A newly released CMS proposed rule could significantly reduce DMEPOS reimbursement rates and limit the number of Medicare contracts available—changes that would be especially harmful to small providers.
The DME industry has until Friday, August 29, to submit comments to CMS opposing these provisions.
What’s in the Proposed Rule
CMS has issued a sweeping proposed rule officially titled CMS-1828-P “Medicare and Medicaid Programs: Calendar Year 2026 Home Health Prospective Payment System Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies.”
While it covers several areas, the DMEPOS provisions raise the most immediate concerns for providers.
“The bid ceiling pricing, lead item bidding, and pricing methodology are extremely concerning for how rates will be impacted,” says Kelsey Kansler. “Rates are already so, so low, and if finalized, the rates could be devastating.”
Key changes in the proposal
- Lower bid ceilings and rate reductions: New rules could cap bids at the most recent single payment amount (plus small adjustments) and calculate payment rates at the 75th percentile of bids, driving reimbursement even lower.
- Fewer required contracts awarded: Reducing minimum contracts from five to two could push small and mid-sized providers out of competitive bid areas.
- National Remote Item Delivery (RID) competitions: Creates national or regional bidding for certain categories—including urological, ostomy, and tracheostomy supplies; continuous glucose monitors; insulin infusion pumps; and off-the-shelf orthotics.
- Accreditation and oversight changes: Moves to annual reaccreditation, new revocation authorities, and other enrollment changes.
Why This Matters for Providers
If finalized, these changes will put additional financial and operational pressure on DMEPOS suppliers, especially small and mid-sized ones.
Lower bid ceilings and a 75th-percentile payment calculation will drive reimbursement well below sustainable levels.
Without Medicare contracts in those areas, some businesses will be forced to scale back services or close altogether, limiting patient access to critical supplies.
For patients, that will mean fewer local providers, longer wait times, and potential disruptions in care for items that are essential to daily living, such as ostomy supplies, glucose monitors, and mobility aids.
“Without action from the industry, these provisions could have long-lasting consequences for both providers and the patients they serve,” warns Kansler.
Take Action: Submit A Comment
CMS is accepting public comments on this proposed rule through Friday, August 29, 2025, at 11:59 p.m. ET.
How to Submit Your Comments
- Visit regulations.gov.
- Search for the posting titled: “Medicare and Medicaid Programs: Calendar Year 2026 Home Health Prospective Payment System Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies.”
- Click “Comment” on the post.
- Type your comments directly in the comment box or upload them as a file.
- Complete the required fields and click “Submit Comment.”
Make sure to frame your comment around how these changes will impact your operations, staff, and patients. Policymakers are most influenced by real-world ripple effects.
AAHomecare’s Commenting Guidance for AAHomecare Members on
CMS’s CY2026 HH/DMEPOS Proposed Rule (CMS-1828-P) includes some advice on how to shape your message and ensure it addresses the most critical issues in the proposal.
Be specific and professional—outline the potential consequences clearly, avoid overly emotional language, and do not include any patient-identifiable information (PHI).
Protect the Future of Your Business
Navigating the complexities of this industry can be overwhelming. Our team specializes in helping DME providers understand regulatory changes and their potential impacts. If you’re concerned about the future of your operations, we’ll partner with you to develop a strategy that safeguards your business.
Don’t face these changes alone. Get in touch with one of our Revenue Cycle Management Specialists.