Obama FY 17 Budget Proposes to Include Ostomy & Urological Supplies in Medicare Competitive Bidding
Wednesday, May 4, 2016
Posted by: Becky Dryden
President Obama released his proposed FY 17 budget in March which included a provision to expand Medicare’s competitive bidding program to new product categories. The budget proposed that inhalation drugs; all prosthetic and orthotics; and ostomy, tracheostomy and urological supplies all be listed as products subjected to competitive bidding. The Wound, Ostomy and Continence Nurses Society™ (WOCN®) has serious concerns with this proposal, as ostomy supplies and urological supplies are not well-suited for a competitively bid program because of their highly customizable nature. The Society has fought to exclude these products from the program in the past and will continue to do so in the future.
Medicare’s competitive bidding program forces suppliers into a program in which each supplier submits bids to provide certain medical equipment and supplies at a lower price than what Medicare now pays for these items. Medicare uses these bids to set the amount it pays for those equipment and supplies under the Competitive Bidding Program. Suppliers with winning bids are chosen as the sole Medicare contract suppliers. The bidding process is specific to various areas of the country where suppliers/prices may vary on the same product type.
The main issue of concern in the competitive bidding program is that it will almost certainly lead to patient complications, as suppliers will be bound by artificial bids to supply products based on price, not by patient need. Specifically to the needs of our ostomy patients, because a supplier is bound by bid, they may not be able to afford higher quality products that a more complicated ostomy patient may need. This bidding system forces patients into a “one-size-fits-all” ostomy solution – a disaster for ostomy patients. Ostomy supplies are clinically prescribed, selected, adjusted and fitted by a certified ostomy specialist for individuals based on the unique medical and physical needs of each person in relation to their disease or condition. The proposal to competitively bid these critical prosthetic supplies fails to recognize that ostomy and urologic prosthetics are not one-size-fits-all generics and are not interchangeable. In addition, ostomy prosthetics should be instituted and adjusted by a certified WOC nurse, meeting the same criteria as other prosthetic equipment.
The Society has joined with other stakeholders to express our opposition to this short-sighted proposal by sending a letter to Congress urging them to not move forward with the President’s proposal. It is important to remember that the President’s budget is just a proposal and this program cannot be expanded without congressional approval. So, it is important that all stakeholders express concern early to prevent its enactment. The Society will be calling on its members to get engaged in this issue, so stay tuned for further updates and calls to action. If you have further questions about the competitive bidding proposal, please feel free to contact the Society at firstname.lastname@example.org.
View the Ostomy Access to Care and Supplies WOCN Society Action Plan here.