Diabetes Foot Health Access and Modernization Act of 2026
- Sponsor
- Rep. Joyce, John [R-PA-13]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Mar 12, 2026
Bottom line
The bill aims to improve access to critical foot and ankle care for diabetic patients under both Medicaid and Medicare by expanding provider recognition and clarifying documentation requirements.
What it actually does
This bill amends Title XIX (Medicaid) of the Social Security Act to recognize Doctors of Podiatric Medicine as physicians for covered services, thereby expanding Medicaid beneficiaries' access to foot and ankle care. It also amends Title XVIII (Medicare) to clarify and update the documentation requirements for therapeutic extra-depth or custom-molded shoes for individuals with diabetes, streamlining the process for obtaining essential preventative footwear.
Proponents argue
Proponents argue that recognizing podiatric physicians as physicians under Medicaid will ensure beneficiaries have access to comprehensive foot and ankle care, which is crucial for managing diabetes and preventing severe complications like amputations. They also contend that clarifying Medicare documentation for diabetic shoes will reduce administrative burdens for providers and ensure timely access to essential preventative care for individuals with diabetes, ultimately improving health outcomes and reducing long-term healthcare costs.
Opponents contend
Opponents might raise concerns about potential increased costs to the Medicaid program by expanding the definition of covered physician services without a clear offsetting mechanism. They might also argue that while clarification is useful, overly specific documentation requirements, even if streamlined, could still create administrative hurdles or lead to increased utilization that impacts program expenditures.
The bill is very short and clearly written, making it highly accessible for any reader to understand its provisions quickly.
Section 2(a), amending Section 1905(a)(5)(A) of the Social Security Act
Recognizing Doctors of Podiatric Medicine as Physicians Under the Medicaid Program
This provision amends the Social Security Act to include Doctors of Podiatric Medicine (DPMs) within the definition of 'physician' for the purposes of Medicaid. This change means that services provided by podiatric physicians will be covered under Medicaid, aligning their recognition with other medical professionals and expanding access to specialized foot and ankle care for Medicaid beneficiaries, particularly those with diabetes.
Supporters argue
Supporters argue this is a critical step to ensure comprehensive care for Medicaid beneficiaries, particularly those with diabetes, who are at high risk for foot complications. They contend it will improve health outcomes, prevent amputations, and reduce overall healthcare costs by enabling preventative and early intervention care.
Critics contend
Critics might express concerns about the potential for increased Medicaid expenditures without a clear offsetting mechanism, arguing that states may face higher costs to cover these newly recognized services. They might also question the necessity of a federal mandate if states already have mechanisms for covering such services.
Tradeoffs
The bill balances the goal of expanding access to specialized care for vulnerable populations against the potential for increased state and federal Medicaid costs. It also addresses the tension between professional recognition and existing program definitions, aiming for greater uniformity.
Section 3(a), amending Section 1861(s)(12) of the Social Security Act
Clarifying Medicare Documentation Requirements for Therapeutic Shoes for Persons with Diabetes
This provision revises the Medicare documentation requirements for extra-depth shoes with inserts or custom-molded shoes with inserts for individuals with diabetes. It specifies that a physician must document the individual's peripheral neuropathy (including altered foot sensation, weakness, or diminished motor control), a history of pre-ulcerative calluses or other ulceration, foot deformity, previous lower extremity amputation, or poor lower extremity circulation. The physician must also attest to a diabetes diagnosis, a comprehensive plan of care, and the individual's need for such shoes. The shoes must be fitted and furnished by a physician or other qualified individual (e.g., a pedorthist or orthotist).