Sec. 414. Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians
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Section 1905(a)(5)(A) of the Social Security Act ( 42 U.S.C. 1396d(a)(5)(A) ) is amended by striking section 1861(r)(1) and inserting paragraphs
(1)and
(3)of section 1861(r) . Except as provided in subparagraph (B), the amendment made by paragraph
(1)shall apply to services furnished on or after the date of enactment of this Act. In the case of a State plan under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) 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 paragraph (1), 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 Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session is considered to be a separate regular session of the State legislature. Section 1861(s)(12) of the Social Security Act ( 42 U.S.C. 1395x(s)(12) ) is amended to read as follows: subject to section 4072(e) of the Omnibus Budget Reconciliation Act of 1987, extra-depth shoes with inserts or custom molded shoes (in this paragraph referred to as therapeutic shoes ) with inserts for an individual with diabetes, if— the physician who is managing the individual’s diabetic condition— documents that the individual has diabetes; certifies that the individual is under a comprehensive plan of care related to the individual’s diabetic condition; and documents agreement with the prescribing podiatrist or other qualified physician (as established by the Secretary) that it is medically necessary for the individual to have such extra-depth shoes with inserts or custom molded shoes with inserts; the therapeutic shoes are prescribed by a podiatrist or other qualified physician (as established by the Secretary) who— examines the individual and determines the medical necessity for the individual to receive the therapeutic shoes; and communicates in writing the medical necessity to the physician described in subparagraph
(A)for the individual to have therapeutic shoes along with findings that the individual has peripheral neuropathy with evidence of callus formation, a history of pre-ulcerative calluses, a history of previous ulceration, foot deformity, previous amputation, or poor circulation; and the therapeutic shoes are fitted and furnished by a podiatrist or other qualified supplier (as established by the Secretary), such as a pedorthist or orthotist, who is not the physician described in subparagraph
(A)(unless the Secretary finds that the physician is the only such qualified individual in the area); . The amendment made by paragraph
(1)shall apply with respect to items and services furnished on or after January 1, 2015.
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Sec. 414
Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians
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