Expanding Access to Diabetes Self-Management Training Act of 2025
Sponsored By: Senator Jeanne Shaheen
Introduced
Summary
Expand Medicare coverage of diabetes outpatient self-management training (DSMT). The bill would let qualified nonphysician practitioners supervise and provide DSMT, set an initial 10 hours of training plus 2 hours per year thereafter, bar limits when services are medically necessary, change cost-sharing so Medicare covers DSMT up to the lesser of the actual charge or the fee schedule and the deductible would not apply, and require a CMS Innovation Center test of virtual DSMT.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
Lower Medicare costs for diabetes training
If enacted, Medicare beneficiaries with diabetes would get broader and cheaper diabetes self-management training starting January 1, 2027. Medicare would pay 100% of the lesser of the providers actual charge or the Medicare fee-schedule amount for DSMT, and the Part B deductible would not apply to those services. You could receive an initial 10 hours of group or individual training that stays available until you use it, plus 2 more hours each year starting the year you finish the first 10. A physician or a qualified nonphysician practitioner could authorize and supervise DSMT. Certified providers could furnish additional medically necessary hours and the Secretary could not limit quantity or duration when a physician or qualified nonphysician practitioner deems them necessary.
Test online diabetes training for Medicare
If enacted, CMS would launch a test model by January 1, 2026 to study virtual diabetes self-management training for Medicare beneficiaries with diabetes. The model would test qualified web-based programs and measure A1c reductions, diabetes-related hospitalizations, DSMT use (including rural and underserved communities), medication adherence, and changes in Medicare spending. CMS must consult diabetes care and patient groups, clinicians, and digital health experts within three months after enactment. The test would not itself immediately change national coverage rules but could inform future policy.
Sponsors & CoSponsors
Sponsor
Jeanne Shaheen
NH • D
Cosponsors
Susan Collins
ME • R
Sponsored 6/2/2025
Angus King
ME • I
Sponsored 12/8/2025
Amy Klobuchar
MN • D
Sponsored 12/15/2025
Roll Call Votes
No roll call votes available for this bill.
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