Diabetes Foot Health Access and Modernization Act of 2026
- Bill Number
- H.R. 7905
- Origin Chamber
- House
- Congress
- 119th Congress, Session 2
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2026-03-12: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-07-10T08:06:15Z
AI-Generated Summary
Purpose
The Diabetes Foot Health Access and Modernization Act of 2026 aims to improve access to foot and ankle care for people with diabetes by expanding coverage under Medicaid and simplifying requirements for diabetic shoes under Medicare. It recognizes podiatric physicians (doctors specializing in foot and ankle conditions) as full physicians for reimbursement purposes and updates documentation rules to make therapeutic footwear more accessible.
Key Provisions
- Medicaid Expansion for Podiatric Services (Section 2):
- Amends the Social Security Act to include Doctors of Podiatric Medicine (DPMs) in the definition of "physicians" for Medicaid-covered services, allowing reimbursement for their foot and ankle care.
- Effective for services provided on or after January 1, 2026.
- Provides states with extra time (until the end of their next legislative session) to update laws if needed, without losing federal compliance.
- Medicare Updates for Diabetic Shoes (Section 3):
- Revises rules for covering extra-depth or custom-molded shoes with inserts for people with diabetes.
- Requires a physician (including DPMs) to document specific conditions, such as peripheral neuropathy (nerve damage causing reduced sensation, weakness, or poor motor control in the legs or feet), history of foot ulcers or calluses, foot deformities, prior amputations, or poor circulation.
- The physician must also confirm a diabetes diagnosis, an ongoing care plan, and the medical need for the shoes.
- Shoes must be fitted by a qualified professional, such as a physician, pedorthist (specialist in foot orthotics), or orthotist (specialist in braces and supports), as defined by the Secretary of Health and Human Services.
- Adds these shoes to the list of items exempt from certain Medicare physician self-referral restrictions (Stark Law).
- Effective for items and services furnished on or after January 1, 2028.
Significant Changes to Existing Law
- Medicaid: Previously, Medicaid's definition of physicians was limited to certain paragraphs of the Medicare definition, excluding full recognition of DPMs. This bill expands it to explicitly include DPMs, broadening reimbursement for their services without needing separate state approvals in all cases.
- Medicare: Replaces outdated documentation requirements for diabetic shoes, which previously involved more restrictive certifications (e.g., from both a physician and a podiatrist in some scenarios). The new rules streamline the process by focusing on clear medical criteria and allowing more qualified providers to fit the shoes, while integrating DPMs more fully.
Potential Impacts
- On Citizens: Enhances access to specialized foot care for Medicaid and Medicare enrollees with diabetes, potentially reducing risks of complications like ulcers, infections, or amputations. This could lower long-term healthcare costs for individuals by preventing severe issues.
- On Government Agencies: The Centers for Medicare & Medicaid Services (CMS) will need to update regulations, guidance, and reimbursement systems, increasing administrative workload initially but promoting more efficient care delivery. States may face minor legislative adjustments for Medicaid compliance.
- On International Relations: No direct impacts, as the bill focuses on domestic U.S. health programs.
- Broader Effects: Could lead to cost savings for federal and state budgets by emphasizing preventive care, though short-term reimbursements for podiatric services and shoes may rise.
Main Stakeholders Affected
- Medicaid and Medicare Beneficiaries: Primarily low-income individuals and seniors with diabetes, who gain easier access to podiatric care and therapeutic footwear.
- Podiatric Physicians (DPMs): Benefit from expanded recognition and reimbursement, allowing them to provide services more seamlessly under both programs.
- Other Healthcare Providers: Physicians, pedorthists, and orthotists involved in fitting diabetic shoes; general doctors may see reduced administrative burdens.
- Government Entities: U.S. Department of Health and Human Services (HHS) and CMS for implementation; state Medicaid agencies for plan updates.
- Insurers and Facilities: Hospitals, clinics, and Medicare Advantage plans adapting to new coverage rules.
Notable Legal, Constitutional, or Political Implications
- Legal: Strengthens parity between podiatric and medical physicians under federal health laws, potentially reducing future disputes over reimbursement. The state grace period aligns with established federal practices for Medicaid amendments, avoiding abrupt compliance issues.
- Constitutional: No apparent challenges; the bill operates within Congress's authority over interstate commerce and spending for public welfare programs.
- Political: Bipartisan sponsorship (from both parties) suggests broad support for diabetes care improvements. It could influence future healthcare debates by highlighting preventive services, but may spark discussions on federal versus state control over Medicaid expansions.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (43)
Rep. DeGette, Diana [D-CO-1], Rep. Rulli, Michael A. [R-OH-6], Rep. Schrier, Kim [D-WA-8], Rep. Kennedy, Mike [R-UT-3], Rep. Soto, Darren [D-FL-9], Rep. Kelly, Mike [R-PA-16], Rep. Stansbury, Melanie A. [D-NM-1], Rep. Hern, Kevin [R-OK-1], Rep. Crow, Jason [D-CO-6], Rep. Bilirakis, Gus M. [R-FL-12], Rep. Craig, Angie [D-MN-2], Rep. Garbarino, Andrew R. [R-NY-2], Rep. Sherman, Brad [D-CA-32], Rep. Thanedar, Shri [D-MI-13], Rep. Pappas, Chris [D-NH-1], Rep. Pingree, Chellie [D-ME-1], Rep. Moulton, Seth [D-MA-6], Rep. Tenney, Claudia [R-NY-24], Rep. DelBene, Suzan K. [D-WA-1], Rep. Trahan, Lori [D-MA-3], Rep. Dingell, Debbie [D-MI-6], Rep. Sewell, Terri A. [D-AL-7], Rep. Barragán, Nanette Diaz [D-CA-44], Rep. Miller, Carol D. [R-WV-1], Rep. Harder, Josh [D-CA-9], Rep. Lynch, Stephen F. [D-MA-8], Rep. Tonko, Paul [D-NY-20], Rep. Bishop, Sanford D. [D-GA-2], Rep. Evans, Gabe [R-CO-8], Rep. Pfluger, August [R-TX-11], Rep. Balint, Becca [D-VT-At Large], Rep. Smith, Adrian [R-NE-3], Rep. Peters, Scott H. [D-CA-50], Rep. Fitzpatrick, Brian K. [R-PA-1], Rep. Cohen, Steve [D-TN-9], Rep. Miller, Max L. [R-OH-7], Rep. Conaway, Herbert C. [D-NJ-3], Rep. Suozzi, Thomas R. [D-NY-3], Rep. Vasquez, Gabe [D-NM-2], Rep. McCollum, Betty [D-MN-4], Rep. Veasey, Marc A. [D-TX-33], Rep. Ross, Deborah K. [D-NC-2], Rep. Bacon, Don [R-NE-2]
Recent Actions
- 2026-03-12: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-03-12: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2026-03-12: Introduced in House
- 2026-03-12: Introduced in House
Bill Versions
- Diabetes Foot Health Access and Modernization Act of 2026 — issued 2026-03-12 — PDF (4 pages)