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

Federal Actions This Week Signal The Administration Is Doubling Down On Its Goal To Eliminate Fraud Waste And Abuse thumbnail Federal Actions This Week Signal The Administration Is Doubling Down On Its Goal To Eliminate Fraud Waste And Abuse This week, the Trump administration, through the Centers for Medicare & Medicaid Services (CMS), announced a significant deferral of federal Medicaid matching funds to Minnesota alongside the release of a new Request for Information (RFI) tied to the administration's Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) initiative. These actions along with the changes to DMEPOS accreditation and enrollment signal the administration's aggressive posture on Medicaid and Medicare... VGM Response To CMS Moratorium On New DMEPOS Provider thumbnail VGM Response To CMS Moratorium On New DMEPOS Provider The federal moratorium on new DME suppliers presents a defining moment for us as an industry—an opportunity to demonstrate that the VGM members serving patients are the gold standard. We have long shown that our members operate with integrity, excellence in compliance, and unmatched commitment to service, efficiency, and patient outcomes. Now, we must elevate that message. Trump Administration Announces Nationwide DMEPOS Enrollment Moratorium thumbnail Trump Administration Announces Nationwide DMEPOS Enrollment Moratorium In a press release published on the CMS website Feb. 25, 2026, it was announced that CMS will implement a six-month moratorium on new enrollments for DMEPOS suppliers. Proposed LCD Changes to Impact Seat Elevation on Group 2 Non-Complex Power Wheelchair Bases thumbnail Proposed LCD Changes to Impact Seat Elevation on Group 2 Non-Complex Power Wheelchair Bases The DME Medicare Administrative Contractors (MACs) issued a proposed Local Coverage Determination (LCD) change for seat elevation use on group 2 non-complex power wheelchair bases (K0830, K0831 and K0108 on group 2 non-complex HD bases). John Quinlan Named 2026 Van G. Miller Homecare Champion thumbnail John Quinlan Named 2026 Van G. Miller Homecare Champion AAHomecare announced earlier this week that John Quinlan of Quinlan's Pharmacy in New York has been selected as the recipient of this year's Van G. Miller Award. John has been a valued VGM member for many years, and his leadership within the DMEPOS community has made a meaningful impact on patients, providers, and the industry as a whole. His commitment to quality care, patient access, and industry advocacy consistently sets him apart. Legislative Update On DMEPOS Bills – Letter To CMS Admin Dr. Oz To Delay Competitive Bidding Program thumbnail Legislative Update On DMEPOS Bills – Letter To CMS Admin Dr. Oz To Delay Competitive Bidding Program Many of you have already contacted your legislators in support of key DME legislation, including the DMEPOS Relief Act, the Choices for Increased Mobility Act, and the Supplemental Oxygen Access Reform (SOAR) Act. We now have another important issue to bring to your attention. 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.