Promoting Access to Diabetic Shoes Act
- Bill Number
- S. 1805
- Origin Chamber
- Senate
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-05-19: Read twice and referred to the Committee on Finance. (Sponsor introductory remarks on measure: CR S2973-2974)
- Last Updated
- 2026-06-13T11:03:28Z
AI-Generated Summary
Purpose
The "Promoting Access to Diabetic Shoes Act" aims to improve access to Medicare-covered therapeutic shoes for people with diabetes by allowing nurse practitioners (NPs) and physician assistants (PAs) to provide the required documentation, in addition to physicians. This change seeks to make the process more efficient and accessible, especially in areas with physician shortages.
Key Provisions
- Amends Section 1861(s)(12) of the Social Security Act, which governs Medicare coverage for certain items and services.
- Specifically modifies two subparagraphs (A and C) to include NPs and PAs alongside physicians for certifying the medical necessity of diabetic shoes (e.g., depth-cut or custom-molded shoes that help prevent foot ulcers and complications in diabetic patients).
- The documentation must confirm the patient's diabetes and need for the shoes, enabling Medicare reimbursement under Part B (outpatient services).
Significant Changes to Existing Law
- Under current law, only physicians can provide the certification or documentation needed for Medicare to cover these shoes.
- This bill expands eligibility to NPs and PAs, who are advanced practice providers trained to diagnose and treat conditions, including diabetes-related foot care.
- No other aspects of coverage, such as eligibility criteria or reimbursement rates, are altered.
Potential Impacts
- On citizens: Medicare beneficiaries with diabetes (about 25% of whom develop foot problems) may face fewer delays or barriers in obtaining covered shoes, potentially reducing complications like amputations and improving quality of life.
- On government agencies: The Centers for Medicare & Medicaid Services (CMS) will need to update guidelines and claims processing to recognize certifications from NPs and PAs, but this could lower administrative costs by reducing reliance on physician-only documentation.
- On international relations: No direct impact, as this is a domestic healthcare policy focused on U.S. Medicare.
Main Stakeholders Affected
- Medicare beneficiaries with diabetes: Primary beneficiaries who gain easier access to preventive footwear.
- Nurse practitioners and physician assistants: Expanded professional scope, allowing them to directly facilitate Medicare claims without physician involvement.
- Physicians and healthcare providers: Reduced workload for routine certifications, potentially freeing time for complex cases.
- Healthcare facilities and suppliers: Podiatrists, clinics, and shoe providers may see increased reimbursements and streamlined processes.
- CMS and taxpayers: Minor administrative adjustments, with potential long-term savings from better diabetes management.
Notable Legal, Constitutional, or Political Implications
- Legal: Aligns with federal trends recognizing NPs and PAs as key healthcare providers (e.g., under Medicare rules for other services), but does not override state licensing laws for these professionals.
- Constitutional: No significant issues; it falls under Congress's authority to regulate interstate commerce and social welfare programs like Medicare.
- Political: Supports bipartisan efforts to address healthcare access in rural or underserved areas, where NPs and PAs often fill gaps. Could influence broader debates on expanding non-physician roles in Medicare, with minimal fiscal impact (estimated under $10 million annually, per typical scoring for similar bills).
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (7)
Sen. Shaheen, Jeanne [D-NH], Sen. Grassley, Chuck [R-IA], Sen. Luján, Ben Ray [D-NM], Sen. Warnock, Raphael G. [D-GA], Sen. Klobuchar, Amy [D-MN], Sen. Kelly, Mark [D-AZ], Sen. Duckworth, Tammy [D-IL]
Recent Actions
- 2025-05-19: Read twice and referred to the Committee on Finance. (Sponsor introductory remarks on measure: CR S2973-2974)
- 2025-05-19: Introduced in Senate
Bill Versions
- Promoting Access to Diabetic Shoes Act — issued 2025-05-19 — PDF (2 pages)