HOUSE BILL REPORT

                      HB 2753

                     As Reported By House Committee on:

                                Health Care

Title:  An act relating to public assistance medical care for treatment of ailments of the human foot.

Brief Description:  Defining coverage by state funded programs that provide foot care services.

Sponsor(s):  Representatives Prentice, D. Sommers, Day, Edmondson, Nelson, Franklin, Morris, H. Myers, Fuhrman, Nealey, Cantwell, Belcher, Fraser, Silver, Ebersole, Wilson, Miller, Braddock, Ballard, Brumsickle, Paris, Winsley, Brough, McLean, Mitchell and Brekke.

Brief History:

   Reported by House Committee on:

Health Care, February 6, 1992, DP.

HOUSE COMMITTEE ON

HEALTH CARE

Majority Report: Do pass.  Signed by 8 members:  Representatives Day, Vice Chair; Moyer, Ranking Minority Member; Casada, Assistant Ranking Minority Member; Cantwell; Edmondson; Morris; Paris; and Prentice.

Minority Report: Do not pass.  Signed by 2 members:  Representatives Braddock, Chair and Sprenkle.

Staff:  John Welsh (786-7133).

Background:  The state Medical Assistance program consists of the federal aid medical care program provided to categorically needy persons under Title XIX of the federal Social Security Act (Medicaid), as well as medically needy persons who are without income or resources sufficient to secure necessary medical services, including general assistance recipients and recipients of alcohol and drug addiction services.

The Department of Social and Health Services administers the program and purchases medical care services. The department determines the amount, scope, and duration of services provided, except that routine foot care shall not be included unless there is a specific appropriation for these services.

The treatment of the foot falls within the scopes of practice of physicians, osteopathic physicians and podiatric physicians.

Summary of Bill:  There is a legislative finding that treatment of foot conditions by podiatric physicians is cost-effective, and a declaration of legislative intent that state-funded services include coverage by podiatric physicians on the same terms and conditions as other physicians providing foot care services.

When the treatment of the human foot is a treatment covered under the state medical assistance program, the treatment shall be performed by podiatric physicians, physicians and osteopathic physicians.

Fiscal Note:  Requested January 29, 1992.

Effective Date:  Ninety days after adjournment of the session in which bill is passed.

Testimony For:  The purpose of the bill is to require the department to recognize under the state medical assistance programs the services of podiatric physicians who specialize in the treatment of foot conditions. The department's budget excludes coverage of treatment by these practitioners allegedly to save costs. This is illusory because patients needing treatment would only shift to other physicians. The department is not eliminating a treatment, only a provider group. This is not only inequitable for podiatric physicians but accomplishes nothing in way of cost savings.

Testimony Against:  Federal law does not mandate the services of podiatric physicians under Medicaid.  The decision to cut podiatrists from the program would save the state money. It affects some 1,600 adults monthly, involving 170 podiatrists. However, eligible elderly persons and children under the federal Medicare program would continue to receive these services.

Witnesses:  Jim Peterson, Department of Social and Health Services (con); and Frank Morrison, Washington State Podiatric Medical Association (pro).