II 118TH CONGRESS 1ST SESSION S. 1367 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 SENATE OF THE UNITED STATES APRIL 27, 2023 Ms. STABENOW (for herself and Mr. YOUNG) introduced the following bill; which was read twice and referred to the Committee on Finance 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 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Helping Ensure Life- 4 and Limb-saving access to Podiatric Physicians Act’’ or 5 the ‘‘HELLPP Act’’. 6 VerDate Sep 11 2014 02:43 May 05, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1367.IS S1367 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •S 1367 IS SEC. 2. RECOGNIZING DOCTORS OF PODIATRIC MEDICINE 1 AS PHYSICIANS UNDER THE MEDICAID PRO- 2 GRAM. 3 (a) IN GENERAL.—Section 1905(a)(5)(A) of the So- 4 cial Security Act (42 U.S.C. 1396d(a)(5)(A)) is amended 5 by striking ‘‘section 1861(r)(1)’’ and inserting ‘‘para- 6 graphs (1) and (3) of section 1861(r)’’. 7 (b) EFFECTIVE DATE.— 8 (1) IN GENERAL.—Except as provided in para- 9 graph (2), the amendment made by subsection (a) 10 shall apply to services furnished on or after January 11 1, 2024. 12 (2) EXTENSION OF EFFECTIVE DATE FOR 13 STATE LAW AMENDMENT.—In the case of a State 14 plan under title XIX of the Social Security Act (42 15 U.S.C. 1396 et seq.) which the Secretary of Health 16 and Human Services determines requires State legis- 17 lation in order for the plan to meet the additional 18 requirement imposed by the amendment made by 19 subsection (a), the State plan shall not be regarded 20 as failing to comply with the requirements of such 21 title solely on the basis of its failure to meet these 22 additional requirements before the first day of the 23 first calendar quarter beginning after the close of 24 the first regular session of the State legislature that 25 begins after the date of enactment of this Act. For 26 VerDate Sep 11 2014 02:43 May 05, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1367.IS S1367 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •S 1367 IS purposes of the previous sentence, in the case of a 1 State that has a 2-year legislative session, each year 2 of the session is considered to be a separate regular 3 session of the State legislature. 4 SEC. 3. CLARIFYING MEDICARE DOCUMENTATION RE- 5 QUIREMENTS FOR THERAPEUTIC SHOES FOR 6 PERSONS WITH DIABETES. 7 (a) IN GENERAL.—Section 1861(s)(12) of the Social 8 Security Act (42 U.S.C. 1395x(s)(12)) is amended to read 9 as follows: 10 ‘‘(12) subject to section 4072(e) of the Omni- 11 bus Budget Reconciliation Act of 1987, extra-depth 12 shoes with inserts or custom molded shoes with in- 13 serts (in this paragraph referred to as ‘therapeutic 14 shoes’) for an individual with diabetes, if— 15 ‘‘(A) the physician who is managing the in- 16 dividual’s diabetic condition— 17 ‘‘(i) documents that the individual has 18 diabetes; 19 ‘‘(ii) certifies that the individual is 20 under a comprehensive plan of care related 21 to the individual’s diabetic condition; and 22 ‘‘(iii) documents agreement with the 23 prescribing podiatrist or other qualified 24 physician (as established by the Secretary) 25 VerDate Sep 11 2014 02:43 May 05, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1367.IS S1367 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •S 1367 IS that it is medically necessary for the indi- 1 vidual to have therapeutic shoes; 2 ‘‘(B) the therapeutic shoes are prescribed 3 by a podiatrist or other qualified physician (as 4 established by the Secretary) who— 5 ‘‘(i) examines the individual and de- 6 termines the medical necessity for the indi- 7 vidual to receive the therapeutic shoes; and 8 ‘‘(ii) communicates in writing the 9 medical necessity to a certifying doctor of 10 medicine or osteopathy for the individual 11 to have therapeutic shoes along with find- 12 ings that the individual has peripheral neu- 13 ropathy with evidence of callus formation, 14 a history of pre-ulcerative calluses, a his- 15 tory of previous ulceration, foot deformity, 16 previous amputation, or poor circulation; 17 and 18 ‘‘(C) the therapeutic shoes are fitted and 19 furnished by a podiatrist or other qualified sup- 20 plier individual (as established by the Sec- 21 retary), such as a pedorthist or orthotist, who 22 is not the physician described in subparagraph 23 (A) (unless the Secretary finds that the physi- 24 VerDate Sep 11 2014 02:43 May 05, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1367.IS S1367 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •S 1367 IS cian is the only such qualified individual in the 1 area);’’. 2 (b) EFFECTIVE DATE.—The amendment made by 3 subsection (a) shall apply with respect to items and serv- 4 ices furnished on or after January 1, 2024. 5 (c) RULE OF CONSTRUCTION.—Nothing in this sec- 6 tion shall be construed as expanding Medicare coverage 7 for therapeutic shoes for individuals with diabetes. 8 SEC. 4. BUDGET SAVINGS: STRENGTHENING MEDICAID 9 PROGRAM INTEGRITY THROUGH CONTIN- 10 UOUS LEVY ON PAYMENTS TO MEDICAID 11 PROVIDERS AND SUPPLIERS. 12 (a) IN GENERAL.—Section 6331(h)(2) of the Inter- 13 nal Revenue Code of 1986 (defining specified payment) 14 is amended by striking ‘‘and’’ at the end of subparagraph 15 (B), by striking the period at the end of subparagraph 16 (C) and inserting ‘‘, and’’, and by adding at the end the 17 following new subparagraph: 18 ‘‘(D) any payment to any Medicaid pro- 19 vider or supplier under a State plan under title 20 XIX of the Social Security Act.’’. 21 (b) EFFECTIVE DATE.—The amendments made by 22 this section shall apply to levies issued after the date of 23 the enactment of this Act. 24 Æ VerDate Sep 11 2014 02:43 May 05, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\S1367.IS S1367 pbinns on DSKJLVW7X2PROD with $$_JOB