APMA Pushes CMS to Reduce Administrative Burdens for Diabetic Shoes

APMA leadership and staff met with officials from the Centers for Medicare & Medicaid Services (CMS), including representatives from the Center for Clinical Standards and Quality and the Center for Program Integrity, to discuss access barriers related to therapeutic shoes for persons with diabetes (TSD).

During the meeting, APMA highlighted concerns that current DME MAC requirements for therapeutic shoes are overly burdensome and go beyond what is required under Medicare statute: This ultimately results in significant delays and reduced access for beneficiaries. APMA shared member survey data demonstrating that documentation requirements frequently prevent eligible patients from receiving medically necessary therapeutic shoes.

APMA emphasized that while Medicare statute allows podiatrists to prescribe and furnish diabetic shoes when certain conditions are met, additional documentation steps imposed by the DME MACs have created confusion, increased administrative burden, and discouraged suppliers from providing shoes even when statutory requirements are satisfied. APMA urged CMS to consider directing the DME MACs to remove these unnecessary requirements to better align policy with statute while maintaining appropriate program integrity.

This meeting is just the latest effort in APMA's ongoing efforts to address this issue for our members. Most recently, APMA led a sign-on letter urging DME MACs to simplify certification for the Medicare TSD program in October.

APMA will continue to engage with CMS on this issue and appreciates the opportunity to share member perspectives on improving patient access to critical foot care services.