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S 1805119th CongressIn Committee

Promoting Access to Diabetic Shoes Act

Introduced: May 19, 2025
Healthcare
Standard Summary
Comprehensive overview in 1-2 paragraphs

The Promoting Access to Diabetic Shoes Act is a narrowly targeted Senate bill that would amend title XVIII (Medicare) of the Social Security Act to allow nurse practitioners (NPs) and physician assistants (PAs) to satisfy the documentation requirement needed for Medicare coverage of certain shoes for people with diabetes. In current law, the documentation for coverage is tied to physicians; this bill inserts NPs and PAs into those documentation roles. If enacted, the change would make it easier for individuals with diabetes to obtain Medicare-covered diabetic footwear by broadening which clinicians can provide the necessary paperwork or attestations. The bill does not change the level of coverage, eligibility rules, or payment rates for diabetic shoes. It simply expands who can fulfill the documentation requirement to qualify for coverage, potentially reducing barriers and delays for beneficiaries who need these shoes.

Key Points

  • 1What it does: Expands the set of clinicians who can satisfy Medicare’s documentation requirement for coverage of certain shoes for individuals with diabetes to include nurse practitioners and physician assistants, in addition to physicians.
  • 2Where the change occurs: Amends Section 1861(s)(12) of the Social Security Act, adding NP and PA references to subparagraphs A and C.
  • 3Scope of effect: Applies specifically to Medicare coverage determinations for “certain shoes” for people with diabetes; does not alter coverage thresholds, eligibility criteria, or payment policy beyond who can provide documentation.
  • 4Implementation details: The statutory text specifies insertion of “nurse practitioner, or physician assistant” after “physician” in relevant places, but does not specify an effective date or other operational requirements beyond the amendment.
  • 5Funding and broader policy: The bill does not include new funding, cost provisions, or broader changes to diabetes care or shoe coverage; it is a focused administrative expansion.

Impact Areas

Primary group/area affected- Medicare beneficiaries with diabetes who need diabetic shoes; potential for smoother access and reduced delays in obtaining coverage if documentation is provided by NPs or PAs.Secondary group/area affected- Nurse practitioners and physician assistants, whose professional scope and administrative roles would include providing the necessary documentation for Medicare coverage.- Physicians, who remain eligible providers for documentation and may experience a shift in documentation workload or collaboration with NPs/PAs.Additional impacts- Medicare program operations: minor administrative change in documentation pathways; potential implications for provider credentialing and attestation processes.- Access and equity: potential improvement in access to diabetic footwear for patients who see NPs or PAs rather than physicians, particularly in settings with limited physician availability.- Costs and utilization: the bill does not authorize additional spending or change reimbursement levels; any impact on costs would stem from changes in access, utilization, and potential downstream effects on diabetes foot health.
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