,,ii  #aaith ,,congress  #b;d ,session  
,s4 #djgj  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,march #ab1    
#bjbf,mr4 ,young 7for himself and ,mr4  
,warnock7 introduced the following bill2
 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 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 ,diabetes ,foot     
,health ,access and ,modernization ,act 
of #bjbf4  #b4 ,recognizing doctors of  
podiatric medicine 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      
#bjbf4  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 ,clarifying ,medicare 
documentation requirements for          
therapeutic shoes for persons with      
diabetes  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      
extra-depth shoes with inserts or custom
 molded shoes with inserts for an       
individual with diabetes1 if-- 7,a7 a   
physician as defined in subsection 7r7  
of this section-- 7i7 documents that the
 individual has peripheral neuropathy   
that may include altered foot sensation1
 weakness1 or diminished motor control  
of the lower extremity2 a history of    
pre-ulcerative calluses or other        
ulceration of the foot2 foot deformity1 

previous lower extremity amputation1 or 
poor lower extremity circulation2  7ii7 
attests that the individual has a       
diabetes diagnosis and is under a       
comprehensive plan of care related to   
the individual's diabetic condition2 and
  7iii7 attests that the individual     
needs such shoes2 and  7,b7 the shoes   
are fitted and furnished by a physician 
or other qualified individual 7such as a
 pedorthist or orthotist7 as established
 by the ,secretary2  4  7b7 ,conforming 
amendment ,section #ahgg7;h77#f7 of the 
,social ,security ,act 7#db ,u4,s4,c4   
#acienn7h77#f77 is amended by inserting 
after subparagraph 7,l7 the following3  
7,m7 ,extra-depth shoes with inserts or 
custom molded shoes with inserts4  4    
7c7 ,effective date ,the amendment made 
by subsection 7a7 shall apply with      
respect to items and services furnished 
on or after ,january #a1 #bjbh4