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 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 
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 juris-
diction 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. 
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. INCLUDING PODIATRISTS AS PHYSICIANS UNDER 
THE MEDICAID PROGRAM. 
(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, 2014. 
(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 
additional requirements before the first day of the 
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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. MODIFICATIONS TO REQUIREMENTS FOR DIABETIC 
SHOES TO BE INCLUDED UNDER MEDICAL 
AND OTHER HEALTH SERVICES UNDER MEDI-
CARE. 
(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 (in this 
paragraph referred to as ‘therapeutic shoes’) with 
inserts 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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previous amputation, or poor circulation; 
and 
‘‘(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, 2014. 
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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