113 HR 1761 IH: Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians Act
U.S. House of Representatives
2013-04-25
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.This Act may be cited as the
Helping Ensure Life- and Limb-Saving
Access to Podiatric Physicians Act
or the
HELLPP Act
.
2.Including
podiatrists as physicians under the Medicaid program
(a)Section 1905(a)(5)(A)
of the Social Security Act (42 U.S.C. 1396d(a)(5)(A)) is amended by striking
section 1861(r)(1)
and inserting paragraphs (1) and (3)
of section 1861(r)
.
(b)
(1)Except as provided in
paragraph (2), the amendment made by subsection (a) shall apply to services
furnished on or after January 1, 2014.
(2)Extension of
effective date for State law amendmentIn the case of a State plan under title XIX
of the Social Security Act (42 U.S.C. 1396 et seq.) which the Secretary of
Health and Human Services determines requires State legislation in order for
the plan to meet the additional requirement imposed by the amendment made by
subsection (a), 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 the session is considered to be a separate regular
session of the State legislature.
3.Modifications to
requirements for diabetic shoes to be included under medical and other health
services under Medicare
(a)Section 1861(s)(12)
of the Social Security Act (42 U.S.C. 1395x(s)(12)) is amended to read as
follows:
(12)subject to section 4072(e) of the Omnibus
Budget Reconciliation Act of 1987, extra-depth shoes with inserts or custom
molded shoes (in this paragraph referred to as therapeutic
shoes
) with inserts for an individual with diabetes, if—
(A)the physician who
is managing the individual’s diabetic condition—
(i)documents that the
individual has diabetes;
(ii)certifies that
the individual is under a comprehensive plan of care related to the
individual’s diabetic condition; and
(iii)documents
agreement with the prescribing podiatrist or other qualified physician (as
established by the Secretary) that it is medically necessary for the individual
to have such extra-depth shoes with inserts of custom molded shoes with
inserts;
(B)the therapeutic
shoes are prescribed by a podiatrist or other qualified physician (as
established by the Secretary) who—
(i)examines the
individual and determines the medical necessity for the individual to receive
the therapeutic shoes; and
(ii)communicates in
writing the medical necessity to a certifying doctor of medicine or osteopathy
for the individual to have therapeutic shoes along with findings that the
individual has peripheral neuropathy with evidence of callus formation, a
history of pre-ulcerative calluses, a history of previous ulceration, foot
deformity, previous amputation, or poor circulation; and
(C)the therapeutic
shoes are fitted and furnished by a podiatrist or other qualified supplier
individual (as established by the Secretary), such as a pedorthist or
orthotist, who is not the physician described in subparagraph (A) (unless the
Secretary finds that the physician is the only such qualified individual in the
area);
.
(b)The amendment made by subsection (a) shall apply with
respect to items and services furnished on or after January 1, 2014.
4.Budget savings:
strengthening medicaid program integrity through continuous levy on payments to
medicaid providers and suppliers
(a)Section 6331(h)(2) of the Internal Revenue Code of 1986
(defining specified payment) is amended by striking and
at the
end of subparagraph (B), by striking the period at the end of subparagraph (C)
and inserting , and
, and by adding at the end the following new
subparagraph:
(D)any payment to any
medicaid provider or supplier under a State plan under title XIX of the Social
Security
Act.
.
(b)The amendments made by this section shall apply to levies
issued after the date of the enactment of this Act.