Collins, Brown Introduce Bill to Improve Diabetes Patients’ Access to Therapeutic Shoes

Washington, D.C. – U.S. Senators Susan Collins (R-ME) and Sherrod Brown (D-OH) reintroduced their bipartisan Promoting Access to Diabetic Shoes Act that would improve diabetic patients’ access to therapeutic shoes by allowing nurse practitioners (NPs) and physician associates/physician assistants (PAs) - who often act as sole primary care providers for many patients with diabetes – to prescribe this important treatment method. Diabetes can be a serious disease that can lead to health complications including the amputation of toes, feet, or legs. In addition to managing the disease through physical activity, diet, and medication, diabetic patients often benefit from the use of therapeutic shoes, which are intended to prevent complications like foot ulcers, calluses, or amputations.

“Therapeutic shoes are a proven method for preventing costly and painful complications related to diabetes, yet current Medicare regulations force patients to endure a time-consuming process to obtain them,” said Senator Collins, the founder and co-chair of the Senate Diabetes Caucus. “Our bipartisan legislation would allow nurse practitioners and physician assistants to certify their patients’ need for this important treatment method.”

“Across the country, nurse practitioners and physician assistants provide absolutely vital primary care services for patients living with diabetes, particularly those in rural and underserved areas,” said Senator Brown. “By cutting through red tape and ensuring those health care professionals can treat their patients and sign-off on the therapies they desperately need, we can improve health care access for Ohioans.”

“I would like to thank Senator Collins for introducing the Promoting Access to Diabetic Shoes Act. Nurse practitioners in Maine and across the country are caring for patients across the lifespan, including those with diabetes, delivering high quality health care in nearly every health care setting. This legislation will create greater efficiency in our system for patients who choose an NP for their care, as it will help to ensure timely access to therapeutic shoes. I am hopeful that action is taken to pass this legislation and the patients can access the care they need without delay," said Valerie Fuller, PhD, DNP, AGACNP-BC, FNP-BC, FAANP, AANP Board of Directors.

“America is facing a perfect storm of growing health care challenges, leaving patients with less than adequate access to the care they need and deserve. An aging U.S. population, increasing prevalence of chronic diseases like diabetes and a growing mental health crisis demand that we disrupt the status quo and embrace commonsense solutions that will make health care delivery more effective for every American,” said American Academy of Physician Associates President and Board Chair Jennifer Orozco, DMSc, PA-C, DFAAPA. “The Promoting Access to Diabetic Shoes Act would correct an undue barrier to care for Medicare beneficiaries by authorizing PAs to order diabetic shoes for their patients. On behalf of the more than 159,000 PAs in the U.S., the American Academy of Physician Associates (AAPA) recognizes and appreciates the leadership of the bill sponsors, Senators Sherrod Brown and Susan Collins and Representatives Earl Blumenauer and Darin LaHood.  This bill demonstrates their continued dedication to patients and their efforts to ensure unnecessary barriers do not stand in the way of a health care provider's ability to provide timely patient care.”

“The American Association of Nurse Practitioners (AANP), on behalf of the more than 355,000 nurse practitioners (NPs) nationwide, would like to commend Senators Brown and Collins for introducing the Promoting Access to Diabetic Shoes Act,” said AANP President April N. Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN. “Every day nurse practitioners are delivering high-quality health care in nearly every health care setting, caring for patients across the lifespan, including those with diabetes. This bipartisan bill will create greater efficiency in the delivery of health care by ensuring that Medicare patients who receive care from a nurse practitioner have timely access to therapeutic shoes. The time is now to enact this legislation, and to ensure patients can access the care they need without delay.”

While NPs and PAs often act as sole primary care providers for patients with diabetes – and particularly those in underserved and rural communities – current law requires that they send their diabetic, Medicare patients who need therapeutic shoes to a physician who will certify that they do in fact need these shoes. The physician is then required to become the provider managing the patient’s diabetic condition moving forward. Not only does the current law impose additional costs on the Medicare program by requiring the participation of an additional provider, it can also result in delays for patients in underserved and rural areas which could jeopardize their overall health.

This bill would authorize NPs and PAs to certify a Medicare beneficiary’s need for therapeutic shoes, thus improving timeliness and access to care while reducing costs. This legislation is endorsed by the American Association of Nurse Practitioners and the American Academy of Physician Associates.

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