Anywhere I can read about these provisions for dentists?
It's going to be really really long, but because it's fitting for this discussion and it should be out there some where on the internet, I searched for the term dental in the 950 page bill and condensed it into the 25 pages that are most relevant to dentistry. You can find the entire bill here:
http://housedocs.house.gov/energycommerce/ppacacon.pdf
So Here We Go!
SEC. 2707 ø42 U.S.C. 300gg6¿. COMPREHENSIVE HEALTH INSURANCE
COVERAGE.
(a) COVERAGE FOR ESSENTIAL HEALTH BENEFITS PACKAGE.A
health insurance issuer that offers health insurance coverage in the
individual or small group market shall ensure that such coverage
includes the essential health benefits package required under section 1302(a) of the Patient Protection and Affordable Care Act.
(b) COST-SHARING UNDER GROUP HEALTH PLANS.A group
health plan shall ensure that any annual cost-sharing imposed
under the plan does not exceed the limitations provided for under
paragraphs (1) and (2) of section 1302(c).
(c) CHILD-ONLY PLANS.If a health insurance issuer offers
health insurance coverage in any level of coverage specified under
section 1302(d) of the Patient Protection and Affordable Care Act,
the issuer shall also offer such coverage in that level as a plan in
which the only enrollees are individuals who, as of the beginning
of a plan year, have not attained the age of 21.
(d)
DENTAL ONLY.This section shall not apply to a plan described in section 1302(d)(2)(B)(ii)(I).
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(b) ESSENTIAL HEALTH BENEFITS.
(1) IN GENERAL.Subject to paragraph (2), the Secretary
shall define the essential health benefits, except that such benefits shall include at least the following general categories and
the items and services covered within the categories:
..........
(F) provide that if a plan described in section
1311(b)(2)(B)(ii) (relating to stand-alone dental benefits
plans) is offered through an Exchange, another health plan
offered through such Exchange shall not fail to be treated
as a qualified health plan solely because the plan does not
offer coverage of benefits offered through the stand-alone
plan that are otherwise required under paragraph (1)(J);
and
(G) periodically review the essential health benefits
under paragraph (1), and provide a report to Congress and
the public that contains
(i) an assessment of whether enrollees are facing
any difficulty accessing needed services for reasons of
coverage or cost;
(ii) an assessment of whether the essential health
benefits needs to be modified or updated to account for
changes in medical evidence or scientific advancement;
(iii) information on how the essential health benefits will be modified to address any such gaps in access
or changes in the evidence base;
(iv) an assessment of the potential of additional or
expanded benefits to increase costs and the interactions between the addition or expansion of benefits
and reductions in existing benefits to meet actuarial
limitations described in paragraph (2); and
(H) periodically update the essential health benefits
under paragraph (1) to address any gaps in access to coverage or changes in the evidence base the Secretary identifies in the review conducted under subparagraph (G).
(5) RULE OF CONSTRUCTION.Nothing in this title shall be
construed to prohibit a health plan from providing benefits in
excess of the essential health benefits described in this subsection.
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(6) ENROLLMENT PERIODS.The Secretary shall require an
Exchange to provide for
(A) an initial open enrollment, as determined by the
Secretary (such determination to be made not later than
July 1, 2012);
(B) annual open enrollment periods, as determined by
the Secretary for calendar years after the initial enrollment period;
(C) special enrollment periods specified in section 9801
of the Internal Revenue Code of 1986 and other special enrollment periods under circumstances similar to such periods under part D of title XVIII of the Social Security Act;
and
(D) special monthly enrollment periods for Indians (as
defined in section 4 of the Indian Health Care Improvement Act).
(d) REQUIREMENTS.
(1) IN GENERAL.An Exchange shall be a governmental
agency or nonprofit entity that is established by a State.
(2) OFFERING OF COVERAGE.
(A) IN GENERAL.An Exchange shall make available
qualified health plans to qualified individuals and qualified employers.
(B) LIMITATION.
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June 9, 2010 73 Sec. 1311 PPACA (Consolidated)
(i) IN GENERAL.An Exchange may not make
available any health plan that is not a qualified health
plan.
(ii) OFFERING OF STAND-ALONE DENTAL BENEFITS.Each Exchange within a State shall allow an
issuer of a plan that only provides limited scope dental
benefits meeting the requirements of section
9832(c)(2)(A) of the Internal Revenue Code of 1986 to
offer the plan through the Exchange (either separately
or in conjunction with a qualified health plan) if the
plan provides pediatric dental benefits meeting the requirements of section 1302(b)(1)(J)).
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(E) SPECIAL RULE FOR PEDIATRIC DENTAL COVERAGE.
For purposes of determining the amount of any monthly
premium, if an individual enrolls in both a qualified health
plan and a plan described in section 1311(d)(2)(B)(ii)(I) of
the Patient Protection and Affordable Care Act for any
plan year, the portion of the premium for the plan described in such section that (under regulations prescribed
by the Secretary) is properly allocable to pediatric dental
benefits which are included in the essential health benefits
required to be provided by a qualified health plan under
section 1302(b)(1)(J) of such Act shall be treated as a premium payable for a qualified health plan.
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(5) SPECIAL RULE FOR PEDIATRIC DENTAL PLANS.If an individual enrolls in both a qualified health plan and a plan described in section 1311(d)(2)(B)(ii)(I) for any plan year, subsection (a) shall not apply to that portion of any reduction in
cost-sharing under subsection (c) that (under regulations prescribed by the Secretary) is properly allocable to pediatric dental benefits which are included in the essential health benefits
required to be provided by a qualified health plan under section 1302(b)(1)(J)
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SEC. 2801. MACPAC ASSESSMENT OF POLICIES AFFECTING ALL MEDICAID BENEFICIARIES.
(a) IN GENERAL.Section 1900 of the Social Security Act (42
U.S.C. 1396) is amended
(1) in subsection (b)
(A) in paragraph (1)
(i) in the paragraph heading, by inserting FOR
ALL STATES before AND ANNUAL; and
(ii) in subparagraph (A), by striking childrens;
(iii) in subparagraph (B), by inserting , the Secretary, and States after Congress;
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June 9, 2010 Sec. 2801 PPACA (Consolidated) 240
(iv) in subparagraph (C), by striking March 1
and inserting March 15; and
(v) in subparagraph (D), by striking June 1 and
inserting June 15;
(B) in paragraph (2)
(i) in subparagraph (A)
(I) in clause (i)
(aa) by inserting the efficient provision
of after expenditures for; and
(bb) by striking hospital, skilled nursing
facility, physician, Federally-qualified health
center, rural health center, and other fees
and inserting payments to medical, dental,
and health professionals, hospitals, residential and long-term care providers, providers of
home and community based services, Federally-qualified health centers and rural health
clinics, managed care entities, and providers
of other covered items and services; and
(II) in clause (iii), by inserting (including how
such factors and methodologies enable such beneficiaries to obtain the services for which they are
eligible, affect provider supply, and affect providers that serve a disproportionate share of lowincome and other vulnerable populations) after
beneficiaries;
(ii) by redesignating subparagraphs (B) and (C) as
subparagraphs (F) and (H), respectively;
(iii) by inserting after subparagraph (A), the following:
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PART TORAL HEALTHCARE PREVENTION
ACTIVITIES
SEC. 399LL ø42 U.S.C. 280k¿. ORAL HEALTHCARE PREVENTION EDUCATION CAMPAIGN.
(a) ESTABLISHMENT.The Secretary, acting through the Director of the Centers for Disease Control and Prevention and in consultation with professional oral health organizations, shall, subject
to the availability of appropriations, establish a 5-year national,
public education campaign (referred to in this section as the campaign) that is focused on oral healthcare prevention and education,
including prevention of oral disease such as early childhood and
other caries, periodontal disease, and oral cancer.
(b) REQUIREMENTS.In establishing the campaign, the Secretary shall
(1) ensure that activities are targeted towards specific
populations such as children, pregnant women, parents, the elderly, individuals with disabilities, and ethnic and racial minority populations, including Indians, Alaska Natives and Native Hawaiians (as defined in section 4(c) of the Indian Health
Care Improvement Act) in a culturally and linguistically appropriate manner; and
(2) utilize science-based strategies to convey oral health
prevention messages that include, but are not limited to, community water fluoridation and dental sealants.
(c) PLANNING AND IMPLEMENTATION.Not later than 2 years
after the date of enactment of this section, the Secretary shall
begin implementing the 5-year campaign. During the 2-year period
referred to in the previous sentence, the Secretary shall conduct
planning activities with respect to the campaign.
SEC. 399LL1 ø42 U.S.C. 280k1¿. RESEARCH-BASED DENTAL CARIES
DISEASE MANAGEMENT.
(a) IN GENERAL.The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall award
demonstration grants to eligible entities to demonstrate the effectiveness of research-based dental caries disease management activities.
(b) ELIGIBILITY.To be eligible for a grant under this section,
an entity shall
(1) be a community-based provider of dental services (as
defined by the Secretary), including a Federally-qualified
health center, a clinic of a hospital owned or operated by a
State (or by an instrumentality or a unit of government within
a State), a State or local department of health, a dental program of the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization (as such terms are
defined in section 4 of the Indian Health Care Improvement
Act), a health system provider, a private provider of dental services, medical, dental, public health, nursing, nutrition educational institutions, or national organizations involved in improving childrens oral health; and
(2) submit to the Secretary an application at such time,
in such manner, and containing such information as the Secretary may require.
(c) USE OF FUNDS.A grantee shall use amounts received
under a grant under this section to demonstrate the effectiveness
of research-based dental caries disease management activities.
(d) USE OF INFORMATION.The Secretary shall utilize information generated from grantees under this section in planning and
implementing the public education campaign under section 399LL.
SEC. 399LL2 ø42 U.S.C. 280k2¿. AUTHORIZATION OF APPROPRIATIONS.
There is authorized to be appropriated to carry out this part,
such sums as may be necessary..
(b) SCHOOL-BASED SEALANT PROGRAMS.Section 317M(c)(1) of
the Public Health Service Act (42 U.S.C. 247b14(c)(1)) is amended
by striking may award grants to States and Indian tribes and inserting shall award a grant to each of the 50 States and territories
and to Indians, Indian tribes, tribal organizations and urban Indian organizations (as such terms are defined in section 4 of the
Indian Health Care Improvement Act).
(c) ORAL HEALTH INFRASTRUCTURE.Section 317M of the Public Health Service Act (42 U.S.C. 247b14) is amended
(1) by redesignating subsections (d) and (e) as subsections
(e) and (f), respectively; and
(2) by inserting after subsection (c), the following:
(d) ORAL HEALTH INFRASTRUCTURE.
(1) COOPERATIVE AGREEMENTS.The Secretary, acting
through the Director of the Centers for Disease Control and
Prevention, shall enter into cooperative agreements with State,
territorial, and Indian tribes or tribal organizations (as those
terms are defined in section 4 of the Indian Health Care Improvement Act) to establish oral health leadership and program guidance, oral health data collection and interpretation,
(including determinants of poor oral health among vulnerable
populations), a multi-dimensional delivery system for oral
health, and to implement science-based programs (including
dental sealants and community water fluoridation) to improve
oral health.
(2) AUTHORIZATION OF APPROPRIATIONS.There is authorized to be appropriated such sums as necessary to carry out
this subsection for fiscal years 2010 through 2014..
(d) UPDATING NATIONAL ORAL HEALTHCARE SURVEILLANCE ACTIVITIES.ø42 U.S.C.280k3¿
(1) PRAMS.
(A) IN GENERAL.The Secretary of Health and Human
Services (referred to in this subsection as the Secretary)
shall carry out activities to update and improve the Pregnancy Risk Assessment Monitoring System (referred to in
this section as PRAMS) as it relates to oral healthcare.
(B) STATE REPORTS AND MANDATORY MEASUREMENTS.
te of enactment of this Act, and every 5 years thereafter, a State shall submit to the Secretary a report
concerning activities conducted within the State under
PRAMS.
(ii) MEASUREMENTS.The oral healthcare measurements developed by the Secretary for use under
PRAMS shall be mandatory with respect to States for
purposes of the State reports under clause (i).
(C) FUNDING.There is authorized to be appropriated
to carry out this paragraph, such sums as may be necessary.
(2) NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY.The Secretary shall develop oral healthcare components
that shall include tooth-level surveillance for inclusion in the
National Health and Nutrition Examination Survey. Such components shall be updated by the Secretary at least every 6
years. For purposes of this paragraph, the term tooth-level
surveillance means a clinical examination where an examiner
looks at each dental surface, on each tooth in the mouth and
as expanded by the Division of Oral Health of the Centers for
Disease Control and Prevention.
(3) MEDICAL EXPENDITURES PANEL SURVEY.The Secretary
shall ensure that the Medical Expenditures Panel Survey by
the Agency for Healthcare Research and Quality includes the
verification of dental utilization, expenditure, and coverage
findings through conduct of a look-back analysis.
(4) NATIONAL ORAL HEALTH SURVEILLANCE SYSTEM.
(A) APPROPRIATIONS.There is authorized to be appropriated, such sums as may be necessary for each of fiscal
years 2010 through 2014 to increase the participation of
States in the National Oral Health Surveillance System
from 16 States to all 50 States, territories, and District of
Columbia.
(B) REQUIREMENTS.The Secretary shall ensure that
the National Oral Health Surveillance System include the
measurement of early childhood caries.
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SEC. 510 ø29 U.S.C. 794f¿. ESTABLISHMENT OF STANDARDS FOR ACCESSIBLE MEDICAL DIAGNOSTIC EQUIPMENT.
(a) STANDARDS.Not later than 24 months after the date of
enactment of the Affordable Health Choices Act, the Architectural
and Transportation Barriers Compliance Board shall, in consultation with the Commissioner of the Food and Drug Administration,
promulgate regulatory standards in accordance with the Administrative Procedure Act (2 U.S.C. 551 et seq.) setting forth the minimum technical criteria for medical diagnostic equipment used in
(or in conjunction with) physicians offices, clinics, emergency
rooms, hospitals, and other medical settings. The standards shall
ensure that such equipment is accessible to, and usable by, individuals with accessibility needs, and shall allow independent entry to,
use of, and exit from the equipment by such individuals to the
maximum extent possible.
(b) MEDICAL DIAGNOSTIC EQUIPMENT COVERED.The standards issued under subsection (a) for medical diagnostic equipment
shall apply to equipment that includes examination tables, examination chairs (including chairs used for eye examinations or procedures, and dental examinations or procedures), weight scales,
mammography equipment, x-ray machines, and other radiological
equipment commonly used for diagnostic purposes by health professionals.
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Subtitle BInnovations in the Health Care
Workforce
SEC. 5101 ø42 U.S.C. 294q¿. NATIONAL HEALTH CARE WORKFORCE COMMISSION.
(a) PURPOSE.It is the purpose of this section to establish a
National Health Care Workforce Commission that
(1) serves as a national resource for Congress, the President, States, and localities;
(2) communicates and coordinates with the Departments of
Health and Human Services, Labor, Veterans Affairs, Homeland Security, and Education on related activities administered
by one or more of such Departments;
(3) develops and commissions evaluations of education and
training activities to determine whether the demand for health
care workers is being met;
(4) identifies barriers to improved coordination at the Federal, State, and local levels and recommend ways to address
such barriers; and
(5) encourages innovations to address population needs,
constant changes in technology, and other environmental factors.
(b) ESTABLISHMENT.There is hereby established the National
Health Care Workforce Commission (in this section referred to as
the Commission).
.....
(3) SPECIFIC TOPICS TO BE REVIEWED.The topics described
in this paragraph include
(A) current health care workforce supply and distribution, including demographics, skill sets, and demands, with
projected demands during the subsequent 10 and 25 year
periods;
(B) health care workforce education and training capacity, including the number of students who have completed education and training, including registered apprenticeships; the number of qualified faculty; the education
and training infrastructure; and the education and training demands, with projected demands during the subsequent 10 and 25 year periods;
(C) the education loan and grant programs in titles
VII and VIII of the Public Health Service Act (42 U.S.C.
292 et seq. and 296 et seq.), with recommendations on
whether such programs should become part of the Higher
Education Act of 1965 (20 U.S.C. 1001 et seq);
(D) the implications of new and existing Federal policies which affect the health care workforce, including
Medicare and Medicaid graduate medical education policies, titles VII and VIII of the Public Health Service Act
(42 U.S.C. 292 et seq. and 296 et seq.), the National
Health Service Corps (with recommendations for aligning
such programs with national health workforce priorities
and goals), and other health care workforce programs, including those supported through the Workforce Investment
Act of 1998 (29 U.S.C. 2801 et seq.), the Carl D. Perkins
Career and Technical Education Act of 2006 (20 U.S.C.
2301 et seq.), the Higher Education Act of 1965 (20 U.S.C.
1001 et seq.), and any other Federal health care workforce
programs;
(E) the health care workforce needs of special populations, such as minorities, rural populations, medically
underserved populations, gender specific needs, individuals
with disabilities, and geriatric and pediatric populations
with recommendations for new and existing Federal policies to meet the needs of these special populations; and (F) recommendations creating or revising national loan
repayment programs and scholarship programs to require
low-income, minority medical students to serve in their
home communities, if designated as medical underserved
community.
(4) HIGH PRIORITY AREAS.
(A) IN GENERAL.The initial high priority topics described in this paragraph include each of the following:
(i) Integrated health care workforce planning that
identifies health care professional skills needed and
maximizes the skill sets of health care professionals
across disciplines.
(ii) An analysis of the nature, scopes of practice,
and demands for health care workers in the enhanced
information technology and management workplace.
(iii) An analysis of how to align Medicare and
Medicaid graduate medical education policies with national workforce goals.
(iv) øAs added by section 10501(a)(3)¿ An analysis
of, and recommendations for, eliminating the barriers
to entering and staying in primary care, including provider compensation.
(v) The education and training capacity, projected
demands, and integration with the health care delivery system of each of the following:
(I) Nursing workforce capacity at all levels.
(II) Oral health care workforce capacity at all
levels.
(III) Mental and behavioral health care workforce capacity at all levels.
(IV) Allied health and public health care
workforce capacity at all levels.
(V) Emergency medical service workforce capacity, including the retention and recruitment of
the volunteer workforce, at all levels.
(VI) The geographic distribution of health
care providers as compared to the identified
health care workforce needs of States and regions.
..........
(i) DEFINITIONS.In this section:
(1) HEALTH CARE WORKFORCE.The term health care
workforce includes all health care providers with direct patient care and support responsibilities, such as physicians,
nurses, nurse practitioners, primary care providers, preventive
medicine physicians, optometrists, ophthalmologists, physician
assistants, pharmacists, dentists, dental hygienists, and other
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June 9, 2010 Sec. 5102 PPACA (Consolidated) 526
oral healthcare professionals, allied health professionals, doctors of chiropractic, community health workers, health care
paraprofessionals, direct care workers, psychologists and other
behavioral and mental health professionals (including substance abuse prevention and treatment providers), social workers, physical and occupational therapists, certified nurse midwives, podiatrists, the EMS workforce (including professional
and volunteer ambulance personnel and firefighters who perform emergency medical services), licensed complementary and
alternative medicine providers, integrative health practitioners, public health professionals, and any other health professional that the Comptroller General of the United States determines appropriate
(2) HEALTH PROFESSIONALS.The term health professionals includes
(A) dentists, dental hygienists, primary care providers,
specialty physicians, nurses, nurse practitioners, physician
assistants, psychologists and other behavioral and mental
health professionals (including substance abuse prevention
and treatment providers), social workers, physical and occupational therapists, øpossible intended addition by section 10501(a)(3)which amended subsection (i)(2)(B): optometrists, ophthalmologists,¿ public health professionals,
clinical pharmacists, allied health professionals, doctors of
chiropractic, community health workers, school nurses,
certified nurse midwives, podiatrists, licensed complementary and alternative medicine providers, the EMS workforce (including professional and volunteer ambulance personnel and firefighters who perform emergency medical
services), and integrative health practitioners;
(B) national representatives of health professionals;
(C) representatives of schools of medicine, osteopathy,
nursing, dentistry, optometry, pharmacy, chiropractic, allied health, educational programs for public health professionals, behavioral and mental health professionals (as so
defined), social workers, pharmacists, physical and occupational therapists, øpossible intended addition by section
10501(a)(3)which amended subsection (i)(2)(B): optometrists, ophthalmologists,¿ oral health care industry dentistry and dental hygiene, and physician assistants;
(D) representatives of public and private teaching hospitals, and ambulatory health facilities, including Federal
medical facilities; and
(E) any other health professional the Comptroller General of the United States determines appropriate.
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SEC. 748 ø42 U.S.C. 293k2¿. TRAINING IN GENERAL, PEDIATRIC, AND
PUBLIC HEALTH DENTISTRY.
(a) SUPPORT AND DEVELOPMENT OF DENTAL TRAINING PROGRAMS.
(1) IN GENERAL.The Secretary may make grants to, or
enter into contracts with, a school of dentistry, public or nonprofit private hospital, or a public or private nonprofit entity
which the Secretary has determined is capable of carrying out
such grant or contract
(A) to plan, develop, and operate, or participate in, an
approved professional training program in the field of general dentistry, pediatric dentistry, or public health dentistry for dental students, residents, practicing dentists,
dental hygienists, or other approved primary care dental
trainees, that emphasizes training for general, pediatric, or
public health dentistry;
(B) to provide financial assistance to dental students,
residents, practicing dentists, and dental hygiene students
who are in need thereof, who are participants in any such
program, and who plan to work in the practice of general,
pediatric, public heath dentistry, or dental hygiene;
(C) to plan, develop, and operate a program for the
training of oral health care providers who plan to teach in
general, pediatric, public health dentistry, or dental hygiene;
(D) to provide financial assistance in the form of
traineeships and fellowships to dentists who plan to teach
or are teaching in general, pediatric, or public health dentistry;
(E) to meet the costs of projects to establish, maintain, or improve dental faculty development programs in
primary care (which may be departments, divisions or
other units);
(F) to meet the costs of projects to establish, maintain, or improve predoctoral and postdoctoral training in
primary care programs;
(G) to create a loan repayment program for faculty in
dental programs; and
(H) to provide technical assistance to pediatric training programs in developing and implementing instruction
regarding the oral health status, dental care needs, and risk-based clinical disease management of all pediatric
populations with an emphasis on underserved children.
(2) FACULTY LOAN REPAYMENT.
(A) IN GENERAL.A grant or contract under subsection (a)(1)(G) may be awarded to a program of general,
pediatric, or public health dentistry described in such subsection to plan, develop, and operate a loan repayment program under which
(i) individuals agree to serve full-time as faculty
members; and
(ii) the program of general, pediatric or public
health dentistry agrees to pay the principal and interest on the outstanding student loans of the individuals.
(B) MANNER OF PAYMENTS.With respect to the payments described in subparagraph (A)(ii), upon completion
by an individual of each of the first, second, third, fourth,
and fifth years of service, the program shall pay an
amount equal to 10, 15, 20, 25, and 30 percent, respectively, of the individuals student loan balance as calculated based on principal and interest owed at the initiation of the agreement.
(b) ELIGIBLE ENTITY.For purposes of this subsection, entities
eligible for such grants or contracts in general, pediatric, or public
health dentistry shall include entities that have programs in dental
or dental hygiene schools, or approved residency or advanced education programs in the practice of general, pediatric, or public