WASHINGTON—The Centers for Medicare & Medicaid (CMS) released a proposed rule on home health and durable medical equipment (DME) that includes new provisions for the next implementation of the Competitive Bidding Program (CBP), the American Association for Homecare (AAHomeCare) shared in an email with its members.
In their fact sheet on the proposed rule, CMS stressed they are not currently announcing what product categories they are bidding, nor announcing the specific timeframe for the next bidding round. A future announcement will provide those details.
The proposed rule also includes new policies regarding rate-setting methodologies, bid limits and payment changes for continuous glucose monitors (CGM) and insulin pumps. In addition, CMS is proposing updates to the durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) accreditation program, including annual reaccreditation of suppliers. The rule also outlines a formal exemption process from prior authorization for suppliers that meet specified claim approval thresholds.
"AAHomecare is fully prepared to work with the administration, Congress and the HME [home medical equipment] sector on this important proposed rule," said Tom Ryan, AAHomecare president and CEO. "We need to make sure the procedures and price-setting methodologies in this new bidding round can deliver reimbursement rates that reflect market reality. In advance of Round 2021, HME stakeholders worked hard to secure program improvements like raising the bid ceiling, using clearing prices to set rates and keeping unqualified bidders from participating—and we are determined to protect and add to those improvements where we can."
AAHomecare said it is analyzing the new rule and working with the HME community to develop a strong comment response is the first order of business for the organization.
"We’ll also work with Congress and our clinician and patient advocacy partners as needed to protect access to care," Ryan said. "And finally, we will coordinate efforts to educate suppliers to make sure they are equipped with the resources and intelligence they need to make informed bidding decisions. Preparing for a new bidding round is going to be a major undertaking for everyone in the HME sector. We’ve got to be united and engaged as an industry to meet this moment."
Comments on the proposed rule will be due 60 days after it is published in the Federal Register (which is set for Tuesday, July 2). The AAHomecare team and leaders on their Regulatory Council will provide additional analysis and perspective as soon as possible.
For more information on the proposed rule, visit cms.gov. For a copy of the full text, visit public-inspection.federalregister.gov/2025-12347.pdf.