Association of Diabetes Care & Education Specialists

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Advocacy

The Expanding Access to DSMT Act

ADCES worked with the Diabetes Advocacy Alliance and our congressional champions on the introduction of the Expanding Access to Diabetes Self-Management Training (DSMT) Act in the 117th Congress.The Expanding Access to DSMT Act (H.R. 5804, S. 2203) amends title XVIII of the Social Security Act to improve access to outpatient DSMT services under the Medicare program.

Senators Jean Shaheen (D-NH) and Susan Collins (R-ME), along with 8 original cosponsors, introduced this legislation in the Senate (S. 2203) on June 24, 2021. Representative Kim Schrier, MD (D-WA-8) along with Diabetes Caucus co-chairs Representatives Diana DeGette (D-C0-01) and Tom Reed (R-NY-23), and 4 other members of the Diabetes Caucus reintroduced the Expanding Access to DSMT Act (H.R. 5804) in the U.S. House of Representatives on November 1, 2021.

Click here to send a letter to your members of Congress asking them to support this legislation.

Why is this bill important?

As diabetes care and education specialists, we know that self-management can be a path to a better quality of life. However, barriers within the Medicare benefit keep some of our most vulnerable citizens from accessing DSMT. The Expanding Access to DSMT Act (H.R. 5804 and S. 2203) will reduce barriers and improve Medicare beneficiary access to DSMT services in the following ways:

  • Allows the initial 10 hours of DSMT during the first year to remain available until fully utilized. If there's a determination of medical necessity, then an additional 6 hours of training/ education may be added.
  • Removes the restriction related to coverage of DSMT and Medical Nutrition Therapy (MNT) services furnished on the same day.
  • Excludes DSMT services from Part B cost-sharing and deductible requirements.
  • Permits physicians and qualified non-physician practitioners who are not directly involved in managing an individual's diabetes to refer them for DSMT services. Examples include podiatrists, specialists treating a comorbidity like gangrene or vision loss, or an emergency room doctor.
  • Establishes a Center for Medicare Innovation demonstration program to test the impact of covering virtual DSMT under the Medicare program.

Bill Information

Below are some helpful materials to help you advocate for the passage of this legislation, including an issue brief summarizing the key points of the bill. Read the bill text or to see if your member of Congress has signed on as a cosponsor.

Issue Brief

H.R. 5804

S. 2203

Advocacy Resources

Visit the Legislative Action Center to take action or send a letter to your legislators.

Subscribe to the Advocacy Forum on ADCES Connect to get the latest advocacy updates and information on the re-introduction of this legislation.

Download our Advocacy Guide which features tips on how to take action on a wide range of advocacy issues, including identifying your members of Congress and opportunities for CB involvement in advocacy.

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