Medicare expands who can authorize diabetic shoes for patients

What it does

This bill allows nurse practitioners and physician assistants to sign off on the medical documentation required for Medicare to cover therapeutic shoes for diabetic patients. Currently, only physicians can authorize this coverage; the bill expands that authority to two additional categories of licensed clinicians who commonly treat diabetic patients in primary care and endocrinology settings.

Why we flagged it

The bill's sole function is to broaden the pool of clinicians authorized to document medical necessity for a specific Medicare benefit, removing a credentialing bottleneck that delays patient access to therapeutic footwear.

What the text implies

• Reduces administrative delays for diabetic patients seeking shoe coverage by allowing them to obtain authorization from nurse practitioners and physician assistants, who are often more readily available in primary care and community health settings.
• May modestly increase Medicare claims volume for diabetic shoes if the expanded clinician pool reduces documentation gatekeeping, though the underlying medical need is unchanged.
• Aligns Medicare documentation authority with clinical scope of practice — nurse practitioners and physician assistants are already authorized to diagnose and manage diabetes in most state licensing regimes.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

Diabetic patients benefit from expanded access to medically necessary shoes through a broader pool of qualified clinicians; the bill removes an artificial bottleneck that forced patients to wait for physician appointments when equally qualified nurse practitioners and physician assistants could authorize the same care. No restrictions on patient rights or protections are imposed.

Who stands to gain

• orthopedic shoe manufacturers and suppliers (modest volume increase)
• diabetic patients (reduced out-of-pocket delays and access friction)

Named in the bill

Centers for Medicare & Medicaid Services (CMS), nurse practitioners, physician assistants, physicians, Medicare, Social Security Act § 1861(s)(12), diabetic patients

Where it stands

8 cosponsors: 6 Democrats, 2 Republicans.

• May 19, 2025 — Introduced · Congress.gov: “Introduced in Senate”
• May 19, 2025 — Referred to Senate Committee on Finance · Congress.gov: “Read twice and referred to the Committee on Finance. (Sponsor introductory remarks on measure: CR S2973-2974)”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

8 lobbying clients named this bill on 12 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $1,913,067 in lobbying spend. A filing names 25 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 88% of bills with at least one filing.

Susan Collins, the sponsor, reported $2,459,513 in PAC receipts in the 2026 cycle.

• American Association of Nurse Practitioners — $950,000 on 2 filings
• American Academy of Physician Associates — $320,000 on 2 filings
• American Nurses Association — $270,000 on 1 filing
• American Association of Nurse Practitioners — $130,000 on 2 filings
• American Academy of Physician Associates — $120,000 on 2 filings

Lobbying Disclosure Act filings through Jul 22, 2026. A filing shows who paid to lobby on a bill it names, not what changed.