What does Preamble of Diabetes Act do?

This bill is formally titled 'A bill to ensure continued access to diabetes technology upon Medicare enrollment, and for other purposes.'

What does SHORT TITLE. of Diabetes Act do?

This bill is formally titled the Diabetes Interventions Addressing Barriers to Enrollment, Technology, and Education Services (DIABETES) Act or the Diabetes Act.

What does FINDINGS; SENSE OF CONGRESS. of Diabetes Act do?

This section outlines findings related to diabetes prevalence and costs in the United States. It notes that approximately 38.4 million Americans (11.6% of the population) had diabetes in 2021, with projections estimating 54.9 million by 2030. Diabetes disproportionately affects Medicare beneficiaries, with 26% having the condition. The section highlights the significant health complications and costs associated with diabetes, totaling $412.9 billion in 2022. It discusses automated insulin delivery (AID) systems, which include continuous glucose monitors, insulin pumps, and algorithms, and notes that Medicare currently does not separately reimburse for the algorithms and software. The section expresses concern that the competitive bidding program and recent CMS rule changes may limit innovation and access to diabetes technologies. Congress expresses its sense that the Secretary of Health and Human Services should take administrative action to recognize the algorithm or software in AID systems as a 'reasonable and necessary' item for Medicare coverage. It further suggests that the algorithm/software should be treated as a separately payable supply to durable medical equipment and recognized as 'medical supplies associated with the injection of insulin' when applicable.

What does CONTINUED ACCESS TO DIABETES RELATED TECHNOLOGIES. of Diabetes Act do?

This section amends Section 1861(ww) of the Social Security Act to ensure care continuity for individuals using diabetes technology covered under part B. During the first 12 months of an individual's enrollment for benefits under part B, a provider may certify to the Secretary that an individual is using diabetes technology covered under part B. The Secretary must issue a finalized certification form by January 1, 2027, developed through public notice and comment. Medicare administrative contractors will only assess whether the certification form is included in an individual's medical records when determining coverage. The Secretary will develop a process to consider whether diabetes technology not currently covered under part B should become a covered benefit. Guidance will be issued to audit and oversight entities to prevent disruptions in access to covered diabetes technology. The term 'diabetes technology covered under part B' refers to devices, supplies, and software covered under part B for individuals with diabetes, as determined by the Secretary. The amendments apply to items and services furnished on or after January 1, 2027.

What does IMPROVING ACCESS TO DIABETES OUTPATIENT SELF-MANAGEMENT of Diabetes Act do?

This section amends Section 1861(qq) of the Social Security Act to modify diabetes outpatient self-management training (DSMT) services. The amendments specify that DSMT services must be provided by a physician or qualified nonphysician practitioner. The legislation establishes a framework for the duration of DSMT services, including an initial 10 hours and an additional 2 hours annually. The Secretary is prohibited from limiting the quantity or duration of DSMT services if deemed medically necessary. 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. The amendments apply to items and services furnished on or after January 1, 2027.

What does CMI TESTING OF PROVIDING VIRTUAL DIABETES OUTPATIENT SELF- of Diabetes Act do?

This section amends Section 1115A of the Social Security Act to include testing of a model described in subsection (h). The Secretary is required to implement a model by January 1, 2027, to test the impact of providing coverage for virtual diabetes outpatient self-management training services. The model aims to evaluate improved health outcomes, reduced hospitalizations, increased utilization of training services, improved medication adherence, and reduced expenditures. The Secretary must consult with stakeholders, including diabetes care experts, clinicians, digital health experts, and beneficiary groups within three months of enactment. An 'applicable beneficiary' is defined as an individual with diabetes as described in section 1861(qq). A 'qualified web-based program' is defined as a program designed to furnish educational and training services to individuals with diabetes and meeting specific quality standards. “Virtual diabetes outpatient self-management training services' means any diabetes outpatient self-management training services furnished by a qualified web-based program.

What does PROVIDING INSULIN PUMP TRAINING AND EDUCATION. of Diabetes Act do?

This section directs the Secretary of Health and Human Services to establish new Healthcare Common Procedure Coding System codes for insulin pump hook-up, calibration, and patient training. These new codes will be under the fee schedule established under section 1848(b) of the Social Security Act. The Secretary must ensure the codes sufficiently describe patient education, training, and insulin pump placement services for technologies covered under sections 1834 and part D of title XVIII of the Social Security Act. The Secretary is also tasked with providing education and outreach to stakeholders regarding the billing of these new codes.

What does NATIONAL COVERAGE DETERMINATION ON INSULIN PUMPS. of Diabetes Act do?

This section requires the Secretary of Health and Human Services to issue a proposed national coverage determination for infusion pumps, specifically CSII number 280.14. The proposed determination must be issued within 180 days of the Act's enactment. The national coverage determination is to be issued pursuant to section 1862(l) of the Social Security Act.

What does REPORT ON ENROLLEE ACCESS TO DIABETES-RELATED SERVICES AND of Diabetes Act do?

This section requires a report assessing barriers to accessing diabetes-related services and technologies within federal healthcare programs. The Comptroller General, in collaboration with the Secretary of Health and Human Services, must submit this report to specified congressional committees. The report will review barriers such as prior authorization practices, preferred formularies, and utilization management techniques. It will also examine whether federal laws, regulations, or policies negatively impact access to these services or limit individuals' ability to receive care aligned with standards of care. The term 'diabetes technologies' is defined to include items described in section 1861(ww)(5)(D) of the Social Security Act, as well as related supplies and software. “Diabetes self-management education and support services” are defined as services described in section 1861(qq) of the Social Security Act. “Federal health care program” is defined as any plan or program providing health benefits funded by the U.S. Government.

What does ENSURING ACCESS TO DIABETES-RELATED TECHNOLOGIES. of Diabetes Act do?

This section amends Section 1847(a)(2) of the Social Security Act. The amendment adds a new subparagraph (E) to specify coverage for certain diabetic-related items. Continuous glucose monitors and insulin pumps are designated as durable medical equipment under section 1861(n). Coverage for these items will begin on or after January 1, 2031.

Back to bills

Diabetes Act

Last updated: 3/10/2026 · Introduced: 3/10/2026

Author: Jeanne Shaheen (D-NH)

TL;DR (AI)

The bill aims to ensure Medicare beneficiaries maintain access to diabetes technologies, including continuous glucose monitors and insulin pumps, during the initial 12 months of enrollment.
It expands diabetes outpatient self-management training (DSMT) services, establishing a minimum of 10 initial hours and 2 annual hours, and prohibiting limitations if medically necessary.
The bill mandates the Secretary of Health and Human Services to establish new Healthcare Common Procedure Coding System codes for insulin pump training, calibration, and patient education.
It requires the Secretary to issue a national coverage determination for infusion pumps within 180 days of enactment.
The legislation directs a report assessing barriers to accessing diabetes-related services and technologies within federal healthcare programs, including reviews of prior authorization practices and utilization management.

119th Congressin committeeOfficial page

Verified Votes

No verified votes yet.

Community Votes

No community votes yet. Be the first!

Voting as guest · Sign in for verified votes

Other Sections

Includes provisions on preamble, short title., and 8 more.

10 sections

Click "Show details" to explore individual sections. Use the community vote above or visit All Sections to vote per section.

Read official text

Want the full experience?

Create a free account to cast verified votes on each section, get a personalized summary, and track your voting history.

Create Free Account