Association of Diabetes Care & Education Specialists

News & Publications

New Medicare Bill to Provide Long Needed Overhaul of Diabetes Treatment Services

Nov 04, 2021

This week 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 Diabetes Self-Management Training (DSMT) Act (H.R. 5804) in the U.S. House of Representatives. The Senate version of this legislation (S. 2203) was introduced by Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME) in June. The bill addresses major barriers for Medicare beneficiaries, increasing access to DSMT services and reducing the overall cost burden.  

“Self-management is a path to better quality of life and improved outcomes. Yet many individuals who could benefit from DSMT are unable to access the service because of outdated rules,” said Kate Thomas, ADCES chief advocacy and external affairs officer. “ADCES is proud to help introduce this important piece of legislation along with the Diabetes Advocacy Alliance and our congressional champions. It’s critical that we encourage every legislator to support this non-partisan, common sense bill.”  

DSMT is an evidence-based service that teaches people with diabetes how to self-manage the disease to live better and reduce their risk of complications. Benefits include lower hemoglobin A1C, weight loss, improved quality of life, healthy coping skills and reduced healthcare costs. However, only an estimated 5 percent of Medicare beneficiaries with newly diagnosed diabetes use these services.  

The COVID-19 pandemic, as well as the disproportionate impact of diabetes on individuals from marginalized racial and ethnic groups, has underscored the urgent need to ensure that Medicare beneficiaries have the support they need to self-manage their diabetes.  

If passed, the Expanding Access to DSMT Act would:  

  • Permit physicians and qualified non-physician practitioners who are not directly involved in managing diabetes to refer DSMT services. 

  • Allow the initial 10 hours of DSMT during the first year to remain available until used. 

  • Allow DSMT and Medical Nutrition Therapy (MNT) services to be furnished on the same day.  

  • Exclude DSMT services from Part B cost-sharing and deductible requirements. 

  • Establish a 2-year demonstration of virtual DSMT, potentially paving the way for future Medicare coverage of virtual DSMT services. 

The Expanding Access to DSMT Act was originally introduced at the end of the 115th Congress and was reintroduced in the 116th Congress. Advancement of this bill was impacted as congress shifted their focus to respond to the COVID-19 pandemic. ADCES and its advocacy partners are focused on building support for this legislation in the 117th Congress.  

ADCES is encouraging the public to contact their legislators to support the Expanding Access to DSMT Act. For more information visit DiabetesEducator.org/actnow.  

Leave a comment

In This Section

News & Publications