Congresswoman Schrier introducing bipartisan bill to improve access to diabetes care

WASHINGTON, D.C. - U.S. Representative Kim Schrier, M.D. (D-WA) introduced HR 3842 - Expanding Access to Diabetes Self-Management Training Act with Representatives Gus Bilirakis (R-FL), Diana DeGette (D-CO), Larry Bucshon, M.D. (R-IN), Suzan DelBene (D-WA), Mike Kelly (R-PA), Raul Ruiz, M.D. (D-CA), and David Schweikert (R-AZ).

The Expanding Access to Diabetes Self-Management Training Act will: 

• Allow the initial 10 hours of diabetes self-management training (DSMT) to remain available until fully used.

• Permit DSMT and Medical Nutrition Therapy (MNT) services to be provided on the same day.

• Exclude DSMT services from Part B cost-sharing and deductible requirements. 

• Permit physicians and qualified nonphysician practitioners (e.g., podiatrists, emergency department providers, physician assistants, nurse practitioners, or clinical nurse specialists) working in coordination with a treating physician or qualified nonphysician to refer for DSMT services. 

• Establish a Center for Medicare Innovation demonstration program to test the impact of covering virtual DSMT under the Medicare program.

"As someone who has managed my own Type-1 Diabetes for almost 40 years, I understand the importance of education in managing this disease. Without proper understanding of the roles of insulin, food, exercise, and illness on blood sugar, people with diabetes can quickly end up in the hospital," said Rep. Schrier.  “We know that self-management training helps people with diabetes live healthy lives and stay out of the hospital, and I am proud to work with my Democratic and Republican colleagues to introduce this important bill and remove barriers to self-management training.”  


“The Association of Diabetes Care & Education Specialists (ADCES) applauds the sponsors of the Expanding Access to DSMT Act for introducing legislation that would improve access to diabetes care and education for Medicare beneficiaries,” said ADCES President Lucille Hughes, DNP, CDCES, BC-ADM. “DSMT services help individuals with diabetes improve their health and reduce complications which in turn can decrease health care costs. Improving access to and utilization of this evidence-based benefit is critical for addressing health equity.”

 “The American Diabetes Association (ADA) appreciates the introduction of the ‘Expanding Access to Diabetes Self-Management Training Act of 2023.’ The ADA’s Standards of Care includes information on how positive health behaviors and the maintenance of psychological well-being are foundational for achieving diabetes treatment goals and maximizing quality of life,” said Dr. Robert Gabbay, ADA’s Chief Scientific and Medical Officer. “Essential to achieving these goals is facilitating behavior change to improve health outcomes through diabetes self-management education and support. It is critical for Medicare beneficiaries to have access to high quality DSMES through the DSMT benefit, in order to achieve better patient self-management, satisfaction, and glucose results.”    


The Expanding Access to Diabetes Self-Management Training Act was also introduced by U.S. Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME). This legislation is a priority of the Diabetes Advocacy Alliance, including the Academy of Nutrition and Dietetics, American Diabetes Association, Black Women’s Health Imperative, Diabetes Leadership Council, Diabetes Patient Advocacy Coalition, Endocrine Society, National Kidney Foundation, Omada Health, Inc., and more.