To amend title XVIII of the Social Security Act to improve access to diabetes outpatient self-management training services, to require the Center for Medicare and Medicaid Innovation to test the provision of virtual diabetes outpatient self-management training services, and for other purposes.
Sponsors
Legislative Progress
IntroducedMs. Schrier (for herself, Mr. Bilirakis, Ms. DelBene, Ms. Wasserman …
Summary
What This Bill Does
This bill expands Medicare coverage for diabetes self-management training services. It increases the amount of training time available to diabetics, eliminates out-of-pocket costs for these services, and requires the testing of virtual (online) training programs for people who may have difficulty accessing in-person care.
Who Benefits and How
Medicare beneficiaries with diabetes will receive more training hours (10 initial hours plus 2 additional hours per year), with no deductibles or copays required. People in rural and underserved areas gain particularly, as the bill mandates testing of web-based virtual training that can be accessed from home. Healthcare providers who offer diabetes education and training services will see expanded demand for their services with guaranteed 100% Medicare payment.
Who Bears the Burden and How
The Centers for Medicare and Medicaid Innovation (CMI) must develop and implement a virtual training pilot program by January 2026, requiring staff time and resources. Medicare (and by extension taxpayers) will bear increased costs from covering more training hours at 100% payment with no beneficiary cost-sharing. The Congressional Budget Office would need to score the fiscal impact.
Key Provisions
- Increases initial diabetes training from an unspecified amount to 10 hours, with 2 additional hours available each year
- Eliminates the 20% coinsurance and deductible for diabetes self-management training services
- Allows non-physician practitioners (not just physicians) to order diabetes training services
- Requires CMI to test a virtual diabetes training model by January 1, 2026
- Mandates evaluation of the virtual program's effects on health outcomes, hospitalizations, and Medicare expenditures
- Changes take effect for services furnished on or after January 1, 2027
Evidence Chain:
This summary is derived from the structured analysis below. See "Detailed Analysis" for per-title beneficiaries/burden bearers with clause-level evidence links.
Primary Purpose
The bill aims to enhance access to diabetes outpatient self-management training services, mandate testing of virtual training by the Center for Medicare and Medicaid Innovation (CMI), and make other related amendments.
Policy Domains
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of Health and Human Services (HHS)
- "the_administrator"
- → Administrator of the Centers for Medicare & Medicaid Services (CMS)
- "the_secretary"
- → Secretary of Health and Human Services (HHS)
Key Definitions
Terms defined in this bill
Establishes a model to test the impact of providing virtual training, including improved health outcomes and reduced expenditures.
Services provided to individuals with diabetes, including initial and additional educational training hours.
Specifies payment amounts and conditions for these services under Medicare.
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