Sponsors (60)
The bill improves access and convenience for Medicare beneficiaries needing therapeutic shoes by letting NPs and PAs document eligibility, at the cost of modestly higher program spending and a small increase in oversight risk.
Medicare beneficiaries with diabetes can more easily obtain coverage for therapeutic shoes because nurse practitioners and physician assistants are authorized to provide the required documentation, expanding access to needed preventive footwear.
Primary care teams (NPs and PAs) can complete documentation for therapeutic shoes, reducing delays and administrative burden for patients and streamlining workflow for healthcare providers.
Taxpayers and the Medicare program may face higher spending if authorizing more clinician types increases claims for therapeutic shoes, which could put modest upward pressure on program costs or premiums over time.
Allowing different provider types to document medical necessity creates a modest risk of inconsistent determinations or improper payments, increasing CMS oversight and administrative monitoring needs.
Based on analysis of 2 sections of legislative text.
Allows nurse practitioners and physician assistants to provide the documentation Medicare requires for coverage of therapeutic shoes for people with diabetes.
Official title: To amend title XVIII of the Social Security Act to permit nurse practitioners and physician assistants to satisfy the documentation requirement under the Medicare program for coverage of certain shoes for individuals with diabetes.
Introduced February 26, 2025 by Darin Lahood · Last progress February 26, 2025
Allows nurse practitioners and physician assistants to provide the required documentation for Medicare coverage of therapeutic shoes for people with diabetes. The change amends federal Medicare statutory language so documentation signed by NPs and PAs explicitly satisfies the documentation requirement for coverage. This modifies the eligibility/definition language in the Medicare statute that governs therapeutic shoes for diabetic beneficiaries, broadening which clinicians may certify medical necessity for those items.