Sec. 3. Clarifying medicare documentation requirements for therapeutic shoes for persons with diabetes
294 words·~1 min read·
/bill/114/s/626/is/section-3A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
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 with inserts (in this paragraph referred to as therapeutic shoes ) 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 therapeutic shoes; 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 a certifying doctor of medicine or osteopathy 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 individual (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 subsection
(a)shall apply with respect to items and services furnished on or after January 1, 2016. Nothing in this section shall be construed as expanding Medicare coverage for therapeutic shoes for individuals with diabetes.
Connectionstraces to 1
Traces to 1 document
U.S. Code
Citation graph
cites case law
Sec. 3
Clarifying medicare documentation requirements for therapeutic shoes for persons with diabetes
Cites 1Cited by 0 across 0 sources