WASHINGTON, D.C. – In the three weeks since CMS released a consequential DMEPOS & Home Health Proposed Rule, the AAHomecare team and leaders on the Board and Regulatory Council have been working to analyze provisions and develop guidance for stakeholder comments.

Last week, the Regulatory Council met in person to further assess the Proposed Rule and how the Association and the HME community can deliver a meaningful comment response. While the Council is still refining messages and guidance to inform industry comments, they have identified key issues that should be addressed in comments.

SPA at 75th Percentile – CMS proposes to set the single payment amount (SPA) to the 75th percentile of winning bids, potentially driving rates below sustainable and market-reflective levels.

Adding Medical Supplies, Including Urological, Ostomy, Tracheostomy –– It has commonly been understood that medical supplies, such as urological, ostomy, and tracheostomy supplies, do not meet the definition of ‘medical equipment items’ and therefore are not eligible to be included in the CBP.  See related policy document on this issue we’ve shared with Capitol Hill.

Inclusion of CGMs and Insulin Pumps – The proposal to include CGMs and insulin pumps in competitive bidding raises significant concerns given the limited number of manufacturers and the evolving nature of the technology. We believe further evaluation is needed to ensure patient access isn’t impacted by adding these products to the CBP.

Lack of Consideration for Supplier Experience – The proposed rule outlines parameters for evaluating supplier capacity, but it does not appear to consider a supplier’s historical experience, either in the product category or within a specific bidding area.

Arbitrary Determination of Contract Awardees – The proposed methodology for determining the number of contract awards arbitrarily limits the total number of winning suppliers.

Small Supplier Participation – CMS is statutorily required to provide small suppliers a fair opportunity to be considered for participation in the DMEPOS CBP and CMS has historically aimed to target at least 30% of contract awards to go to small suppliers. The Proposed Rule does not include any provisions to make sure this level is met.

Shift to Annual Reaccreditation – Requiring annual reaccreditation will be logistically unworkable for accrediting organizations and suppliers. It is not clear that such requirement will have a meaningful reduction in fraud and abuse by fraudsters exploiting the Medicare program. While we support CMS’ commitment to program integrity, we believe there are alternative approaches that would strengthen oversight without imposing additional burdens.

Go Deeper: Comment Guidance Overview
AAHomecare’s regulatory team continues to work on AAHomecare’s comments and guidance for the industry. Given the high interest in the Proposed Rule from our members and the HME community, we’re providing an overview of some of the major issues we will be addressing in the comments and our perspectives on addressing them. Please note: this is a work-in-progress document – see the current version here. We’ll provide a finalized version in the coming weeks to help you make your comments in advance of the Aug. 29 deadline.

Find the Proposed Rule and additional resources for understanding and commenting at aahomecare.org/2025-DMEPOS-proposed-rule.

Proposed Rule/CBP Webinar Set for Aug. 6
AAHomecare will share information on its work responding to the Proposed Rule and how stakeholders can take part in efforts to improve this significant rulemaking through commenting and continued advocacy. Click here for details.