Expanding Access to Diabetes Self-Management Training Act of 2025

This bill aims to significantly improve access to and affordability of diabetes outpatient self-management training (DSMT) services for Medicare beneficiaries. It amends the Social Security Act to standardize the availability of these crucial services, establishing an initial 10 hours of individual or group educational and training services, followed by an additional 2 hours annually . The legislation also expands who can refer beneficiaries for these services to include qualified non-physician practitioners. A key provision ensures that the Secretary cannot limit the quantity or duration of medically necessary DSMT services furnished by a certified provider. Furthermore, the bill eliminates all beneficiary cost-sharing, including deductibles and copayments, for these diabetes outpatient self-management training services, making them 100 percent covered by Medicare . These changes are set to apply to services furnished on or after January 1, 2027. Beyond direct service improvements, the bill mandates the Center for Medicare and Medicaid Innovation (CMMI) to establish a model for testing the provision of virtual diabetes outpatient self-management training services . This model, to be implemented by January 1, 2026, will evaluate the impact of virtual services on improved health outcomes, such as reduced A1c levels and hospitalizations, and increased utilization, particularly in rural and underserved communities. The CMMI will also assess the model's effect on medication adherence and overall Medicare expenditures, designed in consultation with various stakeholders.