12/01/2025

CMS Releases Final Rule Restarting the Competitive Bidding Program

AAHomecare Alert Published 11/29/2025

Over the weekend, AAHomecare released the followoing statement regarding the Competitive Bidding Program, which was published late Friday afternoon.  OAMES will continue to work with AAHomecare and our counterpart state associations in the fight against this policy and will keep members updated on developments.  

CMS Releases DMEPOS/Home Health Proposed Final Rule with Provisions to Restart CB Program 

Late Friday afternoon, CMS published the 2026 DMEPOS/Home Health Final Rule. The proposed rule released this summer included significant changes to the DMEPOS Competitive Bidding Program (CBP) and also impacts to supplier accreditation processes. CMS opened a public comment period to allow stakeholders to provide feedback on the proposals, which were considered prior to the publication of the final rule. Policy changes in the final rule related to DMEPOS include:

Changes to the CBP

• Change calculating the winning bid from the clearing price to 75th percentile of winning bids. 
• Require significantly less financial documentation in the bid submission process. 

 Additions of Product Categories to CBP 

• Addition of CGM and reintroducing insulin pumps to CBP. 
• Addition of urological, ostomy, and tracheostomy supplies to CBP.
• Change the payment category for Class II CGMs and insulin pumps to Frequent and Substantial Servicing (FSS) for CBAs and non-CBAs.

Increase Frequency of Surveys and Accreditations

• Revise to require DMEPOS suppliers to be surveyed and reaccredited at least once every 12 months.

AAHomecare is still in the process of reviewing the full scope of the 762-page final rule and will share a more detailed summary with membership soon. In the meantime, you can find the full final rule here (DMEPOS section starts on page 240) and CMS’ related fact sheet here. The changes are effective January 1, 2026. 

Timeline of the Next Round of CBP
In an additional fact sheet, CMS announced their intentions to have the next CBP Round go live no later than January 2028. In preparation for it, CMS announced pre-bidding education will begin next month with the bidding window to open Summer 2026. This fact sheet also includes product categories for remote item delivery.

*December 2025

• CMS begins pre-bidding supplier awareness program 

*Late Spring/Early Summer 2026

• CMS announces specific dates for registration and bidding
• CMS announces lead items for the DMEPOS CBP product categories and number of contracts to award for each product category
• CMS begins bidder education program

*Late Summer/Early Fall 2026

• Bidder registration period to obtain user IDs and passwords begins
• Bid window opens

*Late Summer/Early Fall 2027

• Contracts awarded and single payment amounts announced
• Beneficiary education begins

*No Later Than January 1, 2028

• Start of Next Round - Contracts and single payment amounts (SPAs) in effect
• Six-month transition period begins for beneficiaries to switch to contract suppliers

*Dates listed are target dates

Next Round Remote Item Delivery (RID) DMEPOS CBP Product Categories

• Class II Continuous Glucose Monitors (CGMs) and Insulin Pumps
• Urological Supplies
• Ostomy Supplies
• Hydrophilic Urinary Catheters [Note: CMS' fact sheet contains a footnote that indicates these items are not included in added CBP product categories despite listing them earlier. We are seeking further clarification on this point.]
• Off-The-Shelf (OTS) Back Braces
• OTS Knee Braces
• OTS Upper Extremity Braces

Statement on DMEPOS/Home Health Final Rule from Tom Ryan, President & CEO, American Association for Homecare

The 2026 DMEPOS/Home Health Final Rule released today is a direct threat to patients and providers. By reviving the Competitive Bidding Program without important guardrails established under the previous Trump Administration and expanding the program to include diabetes equipment, as well as ostomy, urological, and tracheostomy supplies, CMS is setting the stage for more stress on the home medical equipment sector.

Smaller, community-based suppliers will be hit particularly hard, and many patients and family caregivers will lose access to highly experienced and trusted partners who have been providing their care.

A new bidding round without a fair bid-setting mechanism is sure to produce rates that force suppliers to use cheaper, lower-quality products and leave patients with fewer choices. The end result will be higher costs to the Medicare program thanks to increased ER visits and hospitalizations, and more strain on caregivers.

This is not reform, it’s regression.

AAHomecare and HME advocates will continue to engage the Trump Administration, CMS, and Capitol Hill to delay implementation of the DMEPOS-related provisions in the rule and press for a patient-centered, fraud-resistant alternative that protects access, preserves small businesses, and strengthens homecare.

We need every HME stakeholder locked in to support this effort – your voice, your outreach, your advocacy will make the difference.

HHS Releases CGM Acquisition Cost Report

On Tuesday (Nov. 25), the Dept. of Health and Human Services Office of Inspector General (OIG) yesterday published the long-anticipated report on continuous glucose monitors and supplies acquisition cost. In the report Medicare Payments for Continuous Glucose Monitors and Supplies Exceeded Supplier Costs and Retail Market Prices, Indicating Medicare Can Save At Least Tens of Millions of Dollars in One Year the OIG recommends CMS to seek payment reductions for CGMs and supplies. The report also references CMS’s proposal from this summer to include CGMs in the Competitive Bidding Program.