WASHINGTON, D.C. – The Small Business Administration (SBA) Office of Advocacy hosted a listening-session roundtable on CMS’ Competitive Bidding Program RID Model last month. The session gave small DME suppliers, defined as companies with $3.5 million or less in total revenue, an opportunity to outline their most pressing concerns with CMS staff in attendance.
During the session, AAHomecare outlined concerns with the RID design, which will negatively impact hundreds of suppliers, particularly small businesses. The Association also indicated concerns with CMS’ failure to fully analyze the impact of the rule on the DME sector, which is required by law. In the final rule, CMS claims the next round of CBP will not have a significant financial impact on the industry, while publicly the agency claims the program will save hundreds of millions of dollars and reduce the number of suppliers.
Tom Ryan, president of AAHomecare, urged CMS to pause the bid program and create a technical advisory committee to fully vet the impacts to Medicare beneficiaries and suppliers. The message was clear: under the existing rules, small businesses see no viable path to participate in the 2028 bidding program.
As part of his remarks, Ryan emphasized the central role of small suppliers, saying, “Small businesses are the backbone of home medical equipment industry. They know their communities, they know their patients, and they provide the hands on support that keeps people safely at home.”
He highlighted the consolidation concerns, adding, “RID collapses supplier participation: CGM suppliers will go from 800 companies down to 9. Urological and/or ostomy suppliers will drop from hundreds down to 7 and 8 respectively. This is not competition – it is government mandated consolidation. Behind each of these numbers is a company that has served patients – often for years – with staff who know their history, their equipment, and their needs.”
Heather Botteicher, an ostomy nurse and third generation, family-owned owner and operator of Arkansas Ostomy in Little Rock, Arkansas, warned, “This RID program would completely rip the rug from underneath us and put us out of business. The criteria alone make it impossible for us to participate as it is written now, with our 1 brick and mortar location, there are some states that we don’t have the ability to apply for a license that is required. Losing Medicare patients would mean losing 70% of my revenue and eliminating our legacy.”
David Griffin added, “As a local, specialized supplier, we deliver a level of personalized service that is difficult to replicate at scale. Our customers can quickly reach knowledgeable staff who know their history and can resolve problems immediately.”
Next Steps
This listening session allowed suppliers to outline the risks to patient access and the broader supplier community if small businesses are pushed out by rules that favor large companies. As explained by AAHomecare’s general counsel, Cara Bachenheimer, CMS has “acknowledged it expects that only large national suppliers will be able to win bids under the national RID program.”
The session marked another step in the broader campaign to delay the program. AAHomecare has requested a hearing with the House Committee on Small Business and submitted follow-up questions to CMS. If your Representative is on either the Republican or Democratic small business committees, AAHomecare asks providers to follow up to reinforce the key points.
