H.R. 9832

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9832 Introduced in House (IH)]
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119th CONGRESS
  2d Session
                                H. R. 9832
To amend title XVIII of the Social Security Act to provide for coverage
             of dental services under the Medicare program.
_______________________________________________________________________
                    IN THE HOUSE OF REPRESENTATIVES
                             July 22, 2026
  Ms. Barragan (for herself, Ms. Kelly of Illinois, Mr. Carbajal, Ms.
Craig, Mr. Davis of Illinois, Mr. Garcia of Illinois, Ms. Houlahan, Ms.
Norton, Ms. Randall, Ms. Ross, Mr. Takano, Mr. Thanedar, Ms. Tlaib, and
    Ms. Wilson of Florida) introduced the following bill; which was
 referred to the Committee on Energy and 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
             of dental services under the Medicare program.
    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 Dental Benefit Act of
2026''.
SEC. 2. COVERAGE OF DENTAL SERVICES UNDER THE MEDICARE PROGRAM.
    (a) Coverage.--Section 1861(s)(2) of the Social Security Act (42
U.S.C. 1395x(s)(2)) is amended--
            (1) in subparagraph (JJ), by striking ``and'' at the end;
            (2) in subparagraph (KK), by adding ``and'' at the end; and
            (3) by adding at the end the following new subparagraph:
            ``(LL) dental and oral health services (as defined in
        subsection (ooo));''.
    (b) Dental and Oral Health Services Defined.--Section 1861 of the
Social Security Act (42 U.S.C. 1395x) is amended by adding at the end
the following new subsection:
                   ``Dental and Oral Health Services
    ``(ooo) 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,
reduce oral pain, and treat emergency conditions, including--
            ``(1) routine diagnostic and preventive care such as dental
        cleanings, exams, and x-rays;
            ``(2) basic dental services such as fillings and
        extractions;
            ``(3) major dental services such as root canals, crowns,
        and dentures;
            ``(4) emergency dental care; and
            ``(5) other necessary services related to dental and oral
        health (as defined by the Secretary).''.
    (c) Coverage of Routine Diagnostic and Preventive Care as a
Preventive Service.--Section 1861(ddd)(3) of the Social Security Act
(42 U.S.C. 1395x(ddd)(3)) is amended by adding at the end the following
new subparagraph:
            ``(D) Dental and oral health services described in
        paragraph (1) of subsection (ooo), relating to routine
        diagnostic and preventive care.''.
    (d) Payment; Coinsurance; and Limitations.--
            (1) In general.--Section 1833(a)(1) of the Social Security
        Act (42 U.S.C. 1395l(a)(1)) is amended--
                    (A) by striking ``and (HH)'' and inserting
                ``(HH)''; and
                    (B) 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(ooo),
                other than those services described in paragraph (1) of
                such section), the amount paid shall be the payment
                amount specified under section 1834(bb).''.
            (2) Payment and limits specified.--Section 1834 of the
        Social Security Act (42 U.S.C. 1395m) is amended by adding at
        the end the following new subsection:
    ``(bb) Payment and Limits for Dental and Oral Health Services.--
            ``(1) In general.--The payment amount under this part for
        dental and oral health services (as defined in section
        1861(ooo), other than those services described in paragraph (1)
        of such section) shall be, subject to paragraph (3), the
        applicable percentage (specified in paragraph (2)) of the
        lesser of the actual charge for the services or the amount
        determined under the payment basis determined under section
        1848.
            ``(2) Applicable percentage.--
                    ``(A) In general.--For purposes of paragraph (1),
                subject to subparagraph (B), the applicable percentage
                specified in this paragraph is--
                            ``(i) for the first year beginning at least
                        6 months after the date of the enactment of
                        this subsection, 0 percent;
                            ``(ii) for the year following the year
                        specified in subparagraph (A) and each
                        subsequent year through the seventh year
                        following the year specified in subparagraph
                        (A), the applicable percent specified in this
                        paragraph for the previous year increased by 10
                        percentage points; and
                            ``(iii) for the eighth year following the
                        year specified in subparagraph (A) and each
                        subsequent year, 80 percent.
                    ``(B) Special rule for certain low-income
                individuals.--For purposes of paragraph (1), with
                respect to dental and oral health services described in
                such paragraph that are furnished to an individual who
                is a subsidy eligible individual (as defined in section
                1860D-14(a)(3)), or who would be a subsidy eligible
                individual if the individual were enrolled in a
                prescription drug plan or an MA-PD plan under part D,
                for the first year beginning at least 6 months after
                the date of the enactment of this subsection and each
                subsequent year, the applicable percent specified in
                this paragraph is 80 percent.
            ``(3) Limitations and secretarial authority.--
                    ``(A) Frequency.--With respect to dental and oral
                health services that are--
                            ``(i) routine dental cleanings, payment may
                        be made under this part for only two such
                        cleanings during a 12-month period; and
                            ``(ii) routine exams, payment may be made
                        under this part for only two such exams during
                        a 12-month period.
                    ``(B) Secretarial authority.--
                            ``(i) Authority to apply additional
                        limitations.--The Secretary may apply such
                        other reasonable limitations on the extent to
                        which dental and oral services are covered
                        under this part, including through application
                        of a prior authorization requirement.
                            ``(ii) Authority to modify coverage.--
                        Notwithstanding any other provision of this
                        title, if the Secretary determines appropriate,
                        the Secretary may modify the coverage under
                        this part of dental and oral health services to
                        the extent that such modification is consistent
                        with the recommendations of the United States
                        Preventive Services Task Force.
                            ``(iii) Authority to waive frequency
                        limitations.--The Secretary may waive any
                        frequency limitation or other limitation as
                        described in this paragraph for an individual
                        (or category of individuals) as determined
                        appropriate by the Secretary.''.
    (e) Payment Under Physician Fee Schedule.--Section 1848(j)(3) of
the Social Security Act (42 U.S.C. 1395w-4(j)(3)) is amended by
striking ``risk assessment),'' and inserting ``risk assessment),
(2)(LL),''.
    (f) Dental Prostheses.--
            (1) In general.--Section 1861(s)(8) of the Social Security
        Act (42 U.S.C. 1395x(s)(8)) is amended--
                    (A) by striking ``(other than dental)'' and
                inserting ``(including dental)''; and
                    (B) by striking ``internal body''.
            (2) Special payment rules.--Section 1834(a) of the Social
        Security Act (42 U.S.C. 1395m(a)) is amended by adding at the
        end the following new paragraph:
            ``(24) Payment and limits for dental prostheses.--
                    ``(A) In general.--The payment amount under this
                part for dental prostheses shall be, subject to
                subparagraph (C), the applicable percent (specified in
                subparagraph (B)) of the amount otherwise payable for
                such dental prostheses under this section.
                    ``(B) Applicable percent.--
                            ``(i) In general.--For purposes of
                        subparagraph (A), subject to clause (ii), the
                        applicable percent specified in this
                        subparagraph is--
                                    ``(I) for the first year beginning
                                at least 6 months after the date of the
                                enactment of this paragraph, 0 percent;
                                    ``(II) for the year following the
                                year specified in clause (i) and each
                                subsequent year through the seventh
                                year following the year specified in
                                clause (i), the applicable percent
                                specified in this subparagraph for the
                                previous year increased by 10
                                percentage points; and
                                    ``(III) for the eighth year
                                following the year specified in clause
                                (i) and each subsequent year, 80
                                percent.
                            ``(ii) Special rule for certain low-income
                        individuals.--For purposes of subparagraph (A),
                        with respect to dental prostheses furnished to
                        an individual who is a subsidy eligible
                        individual (as defined in section 1860D-
                        14(a)(3)), or who would be a subsidy eligible
                        individual if the individual were enrolled in a
                        prescription drug plan or an MA-PD plan under
                        part D, for the first year beginning at least 6
                        months after the date of the enactment of this
                        paragraph and each subsequent year, the
                        applicable percent specified in this
                        subparagraph is 80 percent.
                    ``(C) Limitations and secretarial authority.--
                            ``(i) In general.--Payment may be made
                        under this part for an individual for--
                                    ``(I) not more than one full upper
                                and one full lower dental prostheses
                                once every five years; and
                                    ``(II) not more than one partial
                                upper dental prostheses and one partial
                                lower dental prostheses once every five
                                years.
                            ``(ii) Secretarial authority.--
                                    ``(I) Authority to apply additional
                                limitations.--The Secretary may apply
                                such other reasonable limitations on
                                the extent to which dental prostheses
                                are covered under this part, including
                                through application of a prior
                                authorization requirement.
                                    ``(II) Authority to modify
                                coverage.--Notwithstanding any other
                                provision of this title, if the
                                Secretary determines appropriate, the
                                Secretary may modify the coverage under
                                this part of dental prostheses to the
                                extent that such modification is
                                consistent with the recommendations of
                                the United States Preventive Services
                                Task Force.
                                    ``(III) Authority to waive
                                frequency limitations.--The Secretary
                                may waive any frequency limitation or
                                other limitation as described in this
                                subparagraph for an individual (or
                                category of individuals) as determined
                                appropriate by the Secretary''.
    (g) Repeal of Ground for Exclusion.--Section 1862(a) of the Social
Security Act (42 U.S.C. 1395y) is amended by striking paragraph (12).
    (h) Effective Date.--The amendments made by this section shall
apply to services furnished on or after January 1, 2028.
SEC. 3. INCREASED FMAP FOR ADDITIONAL EXPENDITURES FOR MEDICARE COST-
              SHARING FOR DENTAL AND ORAL HEALTH SERVICES.
    Section 1905 of the Social Security Act (42 U.S.C. 1396d) is
amended--
            (1) in subsection (b), by striking ``and (ii)'' and
        inserting ``(ii), and (ll)''; and
            (2) by adding at the end the following new subsection:
    ``(ll) Increased FMAP for Additional Expenditures for Medicare
Cost-Sharing for Dental and Oral Health Services.--Notwithstanding
subsection (b), with respect to the portion of the amounts expended by
a State for medical assistance for medicare cost-sharing (as defined in
subsection (p)(3)) for qualified medicare beneficiaries described in
subsection (p)(1) that is attributable to the coverage under part B of
title XVIII of dental and oral health services (as defined in section
1861(ooo)), as determined by the Secretary, 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.''.
SEC. 4. U.S. PREVENTIVE SERVICES TASK FORCE.
    (a) In General.--Section 915(a)(1) of the Public Health Service Act
(42 U.S.C. 299b-4(a)(1)) is amended, in the first sentence, by
inserting ``, including at least 1 oral health professional'' after
``expertise''.
    (b) Effective Date.--The amendment made by subsection (a) shall
take effect January 1, 2028.
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