HR7905119th CongressWALLET

Diabetes Foot Health Access and Modernization Act of 2026

Sponsored By: Representative Joyce (PA)

Introduced

Summary

This bill would recognize doctors of podiatric medicine as physicians under Medicaid, allowing Medicaid payment for podiatric physicians' covered services. It would apply to services furnished on or after January 1, 2026 and includes a state-law implementation delay tied to state legislative calendars.

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  • Families: Medicaid enrollees could get broader access to foot and ankle care through Medicaid-covered services, improving availability of podiatric treatment.
  • Providers: Doctors of podiatric medicine could bill Medicaid as qualifying physicians for covered services, expanding who can receive Medicaid payment.
  • States: States that need to change law to comply get extra time to update their Medicaid plans. For states with two-year legislative sessions each year counts as a separate regular session.

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 2 benefits, 0 costs, 1 mixed.

Medicare coverage for diabetic shoes

If enacted, Medicare would pay for extra-depth shoes with inserts or custom-molded shoes with inserts for some people with diabetes. This would apply to items and services furnished on or after January 1, 2028. A physician as defined in subsection (r) would need to document that you have peripheral neuropathy and at least one of: a history of pre-ulcerative calluses or foot ulceration, a foot deformity, a prior lower extremity amputation, or poor lower extremity circulation. The physician would also need to attest you have diabetes, are under a diabetes care plan, and need the shoes, and the shoes must be fitted and furnished by a physician or other qualified individual the Secretary establishes.

Medicaid treats podiatrists as physicians

If enacted, Medicaid would treat doctors of podiatric medicine as physicians for payment purposes by changing a cross-reference in the Social Security Act. This would apply to services furnished on or after January 1, 2026. States that need new state laws to update their Medicaid plans would get extra time: a State plan would not be regarded as failing to comply until the first day of the first calendar quarter after the close of that State legislature's first regular session following enactment, with special rules for two-year legislative sessions. Medicaid enrollees, podiatrists, and State Medicaid agencies would be affected.

Therapeutic shoes added to self-referral list

If enacted, the bill would add "extra-depth shoes with inserts or custom molded shoes with inserts" to the statutory list used in physician self-referral (Stark) rules. That change would affect how doctors and suppliers can refer and bill for those shoes under the physician self-referral rules. The provision is a conforming amendment and does not itself set Medicare coverage criteria or include a specific effective date.

Sponsors & CoSponsors

Sponsor

Joyce (PA)

PA • R

Cosponsors

  • Rep. DeGette, Diana [D-CO-1]

    CO • D

    Sponsored 3/12/2026

  • Rep. Rulli, Michael A. [R-OH-6]

    OH • R

    Sponsored 3/12/2026

  • Schrier

    WA • D

    Sponsored 3/12/2026

  • Rep. Kennedy, Mike [R-UT-3]

    UT • R

    Sponsored 3/12/2026

  • Soto

    FL • D

    Sponsored 3/12/2026

  • Kelly (PA)

    PA • R

    Sponsored 4/21/2026

  • Stansbury

    NM • D

    Sponsored 4/21/2026

  • Hern (OK)

    OK • R

    Sponsored 4/21/2026

  • Crow

    CO • D

    Sponsored 4/21/2026

  • Bilirakis

    FL • R

    Sponsored 4/21/2026

  • Craig

    MN • D

    Sponsored 4/21/2026

  • Rep. Garbarino, Andrew R. [R-NY-2]

    NY • R

    Sponsored 4/21/2026

  • Rep. Sherman, Brad [D-CA-32]

    CA • D

    Sponsored 4/21/2026

  • Rep. Thanedar, Shri [D-MI-13]

    MI • D

    Sponsored 4/21/2026

  • Rep. Pappas, Chris [D-NH-1]

    NH • D

    Sponsored 5/11/2026

  • Pingree

    ME • D

    Sponsored 5/11/2026

  • Rep. Moulton, Seth [D-MA-6]

    MA • D

    Sponsored 5/11/2026

  • Rep. Tenney, Claudia [R-NY-24]

    NY • R

    Sponsored 5/11/2026

  • DelBene

    WA • D

    Sponsored 5/11/2026

  • Trahan

    MA • D

    Sponsored 5/11/2026

  • Rep. Dingell, Debbie [D-MI-6]

    MI • D

    Sponsored 5/11/2026

  • Sewell

    AL • D

    Sponsored 5/11/2026

  • Barragan

    CA • D

    Sponsored 5/11/2026

Roll Call Votes

No roll call votes available for this bill.

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