Medicare expands diabetes technology access, removes cost barriers for beneficiaries

What it does

The DIABETES Act expands Medicare coverage and access to diabetes management technologies and education. It requires Medicare to separately reimburse for the algorithms and software that power automated insulin delivery systems, ensures continuous glucose monitors and insulin pumps remain accessible outside competitive bidding programs, expands diabetes self-management training hours from 2 to 12 annually with no cost-sharing, and directs the Secretary of Health and Human Services to establish new billing codes for insulin pump training and issue updated coverage rules by specific deadlines.

Why we flagged it

The bill's core function is to broaden Medicare reimbursement and access to diabetes management technologies and education services. While it touches regulatory and coding mechanisms, the primary intent is public health—expanding beneficiary access to clinically recommended treatments.

What the text implies

• Removal of competitive bidding restrictions on continuous glucose monitors and insulin pumps may increase Medicare spending on these items in the short term, though the bill frames this as necessary to prevent access disruption and stifle innovation.
• The requirement that algorithms/software in automated insulin delivery systems be separately reimbursable creates new billing categories and administrative overhead for Medicare contractors and providers, with implementation timelines (January 1, 2027) that may strain readiness.

The full analysis lists 5 implications of this text.

Who stands to gain

Insulin pump manufacturers (e.g., Medtronic, Tandem Diabetes); Continuous glucose monitor manufacturers (e.g., Dexcom, Abbott); Diabetes education and training service providers