[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1221 Introduced in House (IH)]

114th CONGRESS
  1st Session
                                H. R. 1221

   To amend title XIX of the Social Security Act to cover physician 
services delivered by podiatric physicians to ensure access by Medicaid 
  beneficiaries to appropriate quality foot and ankle care, to amend 
 title XVIII of such Act to modify the requirements for diabetic shoes 
         to be included under Medicare, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 3, 2015

   Mrs. Ellmers of North Carolina (for herself, Ms. DeGette, and Mr. 
  Wenstrup) introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
   Ways and Means, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
   To amend title XIX of the Social Security Act to cover physician 
services delivered by podiatric physicians to ensure access by Medicaid 
  beneficiaries to appropriate quality foot and ankle care, to amend 
 title XVIII of such Act to modify the requirements for diabetic shoes 
         to be included under Medicare, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Helping Ensure Life- and Limb-Saving 
Access to Podiatric Physicians Act'' or the ``HELLPP Act''.

SEC. 2. RECOGNIZING DOCTORS OF PODIATRIC MEDICINE AS PHYSICIANS UNDER 
              THE MEDICAID PROGRAM.

    (a) In General.--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) Effective Date.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendment made by subsection (a) shall apply to services 
        furnished on or after January 1, 2016.
            (2) Extension of effective date for state law amendment.--
        In 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.

SEC. 3. CLARIFYING MEDICARE DOCUMENTATION REQUIREMENTS FOR THERAPEUTIC 
              SHOES FOR PERSONS WITH DIABETES.

    (a) In General.--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 with inserts (in this paragraph referred to 
        as `therapeutic shoes') 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 therapeutic shoes;
                    ``(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) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to items and services furnished on or after January 
1, 2016.
    (c) Rule of Construction.--Nothing in this section shall be 
construed as expanding Medicare coverage for therapeutic shoes for 
individuals with diabetes.

SEC. 4. BUDGET SAVINGS: STRENGTHENING MEDICAID PROGRAM INTEGRITY 
              THROUGH CONTINUOUS LEVY ON PAYMENTS TO MEDICAID PROVIDERS 
              AND SUPPLIERS.

    (a) In General.--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) Effective Date.--The amendments made by this section shall 
apply to levies issued after the date of the enactment of this Act.
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