HELLPP Act

I 117TH CONGRESS 1ST SESSION H. R. 2972 To amend title XIX of the Social Security Act to cover physician services delivered by podiatric physicians to ensure access by Medicaid bene- ficiaries 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 MAY 4, 2021 Ms. DEGETTE (for herself and Mr. JOHNSON of Ohio) introduced the fol- lowing bill; which was referred to the Committee on Energy and Com- merce, and in addition to the Committee on Ways and Means, for a pe- riod to be subsequently determined by the Speaker, in each case for con- sideration of such provisions as fall within the jurisdiction of the com- mittee 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 Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 03:05 Jun 18, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2972.IH H2972 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 2972 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Helping Ensure Life- 2 and Limb-saving access to Podiatric Physicians Act’’ or 3 the ‘‘HELLPP Act’’. 4 SEC. 2. RECOGNIZING DOCTORS OF PODIATRIC MEDICINE 5 AS PHYSICIANS UNDER THE MEDICAID PRO- 6 GRAM. 7 (a) IN GENERAL.—Section 1905(a)(5)(A) of the So- 8 cial Security Act (42 U.S.C. 1396d(a)(5)(A)) is amended 9 by striking ‘‘section 1861(r)(1)’’ and inserting ‘‘para- 10 graphs (1) and (3) of section 1861(r)’’. 11 (b) EFFECTIVE DATE.— 12 (1) IN GENERAL.—Except as provided in para- 13 graph (2), the amendment made by subsection (a) 14 shall apply to services furnished on or after January 15 1, 2022. 16 (2) EXTENSION OF EFFECTIVE DATE FOR 17 STATE LAW AMENDMENT.—In the case of a State 18 plan under title XIX of the Social Security Act (42 19 U.S.C. 1396 et seq.) which the Secretary of Health 20 and Human Services determines requires State legis- 21 lation in order for the plan to meet the additional 22 requirement imposed by the amendment made by 23 subsection (a), the State plan shall not be regarded 24 as failing to comply with the requirements of such 25 title solely on the basis of its failure to meet these 26 VerDate Sep 11 2014 03:05 Jun 18, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2972.IH H2972 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 2972 IH additional requirements before the first day of the 1 first calendar quarter beginning after the close of 2 the first regular session of the State legislature that 3 begins after the date of enactment of this Act. For 4 purposes of the previous sentence, in the case of a 5 State that has a 2-year legislative session, each year 6 of the session is considered to be a separate regular 7 session of the State legislature. 8 SEC. 3. CLARIFYING MEDICARE DOCUMENTATION RE- 9 QUIREMENTS FOR THERAPEUTIC SHOES FOR 10 PERSONS WITH DIABETES. 11 (a) IN GENERAL.—Section 1861(s)(12) of the Social 12 Security Act (42 U.S.C. 1395x(s)(12)) is amended to read 13 as follows: 14 ‘‘(12) subject to section 4072(e) of the Omni- 15 bus Budget Reconciliation Act of 1987, extra-depth 16 shoes with inserts or custom molded shoes with in- 17 serts (in this paragraph referred to as ‘therapeutic 18 shoes’) for an individual with diabetes, if— 19 ‘‘(A) the physician who is managing the in- 20 dividual’s diabetic condition— 21 ‘‘(i) documents that the individual has 22 diabetes; 23 VerDate Sep 11 2014 03:05 Jun 18, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2972.IH H2972 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 2972 IH ‘‘(ii) certifies that the individual is 1 under a comprehensive plan of care related 2 to the individual’s diabetic condition; and 3 ‘‘(iii) documents agreement with the 4 prescribing podiatrist or other qualified 5 physician (as established by the Secretary) 6 that it is medically necessary for the indi- 7 vidual to have therapeutic shoes; 8 ‘‘(B) the therapeutic shoes are prescribed 9 by a podiatrist or other qualified physician (as 10 established by the Secretary) who— 11 ‘‘(i) examines the individual and de- 12 termines the medical necessity for the indi- 13 vidual to receive the therapeutic shoes; and 14 ‘‘(ii) communicates in writing the 15 medical necessity to a certifying doctor of 16 medicine or osteopathy for the individual 17 to have therapeutic shoes along with find- 18 ings that the individual has peripheral neu- 19 ropathy with evidence of callus formation, 20 a history of pre-ulcerative calluses, a his- 21 tory of previous ulceration, foot deformity, 22 previous amputation, or poor circulation; 23 and 24 VerDate Sep 11 2014 03:05 Jun 18, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2972.IH H2972 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 2972 IH ‘‘(C) the therapeutic shoes are fitted and 1 furnished by a podiatrist or other qualified sup- 2 plier individual (as established by the Sec- 3 retary), such as a pedorthist or orthotist, who 4 is not the physician described in subparagraph 5 (A) (unless the Secretary finds that the physi- 6 cian is the only such qualified individual in the 7 area);’’. 8 (b) EFFECTIVE DATE.—The amendment made by 9 subsection (a) shall apply with respect to items and serv- 10 ices furnished on or after January 1, 2022. 11 (c) RULE OF CONSTRUCTION.—Nothing in this sec- 12 tion shall be construed as expanding Medicare coverage 13 for therapeutic shoes for individuals with diabetes. 14 SEC. 4. BUDGET SAVINGS: STRENGTHENING MEDICAID 15 PROGRAM INTEGRITY THROUGH CONTIN- 16 UOUS LEVY ON PAYMENTS TO MEDICAID 17 PROVIDERS AND SUPPLIERS. 18 (a) IN GENERAL.—Section 6331(h)(2) of the Inter- 19 nal Revenue Code of 1986 (defining specified payment) 20 is amended by striking ‘‘and’’ at the end of subparagraph 21 (B), by striking the period at the end of subparagraph 22 (C) and inserting ‘‘, and’’, and by adding at the end the 23 following new subparagraph: 24 VerDate Sep 11 2014 03:05 Jun 18, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2972.IH H2972 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 2972 IH ‘‘(D) any payment to any Medicaid pro- 1 vider or supplier under a State plan under title 2 XIX of the Social Security Act.’’. 3 (b) EFFECTIVE DATE.—The amendments made by 4 this section shall apply to levies issued after the date of 5 the enactment of this Act. 6 Æ VerDate Sep 11 2014 03:05 Jun 18, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\H2972.IH H2972 pbinns on DSKJLVW7X2PROD with BILLS