Diabetes Act

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.
• 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.
• 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.
• 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.
• 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.
• 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.