PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2221 Subpart B—Technical and Miscellaneous Provisions SEC. 6131. MODIFICATION OF PAYMENT FOR THERAPEUTIC SHOES FOR INDIVIDUALS WITH SEVERE DIABETIC FOOT DISEASE. (a) PERMITTING ADDITIONAL INSERTS.— (1) IN GENERAL. —Section 1833(o) of the Social Security Act (42 U.S.C. 13951(o)) is amended— (A) by amending subparagraph (A) of paragraph (1) to read as follows: "(A) no payment may be made under this part, with respect to any individual for any year, for the furnishing of— "(i) more than one pair of custom molded shoes (including inserts provided with such shoes) and 2 additional pairs of inserts for such shoes, or "(ii) more than one pair of extra-depth shoes (not includ- ing inserts provided with such shoes) and 3 pairs of inserts ^ for such shoes, and"; (B) in paragraphs (1)(B) and (2)(A), by striking "limit" and inserting "limits"; (C) in the second sentence of paragraph (1), by inserting "(or inserts)" after "shoes" each place it appears; (D) by amending clause (i) of paragraph (2)(A) to read as follows: "(i) for the furnishing of— "(I) one pair of custom molded shoes (including any in- serts that are provided initially with the shoes) is $300, and "(II) any additional pair of inserts with respect to such shoes is $50; and"; and (E) in paragraph (2)(A)(iiXII), by inserting "any pairs of* after "$50 for^'. (2) CONFORMING AMENDMENT. —Section 1861(s)(12) of such Act (42 U.S.C. 1395x(s)(12)) is amended by inserting "with inserts" after "custom molded shoes". (b) PERMITTING SUBSTITUTION OP SHOE MODIFICATIONS FOR IN- SERTS.— Section 1833(o)(2) of such Act is amended by adding at the end the following new subparagraph: "(D) 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) pairs of inserts (other than the original pair of inserts with respect to such shoes). In such case, the Secretary shall substitute, for the limits established under subparagraph (A), such limits as the Secretary estimates will assure that there is no net increase in expenditures K under this subsection as a result of this subparagraph.". (c) EFFECTIVE DATE. — 42 USC 1395/ (1) The amendments made by this section shall apply with ^°^- respect to therapeutic shoes and inserts furnished on or after July 1, 1989. (2) In applying the amendments made by this section, the increase under subparagraph (C) of section 1833(o)(2) of the Social Security Act shall apply to the dollar amounts specified under subparagraph (A) of such section (as amended by this section) in the same manner as the increase would have applied to the dollar amounts specified under subparagraph (A) of such section (as in effect before the date of the enactment of this Act).
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