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

H.R. 5555 Gets Approved By Health Subcommittee thumbnail H.R. 5555 Gets Approved By Health Subcommittee On Wednesday, Nov. 15, the Health Subcommittee convened the health markup. The DMEPOS Relief Act of 2023 (H.R. 5555) was included in the discussion and approved. H.R. 5555 will now move on to the Energy and Commerce committee for consideration in the next few weeks. Important HME Legislation Being Discussed By Health Subcommittee on Wednesday thumbnail Important HME Legislation Being Discussed By Health Subcommittee on Wednesday On Wednesday, Nov. 15, the Health Subcommittee of the House Energy and Commerce Committee is set to meet and discuss important legislation. Included in this session will be H.R. 5555, DMEPOS Relief Act of 2023. This bill, led by Rep. Miller-Meeks (IA) and Rep. Tonko (NY) provides much-needed reimbursement relief. Read the full public memo here. Ronda Vlog: CGM News - Update On the 90 Days Billable on January 1, 2024 thumbnail Ronda Vlog: CGM News - Update On the 90 Days Billable on January 1, 2024 Be sure to listen to this important video update from Ronda Buhrmester on the upcoming change on how to bill a 90-day supply for CGMs. VGM's Ike Isaacson Gets 'Revved Up' thumbnail VGM's Ike Isaacson Gets 'Revved Up' WATERLOO, Iowa – A singular focus and a singular voice: That's what it takes to get the HME industry's message across to both lawmakers and regulators, says Mike “Ike” Isaacson, who was recently named senior vice president of government relations at VGM & Associates. A Summary of the Final Rule on the Lymphedema Treatment Act Recently Released by CMS thumbnail A Summary of the Final Rule on the Lymphedema Treatment Act Recently Released by CMS Craig Douglas, VP of Payer Relations, VGM and Associates, has reviewed the document and summarized the important information. Champions of Change Pushing for 55 in 55 Make Moves in Illinois thumbnail Champions of Change Pushing for 55 in 55 Make Moves in Illinois Champions of Change are making a strong start in the push for 55 in 55 (The goal of 55 in 55 is to schedule 55 visits with legislators and/or their staff in 55 days). Yesterday, a room of nearly 20 people gathered at VGM member, Prism Health Care Services in Schaumburg, IL to discuss S. 1294, current DME rates impacted by supply chain, delivery costs, employee costs, inflation, and so much more. Ronda Vlog: CGM News -90 Days Billable on January 1, 2024 thumbnail Ronda Vlog: CGM News -90 Days Billable on January 1, 2024 Listen as Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement, provides an important CGM update. S. 3069 Introduced Into Senate thumbnail S. 3069 Introduced Into Senate On Oct. 18, U.S. Senators Tammy Duckworth (D-IL) and Lisa Murkowski (R-AK) re-introduced legislation to ensure breast cancer patients and survivors who have experienced a mastectomy are able to access custom breast prosthetics under Medicare.