CMS Updates Competitive Bidding Program for Durable Medical Equipment

The Centers for Medicare & Medicaid Services (CMS) has introduced adjustments to its competitive bidding programme (CBP) that targets durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). This programme system allows suppliers to compete by offering medical equipment at lower costs for Medicare beneficiaries. Key revisions include the phased integration of a nationwide remote item delivery (RID) CBP for items commonly supplied via mail orders, with implementation stretched between December 2025 and January 2028, extending from the previous deadline of 2027. CMS also revised the number of contracts per product category based on suppliers' market shares, affecting categories such as Continuous Glucose Monitors (CGMs), insulin pumps, urological and ostomy supplies, and off-the-shelf braces. While these changes received a cautiously positive reaction from the medical technology industry, patient access concerns persist. AdvaMed, representing the medtech sector, welcomed the extended timeline and updated contract approach but raised significant concerns about the inclusion of certain prosthetic supplies like ostomy and tracheostomy products in the CBP. AdvaMed argues these items are highly individualized prosthetic devices and not durable medical equipment, cautioning that their inclusion could disrupt patient access and result in adverse health outcomes. CMS mandates that contracted suppliers must provide prescribed brands for CGMs and insulin pumps, constituting an effort to protect patient safety and device specificity. Despite recognizing these provisions, industry representatives maintain ongoing vigilance over patient access and statutory scope of CMS authority within the CBP framework. These developments highlight ongoing regulatory adjustments balancing cost-saving measures with clinical needs and patient safety in the Medicare durable medical equipment market.