Congress Has Made Their Final Push of the Year

Published in Government Relations on December 23, 2022

With the holidays almost upon us, there was one last major vote in the 117th Congress before sine die. Today, they voted on a $1.645 trillion Omnibus package that included some language for the DMEPOS industry. Now that it has passed it is off to the President for a signature. There will need to be a continuing resolution in effect until Dec. 30th to allow the time needed to get the final bill signed by the President.

In it, they passed the following: 

  • Stop the PAYGO payment cuts (4%) for 2023 and 2024 
  • Section 4139 – Extends the 75/25 blended rates “through the remainder of the duration of the emergency period described in section 1135(g)(1)(B) of the Social Security Act (42 U.S.C1 1320b–5(g)(1)(B)) or December 31, 2023, whichever is later. 
  • Section 4113 – Advancing telehealth beyond COVID-19 (through Dec. 31, 2024) 
  • Section 4139 – Extending Acute Hospital Care at Home waivers and flexibilities 
  • Section 4133 – Medicare Coverage of certain Lymphedema compression treatment 
  • Section 4136 – Technical amendments to Medicare separate payment for disposable negative pressure wound therapy devices 

Read the full bill here.   

With the language being passed, the work is not done. VGM Government Relations is digesting this information and plans to meet in January with industry stakeholders to decide what the path forward is going to be for 2023.  

“There are some good ‘’wins” in this Omnibus,” says Mike Isaacson, Sr. Vice President of Operations, VGM & Associates. “Wins that point to the great work done by the VGM Government Relations team, our members, our advocacy partners, and other stakeholders. The successes in the bill are a testament to what we can accomplish when we work together as an industry to champion change. We can be optimistic with these wins and confident moving forward that, together, we can create a more equitable, patient-centric health system that works for all providers.” 

Efforts for Legislation in the Omnibus Language 

The immediate steps that are going to be taken are working on some of the language that was included in the Omnibus. As of right now, the CARES Act extension is only set to last until the end of 2023, which means through the year we will need to work to get that fixed or push to have CMS make the non-rural 75/25 blend permanent.  

The PAYGO relief is also a concern since the language is only set to last through 2024. We are hoping to have it made permanent as well. 

Efforts for Legislation Not Included 

There will also need to be effort put toward the bills that were not included in the Omnibus language and will need to be reintroduced in 2023. While the bills will get new identifiers for the next session, they are currently: 

  • H.R. 6641, the 90/10 relief bill for competitive bid areas 
  • Obtaining Medicare coverage for power standing and seat elevation systems for power wheelchairs 
  • H.R. 1990/S. 2556, the Medicare Orthotics and Prosthetics Patient-Centered Care Act 
  • H.R. 3087/S. 2051, the Breast Cancer Patient Equity Act 

These are critical pieces of legislation for our industry and are going to need to be reestablished in the 118th Congress. We will need to work hard in 2023 to get these pieces of legislation passed. 

Our Ask 

The need for quality DMEPOS suppliers is outstanding. Throughout the next year, we will continue to ask you to speak up about these concerns, protect the integrity of the medical equipment and service industry, and support legislation that will provide some much-needed reimbursement relief to keep home medical equipment suppliers alive and working. It’s a fact that grassroots efforts are important because all politics begin in your own backyard. Therefore, it is important to get to know all your legislators, new and old, who will sit on key committees, because these relationships allow us to keep everything moving forward. The need for services will continue to grow, and we need your help to ensure that it grows in a way that supports the patients and your work!  

Along with your help, VGM Government Relations will continue to work with our champions in Congress to improve the industry. We will continue to keep everyone updated on legislation and what you can do to help. We look forward to working with you to create the changes the industry needs in 2023. 


TAGS

  1. vgm
  2. vgm government

From Our Experts

New CMS Nationwide Probationary Prior Authorization Requirement for Newly Enrolled Suppliers of Certain DMEPOS Items thumbnail New CMS Nationwide Probationary Prior Authorization Requirement for Newly Enrolled Suppliers of Certain DMEPOS Items On Sept. 2, 2026, CMS introduced the Probationary Prior Authorization (PPA) program that will place newly enrolled DMEPOS Suppliers and those undergoing 100% change in ownership on a one-year probationary period. Effective Oct. 15, impacted suppliers will be required to submit a prior authorization request for specific HCPCS codes. OIG Report Signals Increased Fraud Oversight for DMEPOS Suppliers thumbnail OIG Report Signals Increased Fraud Oversight for DMEPOS Suppliers The HHS Office of Inspector General (OIG) recently released a white paper examining ongoing Medicare fraud involving durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). Preparing for Increased Audit Activity: How VGM Group and The van Halem Group Can Help thumbnail Preparing for Increased Audit Activity: How VGM Group and The van Halem Group Can Help The recent HHS Office of Inspector General (OIG) report on DMEPOS fraud signals that CMS is likely to increase oversight activities across the industry. The report calls for enhanced supplier enrollment screening, more aggressive medical reviews, expanded use of artificial intelligence and data analytics, greater physician order verification, and increased scrutiny of supplier ownership and billing practices. CMS Releases Critical Updates On The Medicare Supplier Enrollment Moratorium And Round 2028 Competitive Bidding Program thumbnail CMS Releases Critical Updates On The Medicare Supplier Enrollment Moratorium And Round 2028 Competitive Bidding Program See CMS' notice on the Medicare Supplier Enrollment Moratorium below: Medicare's DMEPOS Supplier Enrollment Moratorium Has Expired | Action Required for Round 2028 Bidders This message is to inform you that the 6-month temporary moratorium on accepting Medicare supplier enrollment applications, which became effective on February 27, 2026, has now expired as of August 27, 2026. CMS Updates CBIC Website Bid Preparation Guidance for Round 2028 Competitive Bidding Program thumbnail CMS Updates CBIC Website Bid Preparation Guidance for Round 2028 Competitive Bidding Program On August 13, 2026, CMS posted several updated and new Fact Sheets and one new FAQ to the Bid Preparation Phase page on the CBIC website. Providers interested in submitting a bid for Round 2028 can find more program details, including the estimated number of contract awards, for each category. Important: HME Supplier Survey on Round 2028 Competitive Bidding Impact thumbnail Important: HME Supplier Survey on Round 2028 Competitive Bidding Impact AAHomecare is conducting a brief survey to help quantify the potential impact that Medicare's Remote Item Delivery (RID) model of Competitive Bidding would have on HME suppliers providing continuous glucose monitors (CGMs), insulin pumps, ostomy supplies, and/or urological supplies. Survey findings will be used to inform discussions with the White House, the Centers for Medicare and Medicaid Services (CMS), and Congress about the potential effects on supplier businesses, jobs, and patient... CMS Makes Finalized Change to DMEPOS Competitive Bidding Program thumbnail CMS Makes Finalized Change to DMEPOS Competitive Bidding Program The Centers for Medicare and Medicaid Services (CMS) has issued the FY 2027 Inpatient Rehabilitation Facilities (IRF) Prospective Payment System (PPS) Final Rule (CMS-1845-F), increasing the DMEPOS Competitive Bidding Program's bid surety bond amount to $100,000 (previously $50,000).... VGM Government Relations Launches State Payer Resource Hub for DMEPOS Providers thumbnail VGM Government Relations Launches State Payer Resource Hub for DMEPOS Providers This resource brings together key information frequently used by DMEPOS providers.