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LUGPA Policy Alert: CMS Proposal Threatens Patient Access to Urological Supplies

On August 29, 2025, LUGPA submitted formal comments to the Centers for Medicare & Medicaid Services (CMS) in response to its proposed rule on the CY 2026 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP).

CMS has proposed to redefine “item” under 42 C.F.R. § 414.402 to include urological supplies within the scope of the Competitive Bidding Program. If finalized, this change would represent a major shift in federal policy with serious consequences for both independent urology practices and the patients they serve.

LUGPA’s Position

LUGPA strongly opposes including urological supplies in the DMEPOS Competitive Bidding Program. In our comments, we raised two central concerns:

1. Threat to Patient Access and Outcomes

  • Urological supplies are not interchangeable commodities; they must be matched to patients’ unique medical needs, anatomy, and functional status.
  • Restricting access risks serious medical complications, including infections, emergency care, and hospitalization, outcomes that increase Medicare spending rather than reduce it.
  • CMS’s own prior evaluation of competitive bidding programs found “large, negative and statistically significant” impacts on access to training for urological supplies.

2. Legal Overreach by CMS

  • Congress did not authorize CMS to include prosthetic devices such as urological supplies in the competitive bidding program.
  • Expanding the definition of “item” exceeds CMS’s statutory authority under the Social Security Act.
  • Finalizing this proposal would create legal uncertainty for suppliers and patients while undermining Congressional intent.

Why This Matters to LUGPA Practices and Patients

  • Patient Safety at Risk: Competitive bidding could prevent patients from receiving the appropriate supplies necessary for their condition, directly impacting outcomes and quality of life.
  • Practice Operations Impacted: Many LUGPA practices provide urological supplies directly to patients to ensure proper fit, training, and continuity of care. Competitive bidding would limit or eliminate this vital service.
  • Costly Consequences for Medicare: Disruptions in access could lead to more hospitalizations and higher overall costs, undermining CMS’s stated goal of efficiency.
  • Regulatory Precedent: If CMS expands its authority here, other physician-directed services and supplies could face similar overreach in the future.

Next Steps

LUGPA will continue to oppose CMS’s proposal and advocate for protecting patient access to safe, individualized urological care. We urge CMS to withdraw its proposed redefinition of “item” and exclude urological supplies from the Competitive Bidding Program.

We will keep members updated as CMS reviews stakeholder feedback and moves toward a final rule.