Promoting Access to Diabetic Shoes Act
Introduced May 19, 2025 · Last action May 19, 2025
Plain English Summary
This bill allows nurse practitioners and physician assistants to provide the medical documentation needed for Medicare to cover diabetic shoes, a benefit previously limited to physicians only. The change removes a barrier that forced some Medicare patients with diabetes to see a physician specifically for shoe certification, even if a nurse practitioner or physician assistant was managing their diabetes care.
Who benefits
Medicare beneficiaries with diabetes (particularly those in rural areas and underserved communities where nurse practitioners and physician assistants are the primary care providers), nurse practitioners and physician assistants (expanded scope of practice and patient care authority), and companies that manufacture and sell Medicare-covered diabetic shoes
Who pays / loses
Medicare program (absorbs a modest increase in claims for diabetic shoes as access barriers lower), physicians (lose exclusive authority over this documentation and associated patient visits for shoe certification)
Funding & Lobbying Interests
Nurse practitioner and physician assistant professional organizations, including the American Association of Nurse Practitioners and the American Academy of Physician Assistants, have historically lobbied for scope-of-practice expansions in Medicare and federal health programs. Diabetic shoe manufacturers and suppliers have financial interest in expanded access to the Medicare benefit. The bill sponsors (Collins of Maine and Shaheen of New Hampshire) represent states with significant rural populations where midlevel providers deliver primary care.
Political Impact
Affected Groups
Medicare beneficiaries with diabetes (approximately 7.5 million Medicare beneficiaries have diabetes; beneficiaries in rural counties and underserved areas are disproportionately affected by physician scarcity); rural and community health centers that employ nurse practitioners and physician assistants as primary care providers; small and mid-sized orthopedic shoe manufacturers and medical supply companies
Political Subtext
Proponents argue this is a straightforward scope-of-practice modernization that reduces administrative burden on patients and aligns Medicare policy with how these clinicians are already used in primary care settings. Physicians may frame this as quality-control dilution (some podiatric and orthopedic groups historically preferred physician involvement in shoe fitting). Non-partisan evidence supports that nurse practitioners and physician assistants have comparable outcomes to physicians for routine chronic disease management including diabetes care; this bill applies the principle to documentation only, not clinical decision-making.
Real-World Stakes
If passed: Medicare beneficiaries with diabetes avoid unnecessary physician visits for shoe certification when already seeing a nurse practitioner or physician assistant for diabetes management, reducing out-of-pocket costs and travel burden especially in rural areas. Diabetic shoe suppliers may see higher claim volumes as access improves. Medicare spending on diabetic shoes will likely increase modestly (no CBO score available in bill text). The change affects a low-cost benefit ($400–$600 per pair, one pair annually under current Medicare rules); total impact is likely in the millions annually, not billions. Precedent: Several states have expanded scope-of-practice for nurse practitioners and physician assistants in Medicaid without documented quality degradation; Massachusetts and Oregon expanded chronic disease management authority to midlevel providers in the 2010s with neutral or positive outcomes on access metrics.
Sponsor
Sponsor information not available.
Vote Record
No recorded votes.
Campaign Finance — Primary Sponsor
No campaign finance data available yet.
501(c)(4) disclosure: Contributions from 501(c)(4) "dark money" organizations are not required to be publicly disclosed and are not reflected in the figures above. Data sourced from FEC public disclosure filings.
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