Competitive Bidding Round 2028

CB Round 2028 in Focus

Provisions from the Final Rule restarting the bidding program will have consequential impacts on the DME community, patients, and caregivers.  AAHomecare is beginning work on the next phase of our advocacy related to the proposed rule to address these significant issues that remain.

RID Competitive Bidding Program
The new bidding round will include products that will be furnished by Remote Item Delivery (RID): Class II CGMs & Insulin Pumps, Urological Supplies, Ostomy Supplies, Hydrophilic Urinary Catheters, and OTS Braces. Using 2023 utilization data, we estimate that CMS processes for implementing a nationwide RID bid program will result in fewer than 10 suppliers “winning” bids and serving patients in ostomy, CGMs/insulin pumps, and urological supplies categories.

Payment Setting Methodology/Bid Ceiling
CMS’ process for determining the Single Payment Amount (SPA) for these products is set at the 75th percentile of bids needed to meet market demand. In addition, the new bidding process will utilize the current fee schedule as the bid ceiling for these products (with the exception of braces), instead of using the 2015 unadjusted SPA as a ceiling (as used in the last bidding round). Using these mechanisms severely limits the prospects of delivering payment amounts that reflect market reality for suppliers.

This payment setting methodology will impact bidders under the RID Bidding Round in the near term – but also sets a worrying precedent for any possible future bidding rounds.

CB Advocacy a Priority for 2026
AAHomecare has been working with DME stakeholders, patient advocacy groups, and supporters on Capitol Hill to develop strategy and legislative language to address major aspects the next CB round.  We will share details on legislation and how the DME community can support these initiatives as they take shape.