SB 537 — An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in public assistance, providing for medical assistance payments for orthotics and prosthetics.

PRINTER'S NO.    558

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                        SENATE BILL
                        No. 537
                                               Session of
                                                 2025

     INTRODUCED BY TARTAGLIONE, J. WARD, FARRY, SCHWANK, CULVER,
        HAYWOOD, FONTANA, COSTA, CAPPELLETTI, PENNYCUICK, SAVAL,
        COLLETT, SANTARSIERO AND MILLER, APRIL 4, 2025

     REFERRED TO HEALTH AND HUMAN SERVICES, APRIL 4, 2025


                                    AN ACT
 1   Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
 2      act to consolidate, editorially revise, and codify the public
 3      welfare laws of the Commonwealth," in public assistance,
 4      providing for medical assistance payments for orthotics and
 5      prosthetics.
 6      The General Assembly of the Commonwealth of Pennsylvania
 7   hereby enacts as follows:
 8      Section 1.    The act of June 13, 1967 (P.L.31, No.21), known
 9   as the Human Services Code, is amended by adding a section to
10   read:
11      Section 443.16.    Medical Assistance Payments for Orthotics
12   and Prosthetics.--(a)    The department shall set a rate of
13   reimbursement under the medical assistance fee-for-service
14   program for custom prosthetic and orthotic items and services at
15   a rate no less than the current quarter's Medicare Durable
16   Medical Equipment, Prosthetics, Orthotics and Supplies Fee
17   Schedule established by the Centers for Medicare and Medicaid
18   Services for these items and services in this Commonwealth.
19      (b)   The department shall update the medical assistance fee-
1   for-service program to include all codes for custom prosthetic
2   and orthotic items and services listed in the current quarter's
3   Medicare Durable Medical Equipment, Prosthetics, Orthotics and
4   Supplies Fee Schedule established by the Centers for Medicare
5   and Medicaid Services.
6      (c)   Nothing in this section shall be construed to supersede
7   the provisions of section 443.6 or the act of December 20, 1985
8   (P.L.457, No.112), known as the "Medical Practice Act of 1985."
9      Section 2.   This act shall take effect in 60 days.




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