WASHINGTON, D.C. — U.S. Senators Tom Udall and Martin Heinrich introduced bipartisan legislation to improve patient access to podiatrists in Medicaid and improve care for patients with diabetes who need therapeutic shoes via Medicare. The Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians (HELLPP) Act would recognize podiatrists as physicians under Medicaid as they are defined under Medicare. 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. In New Mexico, more than 230,000 adults have diabetes and an estimated 620,000 adults have prediabetes, a condition that precedes type 2 diabetes.
“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,” said Udall. “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,” said Heinrich. “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 bill would also 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 providing 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 copy of the bill is available here.