AdvaMed Urges CMS to Reconsider Medicare Competitive Bidding for Medical Equipment
The Advanced Medical Technology Association (AdvaMed) has expressed significant concerns regarding the Centers for Medicare & Medicaid Services (CMS) proposal to restart the Competitive Bidding Programme (CBP) for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) within Medicare. After a pause since December 2023 due to operational challenges and industry opposition, CMS aims to reinitiate the CBP by 2027 to reduce Medicare expenditures and eliminate fraudulent DME suppliers. However, AdvaMed argues that the programme's design could negatively impact patient safety and market competition.
AdvaMed's leadership highlights that the medtech industry is inherently competitive and innovation-driven, with declining prices typical over time. The association criticizes the CMS proposal for potentially undermining innovation incentives and pushing quality suppliers out of the Medicare market. Moreover, the CMS's suggested broadening of the definition of 'item' to include certain prosthetic supplies raises legal concerns and questions about the agency's statutory authority, potentially reducing market transparency and patient access.
Additional scrutiny focuses on CMS plans to reimburse for Continuous Glucose Monitors (CGM) and durable insulin infusion pumps. Although supporting increased patient access, AdvaMed cautions that CMS's approach conflicts with FDA regulatory classifications and device labelling. CGMs and insulin pumps require specialized handling, refurbishment, and validation processes that typical DME suppliers are not equipped to manage, creating potential risks related to device safety and reliability.
Scott Whitaker, AdvaMed’s president and CEO, advocates for significant revisions to the CMS proposal to address these issues comprehensively. The dialogue surrounding the CBP underscores ongoing tensions between cost-containment efforts in Medicare and maintaining robust incentives for innovation and patient safety in the medical technology market. The outcome of this regulatory review will influence supplier dynamics, coverage policies, and the broader landscape of medical equipment provisioning under Medicare.