Improve Medicare Patient Access to Needed Diabetic Shoes

ACTION NEEDED: Please Cosponsor the Promoting Access to Diabetic Shoes Act, S. 237/H.R. 808, which would authorize Nurse Practitioners (NPs) to certify their patient’s need for therapeutic shoes.


NPs play an important role in managing and delivering health care to their patients. NPs have been providing primary, acute and specialty health care to patients for over half a century. Since 1998, NPs have been authorized Part B Medicare providers, recognized to furnish, order and refer for services under their Medicare provider numbers. The vast majority of the more than 234,000 practicing NPs in the country are primary care providers. NPs have prescriptive authority in all 50 states and the District of Columbia. In addition to treating acute and chronic illnesses of patients, NPs emphasize health promotion and disease prevention in all their undertakings.

NPs have demonstrated the ability to deliver safe, cost-effective, and responsible care to the patients they serve. They have expert knowledge that allows them to provide high-level assessments of patient needs. They are particularly skilled in the management of diabetic patients. Given their proven track record for the care of seniors and the disabled, it is inconsistent and problematic that NPs are recognized as Part B Medicare providers but are still unable to certify their diabetic patient’s need for therapeutic shoes.

Currently, NPs must send their diabetic patients who need therapeutic shoes to a physician to certify that need. Additionally, according to current statute, the certifying physician must be the provider treating the patient’s diabetic condition going forward. Delays in treatment, caused by this burdensome statute, jeopardize the health of patients and cause the Medicare program to incur additional costs by requiring the participation of an additional provider.

Introduction of and ultimately passage of legislation addressing this issue will make it possible for NPs to provide this service, when necessary, for their Medicare patients. It will reduce Medicare spending by eliminating duplicative services while also improving the quality and timeliness of care for diabetic beneficiaries who need therapeutic shoes.


AANP calls on Members of Congress to support improving diabetic patients’ access to care by cosponsoring S. 237/H.R. 808 which would authorize nurse practitioners (NPs) to certify their patient’s need for therapeutic shoes.

For additional information, please contact the AANP Government Affairs Office at 703-740-2529 or

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