I 

113TH CONGRESS 

1ST SESSION H. R. 1761 

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 

APRIL 25, 2013 

Mr. TERRY 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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Helping Ensure Life3 and Limb-Saving Access to Podiatric Physicians Act’’ or 

4 the ‘‘HELLPP Act’’. 

5 SEC. 2. INCLUDING PODIATRISTS AS PHYSICIANS UNDER 

6 THE MEDICAID PROGRAM. 

7 (a) IN GENERAL.—Section 1905(a)(5)(A) of the So8 cial Security Act (42 U.S.C. 1396d(a)(5)(A)) is amended 

9 by striking ‘‘section 1861(r)(1)’’ and inserting ‘‘para10 graphs (1) and (3) of section 1861(r)’’. 

11 (b) EFFECTIVE DATE.— 

12 (1) IN GENERAL.—Except as provided in para13 graph (2), the amendment made by subsection (a) 

14 shall apply to services furnished on or after January 

15 1, 2014. 

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 legis21 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 additional requirements before the first day of the 


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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. MODIFICATIONS TO REQUIREMENTS FOR DIABETIC 

9 SHOES TO BE INCLUDED UNDER MEDICAL 

10 AND OTHER HEALTH SERVICES UNDER MEDI11 CARE. 

12 (a) IN GENERAL.—Section 1861(s)(12) of the Social 

13 Security Act (42 U.S.C. 1395x(s)(12)) is amended to read 

14 as follows: 

15 ‘‘(12) subject to section 4072(e) of the Omni16 bus Budget Reconciliation Act of 1987, extra-depth 

17 shoes with inserts or custom molded shoes (in this 

18 paragraph referred to as ‘therapeutic shoes’) with 

19 inserts for an individual with diabetes, if— 

20 ‘‘(A) the physician who is managing the in21 dividual’s diabetic condition— 

22 ‘‘(i) documents that the individual has 

23 diabetes; 


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1 ‘‘(ii) certifies that the individual is 

2 under a comprehensive plan of care related 

3 to the individual’s diabetic condition; and 

4 ‘‘(iii) documents agreement with the 

5 prescribing podiatrist or other qualified 

6 physician (as established by the Secretary) 

7 that it is medically necessary for the indi8 vidual to have such extra-depth shoes with 

9 inserts of custom molded shoes with in10 serts; 

11 ‘‘(B) the therapeutic shoes are prescribed 

12 by a podiatrist or other qualified physician (as 

13 established by the Secretary) who— 

14 ‘‘(i) examines the individual and de15 termines the medical necessity for the indi16 vidual to receive the therapeutic shoes; and 

17 ‘‘(ii) communicates in writing the 

18 medical necessity to a certifying doctor of 

19 medicine or osteopathy for the individual 

20 to have therapeutic shoes along with find21 ings that the individual has peripheral neu22 ropathy with evidence of callus formation, 

23 a history of pre-ulcerative calluses, a his24 tory of previous ulceration, foot deformity, 


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1 previous amputation, or poor circulation; 

2 and 

3 ‘‘(C) the therapeutic shoes are fitted and 

4 furnished by a podiatrist or other qualified sup5 plier individual (as established by the Sec6 retary), such as a pedorthist or orthotist, who 

7 is not the physician described in subparagraph 

8 (A) (unless the Secretary finds that the physi9 cian is the only such qualified individual in the 

10 area);’’. 

11 (b) EFFECTIVE DATE.—The amendment made by 

12 subsection (a) shall apply with respect to items and serv13 ices furnished on or after January 1, 2014. 

14 SEC. 4. BUDGET SAVINGS: STRENGTHENING MEDICAID 

15 PROGRAM INTEGRITY THROUGH CONTIN16 UOUS LEVY ON PAYMENTS TO MEDICAID 

17 PROVIDERS AND SUPPLIERS. 

18 (a) IN GENERAL.—Section 6331(h)(2) of the Inter19 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: 


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1 ‘‘(D) any payment to any medicaid pro2 vider or supplier under a State plan under title 

3 XIX of the Social Security Act.’’. 

4 (b) EFFECTIVE DATE.—The amendments made by 

5 this section shall apply to levies issued after the date of 

6 the enactment of this Act. 

Æ 


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