The Expanding Access to DSMT Act would improve access to outpatient DSMT services under the Medicare program. We are currently working with our congressional champions to have the DSMT Act reintroduced in the 118th Congress which began in January 2023 and runs through January 2025. We will alert members soon as this happens.
Why is this bill important?
As diabetes care and education specialists, we know that self-management can be a path to a better quality of life. However, barriers within the Medicare benefit keep some of our most vulnerable citizens from accessing DSMT. The Expanding Access to DSMT Act (H.R. 5804 and S. 2203) will reduce barriers and improve Medicare beneficiary access to DSMT services in the following ways:
- Allows the initial 10 hours of DSMT during the first year to remain available until fully utilized. If there's a determination of medical necessity, then an additional 6 hours of training/ education may be added.
- Removes the restriction related to coverage of DSMT and Medical Nutrition Therapy (MNT) services furnished on the same day.
- Excludes DSMT services from Part B cost-sharing and deductible requirements.
- Permits physicians and qualified non-physician practitioners who are not directly involved in managing an individual's diabetes to refer them for DSMT services. Examples include podiatrists, specialists treating a comorbidity like gangrene or vision loss, or an emergency room doctor.
- Establishes a Center for Medicare Innovation demonstration program to test the impact of covering virtual DSMT under the Medicare program.
Bill Information
Below are some helpful materials to help you advocate for the passage of this legislation, including an issue brief summarizing the key points of the bill. Read the bill text or to see if your member of Congress has signed on as a cosponsor.
Issue Brief
H.R. 5804
S. 2203
Advocacy Resources
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