This bill expands Medicare coverage for diabetes self-management training by removing patient costs, broadening provider eligibility, and mandating a test of virtual training options.
Kim Schrier
Representative
WA-8
The Expanding Access to Diabetes Self-Management Training Act of 2025 aims to significantly improve Medicare coverage for diabetes self-management training by eliminating patient out-of-pocket costs and expanding the pool of qualified providers. The bill establishes a new structure for training hours, granting patients an initial block of 10 hours plus two additional hours annually. Furthermore, it mandates that the Secretary of HHS test models for covering virtual diabetes self-management training services to evaluate their impact on health outcomes and costs.
Medicare Bill Eliminates Co-Pays for Diabetes Training, Guarantees 10 Hours of Education Starting 2027
The Expanding Access to Diabetes Self-Management Training Act of 2025 is a clear win for Medicare beneficiaries managing diabetes, essentially wiping out the financial barriers to getting the education needed to live well with the condition. Starting January 1, 2027, if you are on Medicare and need diabetes self-management training (DSMT), you won’t pay a dime out-of-pocket for it. That means no co-pays and the standard Medicare Part B deductible won’t apply to these specific services anymore (Sec. 2).
The Fine Print on Free Training
This bill standardizes how much training you can get, which is a big deal for clarity and access. Currently, the rules can feel a little fuzzy, but this legislation sets a firm baseline: every Medicare patient with diabetes gets an initial block of 10 hours of individual or group training. Once that’s done, you are entitled to 2 additional hours of training every year going forward (Sec. 2). Think of it like getting a guaranteed refresher course every year to keep up with new technology or just reinforce good habits. Crucially, the bill also removes previous limitations on who can provide this care, allowing qualified nonphysician practitioners—like certified diabetes educators—to deliver the training, giving patients more flexibility than just relying on their primary doctor.
Testing the Virtual Classroom
Beyond making the in-person training free and easier to access, the bill recognizes that many people can’t easily get to a clinic. To address this, it mandates that the Secretary of Health and Human Services must start a test program by January 1, 2026, to figure out how to cover virtual or online DSMT services through Medicare (Sec. 3). This isn't just a pilot project; it’s specifically designed to measure whether virtual training—which can be live video (synchronous) or on-demand content (asynchronous)—actually improves health outcomes, like lowering A1c levels, reducing hospitalizations, and saving Medicare money in the long run.
Why This Matters for Your Wallet and Schedule
If you or someone you know manages diabetes, this legislation tackles two major pain points: cost and convenience. Removing the deductible and co-pays for this training means a diagnosis won't immediately hit your budget just for the essential education required to manage the disease. For someone in a rural area, or a busy working adult juggling kids and shifts, the mandated testing of a “Qualified Web-Based Program” for virtual training could be huge. If that test proves successful, it opens the door to getting critical health education from your home computer, saving travel time and making it much easier to stick with a treatment plan. The bill requires the Secretary to consult with patient groups and digital health experts before designing the test, which suggests they are trying to ensure the virtual programs are actually user-friendly and effective for everyday people (Sec. 3).