased fmap for increased expenses.--Section 1905 of
the Social Security Act (42 U.S.C. 1396d) is amended by adding
at the end the following new subsection:
``(jj) Increased FMAP for Additional Expenditures for Dental
Services.--Notwithstanding subsection (b), with respect to the portion
of the amounts expended for medical assistance for services described
in section 1902(a)(13)(D) furnished on or after the first day of the
first calendar quarter beginning on or after the date that is 80 days
after the date of the enactment of this subsection furnished to an
individual described in such section by a dentist that is attributable
to the amount by which the minimum payment rate required under such
section (or, by application, section 1932(f)) exceeds the payment rate
applicable to such services under the State plan as of January 1, 2023,
the Federal medical assistance percentage for a State that is one of
the 50 States or the District of Columbia shall be equal to 100
percent. The preceding sentence does not prohibit the payment of
Federal financial participation based on the Federal medical assistance
percentage for amounts in excess of those specified in such
sentence.''.
(c) Outreach Efforts for Enrollment of Former Foster Children.--
Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) is
amended--
(1) in paragraph (86), by striking ``; and'' and inserting
a semicolon;
(2) in paragraph (87), by striking the period at the end
and inserting ``; and''; and
(3) by inserting after paragraph (87) the following new
paragraph:
``(88) not later than 6 months after the date of the
enactment of this paragraph--
``(A) establish an outreach and enrollment program,
in coordination with the State agency responsible for
administering the State plan under part E of title IV
and any other appropriate or interested agencies,
designed to increase the enrollment of individuals who
are eligible for medical assistance under the State
plan under paragraph (10)(A)(i)(IX) in accordance with
best practices established by the Secretary; and
``(B) establish an outreach program to dentists
practicing in such State to encourage enrollment by
such dentists in such plan as participating providers
under such plan.''.
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