HR 5909 IHCommentsClose CommentsPermalink

112th CONGRESSCommentsClose CommentsPermalink

2d SessionCommentsClose CommentsPermalink

H. R. 5909CommentsClose CommentsPermalink

To improve access to oral health care for vulnerable and underserved populations.CommentsClose CommentsPermalink

IN THE HOUSE OF REPRESENTATIVESCommentsClose CommentsPermalink

June 7, 2012CommentsClose CommentsPermalink

Mr. CUMMINGS introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, the Judiciary, Natural Resources, Veterans’ Affairs, and Armed Services, 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 concernedCommentsClose CommentsPermalink

A BILLCommentsClose CommentsPermalink

To improve access to oral health care for vulnerable and underserved populations.CommentsClose CommentsPermalink

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,CommentsClose CommentsPermalink

SECTION 1. SHORT TITLE.

This Act may be cited as the ‘Comprehensive Dental Reform Act of 2012’.CommentsClose CommentsPermalink

SEC. 2. TABLE OF CONTENTS.

The table of contents of this Act is as follows:CommentsClose CommentsPermalink





Sec. 1. Short title.CommentsClose CommentsPermalink





Sec. 2. Table of contents.CommentsClose CommentsPermalink





Sec. 3. Findings.CommentsClose CommentsPermalink

TITLE I--MEDICARE AND MEDICAID

Subtitle A--Medicare

Sec. 101. Coverage of dental services under the Medicare program.CommentsClose CommentsPermalink

Subtitle B--Medicaid

Sec. 111. Coverage of dental services under the Medicaid program.CommentsClose CommentsPermalink

Subtitle C--Grant Programs

Sec. 121. Case management grant program.CommentsClose CommentsPermalink

TITLE II--PUBLIC HEALTH PROGRAMS

Subtitle A--National Health Service Corps

Sec. 201. National Health Service Corps.CommentsClose CommentsPermalink

Subtitle B--Oral Health Education

Sec. 211. Authorization of appropriations for oral health education for medical providers.CommentsClose CommentsPermalink





Sec. 212. Oral health education for other non-health professionals.CommentsClose CommentsPermalink





Sec. 213. Dental education.CommentsClose CommentsPermalink





Sec. 214. Oral health professional student loans.CommentsClose CommentsPermalink

Subtitle C--Other Oral Health Programs

Sec. 221. Access points.CommentsClose CommentsPermalink





Sec. 222. Dental clinics in schools.CommentsClose CommentsPermalink





Sec. 223. Emergency room care coordination.CommentsClose CommentsPermalink





Sec. 224. Research funding.CommentsClose CommentsPermalink





Sec. 225. Mobile and portable dental services.CommentsClose CommentsPermalink

TITLE III--DEPARTMENT OF VETERANS AFFAIRS AND DEPARTMENT OF DEFENSE MATTERS

Subtitle A--Department of Veterans Affairs Matters

Sec. 301. Requiring Secretary of Veterans Affairs to furnish dental care in same manner as any other medical service.CommentsClose CommentsPermalink





Sec. 302. Demonstration program on training and employment of alternative dental health care providers for dental health care services for veterans in rural and other underserved communities.CommentsClose CommentsPermalink

Subtitle B--Department of Defense Matters

Sec. 311. Demonstration program on training and employment of alternative dental health care providers for dental health care services for members of the Armed Forces and dependents lacking ready access to such services.CommentsClose CommentsPermalink

TITLE IV--FEDERAL BUREAU OF PRISONS

Sec. 401. Demonstration program on training and employment of alternative dental health care providers for dental health care services for prisoners within the custody of the Bureau of Prisons.CommentsClose CommentsPermalink

TITLE V--INDIAN HEALTH SERVICE

Sec. 501. Demonstration program on training and employment of alternative dental health care providers for dental health care services under the Indian Health Service.CommentsClose CommentsPermalink

TITLE VI--REPORTS TO CONGRESS

Sec. 601. Evaluation of expansion of coverage for dental services.CommentsClose CommentsPermalink

TITLE VII--FUNDING

Sec. 701. Transaction tax.CommentsClose CommentsPermalink

SEC. 3. FINDINGS.

Congress makes the following findings:CommentsClose CommentsPermalink





(1) The United States must establish a nationwide and comprehensive approach to address the lack of access to needed dental care and reduce oral health disparities.CommentsClose CommentsPermalink





(2) Since 2000, when the Surgeon General of the United States called dental disease a ‘silent epidemic’, there has been increasing but still insufficient attention given to addressing oral health issues. The Healthy People 2020 initiative includes oral health as a leading health indicator for the first time in the history of the Healthy People program, and in 2011, the Institute of Medicine published 2 reports, ‘Improving Access to Oral Health Care for Vulnerable and Underserved Populations’ and ‘Advancing Oral Health in America’, that focused on oral health.CommentsClose CommentsPermalink





(3) Dental caries, commonly known as cavities, are the most common chronic disease for children in the United States, affecting nearly 60 percent of children between 5 and 17 years of age. Additionally, 25 percent of American adults who have attained 65 years of age have lost all of their teeth.CommentsClose CommentsPermalink





(4) Untreated oral health problems contribute to an increased risk for serious medical conditions such as diabetes, hospital-acquired pneumonia, and poor birth outcomes.CommentsClose CommentsPermalink





(5) More than 47,000,000 individuals reside in areas where it is difficult to access dental care. Only 45 percent of Americans over 2 years of age have had a dental visit in the preceding 12 months, and approximately 17,000,000 low-income children go each year without seeing a dentist.CommentsClose CommentsPermalink





(6) While the lack of access to oral health services is a national problem, those who are most likely to remain underserved are individuals with low incomes, racial and ethnic minorities, pregnant women, older adults, individuals with special needs, and individuals living in rural communities.CommentsClose CommentsPermalink





(7) Nearly 9,500 additional dental providers are needed in order to meet this Nation’s current oral health needs, especially to work in areas where the need for dental care is the greatest. Only 20 percent of practicing dentists in the United States provide care to individuals enrolled in Medicaid, and a very small percentage of dentists devote a substantial part of their practice towards caring for individuals who are underserved.CommentsClose CommentsPermalink





(8) Over 40 percent of the total expenditures on dental care in the United States are out-of-pocket payments by individuals.CommentsClose CommentsPermalink





(9) The Medicare program and the Department of Veterans Affairs do not provide dental coverage to the majority of their beneficiaries, and States can elect whether to provide dental coverage to adults under the Medicaid program.CommentsClose CommentsPermalink





(10) The number of individuals without dental health insurance is 3 times higher than the number of individuals who lack general health insurance.CommentsClose CommentsPermalink





(11) The lack of access to oral health services can be extremely costly, resulting in higher health care expenditures. In 2009, there were over 830,000 visits to emergency rooms across the United States for preventable dental conditions, which is 16 percent higher than in 2006.CommentsClose CommentsPermalink





(12) According to a report by the Surgeon General of the United States, students miss more than 51,000,000 hours of school and employed adults lose more than 164,000,000 hours of work each year due to dental disease and dental visits.CommentsClose CommentsPermalink

TITLE I--MEDICARE AND MEDICAIDCommentsClose CommentsPermalink

Subtitle A--MedicareCommentsClose CommentsPermalink

SEC. 101. 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--CommentsClose CommentsPermalink





(1) in subparagraph (EE), by striking ‘and’ after the semicolon at the end;CommentsClose CommentsPermalink





(2) in subparagraph (FF), by adding ‘and’ after the semicolon at the end; andCommentsClose CommentsPermalink





(3) by adding at the end the following new subparagraph:CommentsClose CommentsPermalink





‘(GG) dental services (as defined in subsection (iii));’.CommentsClose CommentsPermalink





(b) Dental Services Defined- Section 1861(s) of the Social Security Act (42 U.S.C. 1395x(s)) is amended by adding at the end the following new subsection:CommentsClose CommentsPermalink

‘Dental Services

‘(iii)(1) The term ‘dental services’ means oral health services (as defined by the Secretary) provided by a licensed oral health care provider that are necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions.CommentsClose CommentsPermalink





‘(2) For purposes of paragraph (1), such term shall include mobile and portable oral health services (as defined by the Secretary) that--CommentsClose CommentsPermalink





‘(A) are provided for the purpose of overcoming mobility, transportation, and access barriers for individuals; andCommentsClose CommentsPermalink





‘(B) satisfy the standards and certification requirements established under section 1902(a)(84)(B) for the State in which the services are provided.’.CommentsClose CommentsPermalink





(c) Payment and Coinsurance- Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended--CommentsClose CommentsPermalink





(1) by striking ‘and’ before ‘(Z)’; andCommentsClose CommentsPermalink





(2) by inserting before the semicolon at the end the following: ‘, and (AA) with respect to dental services (as defined in section 1861(iii)), the amount paid shall be (i) in the case of such services that are dental health preventive services described in paragraph (1)(D) of such section, 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’.CommentsClose CommentsPermalink





(d) 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 inserting ‘(2)(GG),’ after ‘risk assessment),’.CommentsClose CommentsPermalink





(e) Dentures- Section 1861(s)(8) of the Social Security Act (42 U.S.C. 1395x(s)(8)) is amended--CommentsClose CommentsPermalink





(1) by striking ‘(other than dental)’ and inserting ‘(including dentures)’; andCommentsClose CommentsPermalink





(2) by striking ‘internal body’.CommentsClose CommentsPermalink





(f) Repeal of Ground for Exclusion- Section 1862(a) of the Social Security Act (42 U.S.C. 1395y) is amended by striking paragraph (12).CommentsClose CommentsPermalink





(g) Effective Date- The amendments made by this section shall apply to services furnished on or after January 1, 2013.CommentsClose CommentsPermalink

Subtitle B--MedicaidCommentsClose CommentsPermalink

SEC. 111. COVERAGE OF DENTAL SERVICES UNDER THE MEDICAID PROGRAM.

(a) In General- Section 1905 of the Social Security Act (42 U.S.C. 1396d) is amended--CommentsClose CommentsPermalink





(1) in subsection (a)(10), by adding ‘(as described in subsection (ee)(1))’ after ‘dental services’; andCommentsClose CommentsPermalink





(2) by adding at the end the following:CommentsClose CommentsPermalink





‘(ee)(1) Subject to paragraphs (2) and (3), for purposes of this title, the term ‘dental services’ means oral health services (as defined by the Secretary) provided by a licensed oral health care provider that are necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions.CommentsClose CommentsPermalink





‘(2) For purposes of paragraph (1), such term shall include mobile and portable oral health services (as defined by the Secretary) that--CommentsClose CommentsPermalink





‘(A) are provided for the purpose of overcoming mobility, transportation, and access barriers for individuals; andCommentsClose CommentsPermalink





‘(B) satisfy the standards and certification requirements established under section 1902(a)(84)(B) for the State in which the services are provided.CommentsClose CommentsPermalink





‘(3) For purposes of paragraph (1), such term shall not apply to dental care or services provided to individuals under the age of 21 under subsection (r)(3).’.CommentsClose CommentsPermalink





(b) Conforming Amendments- Section 1902(a) of such Act (42 U.S.C. 1396a(a)) is amended--CommentsClose CommentsPermalink





(1) in paragraph (10)(A), in the matter preceding clause (i), by inserting ‘(10),’ after ‘(5),’;CommentsClose CommentsPermalink





(2) in paragraph (82)(C), by striking ‘and’ at the end;CommentsClose CommentsPermalink





(3) in paragraph (83), by striking the period at the end and inserting ‘; and’; andCommentsClose CommentsPermalink





(4) by inserting after paragraph (83) the following:CommentsClose CommentsPermalink





‘(84) provide for--CommentsClose CommentsPermalink





‘(A) informing, in writing, all individuals who have been determined to be eligible for medical assistance of the availability of dental services (as defined in section 1905(ee)(1)); andCommentsClose CommentsPermalink





‘(B) establishing and maintaining standards for and certification of mobile and portable oral health services (as described in subsections (r)(3)(C) and (ee)(2) of section 1905).’.CommentsClose CommentsPermalink





(c) Mobile and Portable Oral Health Services Under EPSDT- Section 1905(r)(3) of the Social Security Act (42 U.S.C. 1396d(r)(3)) is amended--CommentsClose CommentsPermalink





(1) in subparagraph (A)(ii), by striking ‘; and’ and inserting a semicolon;CommentsClose CommentsPermalink





(2) in subparagraph (B), by striking the period at the end and inserting ‘; and’; andCommentsClose CommentsPermalink





(3) by adding at the end the following new subparagraph:CommentsClose CommentsPermalink





‘(C) which shall include mobile and portable oral health services (as defined by the Secretary) that--CommentsClose CommentsPermalink





‘(i) are provided for the purpose of overcoming mobility, transportation, or access barriers for children; andCommentsClose CommentsPermalink





‘(ii) satisfy the standards and certification requirements established under section 1902(a)(84)(B) for the State in which the services are provided.’.CommentsClose CommentsPermalink





(d) Increased Federal Funding for Dental Services-CommentsClose CommentsPermalink





(1) IN GENERAL- Section 1905 of the Social Security Act (42 U.S.C. 1396d), as amended by subsection (a), is amended--CommentsClose CommentsPermalink





(A) in subsection (b), in the first sentence, by striking ‘and (aa)’ and inserting ‘(aa), and (ff)’; andCommentsClose CommentsPermalink





(B) by adding at the end the following new subsection:CommentsClose CommentsPermalink





‘(ff) Increased FMAP for Dental Services-CommentsClose CommentsPermalink





‘(1) IN GENERAL- Notwithstanding subsection (b) and section 1903(a)(7) and subject to the requirements described in paragraphs (3) and (4), with respect to amounts expended on or after October 1, 2012, for covered dental expenses (as described in paragraph (2)), the Federal medical assistance percentage for a State that is one of the 50 States or the District of Columbia for such expenses shall be equal to the Federal medical assistance percentage that would otherwise apply to the State for the fiscal year, as determined under subsection (b) or section 1903(a)(7), increased by 10 percentage points.CommentsClose CommentsPermalink





‘(2) COVERED DENTAL EXPENSES- For purposes of paragraph (1), the term ‘covered dental expenses’ means the amounts expended for medical assistance for dental services (as described in subsection (ee)(1)) and amounts expended for the proper and efficient administration of the provision of such dental services under the State plan.CommentsClose CommentsPermalink





‘(3) REQUIREMENTS- For purposes of paragraph (1), the Federal medical assistance percentage applicable to covered dental expenses under this subsection shall not apply to a State unless--CommentsClose CommentsPermalink





‘(A) the State plan for medical assistance provides payment for dental services (as so defined) furnished by a dental provider at a rate that is not less than 70 percent of the usual and customary fee for such services in the State; andCommentsClose CommentsPermalink





‘(B) the State satisfies such additional requirements as are established by the Secretary, which shall include--CommentsClose CommentsPermalink





‘(i) streamlining of administrative procedures for purposes of ensuring adequate provider participation and increasing patient utilization of dental services; andCommentsClose CommentsPermalink





‘(ii) the provision of technical assistance to dental providers designed to reduce the number of missed patient appointments and eliminate other barriers to the provision of oral health services.CommentsClose CommentsPermalink





‘(4) LIMITATION- For purposes of amounts expended for covered dental services, in no case shall any increase under this subsection result in a Federal medical assistance percentage that exceeds 100 percent.’.CommentsClose CommentsPermalink





(2) CONFORMING AMENDMENT- Section 1903(a)(7) of the Social Security Act (42 U.S.C. 1396b(a)(7)) is amended by striking ‘section 1919(g)(3)(B)’ and inserting ‘sections 1905(ff) and 1919(g)(3)(B)’.CommentsClose CommentsPermalink





(e) Effective Date-CommentsClose CommentsPermalink





(1) IN GENERAL- Except as provided in paragraph (2), the amendments made by this section shall apply to calendar quarters beginning on or after January 1, 2013, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date.CommentsClose CommentsPermalink





(2) DELAY PERMITTED FOR STATE PLAN AMENDMENT- In the case of a State plan for medical assistance under title XIX of the Social Security Act which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirements imposed by the amendments made by this section, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of such session shall be deemed to be a separate regular session of the State legislature.CommentsClose CommentsPermalink

Subtitle C--Grant ProgramsCommentsClose CommentsPermalink

SEC. 121. CASE MANAGEMENT GRANT PROGRAM.

(a) Establishment- The Secretary shall award grants to States and eligible entities for the purpose of developing case management programs that--CommentsClose CommentsPermalink





(1) identify eligible individuals who are in need of dental services, with a particular focus on pregnant women, individuals with disabilities, and older adults, and provide them with information regarding dental providers in proximity to their residence;CommentsClose CommentsPermalink





(2) determine the coverage status of an eligible individual or whether such individual is eligible for free dental services;CommentsClose CommentsPermalink





(3) recruit licensed dental providers and coordinate the voluntary provision of medically recommended dental services by such providers to eligible individuals described in subsection (f)(2)(E) with no fee or charge to such individuals and in a manner consistent with State licensing laws;CommentsClose CommentsPermalink





(4) provide community-level oral health education, with a focus on oral health literacy and prevention, and resource information to eligible individuals; andCommentsClose CommentsPermalink





(5) identify and coordinate transportation for eligible individuals in need of dental services as necessary to overcome mobility impairments and transportation barriers.CommentsClose CommentsPermalink





(b) Application- A State or eligible entity that desires to participate in the grant program under this section shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink





(c) Duration and Scope- From any amounts appropriated to carry out this section, the Secretary shall award grants to a total of 10 States and eligible entities, with the amount of each grant to be determined at the discretion of the Secretary.CommentsClose CommentsPermalink





(d) Evaluation- Not later than January 1, 2016, the Secretary shall--CommentsClose CommentsPermalink





(1) conduct an evaluation of the grant program under this section for purposes of determining if case management programs established by participating States and eligible entities sufficiently increased access to dental services; andCommentsClose CommentsPermalink





(2) determine whether case management programs should be made available on a nationwide basis.CommentsClose CommentsPermalink





(e) Authorization- To carry out the grant program under this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2013 through 2015.CommentsClose CommentsPermalink





(f) Definitions- In this section:CommentsClose CommentsPermalink





(1) ELIGIBLE ENTITY- The term ‘eligible entity’ means an organization that is described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code.CommentsClose CommentsPermalink





(2) ELIGIBLE INDIVIDUAL- The term ‘eligible individual’ means an individual who is--CommentsClose CommentsPermalink





(A) entitled to, or enrolled for, benefits under part A of title XVIII of the Social Security Act or enrolled for benefits under part B of such title;CommentsClose CommentsPermalink





(B) eligible to receive medical assistance under a State plan under title XIX of the Social Security Act or any waiver approved with respect to such plan;CommentsClose CommentsPermalink





(C) eligible to receive child health assistance under a State child health plan under title XXI of the Social Security Act or any waiver approved with respect to such plan;CommentsClose CommentsPermalink





(D) entitled to receive medical benefits under the laws administered by the Secretary of Veterans Affairs; orCommentsClose CommentsPermalink





(E) has an income below 200 percent of the Federal poverty level and does not otherwise have any dental insurance coverage.CommentsClose CommentsPermalink





(3) SECRETARY- The term ‘Secretary’ means the Secretary of Health and Human Services.CommentsClose CommentsPermalink





(4) STATE- The term ‘State’ means the 50 States and the District of Columbia.CommentsClose CommentsPermalink

TITLE II--PUBLIC HEALTH PROGRAMSCommentsClose CommentsPermalink

Subtitle A--National Health Service CorpsCommentsClose CommentsPermalink

SEC. 201. NATIONAL HEALTH SERVICE CORPS.

(a) In General- Section 331 of the Public Health Service Act (42 U.S.C. 254d) is amended--CommentsClose CommentsPermalink





(1) in subsection (a)(3), by adding at the end the following:CommentsClose CommentsPermalink





‘(F) The term ‘dental therapist’ means, with respect to a State that licenses such dental therapists, a mid-level dental practitioner who is licensed to practice under the law of the State and who provides preventive and restorative services directly to the public, commensurate with the scope of the practice.’; andCommentsClose CommentsPermalink





(2) in subsection (b)--CommentsClose CommentsPermalink





(A) in paragraph (1), by inserting ‘, dental therapy,’ after ‘dental’; andCommentsClose CommentsPermalink





(B) in paragraph (2), by inserting ‘dental therapists,’ after ‘dentists,’.CommentsClose CommentsPermalink





(b) Facilitation of Effective Provision of Corps Services- Section 336(f)(3) of the Public Health Service Act (42 U.S.C. 254h-1(f)(3)) is amended by inserting ‘dental therapists’ after ‘midwives,’.CommentsClose CommentsPermalink





(c) Scholarship Program and Loan Repayment Program-CommentsClose CommentsPermalink





(1) SCHOLARSHIP PROGRAM- Section 338A of the Public Health Service Act (42 U.S.C. 254l) is amended--CommentsClose CommentsPermalink





(A) in subsection (a)(1), by inserting ‘dental therapists,’ after ‘dentists,’; andCommentsClose CommentsPermalink





(B) in subsection (b)(1), by inserting ‘including dental therapy,’ after ‘or other health profession,’.CommentsClose CommentsPermalink





(2) LOAN REPAYMENT PROGRAM- Section 338B of the Public Health Service Act (42 U.S.C. 254l-1) is amended--CommentsClose CommentsPermalink





(A) in subsection (a)(1), by inserting ‘dental therapists,’ after ‘dentists,’; andCommentsClose CommentsPermalink





(B) in subsection (b)(1)--CommentsClose CommentsPermalink





(i) in subparagraph (A), by inserting ‘dental therapist,’ after ‘nurse practitioner,’;CommentsClose CommentsPermalink





(ii) in subparagraph (B), by inserting ‘dental therapy,’ after ‘mental health,’; andCommentsClose CommentsPermalink





(iii) in subparagraph (C)(ii), by inserting ‘, including dental therapy,’ after ‘health profession’.CommentsClose CommentsPermalink





(3) AUTHORIZATION OF APPROPRIATIONS- Section 338H of the Public Health Service Act (42 U.S.C. 254q) is amended--CommentsClose CommentsPermalink





(A) in subsection (a), by striking ‘this section’ and inserting ‘this subpart’; andCommentsClose CommentsPermalink





(B) by adding at the end the following:CommentsClose CommentsPermalink





‘(d) Authorization of Appropriations With Respect to Oral Health Professionals- To carry out this subpart with respect to dentists, dental therapists, and dental hygienists, in addition to the amounts authorized under subsection (a), there is authorized to be appropriated such sums as may be necessary for fiscal years 2013 through 2016, which shall be used to provide scholarships to such oral health professionals.’.CommentsClose CommentsPermalink

Subtitle B--Oral Health EducationCommentsClose CommentsPermalink

SEC. 211. AUTHORIZATION OF APPROPRIATIONS FOR ORAL HEALTH EDUCATION FOR MEDICAL PROVIDERS.

Section 747(c) of the Public Health Service Act (42 U.S.C. 293k(c)) is amended by adding at the end the following:CommentsClose CommentsPermalink





‘(4) ORAL HEALTH EDUCATION- In addition to other amounts authorized under this subsection for purposes of carrying out this section, there is authorized to be appropriated such sums as may be necessary for fiscal years 2013 through 2016 for the purpose of educating nondental medical professionals, including physicians, nurses, and pharmacists, about oral health, including issues such as oral hygiene instruction, topical application of fluoride, and oral health screenings, with the goal of integrating oral health care into overall health care.’.CommentsClose CommentsPermalink

SEC. 212. ORAL HEALTH EDUCATION FOR OTHER NON-HEALTH PROFESSIONALS.

Subpart I of part C of title VII of the Public Health Service Act (42 U.S.C. 293k et seq.) is amended by inserting after section 748 the following:CommentsClose CommentsPermalink

‘SEC. 748A. ORAL HEALTH EDUCATION FOR OTHER NON-ORAL HEALTH PROFESSIONALS.

‘(a) In General- The Secretary may make grants to, or enter into contracts with, an accredited public or nonprofit private hospital, an educational institution, or a public or private nonprofit entity which the Secretary has determined is capable of carrying out such grant or contract to educate individuals, such as community health workers, social workers, nutritionists, health educators, occupational therapists, and psychologists, to promote oral health education and to provide support for behavior change and assistance with care coordination with respect to oral health.CommentsClose CommentsPermalink





‘(b) Authorization of Appropriations- To carry out this section, there is authorized to be appropriated such sums as may be necessary for fiscal years 2013 through 2016.’.CommentsClose CommentsPermalink

SEC. 213. DENTAL EDUCATION.

(a) Training in General, Pediatric, and Public Health Dentistry- Section 748 of the Public Health Service Act (42 U.S.C. 293k-2) is amended--CommentsClose CommentsPermalink





(1) in subsection (a)(1)(H), by striking ‘pediatric training programs’ and inserting ‘pediatric dental training programs’; andCommentsClose CommentsPermalink





(2) in subsection (c)--CommentsClose CommentsPermalink





(A) by striking the subsection heading and inserting ‘Requirements for Award- ’;CommentsClose CommentsPermalink





(B) by amending the matter preceding paragraph (1) to read as follows: ‘With respect to training provided for under this section, the Secretary shall award grants or contracts only to eligible entities that meet at least 7 of the following criteria:’;CommentsClose CommentsPermalink





(C) in paragraph (2), by striking ‘have a record of training the greatest percentage of providers, or that have demonstrated significant improvements in the percentage of providers, who enter and’ and inserting ‘train significant numbers of providers who’;CommentsClose CommentsPermalink





(D) in paragraph (3)--CommentsClose CommentsPermalink





(i) by striking ‘have a record of training’ and inserting ‘intent to train’; andCommentsClose CommentsPermalink





(ii) by striking the period at the end and inserting ‘and have faculty with experience in treating underserved populations.’;CommentsClose CommentsPermalink





(E) in paragraph (8), by inserting ‘or have established’ after ‘establish’; andCommentsClose CommentsPermalink





(F) by adding at the end the following:CommentsClose CommentsPermalink





‘(9) Qualified applicants that require not less than 200 hours of community-based education rotations.’.CommentsClose CommentsPermalink





(b) Dental Residency Programs- Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 320B. DENTAL RESIDENCY PROGRAMS.

‘As a condition for receiving Federal funds, dental training residency programs shall require individuals enrolled in such residency programs to provide dental services--CommentsClose CommentsPermalink





‘(1) in hospital emergency rooms; orCommentsClose CommentsPermalink





‘(2) in community settings, in addition to the dental training otherwise required by such residency program.’.CommentsClose CommentsPermalink

SEC. 214. ORAL HEALTH PROFESSIONAL STUDENT LOANS.

Part F of title VII of the Public Health Service Act (42 U.S.C. 295j) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 799C. ORAL HEALTH PROFESSIONAL STUDENT LOANS.

‘(a) In General- The Secretary shall establish and operate a student loan fund for oral health professional students, including dental hygienists, dental therapists, and dentists.CommentsClose CommentsPermalink





‘(b) Content- The Secretary shall establish and operate the student loan fund program under subsection (a) in the same manner and subject to the same terms as the loan fund program established with schools of nursing under section 835.CommentsClose CommentsPermalink





‘(c) Authorization of Appropriations- To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2013 through 2016.’.CommentsClose CommentsPermalink

Subtitle C--Other Oral Health ProgramsCommentsClose CommentsPermalink

SEC. 221. ACCESS POINTS.

Subpart X of part D of title III of the Public Health Service Act (42 U.S.C. 256f et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 340G-2. FUNDING FOR ORAL HEALTH SERVICES.

‘(a) In General- The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall establish a program to award grants to eligible entities to provide oral health services, or to contract with private dental practices to provide comprehensive oral health services, to low income individuals and individuals who are underserved with respect to oral health care.CommentsClose CommentsPermalink





‘(b) Technical Assistance- The Secretary shall provide technical assistance to entities receiving grants under subsection (a) to provide technical assistance to such entities in order to--CommentsClose CommentsPermalink





‘(1) with respect to oral health care services, increase efficiency and minimize missed appointments, contract with offsite providers, recruit providers (including oral health specialists), and operate programs outside the physical facilities to take advantage of new systems to improve access to oral health services; orCommentsClose CommentsPermalink





‘(2) contract with private dental practices that will provide oral health services other than preventive oral health care, including restoration and maintenance of oral health, in order to meet the need for oral health services in the community.CommentsClose CommentsPermalink





‘(c) Eligible Entities- To be eligible to receive a grant under subsection (a), an entity shall--CommentsClose CommentsPermalink





‘(1) be--CommentsClose CommentsPermalink





‘(A) a Federally qualified health center (as defined in section 1861(aa) of the Social Security Act);CommentsClose CommentsPermalink





‘(B) a safety net clinic or a free clinic (as defined by the Secretary);CommentsClose CommentsPermalink





‘(C) a health care clinic that provides services to tribal organizations or urban Indian organizations (as such terms are defined in section 4 of the Indian Health Care Improvement Act); orCommentsClose CommentsPermalink





‘(D) any other interested public or private sector health care provider or organization that the Secretary determines has a demonstrated history in serving a high number of uninsured and or low-income individuals or those who lack ready access to oral health services; andCommentsClose CommentsPermalink





‘(2) demonstrate a clear need to expand oral health care services beyond preventive oral health care.CommentsClose CommentsPermalink





‘(d) Allocation for Hiring Oral Health Care Specialists- A portion of the funds available under this section shall be allocated toward hiring oral health care specialists, such as oral surgeons, at entities receiving grants under this section.CommentsClose CommentsPermalink





‘(e) Authorization of Appropriations- To carry out this section, there is authorized to be appropriated such sums as may be necessary for each of fiscal years 2013 through 2016.’.CommentsClose CommentsPermalink

SEC. 222. DENTAL CLINICS IN SCHOOLS.

Part Q of title III of the Public Health Service Act (42 U.S.C. 280h et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 399Z-2. DENTAL CLINICS IN SCHOOLS.

‘(a) In General- The Secretary shall award grants to qualified entities for the purpose of funding the building, operation, or expansion of dental clinics in schools.CommentsClose CommentsPermalink





‘(b) Qualified Entities- To receive a grant under this section, a qualified entity shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink





‘(c) Requirements- An entity receiving a grant under this section shall--CommentsClose CommentsPermalink





‘(1) provide comprehensive oral health services at a dental clinic based at a school, including oral health education, oral screening, fluoride application, prophylaxis, and sealants;CommentsClose CommentsPermalink





‘(2) refer patients to an available qualified oral health provider in the community for any required oral health services not provided in the dental clinic in the school, to ensure that all the oral health needs of students are met; andCommentsClose CommentsPermalink





‘(3) maintain clinic hours that extend beyond school hours.CommentsClose CommentsPermalink





‘(d) Authorization of Appropriations- For purposes of carrying out this section, there is authorized to be appropriated such sums as may be necessary for fiscal years 2013 through 2016.’.CommentsClose CommentsPermalink

SEC. 223. EMERGENCY ROOM CARE COORDINATION.

Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.), as amended by section 213(b), is further amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 320C. EMERGENCY ROOM CARE COORDINATION WITH RESPECT TO DENTAL CARE.

‘(a) In General- The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall establish a grant program to enable individuals to receive dental care at a facility operated by a grant recipient rather than at a hospital emergency room.CommentsClose CommentsPermalink





‘(b) Eligible Entities- To be eligible to receive a grant under this section, an entity shall be--CommentsClose CommentsPermalink





‘(1) a hospital in partnership with a Federally qualified health center;CommentsClose CommentsPermalink





‘(2) a Federally qualified health center;CommentsClose CommentsPermalink





‘(3) a private dental practice; orCommentsClose CommentsPermalink





‘(4) any other interested public or private sector health care provider or organization that the Secretary determines has the capacity to serve a high number of individuals who lack access to oral health services.CommentsClose CommentsPermalink





‘(c) Oral Health Education for ER Physicians- The Secretary shall allocate a portion of the amounts appropriated under subsection (e) toward medical education for emergency room physicians to be trained in oral health.CommentsClose CommentsPermalink





‘(d) Report- Not later than January 1, 2016, the Secretary shall submit to Congress a report on the best practices determined by the program established under this section to address oral health needs of individuals who go to emergency rooms in need of oral health care.CommentsClose CommentsPermalink





‘(e) Authorization of Appropriations- To carry out this section, there is authorized to be appropriated such sums as may be necessary for fiscal years 2013 through 2016.’.CommentsClose CommentsPermalink

SEC. 224. RESEARCH FUNDING.

For fiscal years 2013 through 2016, there is authorized to be appropriated such sums as may be necessary to each of--CommentsClose CommentsPermalink





(1) the Centers for Disease Control and Prevention, for the purpose of conducting research on--CommentsClose CommentsPermalink





(A) the prevention of oral health disease; andCommentsClose CommentsPermalink





(B) oral health disease management;CommentsClose CommentsPermalink





(2) the Agency for Healthcare Research and Quality, for the purpose of conducting--CommentsClose CommentsPermalink





(A) research with respect to oral health services and the delivery of oral health services; andCommentsClose CommentsPermalink





(B) an evaluation of oral health service delivery to underserved and vulnerable populations;CommentsClose CommentsPermalink





(3) the National Institute of Dental and Craniofacial Research for the purpose of conducting research on oral health disease management including pharmaceutical-behavioral intervention; andCommentsClose CommentsPermalink





(4) the Maternal and Child Health Bureau for the purpose of conducting research on maternal and child oral health issues.CommentsClose CommentsPermalink

SEC. 225. MOBILE AND PORTABLE DENTAL SERVICES.

Subpart X of part D of title III of the Public Health Service Act (42 U.S.C. 256f et seq.), as amended by section 221, is further amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 340G-3. MOBILE AND PORTABLE DENTAL SERVICES.

‘(a) In General- The Secretary shall award grants to rural health clinics, as defined in section 1861(aa)(2) of the Social Security Act (42 U.S.C. 1395x(aa)(2)), to provide mobile and portable, comprehensive dental services (including dental services provided by licensed providers through telehealth-enabled collaboration and supervision) and outreach for dental services at locations such as senior centers, nursing homes, assisted living facilities, schools, licensed day care centers that serve children who receive benefits under the State Children’s Health Insurance Program under title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.) or the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), and facilities that provide services under the Special Supplemental Nutrition Program for Women, Infants, and Children (the WIC program) or the Head Start Act (42 U.S.C. 9831 et seq.).CommentsClose CommentsPermalink





‘(b) Authorization of Appropriations- To carry out this section, there are authorized to be appropriated such sums as may be necessary.’.CommentsClose CommentsPermalink

TITLE III--DEPARTMENT OF VETERANS AFFAIRS AND DEPARTMENT OF DEFENSE MATTERSCommentsClose CommentsPermalink

Subtitle A--Department of Veterans Affairs MattersCommentsClose CommentsPermalink

SEC. 301. REQUIRING SECRETARY OF VETERANS AFFAIRS TO FURNISH DENTAL CARE IN SAME MANNER AS ANY OTHER MEDICAL SERVICE.

(a) In General- Title 38, United States Code, is amended--CommentsClose CommentsPermalink





(1) in section 1701(6), by striking ‘as described in sections 1710 and 1712 of this title’;CommentsClose CommentsPermalink





(2) in section 1710(c), by striking the second sentence;CommentsClose CommentsPermalink





(3) in section 1712--CommentsClose CommentsPermalink





(A) by striking subsections (a) and (b); andCommentsClose CommentsPermalink





(B) by redesignating subsections (c) through (e) as subsections (a) through (c), respectively; andCommentsClose CommentsPermalink





(4) by striking section 2062.CommentsClose CommentsPermalink





(b) Conforming Amendments- Such title is further amended--CommentsClose CommentsPermalink





(1) in section 1525(a), by striking ‘medicines under section 1712(d)’ and inserting ‘medicines under section 1712(b)’; andCommentsClose CommentsPermalink





(2) in section 1703(a)(7), by striking ‘, for a veteran described in section 1712(a)(1)(F) of this title’.CommentsClose CommentsPermalink





(c) Clerical Amendments- Such title is further amended--CommentsClose CommentsPermalink





(1) in section 1712, in the heading for such section, by striking ‘Dental care; drugs’ and inserting ‘Drugs’;CommentsClose CommentsPermalink





(2) in the table of sections at the beginning of chapter 17, by striking the item relating to section 1712 and inserting the following new item:CommentsClose CommentsPermalink





‘1712. Drugs and medicines for certain disabled veterans; vaccines.’;CommentsClose CommentsPermalink





andCommentsClose CommentsPermalink





(3) in the table of sections at the beginning of chapter 20, by striking the item relating to section 2062.CommentsClose CommentsPermalink

SEC. 302. DEMONSTRATION PROGRAM ON TRAINING AND EMPLOYMENT OF ALTERNATIVE DENTAL HEALTH CARE PROVIDERS FOR DENTAL HEALTH CARE SERVICES FOR VETERANS IN RURAL AND OTHER UNDERSERVED COMMUNITIES.

(a) Demonstration Program Authorized- 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 entitled to such services who reside in rural and other underserved communities.CommentsClose CommentsPermalink





(b) Telehealth- For purposes of alternative dental health care providers and any other dental care providers who are licensed to provide clinical care, dental services provided under the demonstration program under this section may be administered by such providers through telehealth-enabled collaboration and supervision when deemed appropriate and feasible.CommentsClose CommentsPermalink





(c) Alternative Dental Health Care Providers Defined- In this section, 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)).CommentsClose CommentsPermalink





(d) Authorization of Appropriations- There are authorized to be appropriated such sums as are necessary to carry out the demonstration program under this section.CommentsClose CommentsPermalink

Subtitle B--Department of Defense MattersCommentsClose CommentsPermalink

SEC. 311. DEMONSTRATION PROGRAM ON TRAINING AND EMPLOYMENT OF ALTERNATIVE DENTAL HEALTH CARE PROVIDERS FOR DENTAL HEALTH CARE SERVICES FOR MEMBERS OF THE ARMED FORCES AND DEPENDENTS LACKING READY ACCESS TO SUCH SERVICES.

(a) Demonstration Program Authorized- 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:CommentsClose CommentsPermalink





(1) Members and dependents who reside in rural areas or areas otherwise underserved by dental health care providers.CommentsClose CommentsPermalink





(2) Members of the National Guard and Reserves in active status who are potentially deployable.CommentsClose CommentsPermalink





(b) Telehealth- For purposes of alternative dental health care providers and any other dental care providers who are licensed to provide clinical care, dental services provided under the demonstration program under this section may be administered by such providers through telehealth-enabled collaboration and supervision when deemed appropriate and feasible.CommentsClose CommentsPermalink





(c) Alternative Dental Health Care Providers Defined- In this section, 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)).CommentsClose CommentsPermalink





(d) Authorization of Appropriations- There are authorized to be appropriated such sums as are necessary to carry out the demonstration program under this section.CommentsClose CommentsPermalink

TITLE IV--FEDERAL BUREAU OF PRISONSCommentsClose CommentsPermalink

SEC. 401. DEMONSTRATION PROGRAM ON TRAINING AND EMPLOYMENT OF ALTERNATIVE DENTAL HEALTH CARE PROVIDERS FOR DENTAL HEALTH CARE SERVICES FOR PRISONERS WITHIN THE CUSTODY OF THE BUREAU OF PRISONS.

(a) Demonstration Program Authorized- 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.CommentsClose CommentsPermalink





(b) Telehealth- For purposes of alternative dental health care providers and any other dental care providers who are licensed to provide clinical care, dental services provided under the demonstration program under this section may be administered by such providers through telehealth-enabled collaboration and supervision when deemed appropriate and feasible.CommentsClose CommentsPermalink





(c) Alternative Dental Health Care Providers Defined- In this section, 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)).CommentsClose CommentsPermalink





(d) Authorization of Appropriations- There are authorized to be appropriated such sums as are necessary to carry out the demonstration program under this section.CommentsClose CommentsPermalink

TITLE V--INDIAN HEALTH SERVICECommentsClose CommentsPermalink

SEC. 501. DEMONSTRATION PROGRAM ON TRAINING AND EMPLOYMENT OF ALTERNATIVE DENTAL HEALTH CARE PROVIDERS FOR DENTAL HEALTH CARE SERVICES UNDER THE INDIAN HEALTH SERVICE.

(a) Demonstration Program Authorized- 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 (as those terms are defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603)).CommentsClose CommentsPermalink





(b) Telehealth- For purposes of alternative dental health care providers and any other dental care providers who are licensed to provide clinical care, dental services provided under the demonstration program under this section may be administered by such providers through telehealth-enabled collaboration and supervision when deemed appropriate and feasible.CommentsClose CommentsPermalink





(c) Alternative Dental Health Care Providers Defined- In this section, 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)).CommentsClose CommentsPermalink





(d) Authorization of Appropriations- There are authorized to be appropriated such sums as are necessary to carry out the demonstration program under this section.CommentsClose CommentsPermalink

TITLE VI--REPORTS TO CONGRESSCommentsClose CommentsPermalink

SEC. 601. EVALUATION OF EXPANSION OF COVERAGE FOR DENTAL SERVICES.

(a) Secretary of Health and Human Services- Not later than October 1, 2016, the Secretary of Health and Human Services shall submit to Congress a report that provides a comprehensive cost-benefit analysis regarding the expansion of coverage for dental services pursuant to this Act, including whether the provision of such services resulted in a reduction in total health care costs for individuals under the Medicare and Medicaid programs.CommentsClose CommentsPermalink





(b) Comptroller General-CommentsClose CommentsPermalink





(1) MEDICAID AND MEDICARE- Not later than October 1, 2015, the Comptroller General of the United States shall submit to Congress a report that provides a comprehensive analysis and evaluation of the implementation and utilization of the expanded coverage for dental services pursuant to this Act for individuals enrolled in the Medicare and Medicaid programs.CommentsClose CommentsPermalink





(2) DEMONSTRATION PROGRAMS- Not later than October 1, 2016, the Comptroller General of the United States shall submit to Congress a report that provides a comprehensive analysis and evaluation of the demonstration programs described in sections 302, 311, 401, and 501, including--CommentsClose CommentsPermalink





(A) the extent to which the programs improved access to oral health care and increased utilization of oral health services; andCommentsClose CommentsPermalink





(B) an examination of the training provided under the programs to alternative dental health care providers and the quality of care provided by such providers.CommentsClose CommentsPermalink

TITLE VII--FUNDINGCommentsClose CommentsPermalink

SEC. 701. TRANSACTION TAX.

(a) In General- Chapter 36 of the Internal Revenue Code of 1986 is amended by inserting after subchapter B the following new subchapter:CommentsClose CommentsPermalink

‘Subchapter C--Tax on Trading Transactions

‘Sec. 4475. Tax on trading transactions.CommentsClose CommentsPermalink

‘SEC. 4475. TAX ON TRADING TRANSACTIONS.

‘(a) Imposition of Tax- There is hereby imposed a tax on each covered transaction with respect to any security.CommentsClose CommentsPermalink





‘(b) Rate of Tax- The tax imposed under subsection (a) with respect to any covered transaction shall be 0.025 percent of the specified base amount with respect to such covered transaction.CommentsClose CommentsPermalink





‘(c) Specified Base Amount- For purposes of this section, the term ‘specified base amount’ means--CommentsClose CommentsPermalink





‘(1) except as provided in paragraph (2), the fair market value of the security (determined as of the time of the covered transaction), andCommentsClose CommentsPermalink





‘(2) in the case of any payment described in subsection (h), the amount of such payment.CommentsClose CommentsPermalink





‘(d) Covered Transaction- For purposes of this section, the term ‘covered transaction’ means--CommentsClose CommentsPermalink





‘(1) except as provided in paragraph (2), any purchase if--CommentsClose CommentsPermalink





‘(A) such purchase occurs or is cleared on a facility located in the United States, orCommentsClose CommentsPermalink





‘(B) the purchaser or seller is a United States person, andCommentsClose CommentsPermalink





‘(2) any transaction with respect to a security described in subparagraph (D), (E), or (F) of subsection (e)(1), if--CommentsClose CommentsPermalink





‘(A) such security is traded or cleared on a facility located in the United States, orCommentsClose CommentsPermalink





‘(B) any party with rights under such security is a United States person.CommentsClose CommentsPermalink





‘(e) Security and Other Definitions- For purposes of this section:CommentsClose CommentsPermalink





‘(1) IN GENERAL- The term ‘security’ means--CommentsClose CommentsPermalink





‘(A) any share of stock in a corporation,CommentsClose CommentsPermalink





‘(B) any partnership or beneficial ownership interest in a partnership or trust,CommentsClose CommentsPermalink





‘(C) any note, bond, debenture, or other evidence of indebtedness,CommentsClose CommentsPermalink





‘(D) any evidence of an interest in, or a derivative financial instrument with respect to, any security or securities described in subparagraph (A), (B), or (C),CommentsClose CommentsPermalink





‘(E) any derivative financial instrument with respect to any currency or commodity, andCommentsClose CommentsPermalink





‘(F) any other derivative financial instrument any payment with respect to which is calculated by reference to any specified index.CommentsClose CommentsPermalink





‘(2) DERIVATIVE FINANCIAL INSTRUMENT- The term ‘derivative financial instrument’ includes any option, forward contract, futures contract, notional principal contract, or any similar financial instrument.CommentsClose CommentsPermalink





‘(3) SPECIFIED INDEX- The term ‘specified index’ means any 1 or more of any combination of--CommentsClose CommentsPermalink





‘(A) a fixed rate, price, or amount, orCommentsClose CommentsPermalink





‘(B) a variable rate, price, or amount,CommentsClose CommentsPermalink





which is based on any current objectively determinable information which is not within the control of any of the parties to the contract or instrument and is not unique to any of the parties’ circumstances.CommentsClose CommentsPermalink





‘(4) TREATMENT OF EXCHANGES-CommentsClose CommentsPermalink





‘(A) IN GENERAL- An exchange shall be treated as the sale of the property transferred and a purchase of the property received by each party to the exchange.CommentsClose CommentsPermalink





‘(B) CERTAIN DEEMED EXCHANGES- In the case of a distribution treated as an exchange for stock under section 302 or 331, the corporation making such distribution shall be treated as having purchased such stock for purposes of this section.CommentsClose CommentsPermalink





‘(f) Exceptions-CommentsClose CommentsPermalink





‘(1) EXCEPTION FOR INITIAL ISSUES- No tax shall be imposed under subsection (a) on any covered transaction with respect to the initial issuance of any security described in subparagraph (A), (B), or (C) of subsection (e)(1).CommentsClose CommentsPermalink





‘(2) EXCEPTION FOR CERTAIN TRADED SHORT-TERM INDEBTEDNESS- A note, bond, debenture, or other evidence of indebtedness which--CommentsClose CommentsPermalink





‘(A) is traded on a trading facility located in the United States, andCommentsClose CommentsPermalink





‘(B) has a fixed maturity of not more than 100 days,CommentsClose CommentsPermalink





shall not be treated as described in subsection (e)(1)(C).CommentsClose CommentsPermalink





‘(3) EXCEPTION FOR SECURITIES LENDING ARRANGEMENTS- No tax shall be imposed under subsection (a) on any covered transaction with respect to which gain or loss is not recognized by reason of section 1058.CommentsClose CommentsPermalink





‘(g) By Whom Paid-CommentsClose CommentsPermalink





‘(1) IN GENERAL- The tax imposed by this section shall be paid by--CommentsClose CommentsPermalink





‘(A) in the case of a transaction which occurs or is cleared on a facility located in the United States, such facility, andCommentsClose CommentsPermalink





‘(B) in the case of a purchase not described in subparagraph (A) which is executed by a broker (as defined in section 6045(c)(1)) which is a United States person, such broker.CommentsClose CommentsPermalink





‘(2) SPECIAL RULES FOR DIRECT, ETC., TRANSACTIONS- In the case of any transaction to which paragraph (1) does not apply, the tax imposed by this section shall be paid by--CommentsClose CommentsPermalink





‘(A) in the case of a transaction described in subsection (d)(1)--CommentsClose CommentsPermalink





‘(i) the purchaser if the purchaser is a United States person, andCommentsClose CommentsPermalink





‘(ii) the seller if the purchaser is not a United States person, andCommentsClose CommentsPermalink





‘(B) in the case of a transaction described in subsection (d)(2)--CommentsClose CommentsPermalink





‘(i) the payor if the payor is a United States person, andCommentsClose CommentsPermalink





‘(ii) the payee if the payor is not a United States person.CommentsClose CommentsPermalink





‘(h) Certain Payments Treated as Separate Transactions- Except as otherwise provided by the Secretary, any payment with respect to a security described in subparagraph (D), (E), or (F) of subsection (e)(1) shall be treated as a separate transaction for purposes of this section, including--CommentsClose CommentsPermalink





‘(1) any net initial payment, net final or terminating payment, or net periodical payment with respect to a notional principal contract (or similar financial instrument),CommentsClose CommentsPermalink





‘(2) any payment with respect to any forward contract (or similar financial instrument), andCommentsClose CommentsPermalink





‘(3) any premium paid with respect to any option (or similar financial instrument).CommentsClose CommentsPermalink





‘(i) Administration- The Secretary shall carry out this section in consultation with the Securities and Exchange Commission and the Commodity Futures Trading Commission.CommentsClose CommentsPermalink





‘(j) Guidance; Regulations- The Secretary shall--CommentsClose CommentsPermalink





‘(1) provide guidance regarding such information reporting concerning covered transactions as the Secretary deems appropriate, andCommentsClose CommentsPermalink





‘(2) prescribe such regulations as are necessary or appropriate to prevent avoidance of the purposes of this section, including the use of non-United States persons in such transactions.’.CommentsClose CommentsPermalink





(b) Clerical Amendment- The table of subchapters for chapter 36 of the Internal Revenue Code of 1986 is amended by inserting after the item relating to subchapter B the following new item:CommentsClose CommentsPermalink





‘Subchapter C. Tax on trading transactions.’.CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall apply to transactions after December 31, 2012.CommentsClose CommentsPermalink