An analysis of Congressional Budget Office cost estimates of the HELLPP Act as included in SGR repeal and replace legislation.
The current process 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 HELLPP Act would alleviate this problem.
According to the CDC, more than 29 million Americans live with diabetes. Diabetes is the leading cause of non-traumatic lower-limb amputation; however, amputations can be prevented. Two peer-reviewed published studies evaluated care by podiatrists for patients with diabetes and demonstrated that compared to other health-care professionals, podiatrists are best equipped to treat lower extremity complications from diabetes, prevent amputations, reduce hospitalizations and provide savings to our health-care delivery systems.
With the primary objectives of enhancing access to, and quality of, foot and ankle care for our patients, the American Podiatric Medical Association (APMA) advocates on numerous federal legislative and regulatory issues. APMA’s primary federal legislative priorities in the 115th Congress include:
Doctors of podiatric medicine are podiatric physicians and surgeons, qualified by their education, training, and experience to diagnose and treat conditions affecting the foot, ankle, and related structures of the leg.
The Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians (HELLPP) Act (HR 1221/S 626), was introduced in the 114th Congress by US Reps. Renee Ellmers (R-NC) and Diana DeGette (D-CO) in the House and Sens. Chuck Grassley (R-IA) and Charles Schumer (D-NY) in the Senate. Unlike previous DPM access legislation that has focused solely on rectifying the exclusion of podiatrists from Medicaid, the HELLPP Act includes multiple comprehensive reforms and goes further to ensure podiatric physicians will continue to save lives, limbs, and health-care dollars.
Even though foot and ankle care is generally a covered benefit under Medicaid, the program currently teases out a separate podiatry benefit as being “optional” for patients, focusing on the provider of services, rather than ensuring coverage of medically necessary care regardless of the qualified professional furnishing such care. Thus, Medicaid effectively discriminates and can arbitrarily preclude patient access to a licensed and credentialed specialized physician class even though the services they provide—foot and ankle care—are a covered benefit.