Diabetes Foot Health Access and Modernization Act of 2026

Section 1905(a)(5)(A) of the Social Security Act (42 U.S.C. 1396d(a)(5)(A)) is amended by striking section 1861(r)(1) and inserting paragraphs (1) and (3) of section 1861(r).

Except as provided in paragraph (2), the amendment made by subsection (a) shall apply to services furnished on or after January 1, 2026.

In the case of a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) which the Secretary of Health and Human Services determines requires State legislation in order for the plan to meet the additional requirement imposed by the amendment made by subsection (a), the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session is considered to be a separate regular session of the State legislature.

Section 1861(s)(12) of the Social Security Act (42 U.S.C. 1395x(s)(12)) is amended to read as follows:

(12) extra-depth shoes with inserts or custom molded shoes with inserts for an individual with diabetes, if—

(A) a physician as defined in subsection (r) of this section—

(i) documents that the individual has peripheral neuropathy that may include altered foot sensation, weakness, or diminished motor control of the lower extremity; a history of pre-ulcerative calluses or other ulceration of the foot; foot deformity, previous lower extremity amputation, or poor lower extremity circulation;

(ii) attests that the individual has a diabetes diagnosis and is under a comprehensive plan of care related to the individual’s diabetic condition; and

(iii) attests that the individual needs such shoes; and

(B) the shoes are fitted and furnished by a physician or other qualified individual (such as a pedorthist or orthotist) as established by the Secretary;

Section 1877(h)(6) of the Social Security Act (42 U.S.C. 1395nn(h)(6)) is amended by inserting after subparagraph (L) the following:

(M) Extra-depth shoes with inserts or custom molded shoes with inserts.

The amendment made by subsection (a) shall apply with respect to items and services furnished on or after January 1, 2028.