I 
119TH CONGRESS 
1ST SESSION H. R. 3826 
To amend title XVIII of the Social Security Act to improve access to diabetes 
outpatient self-management training services, to require the Center for 
Medicare and Medicaid Innovation to test the provision of virtual diabetes 
outpatient self-management training services, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 6, 2025 
Ms. SCHRIER (for herself, Mr. BILIRAKIS, Ms. DELBENE, Ms. WASSERMAN 
SCHULTZ, and Ms. NORTON) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce, and in addition to 
the Committee on Ways and Means, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to improve 
access to diabetes outpatient self-management training 
services, to require the Center for Medicare and Medicaid 
Innovation to test the provision of virtual diabetes out-
patient self-management training services, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Expanding Access to 
Diabetes Self-Management Training Act of 2025’’. 
SEC. 2. IMPROVING ACCESS TO DIABETES OUTPATIENT 
SELF-MANAGEMENT TRAINING SERVICES. 
(a) IN GENERAL.—Section 1861(qq) of the Social Se-
curity Act (42 U.S.C. 1395x(qq)) is amended— 
(1) in paragraph (1)— 
(A) by striking ‘‘the Secretary determines 
appropriate’’ and inserting ‘‘specified in para-
graph (3)’’; and 
(B) by striking ‘‘the physician who is man-
aging the individual’s diabetic condition’’ and 
inserting ‘‘a physician or qualified nonphysician 
practitioner’’; 
(2) in paragraph (2)(B), by striking ‘‘para-
graph’’ and inserting ‘‘subparagraph’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(3)(A) For purposes of paragraph (1) and subject 
to subparagraph (B), the times specified in this paragraph 
are the following: 
‘‘(i) An initial 10 hours of individual or group 
educational and training services to remain available 
until used. 
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‘‘(ii) An additional 2 hours of individual or 
group educational and training services each year, 
beginning with the year in which the initial 10 hours 
described in subparagraph (A) are completed. 
‘‘(B) The Secretary shall not limit the quantity or 
duration of educational and training services furnished by 
a certified provider to an individual with diabetes if such 
services are deemed medically necessary by a physician or 
qualified non-physician practitioner.’’. 
(b) MEDICAL NUTRITION THERAPY SERVICES.—Sec-
tion 1861(s)(2)(V) of the Social Security Act (42 U.S.C. 
1395x(s)(2)(V)) is amended— 
(1) by striking clause (i); 
(2) by redesignating clauses (ii) and (iii) as 
clauses (i) and (ii), respectively; and 
(3) in clause (ii), as so redesignated, by striking 
‘‘after consideration of’’ and inserting ‘‘consistent 
with’’. 
(c) COST-SHARING.—Section 1833 of the Social Se-
curity Act (42 U.S.C. 1395l) is amended— 
(1) in subsection (a)(1)— 
(A) by striking ‘‘and (HH)’’ and inserting 
‘‘(HH)’’; and 
(B) by inserting the following before the 
semicolon at the end: ‘‘and (II) with respect to 
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diabetes outpatient self-management training 
services (as defined in section 1861(qq)), the 
amount paid shall be 100 percent of the lesser 
of the actual charge for the services or the 
amount determined under the fee schedule that 
applies to such services under this part;’’; and 
(2) in subsection (b), in the first sentence— 
(A) by striking ‘‘, and (13)’’ and inserting 
‘‘(13)’’; and 
(B) by striking ‘‘1861(n)..’’and inserting 
‘‘1861(n), and (14) such deductible shall not 
apply with respect to diabetes outpatient self- 
management training services (as defined in 
section 1861(qq))’’. 
(d) APPLICATION.—The amendments made by this 
section shall apply with respect to items and services fur-
nished on or after January 1, 2027. 
SEC. 3. CMI TESTING OF PROVIDING VIRTUAL DIABETES 
OUTPATIENT SELF-MANAGEMENT TRAINING 
SERVICES. 
Section 1115A of the Social Security Act (42 U.S.C. 
1315a) is amended— 
(1) in subsection (b)(2)(A), by adding at the 
end the following new sentence: ‘‘The models se-
lected under this subparagraph shall include the 
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testing of the model described in subsection (h).’’; 
and 
(2) by adding at the end the following new sub-
section: 
‘‘(h) TESTING OF PROVIDING VIRTUAL DIABETES 
OUTPATIENT
SELF-MANAGEMENT
TRAINING
SERV-
ICES.— 
‘‘(1) ESTABLISHMENT.—Not later than Janu-
ary 1, 2026, the Secretary shall implement a model 
to test the impact of providing coverage under title 
XVIII for virtual diabetes outpatient self-manage-
ment training services furnished to applicable bene-
ficiaries with respect to improved health outcomes 
for such applicable beneficiaries and reduced expend-
itures under such title XVIII. 
‘‘(2) MODEL DESIGN.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
design the model under this subsection in such 
a manner to allow for the evaluation of demo-
graphic characteristics of applicable bene-
ficiaries participating in such model and the ex-
tent to which such model accomplishes the fol-
lowing purposes: 
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‘‘(i) Improvement in health outcomes 
with respect to the diabetic conditions, in-
cluding by reducing A1c levels. 
‘‘(ii) Reduced hospitalizations due to 
diabetic-related complications. 
‘‘(iii) Increased utilization of diabetes 
outpatient self-management training serv-
ices as evidenced by, for example, Medicare 
beneficiary participation and utilization of 
covered hours during the first year and 
subsequent years or use of diabetes out-
patient self-management training services 
in rural and underserved communities. 
‘‘(iv) Improved medication adherence. 
‘‘(v) Reduced expenditures under this 
title attributable to the model. 
‘‘(B) CONSULTATION.—In designing the 
model under this subsection, the Secretary 
shall, not later than 3 months after the date of 
the enactment of this subsection, consult with 
stakeholders in the field of diabetes care and 
education, clinicians in the primary care com-
munity, experts in digital health, and bene-
ficiary groups. 
‘‘(3) DEFINITIONS.—In this subsection: 
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