Breaking: Year-End Package Update

Published in Government Relations on December 18, 2024

As lawmakers race to avert a government shutdown ahead of this Friday’s deadline, we have learned that the provision to reinstate and extend the 75/25 blended rate will not be included in the proposed continuing resolution that is expected to fund the federal government until March 14, 2025. Despite exhaustive bipartisan efforts from all reaches of the HME community, including providers and stakeholders, there was not enough support to get it included in the package.  

As we understand, negotiations resulted in disagreement as to whether the 75/25 blend fit the definition of a “Medicare extender” or not. Ultimately, a consensus could not be reached and was therefore abandoned. The final package is reported to, however, include a two-year extension of Medicare telehealth flexibilities such as expanding geographic, originating sites, and allowing more provider types to bill for telehealth visits. 

Additionally, the legislation waives the PAYGO (Pay-as-you-go) rule. (PAYGO is a budget rule that requires any new legislation affecting revenues and mandatory spending not to increase the federal deficit.) 

Although we share in the disappointment brought by this news, we remain optimistic. We are confident the groundwork laid in the 118th Congress will lead to results in the 119th. The inroads that we as an industry have made with legislators coupled with the fact that we have an ever-increasing number of our champions are now in leadership roles on several key committees across both houses of government are reasons for optimism. The HME industry is as well positioned as any time in the recent past. 

At the federal level, the incoming administration has clearly articulated a focus on cost-savings and efficiency. We believe that the DMEPOS industry fits this focus very well and will continue our conversations to make the case that our services are an answer to reducing costs. 

From Our Experts

CMS Revises Nebulizer Policy and ABN Form thumbnail CMS Revises Nebulizer Policy and ABN Form CMS has issued an update regarding revisions to the CMS Nebulizer Policy Article and guidance on the Advanced Beneficiary Notice of Noncoverage (ABN) Form. For dates of service on or after Feb. 1, 2026, suppliers must include the KX, GA, or GZ modifier to claims for the following nebulizer items: CMS Releases Updated Telehealth FAQ After Funding Bill Extends Flexibilities Through 2027 thumbnail CMS Releases Updated Telehealth FAQ After Funding Bill Extends Flexibilities Through 2027 Earlier this week, Congress extended Medicare telehealth flexibilities through Dec, 31, 2027, as part of the newly signed federal funding bill. In response, CMS has released updated Telehealth Frequently Asked Questions (FAQ) to provide clarity on what the extension means for both patients and providers. Shutdown Ends, Telehealth Prevails as Pres. Trump Signs Funding Bill thumbnail Shutdown Ends, Telehealth Prevails as Pres. Trump Signs Funding Bill The four-day partial federal government shutdown officially ended on Feb. 3, 2026, after President Donald Trump signed a $1.2 trillion funding package that reopens most federal agencies and restores key programs. CMS Releases New HCPCS thumbnail CMS Releases New HCPCS The Centers for Medicare & Medicaid Services (CMS) released an update adding eight new oxygen HCPCS codes to the Required Face-to-Face and Written Order Prior to Delivery List and adding five new orthoses and two HCPCS codes to the Required Prior Authorization List. The changes go into effect April 13, 2026. Meet the Candidates: Rep. Ashley Hinson Visits VGM During U.S. Senate Campaign thumbnail Meet the Candidates: Rep. Ashley Hinson Visits VGM During U.S. Senate Campaign Waterloo, Iowa — On Wednesday, VGM Group welcomed employees, local DME suppliers, and community guests for the latest installment of its Meet the Candidates series. The featured guest was Rep. Ashley Hinson (R-IA), who currently represents Iowa's 2nd Congressional District and is now running for the U.S. Senate following Sen. Joni Ernst's decision not to seek reelection in 2026. Grassroots Accountability Program Wants YOU! Become a DMEPOS Advocate thumbnail Grassroots Accountability Program Wants YOU! Become a DMEPOS Advocate Are you interested in politics or curious about how government really works behind the scenes The Grassroots Accountability Program (GAP) is a great opportunity to expand your civic knowledge, build meaningful relationships with your state and federal legislators, and make a direct impact on the future of the DMEPOS industry. CMS Issues FAQ On DMEPOS Competitive Bidding Program thumbnail CMS Issues FAQ On DMEPOS Competitive Bidding Program The Centers for Medicare and Medicaid Services (CMS) has issued a DMEPOS CBP Frequently Asked Questions (FAQ) providing clarification on several points of the next round. Medicare Advantage Plans Are in Flux: What Providers Should Know thumbnail Medicare Advantage Plans Are in Flux: What Providers Should Know As reported by HME News WASHINGTON – Medicare Advantage (MA) plans will face new restrictions in 2026 that could force insurers to rethink their business models, according to payer relations experts. While these changes don't directly impact home medical equipment (HME) providers today, they could influence future plan design and reimbursement strategies.