The Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians (HELLPP) Act

On April 25, 2013 HR 1761, at the behest of the American Podiatric Medical Association (APMA), and supported by the Pedorthic Footcare Association (PFA) The Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians (HELLPP) Act, was introduced in the U.S. House of Representatives by Congressman Lee Terry (NE-2). Unlike previous DPM access legislation that has focused solely on rectifying the exclusion of podiatrists from Medicaid, the bi-partisan supported HELLPP Act includes multiple comprehensive reforms that will help pedorthists alleviate some of the burden associated with current Medicare documentation requirements.

The HELLPP Act would accomplish three important goals:

■ Clarify and improve coordination of care in Medicare's Therapeutic Shoe Program for Patients with Diabetes (TSD) —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 the pedorthist and other suppliers. These clarifications would allow each member of the collaborative team—MD/DO, DPM, and supplier—to work together more effectively and seamlessly on behalf of diabetic patients, resulting in less patient confusion, less provider frustration, and fewer office visits for the Medicare system.

■ Strengthen Medicaid program integrity—By closing a loophole that allows tax-delinquent Medicaid providers to still receive full Medicaid reimbursements, this provision will save the Medicaid system money and more than offset any additional federal budget costs associated with the inclusion of podiatrists. Such a mechanism already exists in Medicare and could potentially save billions of dollars for the public health-care system.

■ Recognize podiatrists as physicians under Medicaid—A chief goal of APMA’s Vision 2015, recognizing podiatrists as physicians, would finally bring Medicaid into line with Medicare (and a majority of US health-care delivery systems) and ensure Medicaid patients have access to care by the best educated and trained providers of foot and ankle care.

The net result of implementing these changes would be drastic improvements to patient access to quality foot and ankle care and tremendous savings for the Medicaid system.

Currently, the legislation had 65 co-sponsors in the House:

Rep Bachmann, Michele [MN-6]
Rep Barrow, John [GA-12]
Rep Bishop, Sanford D., Jr. [GA-2]
Rep Blumenauer, Earl [OR-3]
Rep Bonamici, Suzanne [OR-1]
Rep Braley, Bruce L. [IA-1]
Rep Brooks, Susan W. [IN-5]
Rep Butterfield, G. K. [NC-1]
Rep Calvert, Ken [CA-42]
Rep Clay, Wm. Lacy [MO-1]
Rep Connolly, Gerald E. [VA-11]
Rep Crawford, Eric A. "Rick" [AR-1]
Rep Davis, Rodney [IL-13]
Rep DeFazio, Peter A. [OR-4]
Rep DeGette, Diana [CO-1]
Rep Dingell, John D. [MI-12]
Rep Enyart, William L. [IL-12]
Rep Frankel, Lois [FL-22]
Rep Franks, Trent [AZ-8]
Rep Garamendi, John [CA-3]
Rep Guthrie, Brett [KY-2]
Rep Hastings, Alcee L. [FL-20]
Rep Heck, Joseph J. [NV-3]
Rep Johnson, Bill [OH-6]
Rep Kildee, Daniel T [MI-5]
Rep Kind, Ron [WI-3]
Rep King, Peter T. [NY-2]
Rep King, Steve [IA-4]
Rep Kuster, Ann M. [NH-2]
Rep Latham, Tom [IA-3]
Rep Loebsack, David [IA-2]
Rep Lofgren, Zoe [CA-19]
Rep Lujan Grisham, Michelle [NM-1]
Rep Matsui, Doris O. [CA-6]
Rep McCollum, Betty [MN-4]
Rep McNerney, Jerry [CA-9]
Rep Moore, Gwen [WI-4]
Rep Moran, James P. [VA-8]
Rep Negrete McLeod, Gloria [CA-35]
Rep Peters, Gary C. [MI-14]
Rep Petri, Thomas E. [WI-6]
Rep Pocan, Mark [WI-2]
Rep Ribble, Reid J. [WI-8]
Rep Roe, David P. [TN-1]
Rep Rogers, Harold [KY-5]
Rep Ruppersberger, C. A. Dutch [MD-2]
Rep Rush, Bobby L. [IL-1]
Rep Sarbanes, John P. [MD-3]
Rep Schakowsky, Janice D. [IL-9]
Rep Schiff, Adam B. [CA-28]
Rep Schrader, Kurt [OR-5]
Rep Scott, David [GA-13]
Rep Shea-Porter, Carol [NH-1]
Rep Slaughter, Louise McIntosh [NY-25]
Rep Speier, Jackie [CA-14]
Rep Swalwell, Eric [CA-15]
Rep Titus, Dina [NV-1]
Rep Tonko, Paul [NY-20]
Rep Tsongas, Niki [MA-3]
Rep Vargas, Juan [CA-51]
Rep Walden, Greg [OR-2]
Rep Wenstrup, Brad R. [OH-2]
Rep Whitfield, Ed [KY-1]
Rep Wilson, Joe [SC-2]
Rep Wittman, Robert J. [VA-1]

A companion bill, S. 1318, was introduced in the Senate by Senator Charles Schumer of New York and currently has seven co-sponsors:

Sen Cardin, Benjamin L. [MD]
Sen Grassley, Chuck [IA]
Sen Harkin, Tom [IA]
Sen Heinrich, Martin [NM]
Sen Merkley, Jeff [OR]
Sen Shaheen, Jeanne [NH]
Sen Stabenow, Debbie [MI]

PFA strongly supports this legislation and needs your help in advancing it. It is absolutely critical that you contact your Member of Congress by letter and/or phone call to request that they sign on as a co-sponsor to this important bill. If you Member has already signed on, please contact their office – again by letter and/or phone call - to thank them for their support and explain the positive impact that it will have on your patients – and their constituents – as well as your ability to continue to provide critical services under the TSD. After you have made contact, please let PFA know of your contact and their response via a quick e-mail message to info@pedorthics.org. If the legislation remains unpassed when the 113rd Congress adjourns later this year, the entire process will need to begin again when the 114^th Congress convenes in January 2015.

To reach your Congressional Representative by phone, dial the House Switchboard at (202) 225-3121 and ask for your Member’s office. To obtain your Member’s office mailing address at the Capitol, visit the House website at http://house.gov/representatives/. To reach your Senator, dial the Senate Switchboard at (202) 224-3121, and ask for your Senator’s office. To obtain your Senator’s office mailing address at the Capitol, visit the Senate website at http://senate.gov/general/contact_information/senators_cfm.cfm

PFA will continue to keep you updated on this important bill as it moves through the legislative process with updates in Current Pedorthics magazine, the PFA website and PFAOnline.