,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #agfa  ,,in ,,the ,,house ,,of  
,,representatives  ,april #be1 #bjac    
,mr4 ,terry introduced the following    
bill2 which was referred to the         
,committee on ,energy and ,commerce1 and
 in addition to the ,committee on ,ways 
and ,means1 for a period to be          
subsequently determined by the ,speaker1
 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 care1 to amend   
title ,,xviii of such ,act to modify the
 requirements for diabetic shoes to be  
included under ,medicare1 and for other 
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,helping ,ensure    
,life- and ,limb-,saving ,access to     
,podiatric ,physicians ,act or the      

,,hellpp ,act4  #b4 ,including          
podiatrists as physicians under the     
,medicaid program  7a7 ,in general      
,section #aije7;a77#e77;,a7 of the      
,social ,security ,act 7#db ,u4,s4,c4   
#acif;d7a77#e77;,a77 is amended by      
striking section #ahfa7r77#a7 and       
inserting paragraphs 7#a7 and 7#c7 of   
section #ahfa7r74  7b7 ,effective date  
7#a7 ,in general ,except as provided in 
paragraph 7#b71 the amendment made by   
subsection 7a7 shall apply to services  
furnished on or after ,january #a1      
#bjad4  7#b7 ,extension of effective    
date for ,state law amendment ,in the   
case of a ,state plan under title ,,xix 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acif et seq47 which the      
,secretary of ,health and ,human        
,services determines requires ,state    
legislation in order for the plan to    
meet the additional requirement imposed 
by the amendment made by subsection 7a71
 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 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 ,act4 ,for purposes
 of the previous sentence1 in the case  
of a ,state that has a #b-year          
legislative session1 each year of the   
session is considered to be a separate  
regular session of the ,state           
legislature4  #c4 ,modifications to     
requirements for diabetic shoes to be   
included under medical and other health 
services under ,medicare  7a7 ,in       
general ,section #ahfa7s77#ab7 of the   
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7s77#ab77 is amended to read as   
follows3  7#ab7 subject to section      
#djgb7;e7 of the ,omnibus ,budget       
,reconciliation ,act of #aihg1          
extra-depth shoes with inserts or custom
 molded shoes 7in this paragraph        

referred to as therapeutic shoes7 with  
inserts for an individual with diabetes1
 if--  7,a7 the physician who is        
managing the individual's diabetic      
condition--  7i7 documents that the     
individual has diabetes2  7ii7 certifies
 that the individual is under a         
comprehensive plan of care related to   
the individual's diabetic condition2 and
  7iii7 documents agreement with the    
prescribing podiatrist or other         
qualified physician 7as established by  
the ,secretary7 that it is medically    
necessary for the individual to have    
such extra-depth shoes with inserts of  
custom molded shoes with inserts2  7,b7 
the therapeutic shoes are prescribed by 
a podiatrist or other qualified         
physician 7as established by the        
,secretary7 who--  7i7 examines the     
individual and determines the medical   
necessity for the individual to receive 
the therapeutic shoes2 and  7ii7        
communicates in writing the medical     
necessity to a certifying doctor of     

medicine or osteopathy for the          
individual to have therapeutic shoes    
along with findings that the individual 
has peripheral neuropathy with evidence 
of callus formation1 a history of       
pre-ulcerative calluses1 a history of   
previous ulceration1 foot deformity1    
previous amputation1 or poor            
circulation2 and  7,c7 the therapeutic  
shoes are fitted and furnished by a     
podiatrist or other qualified supplier  
individual 7as established by the       
,secretary71 such as a pedorthist or    
orthotist1 who is not the physician     
described in subparagraph 7,a7 7unless  
the ,secretary finds that the physician 
is the only such qualified individual in
 the area72  4  7b7 ,effective date ,the
 amendment made by subsection 7a7 shall 
apply with respect to items and services
 furnished on or after ,january #a1     
#bjad4  #d4 ,budget savings3            
strengthening medicaid program integrity
 through continuous levy on payments to 
medicaid providers and suppliers  7a7   

,in general ,section #fcca7;h77#b7 of   
the ,internal ,revenue ,code of #aihf   
7defining specified payment7 is amended 
by striking and at the end of           
subparagraph 7,b71 by striking the      
period at the end of subparagraph 7,c7  
and inserting 1 and1 and by adding at   
the end the following new subparagraph3 
7,d7 any payment to any medicaid        
provider or supplier under a ,state plan
 under title ,,xix of the ,social       
,security ,act4  4  7b7 ,effective date 
,the amendments made by this section    
shall apply to levies issued after the  
date of the enactment of this ,act4