Nurse practitioners, physician assistants could sign off on therapeutic shoes under new bill

Medicare covers one pair of therapeutic shoes and two inserts for many people with diabetes each year. However, a doctor’s prescription is currently required to confirm coverage. A new bipartisan bill, the Promoting Access to Diabetic Shoes Act, could make it possible for nurse practitioners and physician assistants to also sign off on these prescriptions. Supporters hope this will help more people with diabetes access much-needed therapeutic shoes to prevent complications such as foot ulcers and calluses.

Nurse Practitioner at Canberra Hospital Walk-in Centre

Foot issues are a major concern for people with diabetes. That’s why Medicare and most major insurance companies cover the cost of custom-made diabetic shoes and inserts.

It sounds pretty great – but there’s a catch. To access coverage for these shoes, people need to go through a series of steps. This includes getting a prescription from a doctor and being professionally fitted for shoes.

While the shoe fitting remains critically important for a foot’s health, the prescription requirement has received some pushback. Not everyone who needs these therapeutic shoes has access to a doctor on a regular basis. Particularly in rural and underserved areas, many diabetics depending on nurse practitioners and physician assistants for regular health care support.

Two U.S. Senators, Maine Republican Sen. Susan Collins and Ohio Democratic Sen. Sherrod Brown, have decided to take action on this issue. They have introduced a bill entitled the Promoting Access to Diabetic Shoes Act.

The goals of this proposed legislation are:

  • Reduce cost for patients and/or insurance companies: Many patients incur expenses trying to get routine prescriptions for diabetic shoes from their doctors. By allowing more medical professionals to sign off for shoes and inserts, they will avoid these expenses.
  • Save patients and doctors time: Patients who wear therapeutic shoes often need a new prescription each year in order to get coverage from Medicare or insurance. This will cut out the annual back-and-forth by allowing an NP or assistant to provide the needed renewal. It will also help people who need therapeutic shoes to get them more quickly.
  • Increased access to therapeutic shoes: People in underserved or rural areas may not have access to a doctor. This bill would allow them to still access the shoes they need.
  • Encouraging use of therapeutic shoes for those who need them: By getting rid of some of the red tape, the bill aims to encourage those who truly need these shoes to go ahead and get them. Not using the correct shoes can lead to serious foot complications and loss of limbs for many diabetics, so this is a critical preventative tool for people trying to take care of themselves.

As L. Gail Curtis, MPAS, PA-C, DFAAPA, president and chair of the American foot pain preventionAcademy of Physician’s Assistants’ Board of Directors notes, “With the aging population and the increasing prevalence of this disease, removal of this barrier will make such a difference for patients everywhereAAPA appreciates Senators Collins and Brown for introducing this common sense legislation.” The bill has also been endorsed by the American Association of Nurse Practitioners and the American Podiatric Medical Association.

More than 100 million adults in the United States are now living with diabetes or prediabetes. At No Cost Shoes, we work to connect these people with therapeutic shoes covered by Medicare.  We try to make this as easy as possible by faxing a prescription to a family doctor to sign, but many still find that accessing a doctor is a challenge. For example, some patients do not have a family doctor, while others struggle to afford prescription renewal fees from an MD’s office.

As always, we will continue to keep you updated on any new and legislation that may affect your access to diabetic shoes and inserts. Those seeking support in accessing diabetic shoes can check their eligibility for coverage at

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