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Congress·In Committee·S. 4037

Sens. Shaheen and Collins Introduce DIABETES Act to Protect Medicare Access to Insulin Pumps and Monitors

Diabetes Act

14 days ago·View on Congress.gov·Read full text

Legislative Progress

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Key Points

  • The bill ensures people who already use diabetes technology like insulin pumps and glucose monitors can keep using them when they enroll in Medicare. A provider can certify within the first 12 months of enrollment that the patient is already using these devices, streamlining continued coverage.

    From policy text

    “during the first 12 months of an individual's enrollment for benefits under part B, a provider (as defined in subparagraph (E)) may certify to the Secretary that an individual is using 1 or multiple diabetes technologies covered under part B”
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  • Diabetes self-management training becomes free for Medicare patients by eliminating both cost-sharing and the deductible. Patients currently pay a portion of these training costs, but this bill covers 100% of the charge, removing a financial barrier to learning how to manage their condition.

    From policy text

    “with respect to diabetes outpatient self-management training services (as defined in section 1861(qq)), the amount paid shall be 100 percent of the lesser of the actual charge for the services or the amount determined under the fee schedule that applies to such services under this part”
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  • Congress calls on the HHS Secretary to ensure that the algorithm or software driving automated insulin delivery systems is separately reimbursed by Medicare, recognizing it as a critical and "reasonable and necessary" component. Currently, Medicare covers the physical pump but doesn't always pay for the software that controls insulin dosing.

    From policy text

    “Medicare currently fails to separately reimburse for the essential algorithms and software that drive automated insulin delivery (AID) systems, which may stifle future innovation and maintenance, and impede beneficiary access.”
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  • The bill directs the Center for Medicare Innovation to test virtual diabetes training programs by January 2027. This pilot would allow patients to receive education through online platforms, helping people in rural areas or those with mobility limitations access critical diabetes management support.

    From policy text

    “the Secretary shall implement a model to test the impact of providing coverage under title XVIII for virtual diabetes outpatient self-management training services furnished to applicable beneficiaries with respect to improved health outcomes”
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  • Starting January 2031, continuous glucose monitors and insulin pumps would be excluded from the competitive bidding program, which Congress finds limits innovation and access to diabetes technologies. This means Medicare would no longer force these devices into a lowest-bidder system that can restrict patient choice.

    From policy text

    “Continuous glucose monitors and insulin pumps that are covered as durable medical equipment under section 1861(n) furnished on or after January 1, 2031.”
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  • A GAO report is required within one year to assess barriers people face in accessing diabetes technologies and training across all federal health programs, including problems with prior authorizations, preferred formularies, and coverage limitations.
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Impact Analysis

Personal Impact

Scores: 1 = low, 5 = highSentiment: -5 to +5 (net benefit)

Milestones

2 milestones2 actions
Mar 10, 2026Senate

Read twice and referred to the Committee on Finance.

Mar 10, 2026

Introduced in Senate

What Happens Next

Projected impacts based on AI analysis

Within 6 months of the bill becoming law

HHS must propose a national coverage determination on insulin pumps within 180 days of enactment

This could update and standardize the rules for which Medicare patients qualify for insulin pumps, potentially expanding access

Source Information

Document Type

Congressional Bill

Official Title

Diabetes Act

Bill NumberS 4037
Congress119th Congress
ChamberSenate
Latest ActionRead twice and referred to the Committee on Finance.
Read Full Bill Text

Sponsor

Cosponsors

(1)
R: 1

Analysis generated by AI. Always verify with official sources.