The Competitive Bidding Relief Act requires the Secretary of Health and Human Services to apply the transition rule in 42 C.F.R. 414.210(g)(9)(v) to applicable durable medical equipment and supplies formerly included in Round 2021 of the DMEPOS competitive bidding program for areas other than rural or noncontiguous locations through December 31, 2025. It also bars the Secretary from implementing 42 C.F.R. 414.210(g)(9)(vi) until January 1, 2026, and allows HHS to carry out these actions by program instruction or other administrative means.
For DME suppliers, Medicare contractors, and compliance officers this is a targeted, short-term pause: the bill preserves transitional payment treatment in many non-competitive bidding areas for a defined period and delays the next regulatory step. That relief changes near-term revenue and billing expectations for items tied to the 2021 bidding round and shifts implementation risk onto HHS to issue operational guidance.
At a Glance
What It Does
It requires HHS to apply the 'first-sentence' transition rule at 42 C.F.R. 414.210(g)(9)(v) to applicable DMEPOS items in non-rural/noncontiguous areas through December 31, 2025, and forbids implementing 42 C.F.R. 414.210(g)(9)(vi) before January 1, 2026. The Secretary may use program instructions or comparable administrative actions to implement the statute.
Who It Affects
Directly affects Medicare payment for durable medical equipment and supplies that were part of Round 2021 of the DMEPOS competitive bidding program, the suppliers who bill Medicare for those items, Medicare Administrative Contractors and CMS operational staff, and beneficiaries who rely on affected equipment and supplier networks.
Why It Matters
The bill pauses a regulatory change that would otherwise alter payment rates and market incentives, giving suppliers and contractors a temporary, predictable payment rule while preserving HHS discretion on how to implement the pause. That matters to compliance teams sizing revenue exposure and to budget officers tracking Medicare outlays tied to the competitive bidding program.
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What This Bill Actually Does
The DMEPOS competitive bidding program historically sets Medicare payment rates for many types of durable medical equipment and supplies by awarding contracts and applying bid-derived payment amounts in defined competitive bidding areas. Round 2021 produced a set of items and suppliers that the Centers for Medicare & Medicaid Services (CMS) intended to fold into updated payment mechanics governed by 42 C.F.R. 414.210(g)(9) and related provisions.
This bill intervenes in that regulatory transition for items tied to Round 2021.
Specifically, the statute orders the Secretary to apply the transition mechanism described in paragraph (g)(9)(v) of 42 C.F.R. §414.210 — commonly referenced as a short-term payment transition — to all applicable items and services furnished in areas other than those defined as rural or noncontiguous, and to continue that treatment through December 31, 2025. In parallel, the bill prevents the Secretary from putting paragraph (g)(9)(vi) into effect until January 1, 2026, effectively postponing the next phase of the regulatory change.The bill also builds flexibility for HHS by explicitly allowing implementation by program instruction or other administrative action notwithstanding other law.
That gives CMS a faster, administrable path to put the changes into practice but reduces the formal rulemaking steps and timelines that normally accompany regulatory amendments. For on-the-ground operations, the result is a temporary continuation of the transition payment methodology in most non-competitive areas, a defined pause in further regulatory change, and a statutory deadline after which the delayed regulatory provision may be implemented.
The Five Things You Need to Know
The bill applies the transition rule in 42 C.F.R. §414.210(g)(9)(v) to applicable DMEPOS items furnished in areas other than rural or noncontiguous areas through December 31, 2025.
It prohibits the Secretary from implementing 42 C.F.R. §414.210(g)(9)(vi) before January 1, 2026.
The statute targets items and services that were formerly included in Round 2021 of the DMEPOS competitive bidding program.
HHS may carry out the required adjustments by program instruction or other administrative action, expressly allowing non-rulemaking implementation.
The bill limits its relief to payment treatment; it does not amend the underlying competitive bidding authority or change which items are classified as DMEPOS.
Section-by-Section Breakdown
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Short title
Names the measure the "Competitive Bidding Relief Act." This is purely a caption but signals the bill's targeted purpose: to provide temporary relief tied to competitive bidding payments for DMEPOS items from Round 2021.
Extend transition payment for non-rural/noncontiguous areas through 12/31/2025
Directs the Secretary to implement 42 C.F.R. §414.210(g)(9)(v) (or any successor regulatory text) so that the transition rule described in that provision applies to all applicable items and services furnished in areas other than those defined as rural or noncontiguous. Practically, CMS must preserve the transitional payment treatment for those geographic areas through December 31, 2025; contractors and suppliers should expect to use the transition-based payment methodology until that date unless HHS issues different instructions under the authority provided.
Delay implementation of the subsequent regulatory step until 1/1/2026
Bars the Secretary from implementing 42 C.F.R. §414.210(g)(9)(vi) (or any successor) until January 1, 2026. That provision is the next phase of the regulatory sequence that would otherwise change payment mechanics; the statutory pause forces a one-year deferral of that implementation date and creates a fixed window before the regulation may take effect.
Allow implementation by program instruction or similar means
Authorizes HHS to carry out the statute's requirements by program instruction or 'otherwise,' notwithstanding other law. This lets CMS adopt operational guidance, transmittals, or contractor instructions instead of pursuing notice-and-comment rulemaking to effect the timing changes directed by the statute. The practical implication is faster administrative action but less formal public process.
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Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- DME suppliers that supplied items included in Round 2021 in non-rural/noncontiguous areas: They get continuation of transition-payment treatment through December 31, 2025, which can stabilize near-term revenue and billing.
- Medicare beneficiaries who rely on affected DME: By preserving transitional payments, the bill aims to reduce abrupt supplier exits that could disrupt local access to necessary equipment and repair services.
- Small, independent DME providers outside competitive-bidding areas: Those vendors often lack the scale to compete on bid-derived prices and may avoid immediate rate reductions that would follow full regulatory implementation.
- CMS operations and contractors seeking implementation certainty: The statutory direction and explicit permission to use program instructions give operational teams a clear legal basis for issuing expedited guidance.
Who Bears the Cost
- Medicare trust funds (Part B expenditures): Extending transition payments and delaying lower bid-derived rates likely increases Medicare outlays relative to immediate implementation of the regulatory step the bill pauses.
- Competitive-bidding winners and lower-cost suppliers: The pause can preserve market share for higher-cost suppliers in non-bid areas and distort competitive incentives created by Round 2021 outcomes.
- CMS and Medicare Administrative Contractors: Although given a clear authority to act administratively, they must still draft, distribute, and enforce new or revised program instructions on a compressed timeline.
- Federal budget overseers and appropriations planners: The deferral changes projected savings/timing tied to competitive bidding, complicating budget scoring and fiscal planning.
Key Issues
The Core Tension
The central dilemma is straightforward: ensure short-term supplier stability and beneficiary access by delaying payment changes, or enforce competitive-bidding-driven rate adjustments to realize cost savings and preserve the integrity of the program. The bill favors stability and administrative speed at the expense of immediate budgetary discipline and formal rulemaking transparency.
The bill trades immediate budgetary savings for short-term market stability by statutorily freezing the regulatory timetable for a class of DMEPOS items. That trade-off raises questions about how much additional cost the Medicare program will absorb and whether the temporary relief simply postpones more disruptive adjustments.
Because the statute references regulatory paragraphs by citation and permits use of 'successor' regulations, implementation will require careful legal interpretation to determine which items and geographic designations fall within its scope, especially where CMS has previously modified Competitive Bidding Area boundaries or product lists.
Allowing HHS to implement the changes by program instruction speeds operationalization but constrains public input. Program instructions can be changed more quickly than formal regulations, which helps HHS manage near-term disruptions, yet the lack of notice-and-comment rulemaking creates legal and stakeholder-relations risks.
Finally, the bill sets a hard calendar date for restarting regulatory implementation (January 1, 2026) but provides no transitional details for that restart; absent additional guidance or statutory follow-up, providers and contractors face a 'cliff' risk when the pause ends and the deferred provision takes effect.
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