,i  #aad? ,,congress  #a/ ,session  ,h4 
,r4 #abba  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #c1 #bjae ,mrs4  
,ellm]s ( ,nor? ,c>ol9a 7= h]self1 ,ms4 
,de,gette1 & ,mr4 ,w5/rup7 introduc$ !  
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,en]gy & ,comm]ce1 & 9    
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d title ,,xix ( !       
,social ,security ,act to cov] physician
 s]vices deliv]$ by podiatric physicians
 to ensure access by ,m$icaid           
b5efici>ies to appropriate quality foot 
& ankle c>e1 to am5d title ,,xviii ( su*
 ,act to modify ! requirem5ts = diabetic
 %oes to be includ$ "u ,m$ic>e1 & = o!r 
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,help+ ,ensure ,life- &    
,limb-,sav+ ,access to ,podiatric       
,physicians ,act or ! ,,hellpp ,act4    
#b4 ,recogniz+ doctors ( podiatric      

m$ic9e z physicians "u ! m$icaid program
  7a7 ,9 g5]al ,section                 
#aije7;a77#e77;,a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acif;d7a77#e77;,a77 is am5d$ by /rik+  
section #ahfa7r77#a7 & ins]t+ p>agraphs 
7#a7 & 7#c7 ( section #ahfa7r74  7b7    
,effective date  7#a7 ,9 g5]al ,except z
 provid$ 9 p>agraph 7#b71 ! am5dm5t made
 by subsection 7a7 %all apply to s]vices
 furni%$ on or aft] ,janu>y #a1 #bjaf4  
7#b7 ,ext5sion ( effective date = ,/ate 
law am5dm5t ,9 ! case ( a ,/ate plan "u 
title ,,xix ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acif et seq47 :i* !     
,secret>y ( ,heal? & ,human ,s]vices    
det]m9es requires ,/ate legislation 9   
ord] = ! plan to meet ! additional      
requirem5t impos$ by ! am5dm5t made by  
subsection 7a71 ! ,/ate plan %all n be  
reg>d$ z fail+ to comply ) ! requirem5ts
 ( su* title solely on ! basis ( its    
failure to meet ^! additional           
requirem5ts be=e ! fir/ day ( ! fir/    
cal5d> qu>t] beg9n+ aft] ! close ( !    

fir/ regul> session ( ! ,/ate           
legislature t beg9s aft] ! date (       
enactm5t ( ?is ,act4 ,= purposes ( !    
previ\s s5t5ce1 9 ! case ( a ,/ate t has
 a #b-ye> legislative session1 ea* ye> (
 ! session is consid]$ to be a sep>ate  
regul> session ( ! ,/ate legislature4   
#c4 ,cl>ify+ m$ic>e docum5tation        
requirem5ts = !rapeutic %oes = p]sons ) 
diabetes  7a7 ,9 g5]al ,section         
#ahfa7s77#ab7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciex7s77#ab77 is am5d$
 to read z foll[s3  7#ab7 subject to    
section #djgb7;e7 ( ! ,omnibus ,budget  
,reconciliation ,act ( #aihg1 extra-dep?
 %oes ) ins]ts or cu/om mold$ %oes )    
ins]ts 79 ?is p>agraph ref]r$ to z      
!rapeutic %oes7 = an individual )       
diabetes1 if--  7,a7 ! physician :o is  
manag+ ! individual's diabetic          
condition-- 7i7 docum5ts t ! individual 
has diabetes2  7ii7 c]tifies t !        
individual is "u a compreh5sive plan (  
c>e relat$ to ! individual's diabetic   
condition2 &  7iii7 docum5ts agreem5t ) 

! prescrib+ podiatri/ or o!r qualifi$   
physician 7z e/abli%$ by ! ,secret>y7 t 
x is m$ically necess>y = ! individual to
 h !rapeutic %oes2  7,b7 ! !rapeutic    
%oes are prescrib$ by a podiatri/ or o!r
 qualifi$ physician 7z e/abli%$ by !    
,secret>y7 :o-- 7i7 exam9es ! individual
 & det]m9es ! m$ical necessity = !      
individual to receive ! !rapeutic %oes2 
&  7ii7 communicates 9 writ+ ! m$ical   
necessity to a c]tify+ doctor ( m$ic9e  
or o/eopa?y = ! individual to h         
!rapeutic %oes along ) f9d+s t !        
individual has p]iph]al neuropa?y )     
evid5ce ( callus =mation1 a hi/ory (    
pre-ulc]ative calluses1 a hi/ory (      
previ\s ulc]ation1 foot de=mity1 previ\s
 amputation1 or poor circulation2 &     
7,c7 ! !rapeutic %oes are fitt$ &       
furni%$ by a podiatri/ or o!r qualifi$  
suppli] individual 7z e/abli%$ by !     
,secret>y71 su* z a p$or?i/ or or?oti/1 
:o is n ! physician describ$ 9          
subp>agraph 7,a7 7unless ! ,secret>y    
f9ds t ! physician is ! only su*        

qualifi$ individual 9 ! area72  4  7b7  
,effective date ,! am5dm5t made by      
subsection 7a7 %all apply ) respect to  
items & s]vices furni%$ on or aft]      
,janu>y #a1 #bjaf4  7c7 ,rule (         
con/ruction ,no?+ 9 ?is section %all be 
con/ru$ z exp&+ ,m$ic>e cov]age =       
!rapeutic %oes = individuals ) diabetes4
  #d4 ,budget sav+s3 /r5g!n+ ,m$icaid   
program integrity ?r\gh cont9u\s levy on
 paym5ts to ,m$icaid provid]s & suppli]s
  7a7 ,9 g5]al ,section #fcca7;h77#b7 ( 
! ,int]nal ,rev5ue ,code ( #aihf 7def9+ 
specifi$ paym5t7 is am5d$ by /rik+ & at 
! end ( subp>agraph 7,b71 by /rik+ !    
p]iod at ! end ( subp>agraph 7,c7 &     
ins]t+ 1 &1 & by add+ at ! end ! foll[+ 
new subp>agraph3  7,d7 any paym5t to any
 ,m$icaid provid] or suppli] "u a ,/ate 
plan "u title ,,xix ( ! ,social         
,security ,act4  4  7b7 ,effective date 
,! am5dm5ts made by ?is section %all    
apply to levies issu$ aft] ! date ( !   
enactm5t ( ?is ,act4