Medicare would exclude urinary and ostomy supplies from competitive bidding

Medicare would exclude urinary care and ostomy supplies from competitive bidding. The exclusion would cover the urinary care and ostomy supplies referenced in the bill. Ostomy supplies collect waste through a surgically created opening in the body. The exclusion would apply to supplies furnished on or after January 1, 2028, and before January 1, 2033.

The federal health secretary would establish an expert panel and follow its recommendations when running competitive bidding. At least 15 members would include patients and caregivers, clinical experts, and experts in payment rules and supplies. The panel would review stakeholder input and clinical research to recommend ways to preserve access to products selected by doctors. Its meeting minutes and documents used to develop recommendations would be public. The panel would be established within 90 days of enactment and make recommendations within one year of its establishment.

The federal health secretary would conduct a trial of competitive bidding for these supplies. The trial would last 12 months in no more than three states. A representative sample of prior-year users would be surveyed before the trial and again within three months after it starts. Access problems would trigger consultation with the expert panel. Results would guide bidding rules protecting access to doctor-approved comparable products and previously used brands. The secretary would conduct the trial within three years of enactment.

Contract suppliers could not try to persuade or reward patients to switch their selected supply brand. The brand restriction would cover supplies chosen by the patient and referring doctor. The secretary would establish an access process for patients in the trial or another competitive bidding program. The ban would include offering information about other brands when patients have not requested it. If the same or clinically comparable supplies were unavailable, patients could receive them from another supplier, including one outside the competitive bidding contract.