A group of national and regional patient, provider, and advocacy organizations has recently launched a campaign against the inclusion of urological and ostomy supplies in Medicare’s competitive bidding program.
Why?
Short-term savings will be overruled by weightier costs
CMS estimates that competitive bidding will reduce the number of urological and ostomy product suppliers working with Medicare from several hundred to fewer than 10.
The group finds issue with this.
A limited number of supplier options could reduce product variety and availability, ultimately impacting patients in need of necessary medical supplies, especially those in rural communities.
Urological & ostomy supplies have historically not been included in the CBP
In the pass, urological and ostomy supplies have been excluded from competitive bidding by Congress. The 2003 Medicare Modernization Act is an example of such legislature, deliberately removing these products.
HME News writes: “The group says CMS is now moving to include these products in competitive bidding, despite longstanding concerns and limited evidence that patient safety, product access and continuity of care will be protected.”
Sara Struew, president & CEO of the Spina Bifida Association, suggests:
“Patients need the right fit – not the lowest bid. For individuals living with complex medical conditions like Spina Bifida, access to the correct urological and ostomy supplies is essential to maintaining health, dignity and independence. Moving forward without clear evidence of patient safety puts vulnerable populations at unnecessary risk.”
What Could This Mean for DMEs?
Strategically, DMEs should be paying attention to several factors in light of CBP updates and subsequent pushback:
- CMS's final bidding methodology (especially supplier eligibility requirements
- Projected reimbursement rates for urological and ostomy categories
- Whether Congress intervenes as advocacy groups are requesting
- Market concentration estimates and how many suppliers CMS ultimately expects to contract with
- Operational readiness for lower reimbursement environments, including workflow optimization and automation
Find a full list of the organizations that make up the group here.
