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Senators Collins, Brown Introduce Bipartisan Bill That Would Provide Diabetic Patients with Better Access to Therapeutic Shoes

Washington, D.C. – U.S. Senators Susan Collins (R-ME) and Sherrod Brown (D-OH) introduced a bipartisan bill that would improve access to care for diabetic patients who require therapeutic shoes called the Promoting Access to Diabetic Shoes Act. Diabetes can be a serious disease that can sometimes lead to health complications including the amputation of toes, feet, or legs. In addition to managing the disease with physical activity, diet, and medications to control blood sugar levels, diabetic patients often benefit from the use of therapeutic shoes, which are intended to prevent complications like foot ulcers, calluses, or amputations that can result from diabetes.


 “Therapeutic shoes are a proven method for preventing costly and painful complications related to diabetes, yet current Medicare regulations force patients to endure a time consuming process to obtain them,” said Senator Collins, the founder and co-chair of the Senate Diabetes Caucus. “Our bipartisan legislation would allow nurse practitioners and physician assistants to certify their patients’ need for this important treatment method.”


“Across the country, nurse practitioners and physician assistants provide absolutely vital primary care services for patients living with diabetes, particularly those in rural and underserved areas. By cutting through red tape and ensuring those health care professionals can treat their patients and sign-off on the therapies they desperately need, we can improve health care access for Ohioans,” said Senator Brown.


“AANP commends Senators Brown and Collins on the introduction of S. 3067 the Promoting Access to Diabetic Shoes Act.  This bipartisan bill will provide patients of NPs access to diabetic shoes helping to ensure the right care at the right time is delivered while reducing costs. Millions of patients each year choose an NP as their primary care provider, and this legislation will create greater efficiency in the delivery of health care,” said Joyce Knestrick, PhD, C-FNP, APRN, FAANP, President of the American Association of Nurse Practitioners.


“PAs effectively manage all the complexities of diabetes care. Yet, archaic federal law prohibits their authority to order diabetic shoes. With the aging population and the increasing prevalence of this disease, removal of this barrier will make such a difference for patients everywhere,” said L. Gail Curtis, MPAS, PA-C, DFAAPA, president and chair of the American Academy of PAs Board of Directors. “AAPA appreciates Senators Collins and Brown for introducing this common sense legislation.”


While nurse practitioners and physician assistants (PAs) across the country often act as sole primary care providers for many patients with diabetes – and particularly those in underserved and rural communities – current law requires that they send their diabetic, Medicare patients who need therapeutic shoes to a physician who will then certify that they do in fact need these shoes. The physician is then required to become the provider managing the patient’s diabetic condition moving forward. Not only does the current law impose additional costs on the Medicare program by requiring the participation of an additional provider, but it can result in delays for patients in underserved and rural areas which could jeopardize their health, when they can no longer go to the nurse practitioner or PA from whom they have previously received care.


This bill would authorize nurse practitioners and physician assistants to certify a Medicare beneficiary’s need for therapeutic shoes, thus improving timeliness and access to care while reducing costs.


According to the Centers for Disease Control and Prevention (CDC), more than 100 million adults in the United States are now living with diabetes or prediabetes. A March 2018 article in The American Journal of Medicine found nurse practitioners, PAs, and physicians are comparable in the management of diabetes at diagnosis and during the first five years of follow up care.  


This legislation is endorsed by the American Association of Nurse Practitioners, the American Academy of Physician Assistants, and the American Podiatric Medical Association.


As founder and co-chair of the Senate Diabetes Caucus, Senator Collins has worked to increase awareness of the threats posed by diabetes, invest in research, and improve access to treatment options. Earlier this year, Senator Collins secured a full two-year reauthorization of the Special Diabetes Program in the government funding bill. This program, which includes funding for Type 1 Diabetes research and the Diabetes Program for Indians, supports the livelihood, health, and well-being of the more than 30 million Americans diagnosed with diabetes and the additional 84 million diagnosed with prediabetes.


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