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Bill

S 4070

Diabetes Foot Health Access and Modernization Act of 2026

119th Congress Introduced by Martin Heinrich and 5 co-sponsors

The bill expands access to foot care by recognizing podiatric physicians as physicians under Medicaid and clarifying Medicare coverage criteria for therapeutic diabetic footwear.

Introduced in Senate
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WeVote Research Nonpartisan
Bill Summary · S 4070

Overview

Diabetes Foot Health Access and Modernization Act of 2026 (S. 4070, 119th Congress) aims to improve access to appropriate foot and ankle care for Medicaid beneficiaries and to clarify Medicare requirements for diabetic footwear. The bill addresses both public insurance programs (Medicaid under Title XIX and Medicare under Title XVIII) and sets effective dates for the proposed changes.

Purpose and intent

  • Ensure Medicaid beneficiaries have access to physician services delivered by podiatric physicians (podiatrists) by recognizing podiatrists as physicians under Medicaid.
  • Clarify and standardize Medicare coverage and documentation requirements for therapeutic footwear for people with diabetes, including extra-depth shoes with inserts or custom molded shoes with inserts.
  • Provide a clear effective timeline for implementation and, where needed, potential state plan accommodations to meet newly added requirements.

Key provisions

1) Recognition of podiatric physicians under Medicaid (Section 2)

  • The Social Security Act is amended to redefine who counts as a physician for Medicaid purposes.
  • Specifically, the amendment changes the reference that currently pertains to section 1861(r)(1) to include sections 1861(r)(1) and 1861(r)(3). This broadens the interpretation to recognize podiatric physicians as physicians for Medicaid benefits.
  • Effective date: Services furnished on or after January 1, 2026, with a special extension provision for states needing their own legislation to comply. If a state plan requires state legislative action to meet the new requirement, the state has until the first calendar quarter after the close of the first regular session to comply without being deemed out of compliance.

2) Medicare documentation and coverage for therapeutic diabetic shoes (Section 3)

  • Medicare Part B coverage criteria for extra-depth shoes with inserts or custom molded shoes with inserts are clarified.
  • Under the revised framework:
    • A physician (as defined by the act) must document that the individual with diabetes has peripheral neuropathy or related foot risk factors (e.g., altered sensation, weakness, diminished motor control; history of pre-ulcerative conditions or ulceration; foot deformities; prior amputation; poor distal circulation).
    • The physician must attest that the individual has a diabetes diagnosis and is under a comprehensive diabetic care plan.
    • The physician must attest that the individual needs such shoes.
    • The shoes must be fitted and furnished by a physician or another qualified individual (e.g., pedorthist or orthotist), as established by the Secretary.
  • The amendment also adds to Section 1877(h)(6) of the Social Security Act to explicitly 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 for foot and ankle care, with broader recognition of podiatrists as physicians under Medicaid.
  • Podiatrists and other qualified footwear professionals (pedorthists, orthotists): Increased role and eligibility to furnish prescribed therapeutic footwear under Medicare.
  • Medicare beneficiaries with diabetes: Clarified and potentially enhanced coverage for extra-depth or custom molded shoes with inserts, contingent on meeting documented medical criteria.
  • State Medicaid programs: May need to adjust state plans and statutes to align with the new recognition of podiatrists as physicians and the effective dates.

Procedural and timeline aspects

  • Effective dates:
    • Medicaid recognition of podiatric physicians: January 1, 2026 (with possible state plan extension if state legislation is required; extension allows compliance to occur by the first quarter after the first regular session of the state legislature post-enactment).
    • Medicare footwear documentation changes: January 1, 2028.
  • The bill was introduced in the Senate on March 12, 2026, sponsored by Senator Young with multiple co-sponsors, and referred to the Senate Finance Committee. State implementation may require additional legislative action for compatibility with state-specific Medicaid plans.

Summary

S. 4070 seeks to expand access to foot health care by formally recognizing podiatric physicians as physicians for Medicaid, while also clarifying and enforcing Medicare coverage criteria for diabetic therapeutic footwear. The combined effect is to improve access to appropriate foot and ankle care for low-income individuals and to standardize the documentation and provision of specialized diabetic shoes, with staggered effective dates (2026 for Medicaid changes; 2028 for Medicare footwear provisions).

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

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