Atlanta, Georgia (February 25, 2015) -- The AFL-CIO Executive Council today issued a statement in support of the Office and Professional Employees International Union (OPEIU)’s doctors of podiatric medicine, calling on Congress to enact legislation amending Title XIX of the Social Security Act governing Medicaid to recognize DPMs as “physicians” in the same manner in which they are recognized in Title XVIII governing Medicare.  The statement also called for amendment of Title XVIII of the Social Security Act governing Medicare to recognize the ability of DPMs to independently certify the need for and prescribe appropriate durable medical equipment within their scope of practice.  The AFL-CIO represents 12 million workers.

Following is the full AFL-CIO Executive Council Statement, adopted at 1:39 p.m. on February 25 at its meeting in Atlanta, Georgia:

AFL-CIO Executive Council Statement

                                                                                                                                                                    Atlanta, Georgia

                                                                                                                                                                         February 2015        

 

Prevent Discrimination Against Doctors of Podiatric Medicine

 The AFL-CIO’s affiliate, the Office and Professional Employees International Union (OPEIU), represents over one-third of the licensed Doctors of Podiatric Medicine (DPMs) who practice in the United States.

DPMs are specialists who treat medical and surgical conditions of the foot and ankle and manifestations of systemic diseases in the foot and ankle.  DPMs are defined as “physicians”, along with Medical Doctors (MDs) and Doctors of Osteopathy (DOs) in Title XVIII of the Social Security Act governing Medicare, but DPMs are not similarly defined as “physicians” in Title XIX of the Social Security Act governing Medicaid. 

Failure to recognize DPMs as “physicians” in Title XIX allows a state to eliminate podiatrists from the state Medicaid program as an “optional” service.  This optional elimination prevents podiatrists from treating patients under Medicaid, thereby causing unnecessary interruption of ongoing care provided by podiatrists and resulting in potential harm and injury to patients.  In 2009, there were only two states in which the state Medicaid program eliminated podiatry as an option.  In 2015, that number of states has grown to eight, including Alabama, Alaska, Arizona, California, Nevada, Kansas, South Carolina and Wyoming.

The ability of a state to eliminate the services of a DPM as an option constitutes discrimination in that the medical services which treat the foot and ankle under Medicaid are not eliminated, but instead just the services of one class of provider is eliminated.  This causes all foot and ankle care to be provided by other, often less qualified, providers.  The transfer of those patients from DPMs to other medical providers potentially increases the cost of treatment and decreases a patient’s access to critically needed medical or surgical care.  This discrimination eliminates the sole unionized providers of these medical services from a government-created, supported and financed national medical program servicing the underprivileged populations of the United States.  This elimination and de facto discrimination prevents Medicaid patients, many of whom are victims of diabetes, from gaining access to DPMs who are union members. 

The Centers for Medicare and Medicaid Services (CMS) further discriminate against DPM’s by failing to recognize the independent ability of DPMs to certify the Medicare beneficiary’s need for durable medical equipment under Title XVIII of the Social Security Act governing Medicare.  The elimination of this discrimination does not expand any current entitlement to durable medical equipment under Medicare.

These discriminations can be abolished by the Congress of the United States by enacting legislation amending Title XIX of the Social Security Act governing Medicaid to recognize DPMs as “physicians” in the same manner in which they are recognized in Title XVIII governing Medicare, and amending Title XVIII of the Social Security Act governing Medicare to recognize the ability of DPMs to independently certify the need for and prescribe appropriate durable medical equipment within their scope of practice.  The AFL-CIO urges Congress to enact such an amendment.