Tag: Medicare
AAHomecare gears up for bid response
July 10, 2025HME News Staff
WASHINGTON – AAHomecare’s regulatory council will meet next week to begin developing official comments and strategy for mobilizing the HME Industry to provide a strong comment response on CMS’s proposed rule for competitive bidding. The association is also beginning outreach to members of Congress and staff about the proposed rule and the program. “We’ve had success in enlisting Capitol Hill to help shape regulatory policy – including the bidding program –...
CQRC says bid program could harm access, underscores need for SOAR Act
July 9, 2025HME News Staff
WASHINGTON – The Council for Quality Respiratory Care (CQRC) is concerned that Medicare’s proposed competitive bidding program could have substantial negative consequences on patient access and quality of care. The council says it's time to pass reform that permanently removes the supplemental oxygen benefit from the program.
“While we continue to review the proposed rule to understand its full impact and scope, the CQRC is deeply concerned the methodology proposed...
Trump signs HR 1
July 7, 2025HME News Staff
WASHINGTON – President Donald Trump has signed H.R. 1, the One Big Beautiful Bill Act, ushering in several Medicare and Medicaid changes that will impact the HME industry. The bill will, among other things, cut Medicare reimbursement by 4% across the board (unless PAYGO is waived) and implement a mandatory work / education requirement for Medicaid that is expected to reduce the number of total enrollees. Other measures in the bill could also have a ripple effect on the industry by decreasing...
CMS signals potential big changes to bid program
July 3, 2025Theresa Flaherty, Managing Editor
WASHINGTON – Industry stakeholders await more details, but their initial analysis of CMS’s proposed rule for a new round of competitive bidding has them worried the agency plans to significantly expand the program to new product categories and impose new requirements.
Are CGMs a hot-ticket item?
In the June 30 announcement, CMS said product categories and a specific timeframe for the next round will be announced at a future date. Yet the agency highlighted continuous...
Prior authorizations: Insurer pledges, tech plays & exemption pathway
July 3, 2025Liz Beaulieu, Editor
WASHINGTON – In about a one-week span, the Department of Health & Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) proposed three new initiatives that seek to improve and modernize the prior authorization process. Industry stakeholders say the initiatives – while some are geared more toward physicians and are smaller in scale – could have a positive impact on HME providers.
All in late June:
HHS and CMS announced that major health...
HR1 clears Senate: DMEPOS industry faces cuts, Medicaid shake-up & new challenges
July 2, 2025HME News Staff
WASHINGTON – The Senate cleared the One Big Beautiful Bill Act, HR1, in a 51–50 vote, with Vice President JD Vance casting the tie-breaking vote. The bill now returns to the House of Representatives, where lawmakers must decide whether to adopt the Senate’s revised version or negotiate further changes before it can reach the president’s desk.
Among the bill’s many provisions, several have significant implications for the DMEPOS industry, particularly through...
Bills would provide more oversight of DME
June 26, 2025HME News Staff
WASHINGTON - New legislation introduced in the House of Representatives and Senate would create a pilot program for testing the use of a predictive risk-scoring algorithm to provide oversight of payments for durable medical equipment and clinical diagnostic laboratory tests under the Medicare program, AAHomecare has reported.
The algorithm would then assign a risk score to all fee-for-service transactions, with high-risk scores assigned for claims billed at a rate or style that...
Medicare spending projected to surge, outpace economic growth
June 23, 2025HME News Staff
WASHINGTON – Medicare expenditures are projected to grow significantly faster than both aggregate worker earnings and the overall U.S. economy, according to the 2025 Annual Report from the Boards of Trustees of the Federal Hospital Insurance (HI) and Federal Supplementary Medical Insurance (SMI) Trust Funds.
Key findings from the 2025 Medicare Trustees Report
Medicare spending as a share of GDP is expected to rise from 3.8% in 2024 to 6.7% by 2099.
Under an...
‘Flawed from the beginning’: Revival of bidding program raises alarms
June 20, 2025Theresa Flaherty, Managing Editor
YARMOUTH, Maine – After several years of wondering if they will or won’t, CMS has signaled its intent to restart the Medicare competitive bidding program. It’s an unwelcome and surprising development for 71% of respondents to a recent HME Newspoll.
The Department of Health and Human Services on May 30 released a FY 2026 Budget in Brief that earmarked $22 million for the program.
“I am disappointed they’ve reinstated this program that was clearly flawed...
In brief: CQRC urges caution, ASAA rebrands, Dr. Oz turns 65
June 13, 2025HME News Staff
WASHINGTON – While it commends the Trump Administration for finalizing a National Coverage Determination (NCD) for “Noninvasive Positive Pressure Ventilation (NIPPV) in the Home for the Treatment of Chronic Respiratory Failure consequent to COPD,” the Council for Quality Respiratory Care (CQRC) is concerned about its quick implementation and potential access issues.
The effective date of the final NCD is the date of publication, but the CQRC continues to urge CMS to provide...