National Campaign Launches Against Medicare’s Bid for Urological Supplies

WASHINGTON—A group of national patient advocacy organizations announced the launch of The High Cost of Low Bids, a campaign urging policymakers to stop the inclusion of urological and ostomy supplies in Medicare competitive bidding. 

The campaign responds to Centers for Medicare & Medicaid Services’s (CMS) decision to include these supplies in the Medicare Competitive Bidding Program, effective January 2028, warning that applying a lowest-bid purchasing model to clinically complex, highly individualized products could reduce access to necessary products and increase both avoidable complications and long-term healthcare costs.

Urological and ostomy supplies are a daily necessity for millions of Americans living with a wide range of conditions, including spina bifida, multiple sclerosis, spinal cord injuries, cancer, inflammatory bowel disease and others. These prosthetic devices must be matched to each patient’s anatomy, diagnosis, skin integrity, dexterity, lifestyle and clinician-directed care plan.

Historically, Congress has excluded urological and ostomy supplies from competitive bidding: the 2003 Medicare Modernization Act deliberately removed these products due to their complexity, highly individualized usage and potential for patient infection. 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.

“Patients need the right fit—not the lowest bid,” said Sara Struwe, president & CEO of the Spina Bifida Association. “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.”

Currently, Medicare contracts with hundreds of ostomy and urological product suppliers nationwide, and CMS has estimated that expanding competitive bidding could result in fewer than 10 national contract suppliers. Patient advocates warn this consolidation could reduce product choice, make it harder for patients to obtain the specific supplies they need and risk eliminating local suppliers, who play a critical role in ensuring timely delivery of medically necessary supplies for patients—especially those living in rural areas.

“Selecting the appropriate ostomy or urological supply requires careful clinical assessment and consideration of each patient’s lived experience,” said Struwe. “Limiting access to the full range of products can have serious health consequences including leakage, skin breakdown, infection or an avoidable emergency room visit. In many cases, the resulting complications can quickly outweigh any short-term savings gained by restricting access to appropriate supplies.”

The High Cost of Low Bids, which includes national and regional patient, provider and advocacy organizations, urges Congress and the administration to delay the implementation of competitive bidding for urological and ostomy supplies and to require CMS to demonstrate that patients will maintain timely access to the full range of medically necessary products, supplier choice, product quality and clinician-directed care.

Visit highcostoflowbids.org to urge Congress to protect patient access by requiring a formal clinical and patient access review before including urological and ostomy supplies in competitive bidding.