Congress Urges Caution on Some Competitive Bidding Categories

WASHINGTON—Members of Congress are urging the Centers for Medicare & Medicaid Services (CMS) to consider the impact of including some items in the revived competitive bidding program. In a committee report accompanying a broad 2027 appropriations bill, lawmakers asked the agency to report back on how bidding would affect access to medically appropriate devices, the American Association for Homecare said in a recent newsleter. 

In the comments, which accompanied the appropriations bill for the Departments of Labor, Health and Human Services and others, Congress included several statements about the future of competitive bidding for continuous glucose monitors (CGMs), insulin pumps, ostomy, tracheostomy and urological supplies, warning that including CGMs and insulin pumps in competitive bidding could disrupt access and harm patient safety. 

“While they are not included in the legislations, they show Congress is paying attention to the risks of expanding competitive bidding into remote item delivery (RID) categories,” AAHomecare wrote. 

Congress also acknowledged the critical role of advanced technology for improving the health and safety of individuals with diabetes and asked CMS to report back within 180 days.

CMS wants to add ostomy, tracheostomy and urological supplies to competitive bidding. Congress noted these were new items in this bidding program and urged caution, citing risks to patient access, clinician decision making, domestic manufacturing and overall Medicare costs. They also expressed concern for any requirements that could impact the market for these products, resulting in limited patient access. Lawmakers requested an update on current rulemaking related to this.

Lawmakers also mentioned supplier verification, noting that durable medical equipment, prosthetics, orthotics and supplies require strong mechanisms to verify the identity and legitimacy of manufacturers and distributors. They asked that CMS and its contractors strengthen their monitoring and even suggested including unannounced “secret shopper” calls to suppliers to ensure Medicare beneficiaries are not being steered toward products that were not ordered by their prescribing physician.

AAHomecare said it will continue working closely with lawmakers, CMS and industry partners toward legislation to delay these products from inclusion in competitive bidding program.