A broad community of patient and disability organizations sounded the alarm at the Centers for Medicare & Medicaid Services (CMS) for its November 28 final DMEPOS rule, which seemingly fast-tracks the inclusion of ostomy, tracheostomy, and urological supplies into Medicare’s Competitive Bidding Program as early as next year.
“CMS has chosen to run a dangerous experiment on people whose lives depend on highly individualized ostomy, urological, and tracheostomy supplies,” said Dr. Caroll Koscheski, President, Digestive Disease National Coalition (DDNC). “These are not commodity products. They are life-sustaining prosthetic devices that must be tailored to each person’s anatomy, skin, and clinical condition. A lowest-bid, one-size-fits-all model will inevitably mean leaks, infections, hospitalizations – and avoidable suffering for hundreds of thousands of Medicare beneficiaries.”
Upon release of CMS’ proposed regulation to include these prosthetic products into the Medicare competitive bidding program earlier this year, dozens of national patient, disability and clinical organizations warned CMS and Congress that expanding competitive bidding to these prosthetic supplies would slash choice to a small handful of mail-order contractors, override clinicians’ treatment plans, and strip beneficiaries of access to the specific products that keep them safe, independent, and out of the hospital. The final rule largely ignores those warnings and locks in an accelerated implementation timeline.
This policy undermines the very principles CMS claims for competitive bidding – choice, efficiency, and meaningful savings – by planning to concentrate power to a few remote suppliers while shifting costs downstream to emergency rooms, wound clinics, and hospitals.
“Competitive bidding may make sense for standardized, off-the-shelf commodities. It does not make sense for products that literally replace lost limb and organ function,” said Cheryl Ory, President of the United Ostomy Associations of America, Inc. (UOAA). “Congress deliberately protected prosthetic ostomy and urological supplies from bidding for a reason. CMS is now trying to do administratively what lawmakers didn’t do legislatively – and patients will pay the price.”
“Thousands of colorectal cancer patients and survivors live with ostomies, many permanently. One size does not fit all in ostomy care, and preserving patient choice in ostomy supplies is essential to safeguarding quality of life and clinical outcomes. The competitive bidding process will limit access to products and deny patients the chance to find what supplies work best for their body and circumstances. Patients deserve better. We will continue to work with UOAA and other partners to ensure patient access to the ostomy supplies that work best for them,” said Anjee Davis, CEO, Fight Colorectal Cancer.
“WOC nurses play an essential role in proper fitting, education, and clinical monitoring,” said Christine (Chris) Berke, MSN, APRN-NP, CWOCN-AP, AGPCNP-BC, President of the Wound, Ostomy, and Continence Nurses Society™ (WOCN®). “The decision by CMS to include ostomy, tracheostomy, and urological supplies into Medicare’s Competitive Bidding Program not only undercuts our care model but also threatens the safety and well-being of the very patients we care for. Every patient has distinct care requirements, and these medical items should be treated similarly. They are not interchangeable and should not be managed with a ‘one-size-fits-all’ assumption.”
We call on CMS to immediately halt implementation of competitive bidding for ostomy, tracheostomy, and urological supplies and to work with patient organizations, clinicians, and Congress on targeted, data-driven integrity solutions that combat fraud and abuse without jeopardizing access to medically necessary, individualized products.
“Medicare should not balance the books on the backs of people who cannot go a day without these prosthetics,” the groups said. “We urge CMS and Congress to reverse this decision before harm is done.”
Signed,
American Society for Parenteral and Enteral Nutrition
Bladder Cancer Advocacy Network
Color of Gastrointestinal Illnesses
Connecting Pieces
Crohn’s & Colitis Foundation
Digestive Disease National Coalition
Fight Colorectal Cancer
Friends of Ostomates Worldwide – USA
Girls With Guts
National Alliance of Wound Care and Ostomy
National Association For Continence
Patients Rising
United Ostomy Associations of America, Inc.
Wound, Ostomy, and Continence Nurses Society™