LUGPA Policy Alert – LUGPA Urges CMS to Preserve Physician-Directed Access to Urological Supplies

September 2026

At a Glance

In late August, LUGPA submitted comments to the Centers for Medicare & Medicaid Services (CMS) urging the agency to preserve physician-directed access to urological and ostomy supplies as it moves forward with the DMEPOS Competitive Bidding Program.

LUGPA is particularly concerned about the nationwide Remote Item Delivery (RID) program, which would include urological supplies, ostomy supplies, and hydrophilic urinary catheters. Contracts under Round 2028 are expected to begin no later than January 1, 2028.

LUGPA supports responsible Medicare spending and program integrity but cautions that lower prices should not come at the expense of patient choice, clinical judgment, continuity of care, or access to local physician-directed delivery.

Why It Matters

For many urology patients, urinary catheters and other supplies are an important part of ongoing treatment. Product selection can depend on individual clinical factors, including anatomy, dexterity, mobility, cognition, infection history, and tolerance.

LUGPA is concerned that relying on a limited number of nationwide contract suppliers could reduce physician involvement and create challenges with product selection, fulfillment, substitutions, and continuity of care.

Competitive pricing does not require competitive displacement. Patients should retain access to physician-directed delivery when their treating physician or practice is willing to furnish an appropriate product and accept applicable Medicare reimbursement.

LUGPA’s Recommendations

LUGPA is urging CMS to:

Expand the physician exception under 42 CFR § 414.404(b)(1)(i) to allow physicians and treating practitioners to furnish qualifying urological and ostomy supplies to their own patients.
Preserve clinical judgment by ensuring competitive bidding does not interfere with a urologist’s ability to select medically appropriate products.
Protect patient choice and access by evaluating supplier concentration, rural access, timely delivery, product availability, and continuity of care.
Measure access—not just savings by monitoring fulfillment delays, substitutions, supply disruptions, beneficiary complaints, emergency access, additional utilization, and physician administrative burden.

What It Means for Independent Urology

The DMEPOS Competitive Bidding Program could affect more than Medicare spending—it could change how patients obtain the supplies that support ongoing urologic care.

LUGPA believes CMS can pursue competitive pricing and program integrity while maintaining physician-directed access as an option for beneficiaries. Preserving this pathway would allow urologists to remain closely involved in the care and management of patients who depend on these supplies.

LUGPA will continue advocating for policies that support patient access, physician-led care, and the stability of independent urology practices.