On August 22, Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME) introduced the Expanding Access to Diabetes Self-Management Training (DSMT) Act (S. 3366) in the U.S. Senate. This is the Senate companion to legislation of the same name introduced in the U.S. House of Representatives (H.R. 5768) in May by Reps. Tom Reed (R-NY) and Diana DeGette (D-CO). AADE worked in collaboration with the Diabetes Advocacy Alliance and our Senate champions to introduce this important piece of legislation.
As diabetes educators know, effective self-management is the path to a better quality of life for people with diabetes. However, barriers within Medicare keep those who might benefit the most for DSMT from accessing the benefit. H.R. 5768 and S. 3366 will reduce barriers and improve Medicare beneficiaries’ 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.
- Allows 6 hours of DSMT in subsequent years, up from 2 hours.
- 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. An example would be a specialist treating a comorbidity like gangrene and vision loss, or an emergency room doctor.
- Revises the Medicare Benefit Policy Manual to allow DSMT services to be furnished in a community-based location.
- Establishes a 2-year demonstration of virtual DSMT, potentially paving the way for future Medicare coverage of virtual DSMT services.
Now that legislation has been introduced in the House and the Senate, we need the help of all diabetes educators to build support for these bills on Capitol Hill. Click here to send a letter to your legislators asking them to co-sponsor the bill in their chamber. You can also call or Tweet your members of Congress urging them to support this important legislation by becoming a cosponsor of the bill. We also encourage everyone to subscribe the Advocacy Forum in MyAADE Network. There you can view our advocacy blog posts, discover the latest in advocacy and discuss advocacy issues with your colleagues.
DSMT is effective. People who complete DSMT programs achieve greater glycemic control, and are better able to lower their A1C levels than people who do not. Additionally, Medicare saves $135 per DSMT participant per month (that’s $22 billion dollars a year) on caring for beneficiaries who complete DSMT. Despite the well- known benefits of DSMT, only about 5 percent of eligible Medicare beneficiaries make use of the DSMT benefit. We are working legislatively to change that and we hope you will join us in our efforts to remove some of these barriers to DSMT.