WASHINGTON – Sen. Chuck Grassley of Iowa and Sen. Chuck Schumer of New York today re-introduced legislation to improve patient access to podiatrists in Medicaid and improve care for patients with diabetes who need therapeutic shoes via Medicare.
“Foot and ankle health is important to individual health,” Grassley said. “Maintaining mobility helps people exercise, which prevents other health-related problems, and helps to prevent falls, which cause dangerous injury. Good care increases the ability of patients to live without pain. Getting the right care for diabetes is critical to avoiding worst case scenarios such as loss of limb. Wherever we can, Congress ought to make sure Medicaid and Medicare reflect the modern practice of medicine. That’s what our bill does for foot and ankle care.”
Schumer said, “Increasing access to specialized doctors, including podiatrists, for individuals on Medicaid and providing the kinds of health accessories, like therapeutic shoes, for Medicare beneficiaries with diabetes are both prime examples of ways we can improve health care for patients with specific needs, while realizing saving through prevention. Enhancing this kind of access for unique health requirements is often overlooked and it should not be. This bill will help us address this void so that we can bring these beneficiaries the quality foot and therapeutic health care they need as soon as possible.”
The Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians (HELLPP) Act would recognize podiatrists as physicians under Medicaid. For decades, Medicare has defined doctors of podiatric medicine as “physicians.” But this is not the case in Medicaid. The bill would bring Medicaid in line with Medicare (and a majority of U.S. health-care delivery systems) and ensure that Medicaid patients have access to a range of options presented by the physicians who are best trained for the foot and ankle care they seek.
The bill would clarify and improve the coordination of care in Medicare’s Therapeutic Shoe Program for patients with diabetes. The current processes and Medicare contractor requirements for determining eligibility for Medicare’s Therapeutic Shoe Program for patients with diabetes, and for furnishing this medically necessary benefit, are unnecessarily burdensome and frequently bogged down, leading to frustration on the part of the certifying physician, prescribing doctor, and supplier. The clarifications in the legislation would remove confusion and regulatory inconsistencies in the provision of this medically necessary benefit.
The bill would strengthen Medicaid program integrity by closing a loophole that allows tax-delinquent Medicaid providers to still receive full Medicaid reimbursements. This provision would save the Medicaid system money and more than offset any additional federal budget costs associated with the recognition of podiatrists as physicians under Medicaid. Such a mechanism already exists in Medicare so this could save billions of dollars for the public health care system.
A companion bill is being introduced today in the House of Representatives.
Grassley and Schumer are members of the Finance Committee, with jurisdiction over Medicare and Medicaid. Grassley is former chairman.
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