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HR 7905

Diabetes Foot Health Access and Modernization Act of 2026

119th Congress Introduced by Becca Balint and 41 co-sponsors

Expands Medicaid to recognize podiatric physicians and clarifies Medicare coverage for diabetic therapeutic footwear, with new documentation and fitting requirements.

Introduced in House
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WeVote Research Nonpartisan
Bill Summary · HR 7905

Overview

Diabetes Foot Health Access and Modernization Act of 2026 (H.R. 7905) aims to improve access to foot and ankle care for people with diabetes by expanding Medicaid coverage to include podiatric physicians as qualified physicians under the Medicaid program, and to modernize Medicare rules for diabetic therapeutic footwear. The bill was introduced in the 119th Congress and has multiple co-sponsors.

Purpose and intent

  • Increase access to appropriate, quality foot and ankle care for Medicaid beneficiaries by recognizing doctors of podiatric medicine as physicians under Medicaid.
  • Clarify and expand Medicare coverage rules for therapeutic footwear for people with diabetes, including extra-depth shoes with inserts or custom molded shoes with inserts, with specific documentation and provider requirements.
  • Provide a clearer, standardized framework for both Medicaid and Medicare around diabetic foot health to potentially reduce complications and improve outcomes.

Key provisions

  1. Medicaid physician recognition for podiatrists (Section 2)

    • Amends Section 1905(a)(5)(A) of the Social Security Act to replace references to physician coverage with a broader recognition that includes podiatric physicians under Medicaid.
    • Effective date: Generally applies to services furnished on or after January 1, 2026.
    • State plan flexibility: If a state plan requires new state legislative action to meet the amendment, the effective date for that state can be extended beyond the initial date, with a specific transitional period tied to the start of the next calendar quarter after the end of the first regular session of the state legislature following enactment.

  2. Medicare footwear documentation and coverage (Section 3)

    • Amends Section 1861(s)(12) to clarify eligibility and documentation for extra-depth shoes with inserts or custom molded shoes with inserts for individuals with diabetes.
    • Documentation requirements include:
      • A physician (as defined in Section 1861(r)) must document:
      • Peripheral neuropathy or related foot issues (altered sensation, weakness, or diminished motor control) and/or a history of pre-ulcerative conditions or foot ulceration, plus foot deformity, prior lower-extremity amputation, or poor circulation.
      • A current diabetes diagnosis and a comprehensive care plan for the diabetes condition.
      • A determination that the individual needs such shoes.
      • The shoes must be fitted and furnished by a physician or other qualified individual (e.g., pedorthist or orthotist) as established by the Secretary.
    • Conforming amendment to Section 1877(h)(6) to include extra-depth shoes with inserts or custom molded shoes with inserts as covered items.
    • Effective date: Applies to items and services furnished on or after January 1, 2028.

Affected parties

  • Medicaid beneficiaries: Expanded access to podiatric physician services under Medicaid, improving access to foot and ankle care.
  • Podiatric physicians: Recognized as physicians for Medicaid purposes, potentially increasing reimbursement opportunities and scope of practice within Medicaid.
  • Medicare beneficiaries with diabetes: Potentially expanded coverage and clarified documentation for therapeutic footwear.
  • State Medicaid programs: May need to adjust state plans to comply with the new requirements; some states may require legislative action to align with the federal amendment, triggering transitional provisions.

Timelines and procedural notes

  • Introduction date: March 12, 2026.
  • Medicaid effective date for the podiatric physician recognition: January 1, 2026 (with State plan extension provisions if state law changes are required).
  • Medicare footwear provisions effective date: January 1, 2028.
  • The bill was referred to the House Committees on Energy and Commerce and Ways and Means for consideration.

Potential impact

  • Access: Improved access to appropriate foot and ankle care for Medicaid beneficiaries through podiatric physicians; clearer coverage for therapeutic footwear under Medicare may improve access to necessary diabetic footwear.
  • Quality of care: Documentation and qualification requirements aim to ensure appropriate patient selection and proper fitting of specialized footwear.
  • Administrative: State Medicaid plan administrations may need to adjust policies; transitional provisions provide flexibility for states requiring new legislation.

Summary

H.R. 7905 seeks to modernize and expand diabetes-related foot health care by (1) recognizing podiatric physicians within Medicaid, and (2) refining Medicare rules for therapeutic footwear to ensure proper diagnosis, care planning, and professional fitting. It sets specific effective dates (2026 for Medicaid changes; 2028 for Medicare footwear changes) and includes transitional provisions for state plan compliance.

Compiled from official sources — confirm details with the bill’s official record.

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