Diabetes Act
Sponsored By: Senator Jeanne Shaheen
Introduced
Summary
Would expand Medicare access to diabetes technologies and education. This bill would change Medicare rules to recognize software in automated insulin delivery systems, increase coverage and training for diabetes care, create new billing codes, and test virtual diabetes education models.
Show full summary
- Medicare beneficiaries would get clearer routes to keep tech covered. Providers could certify use of covered diabetes devices during a patient's first 12 months of Part B enrollment. Diabetes self‑management training would start with 10 hours and add 2 hours per year after that, with no medically necessary limits and adjusted cost‑sharing and deductible rules.
- Providers and device makers would see new billing pathways. The Secretary would be required to create new HCPCS codes for insulin pump hookup and training by January 1, 2027 and to issue a national coverage proposal for infusion pumps within 180 days. The bill also directs treating algorithms and software as separately payable supplies when appropriate.
- Federal programs and oversight would be tested and reviewed. The bill would require a virtual diabetes training demonstration model to be implemented by January 1, 2027 and a Government Accountability Office report within one year on barriers to access across federal health programs.
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 3 benefits, 0 costs, 0 mixed.
Easier Medicare billing for pumps and CGMs
If enacted, Medicare would treat continuous glucose monitors (CGMs) and insulin pumps as durable medical equipment when furnished on or after January 1, 2031. The HHS Secretary would add new Medicare billing codes for insulin pump setup, calibration, and training by January 1, 2027. The Secretary would also publish a proposed national coverage decision for infusion pumps and continuous insulin infusion within 180 days after enactment to give consistent national coverage guidance.
Faster technology certification for new Medicare enrollees
If enacted, an authorized provider could certify during the first 12 months of your Medicare Part B enrollment that you use one or more diabetes technologies. The HHS Secretary would finalize a uniform certification form by January 1, 2027 and require Medicare contractors to rely on that form when checking coverage. The Secretary would also issue guidance to audit and oversight entities to avoid disruptions and start a notice-and-comment rulemaking to consider adding non-covered technologies as benefits.
More diabetes training and virtual tests
If enacted, Medicare would give an initial 10 hours of diabetes self-management training (DSMT) that you could use until finished, and you would be able to get 2 more hours each year after you finish the first 10 hours. The bill would stop the Medicare deductible from applying to DSMT and set Medicare payment at 100 percent of the lesser of the actual charge or the fee-schedule amount for DSMT. The HHS Secretary would also run a CMMI test of virtual DSMT by January 1, 2027 to evaluate effects on A1c, hospital stays, medication adherence, use in rural and underserved areas, and Medicare costs.
Sponsors & CoSponsors
Sponsor
Jeanne Shaheen
NH • D
Cosponsors
Susan Collins
ME • R
Sponsored 3/10/2026
Roll Call Votes
No roll call votes available for this bill.
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