II 

114TH CONGRESS 

1ST SESSION S. 626 

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 SENATE OF THE UNITED STATES 

MARCH 3, 2015 

Mr. GRASSLEY (for himself and Mr. SCHUMER) 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. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Helping Ensure Life5 and Limb-Saving Access to Podiatric Physicians Act’’ or 

6 the ‘‘HELLPP Act’’. 


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•S 626 IS

1 SEC. 2. RECOGNIZING DOCTORS OF PODIATRIC MEDICINE 

2 AS PHYSICIANS UNDER THE MEDICAID PRO3 GRAM. 

4 (a) IN GENERAL.—Section 1905(a)(5)(A) of the So5 cial Security Act (42 U.S.C. 1396d(a)(5)(A)) is amended 

6 by striking ‘‘section 1861(r)(1)’’ and inserting ‘‘para7 graphs (1) and (3) of section 1861(r)’’. 

8 (b) EFFECTIVE DATE.— 

9 (1) IN GENERAL.—Except as provided in para10 graph (2), the amendment made by subsection (a) 

11 shall apply to services furnished on or after January 

12 1, 2016. 

13 (2) EXTENSION OF EFFECTIVE DATE FOR

14 STATE LAW AMENDMENT.—In the case of a State 

15 plan under title XIX of the Social Security Act (42 

16 U.S.C. 1396 et seq.) which the Secretary of Health 

17 and Human Services determines requires State legis18 lation in order for the plan to meet the additional 

19 requirement imposed by the amendment made by 

20 subsection (a), the State plan shall not be regarded 

21 as failing to comply with the requirements of such 

22 title solely on the basis of its failure to meet these 

23 additional requirements before the first day of the 

24 first calendar quarter beginning after the close of 

25 the first regular session of the State legislature that 

26 begins after the date of enactment of this Act. For 


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1 purposes of the previous sentence, in the case of a 

2 State that has a 2-year legislative session, each year 

3 of the session is considered to be a separate regular 

4 session of the State legislature. 

5 SEC. 3. CLARIFYING MEDICARE DOCUMENTATION RE6 QUIREMENTS FOR THERAPEUTIC SHOES FOR 

7 PERSONS WITH DIABETES. 

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

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

10 as follows: 

11 ‘‘(12) subject to section 4072(e) of the Omni12 bus Budget Reconciliation Act of 1987, extra-depth 

13 shoes with inserts or custom molded shoes with in14 serts (in this paragraph referred to as ‘therapeutic 

15 shoes’) for an individual with diabetes, if— 

16 ‘‘(A) the physician who is managing the in17 dividual’s diabetic condition— 

18 ‘‘(i) documents that the individual has 

19 diabetes; 

20 ‘‘(ii) certifies that the individual is 

21 under a comprehensive plan of care related 

22 to the individual’s diabetic condition; and 

23 ‘‘(iii) documents agreement with the 

24 prescribing podiatrist or other qualified 

25 physician (as established by the Secretary) 


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1 that it is medically necessary for the indi2 vidual to have therapeutic shoes; 

3 ‘‘(B) the therapeutic shoes are prescribed 

4 by a podiatrist or other qualified physician (as 

5 established by the Secretary) who— 

6 ‘‘(i) examines the individual and de7 termines the medical necessity for the indi8 vidual to receive the therapeutic shoes; and 

9 ‘‘(ii) communicates in writing the 

10 medical necessity to a certifying doctor of 

11 medicine or osteopathy for the individual 

12 to have therapeutic shoes along with find13 ings that the individual has peripheral neu14 ropathy with evidence of callus formation, 

15 a history of pre-ulcerative calluses, a his16 tory of previous ulceration, foot deformity, 

17 previous amputation, or poor circulation; 

18 and 

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

20 furnished by a podiatrist or other qualified sup21 plier individual (as established by the Sec22 retary), such as a pedorthist or orthotist, who 

23 is not the physician described in subparagraph 

24 (A) (unless the Secretary finds that the physiVerDate Sep 11 2014 22:24 Mar 10, 2015 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S626.IS S626

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1 cian is the only such qualified individual in the 

2 area);’’. 

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

4 subsection (a) shall apply with respect to items and serv5 ices furnished on or after January 1, 2016. 

6 (c) RULE OF CONSTRUCTION.—Nothing in this sec7 tion shall be construed as expanding Medicare coverage 

8 for therapeutic shoes for individuals with diabetes. 

9 SEC. 4. BUDGET SAVINGS: STRENGTHENING MEDICAID 

10 PROGRAM INTEGRITY THROUGH CONTIN11 UOUS LEVY ON PAYMENTS TO MEDICAID 

12 PROVIDERS AND SUPPLIERS. 

13 (a) IN GENERAL.—Section 6331(h)(2) of the Inter14 nal Revenue Code of 1986 (defining specified payment) 

15 is amended by striking ‘‘and’’ at the end of subparagraph 

16 (B), by striking the period at the end of subparagraph 

17 (C) and inserting ‘‘, and’’, and by adding at the end the 

18 following new subparagraph: 

19 ‘‘(D) any payment to any Medicaid pro20 vider or supplier under a State plan under title 

21 XIX of the Social Security Act.’’. 

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

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

24 the enactment of this Act. 

Æ 


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