S1805-119

Introduced

To amend title XVIII of the Social Security Act to permit nurse practitioners and physician assistants to satisfy the documentation requirement under the Medicare program for coverage of certain shoes for individuals with diabetes.

119th Congress Introduced May 19, 2025

Legislative Progress

Introduced
Introduced Committee Passed
May 19, 2025

Ms. Collins (for herself and Mrs. Shaheen) introduced the following …

Summary

What This Bill Does

The Promoting Access to Diabetic Shoes Act expands who can certify the medical necessity of therapeutic shoes for Medicare beneficiaries with diabetes. Currently, only physicians can sign off on this documentation; this bill adds nurse practitioners and physician assistants to the list of authorized certifiers.

Who Benefits and How

Medicare beneficiaries with diabetes gain easier access to therapeutic footwear coverage. With more healthcare providers authorized to certify their need, patients face fewer barriers and delays in obtaining specialized shoes that help prevent serious diabetic foot complications.

Nurse practitioners and physician assistants benefit from an expanded scope of practice. They can now provide complete diabetic foot care without requiring patients to see a separate physician just for documentation purposes.

Medical equipment suppliers may see increased sales as the streamlined certification process reduces friction for patients seeking covered diabetic footwear.

Who Bears the Burden and How

The Medicare program bears minimal burden from this change. The bill does not create new benefits or expand coverage categories—it simply adjusts which healthcare providers can complete existing paperwork. No significant new costs are expected.

Key Provisions

  • Amends Section 1861(s)(12) of the Social Security Act to add nurse practitioners and physician assistants as authorized certifiers
  • Applies to documentation requirements in both subparagraph (A) and subparagraph (C) of the statute
  • Takes effect upon enactment with no phase-in period
  • Does not change the medical criteria for coverage—only who can certify the documentation
Model: claude-opus-4-5
Generated: Dec 27, 2025 21:50

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

Expands Medicare coverage documentation for diabetic shoes by allowing nurse practitioners and physician assistants (in addition to physicians) to certify medical necessity.

Policy Domains

Healthcare Medicare Medical Services

Legislative Strategy

"Expand healthcare provider flexibility and improve access to diabetic care"

Likely Beneficiaries

  • Medicare beneficiaries with diabetes (improved access to diabetic shoes)
  • Nurse practitioners (expanded scope of practice)
  • Physician assistants (expanded scope of practice)
  • Medical equipment suppliers (potentially larger market)

Likely Burden Bearers

  • Medicare program (minimal - administrative change only, no new spending)

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Healthcare 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