GOVERNMENTAFFAIRS
( 12 ) subject to section 4072 ( e ) of the Omnibus Budget Reconciliation Act of 1987 , extra-depth shoes with inserts or custom molded shoes with inserts for an individual with diabetes , if —
( A ) the physician who is managing the individual ' s diabetic condition ( i ) documents that the individual has peripheral neuropathy with evidence of callus formation , a history of preulcerative calluses , a history of previous ulceration , foot deformity , or previous amputation , or poor circulation , and ( ii ) certifies that the individual needs such shoes under a comprehensive plan of care related to the individual ' s diabetic condition ;
( B ) the particular type of shoes are prescribed by a podiatrist or other qualified physician ( as established by
the Secretary ); and ...
( C ) the shoes are fitted and furnished by a podiatrist or other qualified individual ( such as a pedorthist or orthotist , as established by the Secretary ) who is not the physician described in subparagraph ( A ) ( unless the Secretary finds that the physician is the only such qualified individual in the area );
The change that is proposed by this Act is to add “, nurse practitioner , or physician assistant ” after the word “ physician ” in ( A ) and ( C ). This change would allow a nurse practitioner or physician assistant to conduct the examination , document it and then sign the Statement of Certifying Physician for the patient . This change would represent what truly happens in a primary care physician ’ s office where the doctor often does not do the examination and testing , the care extenders do . In some cases , nurse
46 Pedorthic Footcare Association | www . pedorthics . org