Sec. 4251. Improving access to dental care

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Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress— a report on the Alaska Dental Health Aide Therapists program and the Dental Therapist and Advanced Dental Therapist programs in Minnesota, to assess the effectiveness of dental therapists in— improving access to timely dental care among communities of color; providing high-quality care; providing culturally competent care; and providing accessible care to people with disabilities; a report on State variations in the use of dental hygienists and the effectiveness of expanding the scope of practice for dental hygienists in— improving access to timely dental care among communities of color; providing high-quality care; providing culturally competent care; and providing accessible care to people with disabilities; and a report on the use of telehealth services to enhance services provided by dental hygienists and therapists, including recommendations for any modifications to the Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. ) and the Medicaid program under title XIX of such Act ( 42 U.S.C. 1396 et seq. ) to better provide for telehealth consultations in conjunction with therapists’ and hygienists’ care.

Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services, acting through the Administrator of the Health Resources and Services Administration, shall submit to Congress a report which details geographic dental access shortages and the preparedness of dental providers to offer culturally and linguistically appropriate, affordable, accessible, and timely services. Section 119 of the Indian Health Care Improvement Act ( 25 U.S.C. 1616l ) is amended— in subsection (d)— by striking paragraph

(2)and inserting the following: Subject to paragraphs

(3)and (4), in establishing a national program under paragraph (1), the Secretary— shall not reduce the amounts provided for the Community Health Aide Program described in subsections

(a)and (b); shall exclude dental health aide therapist services from services covered under that Program; and shall include urban Indian organizations. ; and in paragraph (3)— in the paragraph heading, by striking and inserting or tribal organization ; and , tribal organization, or urban Indian organization in each of subparagraphs

(A)and (B), by striking or tribal organization and inserting , tribal organization, or urban Indian organization ; and in subsection (e), by striking or a tribal organization and inserting a tribal organization, or an urban Indian organization . Section 1861(s)(2) of the Social Security Act ( 42 U.S.C. 1395x(s)(2) ) is amended— in subparagraph (JJ), by inserting and at the end; and by adding at the end the following new subparagraph: dental and oral health services (as defined in subsection (ppp)); . Section 1861 of the Social Security Act ( 42 U.S.C. 1395x ), as amended by sections 2007(b) and 4221(a), is amended by adding at the end the following new subsection: The term dental and oral health services means services (as defined by the Secretary) that are necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions, including— routine diagnostic and preventive care such as dental cleanings, exams, and x-rays; basic dental services such as fillings and extractions; major dental services such as root canals, crowns, and dentures; emergency dental care; and other necessary services related to dental and oral health (as defined by the Secretary). For purposes of paragraph (1), such term shall include mobile and portable oral health services (as defined by the Secretary) that— are provided for the purpose of overcoming mobility, transportation, and access barriers for individuals; and satisfy the standards and certification requirements established under section 1902(a)(82) for the State in which the services are provided. . Section 1833(a)(1) of the Social Security Act ( 42 U.S.C. 1395l(a)(1) ) is amended— by striking and before

(HH); and by inserting before the semicolon at the end the following: and

(II)with respect to dental and oral health services (as defined in section 1861(ppp)), the amount paid shall be

(i)in the case of such services that are preventive, 100 percent of the lesser of the actual charge for the services or the amount determined under the payment basis determined under section 1848, and

(ii)in the case of all other such services, 80 percent of the lesser of the actual charge for the services or the amount determined under the payment basis determined under section 1848 . Section 1848(j)(3) of the Social Security Act ( 42 U.S.C. 1395w–4(j)(3) ) is amended by inserting , (2)(KK), after (including administration of the health risk assessment) . Section 1861(s)(8) of the Social Security Act ( 42 U.S.C. 1395x(s)(8) ) is amended— by striking (other than dental) and inserting (including dentures) ; and by striking internal body . Section 1862(a) of the Social Security Act ( 42 U.S.C. 1395y ) is amended by striking paragraph (12). The amendments made by this section shall apply to services furnished on or after January 1, 2026. Section 1902(a)(10)(A) of the Social Security Act ( 42 U.S.C. 1396a(a)(10)(A) ) is amended by inserting (10), before (13)(B), . Section 1902(a)(10)(C)(iv) of such Act ( 42 U.S.C. 1396a(a)(10)(C)(iv) ) is amended by inserting (10), before (13)(B) . Nothing in this section or the amendments made by this section shall be construed to limit the access of an individual residing in an institutional setting to dental and oral health services (as such term is defined in section 1905(ll) of the Social Security Act, as added by paragraph (2)(B)). The amendments made by clauses

(i)and

(ii)shall apply with respect to expenditures for medical assistance in calendar quarters beginning on or after January 1, 2026. Section 1937(b)(5) of the Social Security Act ( 42 U.S.C. 1396u–7(b)(5) ) is amended by striking the period and inserting , and, beginning January 1, 2026, coverage of dental and oral health services (as such term is defined in section 1905(ll)). . Section 1902(j) of the Social Security Act ( 42 U.S.C. 1396a(j) ) is amended— by striking this title, the Secretary and inserting “this title— in the case of a State other than the 50 States and the District of Columbia the requirement under subsection (a)(10)(A) to provide the care and services listed in paragraph

(10)of section 1905(a) shall be optional; and the Secretary ; and by striking the second comma after section 1108(f) . Section 1905 of the Social Security Act ( 42 U.S.C. 1396d ), as amended by section 4107(c), is amended— in subsection (a)(10), by inserting and dental and oral health services (as defined in subsection (ll)) after dental services ; and by adding at the end the following new subsection: For purposes of subsection (a)(10), the term dental and oral health services means dentures and denture services, implants and implant services, and services necessary to prevent oral disease and promote oral health, restore oral structures to health and function, reduce oral pain, and treat emergency oral conditions, that are furnished by a provider who is legally authorized to furnish such items and services under State law (or the State regulatory mechanism provided by State law). . Section 1905(a)(10) of the Social Security Act ( 42 U.S.C. 1396d(a)(10) ), as amended by paragraph (2), is amended by striking dental services and . The amendment made by subparagraph

(A)shall take effect on January 1, 2026. Section 1905(a)(13) of the Social Security Act ( 42 U.S.C. 1396d(a)(13) ) is amended by inserting the following new subparagraph after subparagraph (C): at State option, such items and services related to dental and oral health services (as defined in subsection (ll)) that are in addition to those identified in such subsection

(ll)as the State may specify; . Section 1905 of the Social Security Act ( 42 U.S.C. 1396d ), as amended by paragraph (1), is further amended— in subsection (b), by striking and

(kk)and inserting (kk), and

(mm); in subsection (ff), by striking and

(ii)and inserting , (ii), and

(mm); and by adding at the end the following new subsection: Notwithstanding subsection (b), in the case of a State that is 1 of the 50 States or the District of Columbia, during the 12-quarter period that begins on January 1, 2026, the Federal medical assistance percentage shall be equal to 100 percent with respect to amounts expended by the State for medical assistance for dental and oral health services authorized under paragraph

(10)of subsection (a). In no case may the application of this subparagraph result in the Federal medical assistance percentage determined for a State with respect to expenditures described in this subparagraph exceeding 100 percent. Notwithstanding subsection (b), in the case of a State that is Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa, during a period described in clause (ii), the Federal medical assistance percentage shall be equal to 100 percent with respect to amounts expended by the State for medical assistance for any item or service that is included in dental and oral health services authorized under paragraph

(10)of subsection (a). In no case may the application of this clause result in the Federal medical assistance percentage determined for a State with respect to expenditures described in this clause exceeding 100 percent. A period described in this clause is, with respect to an item or service described in clause

(i)and a State described in such clause, the 12-quarter period that begins with the first quarter beginning on or after January 1, 2026, in which such item or service is first covered under the State plan or under a waiver of such plan. The Federal medical assistance percentage specified in paragraph

(1)shall not apply to amounts expended for medical assistance during any period for— additional items and services authorized under paragraph (13)(D) of subsection (a); or items and services furnished to an individual if, as of the date of enactment of this subsection, medical assistance was available to such individual for such items and services or medicare cost-sharing under the State plan or a waiver of such plan. . Section 1108 of the Social Security Act ( 42 U.S.C. 1308 ), as amended by section 4101, is amended— in subsection (f), in the matter preceding paragraph (1), by striking (h), and

(j)and inserting (h), (j), and

(k); and by adding at the end the following: Any additional amount paid to Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa for expenditures for medical assistance that is attributable to an increase in the Federal medical assistance percentage applicable to such expenditures under section 1905(mm) shall not be taken into account for purposes of applying payment limits under subsections

(f)and (g). . Section 1302(b) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18022(b) ), as amended by section 2013(a), is further amended— in paragraph (1)— in subparagraph (J), by striking oral and ; and by adding at the end the following: Oral health services for children and adults. ; and by adding at the end the following: For purposes of paragraph (1)(L), the term oral health services means services (as defined by the Secretary) that are necessary to prevent any oral disease and promote oral health, restore oral structures to health and function, and treat emergency oral conditions. . The Secretary of Veterans Affairs may carry out a demonstration program to establish programs to train and employ alternative dental health care providers in order to increase access to dental health care services for veterans who are entitled to such services from the Department of Veterans Affairs and reside in rural and other underserved communities. For purposes of alternative dental health care providers and other dental care providers who are licensed to provide clinical care, dental services provided under the demonstration program under this subsection may be administered by such providers through telehealth-enabled collaboration and supervision when appropriate and feasible. In this subsection, the term alternative dental health care providers has the meaning given that term in section 340G–1(a)(2) of the Public Health Service Act ( 42 U.S.C. 256g–1(a)(2) ). There are authorized to be appropriated such sums as are necessary to carry out the demonstration program under this subsection. The Secretary of Defense may carry out a demonstration program to establish programs to train and employ alternative dental health care providers in order to increase access to dental health care services for members of the Armed Forces and their dependents who lack ready access to such services, including the following individuals: Members and dependents who reside in rural areas or areas otherwise underserved by dental health care providers. Members of a reserve component of the Armed Forces in active status who are potentially deployable. For purposes of alternative dental health care providers and other dental care providers who are licensed to provide clinical care, dental services provided under the demonstration program under this subsection may be administered by such providers through telehealth-enabled collaboration and supervision when appropriate and feasible. In this subsection: The term active status has the meaning given that term in section 101(d) of title 10, United States Code. The term alternative dental health care providers has the meaning given that term in section 340G–1(a)(2) of the Public Health Service Act ( 42 U.S.C. 256g–1(a)(2) ). There are authorized to be appropriated such sums as are necessary to carry out the demonstration program under this subsection. The Attorney General, acting through the Director of the Bureau of Prisons, may carry out a demonstration program to establish programs to train and employ alternative dental health care providers in order to increase access to dental health services for prisoners within the custody of the Bureau of Prisons. For purposes of alternative dental health care providers and other dental care providers who are licensed to provide clinical care, dental services provided under the demonstration program under this subsection may be administered by such providers through telehealth-enabled collaboration and supervision when appropriate and feasible. In this subsection, the term alternative dental health care providers has the meaning given that term in section 340G–1(a)(2) of the Public Health Service Act ( 42 U.S.C. 256g–1(a)(2) ). There are authorized to be appropriated such sums as are necessary to carry out the demonstration program under this subsection. The Secretary of Health and Human Services, acting through the Indian Health Service, may carry out a demonstration program to establish programs to train and employ alternative dental health care providers in order to help eliminate oral health disparities and increase access to dental services through health programs operated by the Indian Health Service, Indian tribes, tribal organizations, and Urban Indian organizations. For purposes of alternative dental health care providers and other dental care providers who are licensed to provide clinical care, dental services provided under the demonstration program under this subsection may be administered by such providers through telehealth-enabled collaboration and supervision when appropriate and feasible. In this subsection: The term alternative dental health care providers has the meaning given that term in section 340G–1(a)(2) of the Public Health Service Act ( 42 U.S.C. 256g–1(a)(2) ). The terms Indian tribe , tribal organization , and Urban Indian organization have the meaning given the terms in section 4 of the Indian Health Care Improvement Act ( 25 U.S.C. 1603 ). There are authorized to be appropriated such sums as are necessary to carry out the demonstration program under this subsection.

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