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