Why It Matters
The home healthcare industry faces the strain of persistent Medicare payment cuts while Congress advances concrete reform opportunities. CMS finalized its 2026 home health payment rule with a 1.3% aggregate reduction, marking the fourth consecutive year of cuts threatening provider sustainability and patient access—particularly in rural areas.
Simultaneously, Congress is actively advancing multiple bills addressing key industry concerns: the SOAR Act to reform supplemental oxygen reimbursement, legislation expanding home infusion therapy coverage, and the DMEPOS Relief Act to prevent competitive bidding program reinstatement. Rep. Vern Buchanan, Chair of the Ways and Means Health Subcommittee, is actively championing these reforms, creating genuine momentum for legislative solutions.
By the Numbers
The American Association for Homecare maintains a robust Washington presence with 264 lobbying disclosures since 2003. AAH’s in-house operation accounts for $12.3 million across 77 disclosures.
The new $60,000 quarterly payment to Brown & Fortunato PC continues a partnership since May 2018, with the firm earning $1.6 million over 32 filings—making AAH their largest client. Beyond Brown & Fortunato, AAH retains multiple firms including Prime Policy Group ($1 million from 2016-2024) and Nickles Group LLC ($1 million since 2021).
The Agenda
AAH’s lobbying focuses on Medicare/Medicaid reimbursement rates, the DMEPOS competitive bidding program, and tariff impacts on medical supplies. Key legislative priorities include the SOAR Act of 2025 reforming supplemental oxygen reimbursement, multiple bills expanding home infusion therapy coverage, the Home Health Stabilization Act seeking positive payment adjustments for 2026-2027, and the DMEPOS Relief Act preventing drastic reimbursement cuts.
Broader Context
Congressional activity directly impacts the industry. The DMEPOS Competitive Bidding Program faces reinstatement with a timeline extending to January 2028, threatening reimbursement rates.
Multiple bills offer opportunities: The SOAR Act would remove supplemental oxygen from competitive bidding, while the Preserving Patient Access to Home Infusion Act seeks expanded Medicare coverage. Multiple representatives have publicly supported DMEPOS relief legislation, signaling bipartisan momentum.
Demographic trends favor the industry—aging population and "aging in place" preferences drive structural demand growth, though medical equipment tariffs ranging from 10% to 50% create cost pressures.
Between The Lines
Key committee leadership engagement is accelerating. The House Energy and Commerce Health Subcommittee held hearings on "Examining Policies to Enhance Seniors’ Access to Breakthrough Medical Technologies", emphasizing bipartisan support for streamlining Medicare coverage. Representatives Miller-Meeks, Feenstra, Panetta, and Tonko reintroduced the DMEPOS Relief Act, while Rep. Brian Mast introduced the Veterans Homecare Choice Act.
Competitive Landscape
AAH faces competition from major DME suppliers lobbying on overlapping issues. Lincare Holdings Inc. consistently spends $80,000 quarterly on competitive bidding and Medicare reimbursement, while Rotech Healthcare Inc. lobbies on the SOAR Act and DMEPOS Relief Act, spending $30,000-$40,000 quarterly.
The Bottom Line
AAH’s $60,000 fourth quarter 2025 payment to Brown & Fortunato reflects strategic positioning amid significant congressional activity. Multiple home healthcare bills are advancing as CMS imposed another Medicare payment reduction. With key committee leaders like Buchanan supporting industry priorities, the timing aligns with bipartisan congressional interest in modernizing home-based care access and payment structures.
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