PREVENT DIABETES Act
Summary
What This Bill Does
The PREVENT DIABETES Act directs the Centers for Medicare and Medicaid Services to revise regulations by January 1, 2026, so entities can participate in the Medicare Diabetes Prevention Program by offering online-only services through synchronous or asynchronous technology. The authority runs from January 1, 2026, through December 31, 2030. A supplier must be enrolled as an MDPP supplier and use the administrative location tied to Diabetes Prevention Recognition Program recognition. CMS could not deny a claim solely because the beneficiary participates from a different state. The bill uses telehealth-style flexibility to expand diabetes-prevention coaching and lifestyle intervention access for Medicare beneficiaries with prediabetes.
Who Benefits and How
Medicare beneficiaries with prediabetes benefit from online access to diabetes-prevention services without traveling to an in-person class. Virtual MDPP suppliers benefit because online-only delivery becomes a recognized Medicare participation pathway. Rural beneficiaries benefit when distance from an in-person diabetes-prevention site no longer blocks participation. Disabled beneficiaries benefit because asynchronous or synchronous online services can reduce transportation and mobility barriers.
Who Bears the Burden and How
CMS must revise MDPP regulations, supplier enrollment instructions, and claims rules by January 1, 2026. Medicare contractors must process claims where the beneficiary participates from a different state. In-person MDPP suppliers may face competition from national or multistate online-only providers. Program integrity staff must monitor online suppliers for recognition, attendance, documentation, and fraud risks.
Key Provisions
- Requires CMS regulations allowing online-only MDPP suppliers from 2026 through 2030.
- Authorizes synchronous and asynchronous technology for diabetes-prevention services.
- Blocks claim denials based solely on the beneficiary participating from a different state.
- Uses Diabetes Prevention Recognition Program status to anchor supplier administrative location.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Requires CMS to allow online-only Medicare Diabetes Prevention Program suppliers from 2026 through 2030 and protects claims for beneficiaries participating from another state.
Key Policy Areas
Medicare, Diabetes Prevention, Telehealth
Primary Purpose
Requires CMS to allow online-only Medicare Diabetes Prevention Program suppliers from 2026 through 2030 and protects claims for beneficiaries participating from another state.
Policy Domains
Resolution provisions
Identified Gains
- Medicare beneficiaries with prediabetes
- Virtual MDPP suppliers
- Rural beneficiaries
- Disabled beneficiaries
Identified Costs
- CMS
- Medicare contractors
- In-person MDPP suppliers
- Program integrity staff
Sponsors
Legislative Progress
In CommitteeMs. DeGette (for herself, Mr. Bilirakis, Mr. Crow, and Ms. …
Referred to the Committee on Energy and Commerce, and in …
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology