What does SHORT TITLE. of Expanding Access to Diabetes Self-Management Training Act of 2025 do?

This bill is formally titled the Expanding Access to Diabetes Self-Management Training Act of 2025.

What does IMPROVING ACCESS TO DIABETES OUTPATIENT SELF-MANAGEMENT of Expanding Access to Diabetes Self-Management Training Act of 2025 do?

This section amends Section 1861(qq) of the Social Security Act to specify diabetes outpatient self-management training services, requiring the Secretary to follow parameters defined in paragraph (3). The amendments broaden the types of practitioners who can provide these services, allowing 'a physician or qualified nonphysician practitioner'. The legislation establishes a framework for the duration of training services, including an initial 10 hours and an additional 2 hours annually after completion. The Secretary is prohibited from limiting the quantity or duration of services if deemed medically necessary by a practitioner. Section 1861(s)(2)(V) of the Social Security Act is amended to modify medical nutrition therapy services. Section 1833 of the Social Security Act is amended to establish 100% coverage for diabetes outpatient self-management training services, up to the lesser of the actual charge or the fee schedule amount. The amendments apply to services furnished on or after January 1, 2027.

What does CMI TESTING OF PROVIDING VIRTUAL DIABETES OUTPATIENT SELF- of Expanding Access to Diabetes Self-Management Training Act of 2025 do?

This section amends Section 1115A of the Social Security Act to include testing of a model for providing virtual diabetes outpatient self-management training services. The Secretary is required to implement a model by January 1, 2026, to test the impact of providing coverage for these virtual services on health outcomes and expenditures. The model design should allow for evaluation of demographic characteristics and assess improvements in health outcomes, reduced hospitalizations, increased utilization of training services, improved medication adherence, and reduced expenditures. The Secretary must consult with stakeholders, including diabetes care and education professionals, primary care clinicians, digital health experts, and beneficiary groups, within three months of enactment. The definition of 'applicable beneficiary' is linked to individuals with diabetes as described in section 1861(qq). A 'qualified web-based program' is defined as one designed to furnish educational and training services to individuals with diabetes and meeting specific quality standards. The term 'virtual diabetes outpatient self-management training services' refers to services furnished by a qualified web-based program, either synchronously or asynchronously.

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Expanding Access to Diabetes Self-Management Training Act of 2025

Q: What does Preamble of Expanding Access to Diabetes Self-Management Training Act of 2025 do?

This bill, formally titled 'A BILL 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,' aims to amend Title XVIII of the Social Security Act. The bill seeks to improve access to diabetes outpatient self-management training services. It requires the Center for Medicare and Medicaid Innovation to test the provision of virtual diabetes outpatient self-management training services.

Last updated: 6/2/2025 · Introduced: 6/2/2025

Author: Jeanne Shaheen (D-NH)

TL;DR (AI)

This bill expands Medicare coverage for diabetes outpatient self-management training services, requiring 100% coverage up to the fee schedule amount for services provided on or after January 1, 2027.
The legislation broadens the types of practitioners who can provide diabetes self-management training services and establishes a framework for the duration of training, including an initial 10 hours and 2 hours annually thereafter.
The bill mandates the Center for Medicare and Medicaid Innovation to test a model for providing virtual diabetes outpatient self-management training services, evaluating its impact on health outcomes and expenditures.

119th Congressin committeeHR. 3826(In Committee)Official page

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Includes provisions on preamble, short title., and 2 more.

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