S. 1294, A Bill to Provide a 75/25 Blended Rate for Non-Rural, Non-CBA Supplier Has Been Introduced

Published in Government Relations on April 27, 2023

S.1294 has been introduced by Senators John Thune and Debbie Stabenow and has significant implications for non-rural, non-CBA suppliers seeking to maintain the Medicare 75/25 blended rate. This rate structure, which has proven to be a lifeline for many suppliers, is set to expire soon. The new bill, if passed, would extend this rate until the end of 2024, providing much-needed relief and stability to suppliers and patients alike. 

"Years ago Kay Johnson with Midwest Medical arranged to have Senator John Thune visit her store and invited some other suppliers from South Dakota," said Cindy Coy with Avera Health. "Senator Thune has been a champion for DME ever since and has met with us several times since then.  Senator Thune and his staff understand why we are so important for the continuum of care."

This legislation comes shortly after the 2022 Omnibus budget legislation, which provided a one-year extension for the 75/25 rates. Senators Thune, Stabenow, and Hassan were instrumental in ensuring that the rates were included in the final Omnibus package last December. This extension provided a critical lifeline for suppliers impacted by the pandemic, and the proposed extension under S.1294 would continue this support. 

"At MAMES, we are grateful for the strong and productive partnership we have forged with Senator Thune over the years," said Rose Schafhauser, Executive Director of MAMES. "His unwavering support for our industry has been instrumental in advancing our mission and serving the needs of those we represent. We look forward to continuing our relationship with Sen. Thune and working together to strengthen the industry."

The timing of the new bill's introduction is notable, as more than fifty HME leaders from around the country are set to come to Washington from May 9-10 for Capitol Hill legislative visits. These leaders are expected to prioritize building support for the proposed legislation, as the extension of the 75/25 rate is a critical issue for both suppliers and patients.  

"Change rarely starts at the top, but rather from the ground up, where the voices of ordinary people can create a powerful force for progress," said John Gallagher, VP of VGM Government Relations. "The introduction of S. 1294 is a testament to the tireless efforts of grassroots advocates who refuse to be silent, who refuse to accept the status quo, and work tirelessly to improve the industry for all."

Please use the button below to become an advocate and reach out to your senators asking them to support S. 1294 and ensure that this critical legislation goes through. 

MESSAGE YOUR SENATOR

From Our Experts

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. The Return of Competitive Bidding thumbnail The Return of Competitive Bidding The Centers for Medicare & Medicaid Services (CMS) appear to be laying the groundwork for another round of the Competitive Bidding Program (CBP). While full implementation will take a couple of years, an official announcement is expected this summer—potentially as early as July. Out With The Old RAC, In With The New thumbnail Out With The Old RAC, In With The New On April 28, 2025, CMS awarded Cotiviti GOV Services LLC, the new RAC Recovery Audit Contractor (RAC) Region 3, 4, and 5 contracts. RAC Region 3 includes the following Medicare Administrative Contractor (MAC) jurisdictions: JJ, JM, and JN. RAC Region 4 includes jurisdictions: JE, JF, and JL. And RAC Region 5 includes jurisdictions: JA, JB, JC, JD, as well as the HH/H MACs: J6, J15, JK, and JM. Iowa Leads the Charge! All Four Representatives Back H.R. 2005—Will Your State Step Up? thumbnail Iowa Leads the Charge! All Four Representatives Back H.R. 2005—Will Your State Step Up? At VGM Group, Inc. we have the pleasure of serving our members and partners throughout the country.  One of the many ways we do this is through legislative advocacy, working with our partners to create a more equitable and effective healthcare system. All our VGM units are dedicated to advancing our partners' businesses, streamlining operations, and working every day to enhance reimbursement for the quality in-home healthcare our industry provides all people. Mike Hamilton Of ADMEA Honored With The Mal Mixon Advocate Award thumbnail Mike Hamilton Of ADMEA Honored With The Mal Mixon Advocate Award Last week, during the 2025 AAHomecare Washington Legislative Conference, Mike Hamilton, Executive Director of ADMEA, was honored with the prestigious Mal Mixon Advocate Award. VGM Senior Leaders Engage in Advocacy at AAHomecare Legislative Conference thumbnail VGM Senior Leaders Engage in Advocacy at AAHomecare Legislative Conference This week, VGM leaders attended the AAHomecare Legislative Conference in Washington, D.C., a premier event dedicated to advancing healthcare policy and advocacy. AAHomecare provided attendees with valuable insights, equipping them with key discussion points and strategies for effective meetings with legislators.