Chuck Grassley

United States Senator from Iowa





Grassley, Stabenow, Cotton, Udall, Heinrich, Brown, Introduce Bill to Increase Access to Podiatrists in Medicaid, Improved Care in Medicare

Jul 12, 2017

WASHINGTON – Sen. Chuck Grassley, Sen. Debbie Stabenow, Sen. Tom Cotton, Sen. Tom Udall, Sen. Martin Heinrich and Sen. Sherrod Brown today introduced bipartisan 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 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 serious complications such as loss of limb or even death.  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.”

“People in Michigan rely on quality foot and ankle care to keep moving and stay healthy,” Stabenow said.  “This bill will make it easier for patients to access the doctors and care they need and for seniors with diabetes who rely on therapeutic shoes to stay mobile.”

“Diabetes is a significant health issue in New Mexico and we need to ensure New Mexicans suffering from diabetes have access to the care they need to treat this lifelong disease,” Udall said. “Many New Mexicans rely on Medicaid — especially in rural communities — and the HELLPP Act is a commonsense solution to ensuring our Medicaid patients suffering from diabetes are getting the specialty care they need to help them live their lives with less pain, and improve their health overall.”

“New Mexico has one of the highest rates of diabetes in the country. Providing treatment for diabetes requires a comprehensive approach to help prevent other health-related problems,” Heinrich said. “Improving access to podiatric care for patients with diabetes is fundamental to overall health, and results in less time spent in treatment and reduces health care costs.”

The Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians (HELLPP) Act, S. 1533, 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.
The bill text is available here.