Expanding Access to Diabetes Self-Management Training Act

Why Diabetes Self Management Training Matters

Diabetes Self Management Training (DSMT) is a proven, evidence based intervention that helps individuals with diabetes improve glycemic control, reduce complications, enhance quality of life and lower health care spending.

Medicare has covered DSMT for more than 15 years, yet only 5% of beneficiaries with newly diagnosed diabetes use the benefit, reflecting significant gaps in access and utilization. Expanding access to DSMT is critical to supporting patients in managing a complex chronic condition and reducing the long term burden on the health care system.

Legislation

The Expanding Access to Diabetes Self Management Training Act addresses long standing barriers that prevent Medicare beneficiaries from fully accessing DSMT services:

• Expands ordering authority by allowing physicians and qualified non physician practitioners who are not directly managing a patient’s diabetes—but who are coordinating with the managing clinician—to order DSMT.
• Extends the initial 10 hours of DSMT beyond the first year until fully used and provides for additional hours when needed.
• Removes same day restrictions so DSMT and medical nutrition therapy (MNT) can be provided on the same day.
• Eliminates patient cost sharing and exempts DSMT from Medicare deductibles.
• Allows DSMT services furnished by hospital outpatient departments in community based locations, expanding access beyond hospital settings.
• Creates a Virtual DSMT demonstration project at CMMI to evaluate the effectiveness of telehealth delivery.

Together, these provisions reduce administrative barriers, improve affordability, and expand access points so more beneficiaries can receive essential diabetes education and support.

The Academy's Stance on DSMT

The Academy strongly supports the Expanding Access to DSMT Act and advocates for improving Medicare beneficiary access to high quality diabetes self management training. RDNs play a central role in DSMT delivery, and removing outdated restrictions—such as same day DSMT and MNT limitations—strengthens coordinated care, enhances patient outcomes, and reduces unnecessary utilization and costs.

The Academy also supports virtual DSMT options to reach rural and underserved populations and endorses expanding who may refer beneficiaries to ensure patients receive timely, comprehensive diabetes care.

DSMT Advocacy Resources

• Expanding Access to Diabetes Self-Management Training Act: Issue Brief (PDF)