Sponsors (9)
The bill expands and expedites access to Medicare-covered therapeutic shoes by letting nurse practitioners and physician assistants document need, but it raises modest fiscal and administrative risks for Medicare and its administrators.
Medicare beneficiaries with diabetes can get coverage for therapeutic shoes based on documentation from nurse practitioners and physician assistants, increasing access to needed footwear for people with chronic diabetic foot risk.
Allowing NPs and PAs to complete required paperwork reduces administrative steps for patients and may speed approvals and access to covered therapeutic shoes.
Broader eligibility for who can document need may increase Medicare spending on therapeutic shoes, putting upward pressure on program costs and potentially affecting taxpayers and the trust fund.
If documentation standards are not well-defined, accepting NP/PA notes could raise improper payments or billing disputes, increasing administrative burden for CMS and potentially causing delays or denials for beneficiaries.
Based on analysis of 2 sections of legislative text.
Permits nurse practitioner and physician assistant documentation to qualify for Medicare coverage of therapeutic diabetic shoes and inserts.
Official title: 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 May 19, 2025 by Susan Margaret Collins · Last progress May 19, 2025
Allows nurse practitioners and physician assistants to provide the required documentation so Medicare will cover therapeutic shoes and inserts for beneficiaries with diabetes. The change amends the Medicare statute that defines which practitioners’ notes qualify, expanding the set of qualifying clinicians and directing HHS/Medicare to recognize that documentation for coverage decisions.