APMA partnered with 17 other societies representing providers, patients, and suppliers to send a letter to all four Durable Medical Equipment (DME) Medicare Administrative Contractors (MACs) requesting that they revise "Therapeutic Shoes for Persons with Diabetes – Policy Article" (A52501). The goal is to restore beneficiary access to this important Medicare benefit.
Specifically, the sign-on letter calls on the DME MACs to remove the following duplicative certification:
"Obtain, initial, date (prior to signing the certification statement), and indicate agreement with information from the medical records of an in-person visit with a podiatrist, other M.D or D.O., physician assistant, nurse practitioner, or clinical nurse specialist that is within 6 months prior to delivery of the shoes/inserts, and that documents one of more of criteria a – f."
Elimination of this duplicative step would not compromise program integrity because a statutory requirement would remain for the managing physician to submit a statement certifying the patient's need for diabetic shoes.
This letter is just one way in which APMA is working to address podiatric physicians' frustrations with being unable to provide this service to their patients. While APMA works fix this issue, members should continue to use the comprehensive Documentation Guidelines for the Medicare Therapeutic Shoe Program, which is designed to assist podiatric physicians in meeting the coverage and reimbursement requirements for the Medicare Therapeutic Shoe Program.
Read all advocacy comment letters at www.apma.org/commentletters. Contact the APMA Advocacy Department with any questions, concerns, or feedback.
Join the fight today by becoming a member of APMA at www.apma.org/join!