I 
118TH CONGRESS 
1ST SESSION H. R. 1634 
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 
MARCH 17, 2023 
Mr. JOHNSON of Ohio (for himself and Ms. DEGETTE) 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-
tives of the United States of America in Congress assembled, 
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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 PRO-
GRAM. 
(a) IN GENERAL.—Section 1905(a)(5)(A) of the So-
cial Security Act (42 U.S.C. 1396d(a)(5)(A)) is amended 
by striking ‘‘section 1861(r)(1)’’ and inserting ‘‘para-
graphs (1) and (3) of section 1861(r)’’. 
(b) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendment made by subsection (a) 
shall apply to services furnished on or after January 
1, 2024. 
(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 legis-
lation 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 
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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 RE-
QUIREMENTS 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 Omni-
bus Budget Reconciliation Act of 1987, extra-depth 
shoes with inserts or custom molded shoes with in-
serts (in this paragraph referred to as ‘therapeutic 
shoes’) for an individual with diabetes, if— 
‘‘(A) the physician who is managing the in-
dividual’s diabetic condition— 
‘‘(i) documents that the individual has 
diabetes; 
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‘‘(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 indi-
vidual 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 de-
termines the medical necessity for the indi-
vidual 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 find-
ings that the individual has peripheral neu-
ropathy with evidence of callus formation, 
a history of pre-ulcerative calluses, a his-
tory of previous ulceration, foot deformity, 
previous amputation, or poor circulation; 
and 
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‘‘(C) the therapeutic shoes are fitted and 
furnished by a podiatrist or other qualified sup-
plier individual (as established by the Sec-
retary), such as a pedorthist or orthotist, who 
is not the physician described in subparagraph 
(A) (unless the Secretary finds that the physi-
cian 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 serv-
ices furnished on or after January 1, 2024. 
(c) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed as expanding Medicare coverage 
for therapeutic shoes for individuals with diabetes. 
SEC. 4. BUDGET SAVINGS: STRENGTHENING MEDICAID 
PROGRAM 
INTEGRITY 
THROUGH 
CONTIN-
UOUS LEVY ON PAYMENTS TO MEDICAID 
PROVIDERS AND SUPPLIERS. 
(a) IN GENERAL.—Section 6331(h)(2) of the Inter-
nal 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: 
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‘‘(D) any payment to any Medicaid pro-
vider 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. 
Æ 
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