WASHINGTON, D.C. – The Nov. 28 release of the DMEPOS/Home Health Final Rule essentially contained the same provisions as the Proposed Rule. It’s a development that AAHomecare officials believe will “make a currently challenging business environment even more difficult for every segment of our industry.”
“I think the industry is extremely disappointed that CMS did not take into account any of its suggested recommendations to change the regulatory language of the competitive bidding regulations,” says Cara C. Bachenheimer, head of government affairs at Brown & Fortunato. “We are deeply concerned about the potential negative impacts these competitive bidding rules will have on the industry. AAHomecare and industry leaders are already strategizing about what can be done to improve the program between now and the expected start date of January 2028.”
In a message last week, AAHomecare wrote: “Despite a strong comment response from the DME sector and patient advocates, along with a comprehensive lobbying effort, CMS and the Administration did not give meaningful weight to the widespread opposition to provisions in the Proposed Rule. Our team worked every available channel to make our case with decision makers but could not overcome CMS’ desire to re-start the program under this flawed framework.”
AAHomecare leaders are already working to assess the situation and chart a path forward, including as part of Regulatory Council meetings that began last week. Intelligence gathering with contacts in the Administration and on Capitol Hill is in the works.
“Releasing the devastating rule on the Friday of a holiday week was not a surprise,” says Rose Schafhauser, recipient of the 2025 Van Miller Homecare Champion Award. “The Competitive Bidding Program changes significantly impact both suppliers and most importantly the patients. New bid and payment limitations most likely do not cover real service costs. Losing more supplier rooftops is a risk.”
It’s likely that the next phase of the campaign will seek to leverage Congressional support to seek a further delay in implementing the next bidding round, as well as continued efforts to directly engage the administration. As laid out on the Fact Sheet accompanying the Final Rule, CMS envisions bidding to take place in late Summer/early Fall 2026 with bid winners and rates announced one year later. New rates would go into effect on Jan. 1, 2028.
Policy changes in the final rule related to DMEPOS include:
Changes to the CBP
• Change calculating the winning bid from the clearing price to 75th percentile of winning bids.
• Require significantly less financial documentation in the bid submission process.
Additions of Product Categories to CBP
• Addition of CGM and reintroducing insulin pumps to CBP.
• Addition of urological, ostomy, and tracheostomy supplies to CBP.
• Change the payment category for Class II CGMs and insulin pumps to Frequent and Substantial Servicing (FSS) for CBAs and non-CBAs.
Increase Frequency of Surveys and Accreditations
• Revise to require DMEPOS suppliers to be surveyed and reaccredited at least once every 12 months.
The changes are effective January 1, 2026.
AAHomecare is still in the process of reviewing the full scope of the 762-page final rule and will soon share a more detailed summary. The DMEPOS section starts on page 240 and CMS’ related fact sheet can be found here.
“VGM is deep in the process of analyzing the details of the final rule and the impact it may have on all our members,” adds Ike Isaacson, senior vice president, Government & Regulatory Relations. “We stand ready to support our members through every step of the process. At the same time, VGM remains committed to continuing efforts working with the industry to educate the administration as well as the legislature to combat the harmful impacts of this bidding process.”
