Medicare Bill Eliminates Co-Pays for Diabetes Training and Mandates Virtual Care Testing by 2026

The Expanding Access to Diabetes Self-Management Training Act of 2025 is a major shift in how Medicare plans to handle diabetes care, focusing heavily on education and removing financial barriers for beneficiaries. Essentially, this bill recognizes that managing diabetes is a skill, and it wants to make sure people can afford to learn it.

The End of Out-of-Pocket Costs for Training

This is the headline provision, kicking in on January 1, 2027. The bill completely eliminates cost-sharing for Diabetes Outpatient Self-Management Training Services (DOSMT). Right now, if you’re on Medicare Part B, you usually have to pay a co-pay and meet your annual deductible before these training services are fully covered. Under this new act, Medicare will pay 100% of the cost for DOSMT. Think about it this way: for a retired factory worker living on a fixed income, eliminating that co-pay and deductible could be the difference between getting the essential training needed to stay healthy and skipping it entirely because of the cost barrier. This change removes the financial friction from a service proven to prevent costly complications down the road.

More Training, Less Red Tape

The bill also makes two key changes to how training is prescribed and delivered, also starting in 2027. First, it expands who can oversee this training. Instead of requiring a physician who manages the patient’s diabetes to prescribe it, now any qualified nonphysician practitioner (like a Nurse Practitioner or Physician Assistant) can do the job. This is a practical fix that frees up doctors’ time and makes it easier for patients, especially those in rural areas, to get the sign-off they need.

Second, the bill sets up a clear structure for ongoing support. Patients get an initial block of 10 hours of training. Crucially, after that, they are guaranteed an additional 2 hours of training every year. This annual check-in recognizes that diabetes management isn't a one-and-done deal—it changes as you age and as technology evolves. Plus, the bill removes previous limitations on the total amount of training a certified provider can give if a doctor or qualified practitioner deems it medically necessary. This means if you have a complicated case, you won't be artificially capped by a bureaucratic hour limit.

The Virtual Care Experiment

Starting much sooner, by January 1, 2026, the Secretary of Health and Human Services must start testing a new model for virtual diabetes care. This isn't just a pilot program; it’s a mandate to see if covering virtual DOSMT services—delivered through qualified web-based programs—actually improves health and saves Medicare money. The test has to measure concrete results, like whether patients' A1c levels improve, if hospitalizations related to diabetes complications decrease, and whether people actually stick with their medication schedules.

This is a big step toward bringing diabetes care into the digital age. For a busy working professional who can't easily take time off for in-person classes, or someone living far from a clinic, accessing a “qualified web-based program” (which can be live or on-demand) could be a game-changer for consistency and convenience. The results of this test will likely shape how Medicare covers remote chronic disease management moving forward.

Who Pays for the Upgrade?

While the benefits for Medicare beneficiaries are clear—better access and zero co-pays for training—it's important to recognize that eliminating cost-sharing shifts 100% of the financial burden onto Medicare Part B. This means increased expenditures for the federal government. While the hope is that better training leads to fewer expensive complications (like amputations or kidney failure), which ultimately saves money, the immediate effect is a higher cost outlay for the system. This is the trade-off: investing in prevention now to avoid higher costs later. The bill also makes a subtle but important change to Medical Nutrition Therapy (MNT) rules, requiring coverage decisions to be made “consistent with” standards, which tightens up the regulatory language slightly to ensure MNT is aligned with best practices.