To: Tim Kaine

From: Lauren Morris

Date: November 12, 2022
Subject: S.800 - Promoting Access to Diabetic Shoes Act

The use of diabetic shoes is imperative to the vascular health of those suffering with diabetes.
Currently, only physicians can provide documentation to Medicare for patients to receive
coverage for these shoes. With a growing need in patient care, more people are relying on
physician assistants (PA) and nurse practitioners (NP) for their primary care. This bill allows
nurse practitioners and physician assistants to provide the required documentation for Medicare
to cover the cost of diabetic shoes. Due to the higher need for care from these practitioners, I
support S.800 the Promoting Access to Diabetic Shoes Act. Not only does this act expand NP’s
and PA’s scope of practice, but it also allows a bigger population to gain access to diabetic
shoes—something they need to prevent further complications from diabetic neuropathy.

Diabetic shoes are shoes made to specifically protect patients’ feet from forming ulcers, a
common complication from diabetes. These ulcers lead to amputations, which are very costly
and life-altering. Currently, a patient must see a physician to receive coverage for these shoes.
However, with practice expanding among nurse practitioners and physician assistants, many
patients see these practitioners for primary care. Limiting accessibility of diabetic shoes to those
seen only by physicians is damaging to preventative diabetic care. That is why this bill is
imperative in expanding accessibility to everyone who sees any type of provider.

• Foot ulcers are one of the most common complications of diabetes and are commonly
because of poor foot care (Dmitriyeva et al., 2022).
• The amount of nurse practitioners providing primary care has dramatically increased and
is projected to grow even more (Buerhaus, 2018).
• Diabetic shoes effectively prevent recurrence of foot ulcers (Busch & Chantelau, 2003).

Recommendation: Vote to pass S.800 Promoting Access to Diabetic Shoes Act. Due to the
growing need for care from nurse practitioners and physician assistants, action must be taken to
expand their abilities to provide care for at-risk populations such as those with diabetes. Passing
this act is imperative to the prevention of life-altering complications of diabetes and will help the
population greatly.

Many Americans suffer from diabetic foot ulcers and rely on diabetic shoes to protect them from
needing amputations. I proudly support S.800 Promoting Access to Diabetic Shoes Act to
expand the scope of nurse practitioners and physician assistants, so that their patients have access
to diabetic shoes.
 References

Busch, K., & Chantelau, E. (2003). Effectiveness of a new brand of stock 'diabetic' shoes to

protect against diabetic foot ulcer relapse. a prospective cohort study. Diabetic Medicine,

20(8), 665–669. https://doi.org/10.1046/j.1464-5491.2003.01003.x

Buerhaus, P. (2018). Nurse practitioners: A solution to America’s primary care crisis. American

Enterprise Institute, 1-30.

Dmitriyeva, M., Kozhakhmetova, Z., Urazova, S., Kozhakhmetov, S., Turebayev, D., &

Toleubayev, M. (2022). Diabetic foot ulcer. Current diabetes reviews, 18(6). Retrieved

November 12, 2022, from https://doi.org/10.2174/1573399817666210928144706

Elevator Pitch
Lauren Morris
November 12, 2022

Hi Mr. Kaine! My name is Lauren Morris, and I am a nursing student graduating in

December 2023. I understand that there is a new bill that is has been introduced into senate--
S.800 - Promoting Access to Diabetic Shoes Act. I think this bill should be passed because it
expands access to diabetic shoes. One of the biggest complications from diabetes are foot ulcers.
Diabetic shoes offer protection and pressure redistribution—this is recommended to prevent
recurrence which can lead to amputations. Amputations are costly and can lead to other
complications such as sepsis and even death. It is important that this bill is passed because many
diabetic patients rely on nurse practitioners or physician assistants for their care. Currently only a
physician can fill out the documentation for Medicare to cover these shoes. That greatly limits
the amount of people who can receive these shoes. I believe that if this bill is passed, access to
diabetic shoes will be greatly improved and the number of preventative amputations will decline.
Thank you for your time, and I hope that you pass this bill to expand access to diabetic shoes.