To amend title XVIII to revise the payment methodology under the Medicare Program for extra-depth shoes with inserts or custom molded shoes with inserts for individuals with diabetes.

January 27, 2003

Mr. FOLEY introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

To amend title XVIII to revise the payment methodology under the Medicare Program for extra-depth shoes with inserts or custom molded shoes with inserts for individuals with diabetes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Fair and Equitable Expenses for Treatment Act of 2003'.

SEC. 2. PAYMENT FOR CERTAIN SHOES AND INSERTS UNDER THE FEE SCHEDULE FOR ORTHOTICS AND PROSTHETICS.

(a) IN GENERAL- Section 1833(o) of the Social Security Act (42 U.S.C. 1395l(o)) is amended--

(1) in paragraph (1), by striking `no more than the limits established under paragraph (2)' and inserting `no more than the amount of payment applicable under paragraph (2)'; and

(2) in paragraph (2), to read as follows:

`(2)(A) Except as provided by the Secretary under subparagraphs (B) and (C), the amount of payment under this paragraph for custom molded shoes, extra depth shoes, and inserts shall be the amount determined for such items by the Secretary under section 1834(h).

`(B) The Secretary or a carrier may establish payment amounts for shoes and inserts that are lower than the amount established under section 1834(h) if the Secretary finds that shoes and inserts of an appropriate quality are readily available at or below the amount established under such section.

`(C) In accordance with procedures established by the Secretary, an individual entitled to benefits with respect to shoes described in section 1861(s)(12) may substitute modification of such shoes instead of obtaining one (or more, as specified by the Secretary) pair of inserts (other than the original pair of inserts with respect to such shoes). In such case, the Secretary shall substitute, for the payment amount established under section 1834(h), a payment amount that the Secretary estimates will assure that there is no net increase in expenditures under this subsection as a result of this subparagraph.'.

(b) CONFORMING AMENDMENT- Section 1834(h)(4)(C) of such Act (42 U.S.C. 1395m(h)(4)(C)) is amended by inserting `(and includes shoes described in section 1861(s)(12))' after `in section 1861(s)(9)'.

(c) EFFECTIVE DATE- The amendments made by this section shall apply to items furnished on or after January 1, 2004.

END