DAA activities in support of Diabetes Self-Management, Education and Support (DSMES) or what CMS refers to as Diabetes Self-Management Training (DSMT) include:

  • Advocating for improvements to DSMT coverage in Medicare
  • Advocating for equitable access to DSMT services for all people with diagnosed diabetes

DSMT is an evidence-based service that teaches people with diabetes how to self-manage the disease to live better and reduce their risk of diabetes-related complications.

DSMT has been a covered benefit under Medicare for more than 20 years. Despite the undisputed benefits of DSMT for people with diabetes – lower hemoglobin A1C, weight loss, improved quality of life, healthy coping skills, and reduced healthcare costs – only an estimated 5 percent of Medicare beneficiaries with newly diagnosed diabetes use DSMT services.

The COVID-19 pandemic, as well as the disproportionate impact of diabetes on individuals from marginalized racial and ethnic groups, has underscored the urgent need to ensure that Medicare beneficiaries have the support they need to self-manage their diabetes.


Some DAA members are advocating for passage of the Expanding Access to Diabetes Self-Management Training Act of 2021 (S. 2203/H.R. 5804), which amends title XVIII of the Social Security Act to improve access to outpatient diabetes self-management training (DSMT) services under the Medicare program.

This legislation makes necessary changes to help increase access to the DSMT benefit to better meet the needs of Medicare beneficiaries with diabetes.

  • Allows the initial 10 hours of DSMT to remain available until fully used.
  • Permits DSMT and Medical Nutrition Therapy (MNT) services to be provided on the same day.
  • Excludes DSMT services from Part B cost-sharing and deductible requirements.
  • Permits physicians and qualified nonphysician practitioners (e.g., podiatrists, emergency department providers, physician assistants, nurse practitioners, or clinical nurse specialists) working in coordination with a treating physician or qualified nonphysician to refer for DSMT services.
  • Establishes a Center for Medicare Innovation demonstration program to test the impact of covering virtual DSMT under the Medicare program.

Congressional sponsors:

  • S. 2203; Sponsors: Collins (R-ME), Shaheen (D-NH)
  • H.R. 5804; Sponsors: Schrier (D-WA), Reed (R-NY), DeGette (D-CO), Upton (R-MI), DelBene (D-WA), Kelly (R-PA), Ruiz (D-CA), Schweikert (R-AZ)

To co-sponsor, please contact:

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