CEO/President Tom Ryan said the American Association for Homecare is responding quickly to a new Centers for Medicare & Medicaid Services (CMS) durable medical equipment (DME) and home health proposed rule that included information on the resumption of Medicare competitive bidding.
“The return of the bidding program presents the most profound challenge for the DME community in years,” Ryan said in a July 9 bulletin to stakeholders. “And helping our members and this industry meet this challenge is the top priority for AAHomecare.”
Proposed rule would add CGMs to competitive bidding program
The Calendar Year 2026 Home Health Prospective Payment System proposed rule, which included information on DME, was published in the Federal Register on July 2. Public comments will be accepted through Aug. 29.
The proposed rule was “the first instance where CMS has officially stated their interest in adding CGMs [continuous glucose monitors] and insulin pumps to the competitive bidding program,” AAHomecare said in a July 7 email. “The proposed rule indicates this could be implemented as part of a new national or regional Remote Item Delivery (RID) CBP [competitive bidding program], which would include DME items that are typically shipped and aren’t usually picked up by the patient at supplier locations.”
AAHomecare added that the proposed new program would be “similar to the national mail-order program, but would include items that are not typically picked up by the beneficiary at a supplier location. The items included are based on historical utilization and the typical method beneficiaries are receiving the items.”
Under the proposed rule, contracted suppliers would need to provide mail- and non-mail-order products under Remote Item Delivery competitive bidding. “If a patient decides to pick up supplies from a supplier, they would need to go to a contracted supplier,” AAHomecare said. The proposed rule would also “phase in the RID competitive bidding program and non-CBA [competitive bid areas] rates based on RID competitive bidding program competitions.”
The proposed rule also included a bid limit for monthly rental of Class II CGMs and supplies.
AAHomecare objects to inclusion of medical supplies
AAHomecare also objected to CMS’s plan to include medical supplies “such as urological, ostomy and tracheostomy care supplies” in the competitive bidding program when it resumes.
“Under the Social Security Act, CMS can only include in the DMEPOS [durable medical equipment, prosthetics, orthotics and supplies] competitive bidding program items that Congress has provided CMS with the legal authority,” the association said. “Those items are DME; enteral and enteral nutrients, equipment, and supplies; and off-the-shelf orthotics. Urological, ostomy and tracheostomy medical supplies are covered by Medicare under the prosthetic benefit, §1861(s)(8) of the Social Security Act (SSA). Congress did not include items under SSA §1861(s)(8) as items CMS can include in the DME competitive bid program.”
Ryan said AAHomecare’s regulatory council will develop the association’s “official comments and strategy for mobilizing the DME industry to provide a strong and well-informed comment response. With an Aug. 29 deadline for submitting comments, we understand the need to move fast.”
The organization is taking a “comprehensive approach” that includes reaching out to members of Congress and their staffs, and working with industry groups such as VGM & Associates, the Council for Quality Respiratory Care, the National Coalition for Assistive & Rehab Technology, and state and regional supplier associations.
Ryan said that should they be enacted, provisions in the proposed rule plus a restructured competitive bidding program “will shape the next few years for the DME sector and have impacts on the majority of companies and their employees and patients. We have a brief opportunity to make our case to CMS on specific aspects of the program, including proposed new categories and rate-setting mechanisms.”
The proposed rule and competitive bidding’s resumption is the association’s top focus, Ryan added.
“Every company and every stakeholder in our industry can help make a difference in this comment round,” he said. “We need you on board to help shape a better future for DME.”
