APMA Pushes For Medicaid Bill To Define DPMs As Physicians

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By Brian McCurdy, Associate Editor

Podiatrists looking for an even playing field when it comes to Medicaid reimbursement may be interested in a resolution that is making its way through the House of Representatives. As this issue went to press, Congress is considering a resolution to expand the definition of “physician”in the Medicaid program. House Resolution 2959 would amend Title XIX of the Social Security Act to include podiatrists as physicians in Medicaid, making it consistent with Medicare’s definition of physicians. Physician is now defined by Medicaid as MDs and DOs.
The American Podiatric Medical Association (APMA) lobbied for the change, according to APMA President-Elect Lloyd Smith, DPM. As the association notes, if the resolution passes, state podiatric bodies will no longer have to fight Medicaid on this issue in state legislatures.
Dr. Smith says the resolution would be “historic legislation.” He notes that with the redefinition, “(reimbursement for) podiatrists would no longer be (considered) optional and, as a result, all state Medicaid programs would need to allow patients access to DPMs in the same manner as they do for MDs and DOs.”
Stephen Monaco, DPM, explains that, under the current statutes, if a patient has Medicare as a primary insurer and Medicaid as a secondary insurer, Medicare would cover podiatric services but Medicaid can deny such payments. If Medicaid redefines physician, Dr. Monaco notes DPMs will get paid for their services regardless of whether Medicaid is listed as a primary or secondary insurer.
“It appears discriminatory to deny payments for a covered service (in the Medicaid system) based upon the provider’s degree,” explains Dr. Monaco.
The resolution, introduced in the House in July, has been referred to the Subcommittee on Health. The APMA is seeking a sponsor for a companion bill in the Senate.

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