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

August Of Action: Your Chance To Connect With Congress thumbnail August Of Action: Your Chance To Connect With Congress It's time to take advantage of August Of Action—a perfect opportunity to make your voice heard. Every summer, federal legislators return to their home states during the Congressional recess. While it gives them a break from Washington D.C., it's primarily a time for them to connect with constituents like you. Proposed Rule Suggests Significant Change To Accreditation Process thumbnail Proposed Rule Suggests Significant Change To Accreditation Process The recently released proposed rule CMS-1828-P contains a significant change that could reshape how suppliers navigate accreditation. The rule proposes a major change that would require suppliers to be surveyed and reaccredited annually instead of the current three (3) year cadence. This proposal raises substantial questions about both operational feasibility and cost implications. HR1 Passes House, Advances to President Trump's Desk for Signature thumbnail HR1 Passes House, Advances to President Trump's Desk for Signature After extensive negotiations and partisan debate, the House has officially passed HR1, clearing the path for the bill to be signed into law by President Donald Trump. The legislation, which aims to reduce federal healthcare expenditures, contains several provisions that may impact the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) industry. CMS files the Proposed Rule that sheds light on the next round of the Competitive Bidding Program thumbnail CMS files the Proposed Rule that sheds light on the next round of the Competitive Bidding Program On June 30, 2025, CMS filed the anticipated Proposed Rule that includes updates to the Competitive Bidding Program (CBP). Public comments are due 60 days from June 30, 2025. Below is a high-level summary of the rule. It is critical to note that, according to the Proposed Rule Fact Sheet dated June 30, 2025, CMS has stated that they have not announced the specific product categories they are bidding or the specific timeframe for the next competition. Those specifics will be forthcoming in a fu Senate Narrowly Passes HR1, Sending It Back to House for Final Approval thumbnail Senate Narrowly Passes HR1, Sending It Back to House for Final Approval President Donald Trump's sweeping legislative package, formally titled the One Big, Beautiful Bill Act, now referred to as HR1., cleared the Senate today in a dramatic 51–50 vote, with Vice President JD Vance casting the tie-breaking vote. The bill now returns to the House, where lawmakers must decide whether to adopt the Senate's revised version or negotiate further changes before it can reach the president's desk. Several Prominent Medicaid Provisions in Senate's Budget Bill Deemed in Violation of Byrd Rule thumbnail Several Prominent Medicaid Provisions in Senate's Budget Bill Deemed in Violation of Byrd Rule Senate Parliamentarian Elizabeth MacDonough advised this week that multiple Medicaid provisions in the Senate's reconciliation bill would violate Senate procedure by violating the Byrd Rule. The Byrd Rule is a Senate-specific procedural process that allows Senators to prevent or block inclusion of extraneous provisions in reconciliation bills. Other provisions are still under review. Evaluating the Value of a Payer Contract thumbnail Evaluating the Value of a Payer Contract In our last article, Key Payers Denied Your Application Citing Their Network Is Closed – Now What?, we discussed strategies for addressing payer contracting denials due to a closed network. As indicated, this process can be an extremely time-consuming exercise with no guarantees and mixed results. Below are a few things to consider as you evaluate whether a contract is worth the extra effort. Webinar: Webinar: "Navigating The New CMS Landscape: RADs, HMVs, and Supplier Survival" on June 25 at 1 p.m. CT. The Centers for Medicare & Medicaid Services (CMS) has released its final National Coverage Determination (NCD) for RADs and HMVs used in treating chronic respiratory failure due to COPD. While the rule potentially expands access to bilevel ST therapy (RADs), it also introduces complex compliance requirements, tighter usage criteria, and increased documentation burdens—without additional reimbursement.