Medicare's Cost-Cutting Plan Sparks Fears for Patient Safety

WASHINGTON – May 20, 2026 – A new front has opened in the battle between federal healthcare cost-cutting and patient care. A coalition of national patient advocacy organizations has launched a campaign, "The High Cost of Low Bids," to combat a looming Medicare policy change that they warn could endanger millions of Americans who rely on specialized medical supplies.

At the heart of the dispute is the Centers for Medicare & Medicaid Services (CMS) decision to include urological and ostomy supplies in its Competitive Bidding Program, effective January 2028. The program, designed to drive down costs by awarding contracts to the lowest bidders, will be applied to these highly personalized products for the first time. Advocates argue this move prioritizes fiscal savings over patient safety, potentially restricting access to essential supplies and leading to a surge in avoidable complications and higher long-term healthcare costs.

A Fight for the Right Fit

For millions of Americans living with conditions ranging from spina bifida and multiple sclerosis to spinal cord injuries and cancer, ostomy and urological supplies are not optional accessories; they are a daily necessity. These prosthetic devices, which include catheters, drainage bags, and ostomy pouches, must be meticulously matched to a patient's unique anatomy, medical condition, skin integrity, and lifestyle. A mismatch can have devastating consequences.

"Patients need the right fit – not the lowest bid," said Sara Struwe, President & CEO of the Spina Bifida Association, in a statement announcing the campaign. "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."

Advocates stress that these are not interchangeable commodities. The wrong catheter can cause urinary tract infections, a leading cause of hospitalization for this patient population. An ill-fitting ostomy pouch can lead to leakage, severe skin breakdown, and social isolation.

"Selecting the appropriate ostomy or urological supply requires careful clinical assessment and consideration of each patient's lived experience," Struwe explained. "Limiting access to the full range of products can have serious health consequences... In many cases, the resulting complications can quickly outweigh any short-term savings gained by restricting access to appropriate supplies."

A High-Stakes Bet on Savings

CMS's rationale for the policy change, finalized in a rule published late last year, is rooted in the successful cost reductions achieved by the Competitive Bidding Program (CBP) for other types of durable medical equipment (DME). Past rounds of competitive bidding have driven significant savings for taxpayers. For example, a 2017 study showed the program led to a 35% reduction in total Medicare DME spending, while costs for items like Continuous Positive Airway Pressure (CPAP) devices fell by over 45%. The agency aims to replicate this success to control rising healthcare expenditures.

However, critics are quick to point out the historical context. The 2003 Medicare Modernization Act, which created the bidding program, deliberately excluded ostomy and urological supplies. A subsequent 2004 evaluation by the U.S. Department of Health and Human Services concluded these specific products were "not well suited" for competitive bidding, warning that "quality may suffer" with "insufficient potential for Medicare savings."

Patient advocacy groups like the United Ostomy Associations of America (UOAA) argue that CMS is now exceeding its statutory authority. They contend these supplies are legally defined as prosthetic devices—which restore a lost bodily function—and were therefore specifically protected from competitive bidding by Congress. By attempting to include them now, advocates say the agency is ignoring both legislative intent and clear clinical risks.

The Looming Supply Chain Shake-Up

The proposed change threatens to radically reshape the medical supply landscape for these products. Currently, Medicare contracts with hundreds of suppliers nationwide, including many small, local businesses that provide personalized fittings and timely support. Under the new remote delivery model, CMS estimates it will award contracts to fewer than 10 national suppliers for both urological and ostomy supplies combined.

This massive consolidation could decimate the network of local providers who play a critical role, especially for patients in rural areas. Industry experts warn that the shift to a few national, low-bid contract holders will inevitably reduce product choice, as these large suppliers will likely focus on a limited catalog of the cheapest available options. This could leave patients unable to obtain the specific brand or type of product prescribed by their clinician.

While the Government Accountability Office (GAO) has found "no widespread problems" in patient access in past bidding rounds for other equipment, it has also documented a significant decline in the number of active suppliers. For a patient group dependent on highly individualized products, the loss of choice and specialized local support represents a profound threat to their health and quality of life. The new system, critics fear, will sever the personal relationships between patients and local suppliers, replacing them with an impersonal, one-size-fits-all national distribution model.

An Urgent Call for Review

Faced with the impending 2028 implementation date, The High Cost of Low Bids campaign is urging Congress and the Biden Administration to intervene. Their primary demand is a delay of the policy's implementation for urological and ostomy supplies until CMS can definitively demonstrate that patient access, product quality, supplier choice, and clinician-directed care will not be compromised.

The campaign is mobilizing patients, caregivers, and clinicians to contact their elected officials, framing the issue as a critical test of whether the healthcare system prioritizes its most vulnerable members. Medical technology industry groups like AdvaMed have echoed these concerns, arguing that the medtech market is already highly competitive and that the CMS rule could stifle innovation while posing unnecessary risks to patients. The debate crystallizes a fundamental question for policymakers: where is the line between prudent fiscal management and a gamble on patient health that could prove far more costly in the long run?