Foster Youth Dental Act of 2023

I 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 Com- mittee 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 Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Foster Youth Dental 4 Act of 2023’’. 5 VerDate Sep 11 2014 04:19 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3701.IH H3701 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •HR 3701 IH SEC. 2. STRENGTHENING COVERAGE UNDER THE MED- 1 ICAID PROGRAM FOR CERTAIN FOSTER 2 YOUTH INDIVIDUALS. 3 (a) EXPANSION OF EPSDT SERVICES TO CERTAIN 4 INDIVIDUALS AGED 21–25.— 5 (1) IN GENERAL.—Section 1905(a) of the So- 6 cial Security Act (42 U.S.C. 1396d(a)) is amend- 7 ed— 8 (A) in paragraph (4)(B), by inserting ‘‘(or, 9 in the case of a specified individual (as defined 10 in the matter at the end of this subsection), 11 under the age of 26)’’ after ‘‘21’’; and 12 (B) by adding at the end the following new 13 sentence: ‘‘For purposes of paragraph (4)(B), 14 the term ‘specified individual’ means an indi- 15 vidual who is in foster care under the responsi- 16 bility of a State (or was in foster care under the 17 responsibility of the State on the date of attain- 18 ing 18 years of age or such higher age as the 19 State has elected under section 475(8)(B)(iii) 20 and was enrolled in a State plan under this title 21 or under a waiver of a plan while in such foster 22 care).’’. 23 (2) PROVISION OF INFORMATION WITH RE- 24 SPECT TO DENTAL SERVICES.—Section 25 VerDate Sep 11 2014 04:19 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3701.IH H3701 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •HR 3701 IH 1902(a)(43)(A) of the Social Security Act (42 1 U.S.C. 1396a(a)(43)(A)) is amended— 2 (A) by inserting ‘‘(or, in the case of a spec- 3 ified individual (as defined in the matter at the 4 end of section 1905(a)), under the age of 26)’’ 5 after ‘‘21’’; 6 (B) by inserting ‘‘(including dental serv- 7 ices)’’ after ‘‘treatment services’’; 8 (C) by striking ‘‘and the need’’ and insert- 9 ing ‘‘, the need’’; and 10 (D) by striking the comma at the end and 11 inserting ‘‘, and the importance of maintaining 12 good oral health,’’. 13 (3) EFFECTIVE DATE.— 14 (A) EXTENSION OF COVERAGE.—The 15 amendments made by paragraph (1) shall apply 16 with respect to medical assistance furnished 17 during calendar quarters beginning on or after 18 the date that is 80 days after the date of the 19 enactment of this Act. 20 (B) PROVISION OF INFORMATION.—The 21 amendment made by paragraph (2) shall apply 22 to information provided under section 23 1902(a)(43)(A) of the Social Security Act (42 24 U.S.C. 1396a(a)(43)(A)) beginning with the 25 VerDate Sep 11 2014 04:19 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3701.IH H3701 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •HR 3701 IH first calendar quarter beginning on or after the 1 date that is 80 days after the date of the enact- 2 ment of this Act. 3 (b) INCENTIVE FOR THE PROVISION OF DENTAL 4 SERVICES TO CERTAIN INDIVIDUALS.— 5 (1) IN GENERAL.—Section 1902(a) of the So- 6 cial Security Act (42 U.S.C. 1396a(a)) is amend- 7 ed— 8 (A) in paragraph (13)— 9 (i) in subparagraph (B), by striking 10 ‘‘and’’ at the end; 11 (ii) in subparagraph (C), by adding 12 ‘‘and’’ at the end; and 13 (iii) by adding at the end the fol- 14 lowing new subparagraph: 15 ‘‘(D) for payment for dental services fur- 16 nished on or after the first day of the first cal- 17 endar quarter beginning on or after the date 18 that is 80 days after the date of the enactment 19 of this subparagraph by a dentist to a specified 20 individual (as defined in the matter at the end 21 of section 1905(a)) under the age of 26 at a 22 rate not less than the specified average rate (as 23 defined in subsection (uu)) for such services.’’; 24 and 25 VerDate Sep 11 2014 04:19 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3701.IH H3701 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •HR 3701 IH (B) by adding at the end the following new 1 subsection: 2 ‘‘(uu) SPECIFIED AVERAGE RATE DEFINED.— 3 ‘‘(1) IN GENERAL.—For purposes of subsection 4 (a)(13)(D), the term ‘specified average rate’ means, 5 with respect to a dental service furnished in a State, 6 the average of the contracted rates (as defined in 7 paragraph (2)) in effect during the 5-year period 8 ending on the date such service is so furnished— 9 ‘‘(A) for such service furnished in such 10 State (as determined by the State); or 11 ‘‘(B) for such service furnished in the 12 United States (as determined by the Secretary); 13 as selected by such State. 14 ‘‘(2) CONTRACTED RATE DEFINED.— 15 ‘‘(A) IN GENERAL.—For purposes of para- 16 graph (1), the term ‘contracted rate’ means, 17 with respect to a dental service, a rate in effect 18 between a health insurance issuer offering 19 group or individual health insurance coverage 20 or a group health plan (as such terms are de- 21 fined in section 2791 of the Public Health Serv- 22 ice Act) and a dentist with a contractual rela- 23 tionship in effect with such issuer or plan (as 24 applicable) for furnishing such service under 25 VerDate Sep 11 2014 04:19 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3701.IH H3701 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •HR 3701 IH such coverage or plan (as applicable) that rep- 1 resents the total amount payable (including cost 2 sharing) under such coverage or plan (as appli- 3 cable) for such service so furnished. 4 ‘‘(B) EXCLUSION OF SELF-INSURED 5 GROUP HEALTH PLAN RATES.—For purposes of 6 subparagraph (A), the term ‘contracted rate’ 7 shall not include a rate described in such sub- 8 paragraph that is in effect between a self-in- 9 sured group health plan and a dentist.’’. 10 (2) MEDICAID MANAGED CARE PLANS.—Section 11 1932(f) of the Social Security Act (42 U.S.C. 12 1396u–2(f)) is amended— 13 (A) in the header, by striking ‘‘PRIMARY 14 CARE SERVICES’’ and inserting ‘‘CERTAIN 15 SERVICES’’; 16 (B) by inserting ‘‘or dental services’’ after 17 ‘‘primary care services’’; 18 (C) by striking ‘‘section 1902(a)(13)(C)’’ 19 and inserting ‘‘subparagraph (C) or (D), re- 20 spectively, of section 1902(a)(13)’’; and 21 (D) by striking ‘‘such section’’ and insert- 22 ing ‘‘such subparagraph (C) or (D), as applica- 23 ble’’. 24 VerDate Sep 11 2014 04:19 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3701.IH H3701 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •HR 3701 IH (3) INCREASED FMAP FOR INCREASED EX- 1 PENSES.—Section 1905 of the Social Security Act 2 (42 U.S.C. 1396d) is amended by adding at the end 3 the following new subsection: 4 ‘‘(jj) INCREASED FMAP FOR ADDITIONAL EXPENDI- 5 TURES FOR DENTAL SERVICES.—Notwithstanding sub- 6 section (b), with respect to the portion of the amounts ex- 7 pended for medical assistance for services described in sec- 8 tion 1902(a)(13)(D) furnished on or after the first day 9 of the first calendar quarter beginning on or after the date 10 that is 80 days after the date of the enactment of this 11 subsection furnished to an individual described in such 12 section by a dentist that is attributable to the amount by 13 which the minimum payment rate required under such 14 section (or, by application, section 1932(f)) exceeds the 15 payment rate applicable to such services under the State 16 plan as of January 1, 2023, the Federal medical assist- 17 ance percentage for a State that is one of the 50 States 18 or the District of Columbia shall be equal to 100 percent. 19 The preceding sentence does not prohibit the payment of 20 Federal financial participation based on the Federal med- 21 ical assistance percentage for amounts in excess of those 22 specified in such sentence.’’. 23 VerDate Sep 11 2014 04:19 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H3701.IH H3701 pbinns on DSKJLVW7X2PROD with $$_JOB 8 •HR 3701 IH (c) OUTREACH EFFORTS FOR ENROLLMENT OF 1 FORMER FOSTER CHILDREN.—Section 1902(a) of the So- 2 cial Security Act (42 U.S.C. 1396a(a)) is amended— 3 (1) in paragraph (86), by striking ‘‘; and’’ and 4 inserting a semicolon; 5 (2) in paragraph (87), by striking the period at 6 the end and inserting ‘‘; and’’; and 7 (3) by inserting after paragraph (87) the fol- 8 lowing new paragraph: 9 ‘‘(88) not later than 6 months after the date of 10 the enactment of this paragraph— 11 ‘‘(A) establish an outreach and enrollment 12 program, in coordination with the State agency 13 responsible for administering the State plan 14 under part E of title IV and any other appro- 15 priate or interested agencies, designed to in- 16 crease the enrollment of individuals who are eli- 17 gible for medical assistance under the State 18 plan under paragraph (10)(A)(i)(IX) in accord- 19 ance with best practices established by the Sec- 20 retary; and 21 ‘‘(B) establish an outreach program to 22 dentists practicing in such State to encourage 23 VerDate Sep 11 2014 04:19 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H3701.IH H3701 pbinns on DSKJLVW7X2PROD with $$_JOB 9 •HR 3701 IH enrollment by such dentists in such plan as par- 1 ticipating providers under such plan.’’. 2 Æ VerDate Sep 11 2014 04:19 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6301 E:\BILLS\H3701.IH H3701 pbinns on DSKJLVW7X2PROD with $$_JOB