VGM Government Relations Along with Leitten Consulting Release the Latest Update to Competitive Bidding Study

Published in Government Relations on July 15, 2022

Graphic

VGM Government, in conjunction with Brian Leitten and Leitten Consulting, has released an updated study analyzing the efforts by the Centers for Medicare and Medicaid Services (CMS) to control distribution of Durable Medical Equipment (DME). The study, “Competitive Bidding – Pressure Sore, Urological and Diabetes Equipment & Supplies. The Expanded Case for Medicare Investment in DME in 2022,” builds off the 2021 study by expanding the range of DME and adding three additional categories: equipment and supplies to prevent pressure sores, catheters and related urological supplies to resolve urine and retention and incontinence, and diabetic test strips and meter to monitor blood glucose levels.  

“As CMS forced prices down and treatment costs continued to rise, the power of a dollar spent on preventive DME became ever more powerful,” stated Brian Leitten, head of Leitten Consulting. “CMS continues to spend its budget dollars on treating the very illnesses and injuries that could be avoided if they would just invest in providing the right DME to beneficiaries before they need it.”

The previous studies were focused around three areas of DME, mobility equipment (e.g., wheelchairs, walkers, and power chairs) to avoid falls; oxygen therapy equipment to counter symptoms of COPD; and continuous positive airway pressure equipment to treat obstructive sleep apnea (OSA). In the most recent study, DME was expanded to include three new categories of Medicare Spending that are significant to Medicare beneficiaries. Adding the three new categories significantly increases the cost and potential amount that could be saved if CMS were to invest in DME. 

“With the success of the previous studies, that had shown how much could be saved if CMS invested in three main DME categories, we wanted to expand with this most recent study to encompass three additional categories and how they could be affected,” says John Gallagher, vice president, VGM Government Relations. “In turn, we hope that these studies can then be used to help educate key legislators on why it is so important, and cost efficient, to invest now into DME.” 

READ FULL STUDY

From Our Experts

Bipartisan Medicare O&P Bill Introduced thumbnail Bipartisan Medicare O&P Bill Introduced In a timely move ahead of next week's NAAOP Legislative Fly-In, a bipartisan group of lawmakers introduced the Medicare Orthotics and Prosthetics Patient-Centered Care Act, a bill aimed at improving access to high-quality orthotic and prosthetic care for Medicare beneficiaries. The Patient-Centered Care Act seeks to address critical gaps in Medicare coverage for orthotic and prosthetic (O&P) services. Under current rules, beneficiaries may receive devices without the necessary clinical services Proposed Rule Suggests Significant Change To Accreditation Process thumbnail Proposed Rule Suggests Significant Change To Accreditation Process The recently released proposed rule CMS-1828-P contains a significant change that could reshape how suppliers navigate accreditation. The rule proposes a major change that would require suppliers to be surveyed and reaccredited annually instead of the current three (3) year cadence. This proposal raises substantial questions about both operational feasibility and cost implications. August Of Action: Your Chance To Connect With Congress thumbnail August Of Action: Your Chance To Connect With Congress It's time to take advantage of August Of Action—a perfect opportunity to make your voice heard. Every summer, federal legislators return to their home states during the Congressional recess. While it gives them a break from Washington D.C., it's primarily a time for them to connect with constituents like you. HR1 Passes House, Advances to President Trump's Desk for Signature thumbnail HR1 Passes House, Advances to President Trump's Desk for Signature After extensive negotiations and partisan debate, the House has officially passed HR1, clearing the path for the bill to be signed into law by President Donald Trump. The legislation, which aims to reduce federal healthcare expenditures, contains several provisions that may impact the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) industry. CMS files the Proposed Rule that sheds light on the next round of the Competitive Bidding Program thumbnail CMS files the Proposed Rule that sheds light on the next round of the Competitive Bidding Program On June 30, 2025, CMS filed the anticipated Proposed Rule that includes updates to the Competitive Bidding Program (CBP). Public comments are due 60 days from June 30, 2025. Below is a high-level summary of the rule. It is critical to note that, according to the Proposed Rule Fact Sheet dated June 30, 2025, CMS has stated that they have not announced the specific product categories they are bidding or the specific timeframe for the next competition. Those specifics will be forthcoming in a fu Senate Narrowly Passes HR1, Sending It Back to House for Final Approval thumbnail Senate Narrowly Passes HR1, Sending It Back to House for Final Approval President Donald Trump's sweeping legislative package, formally titled the One Big, Beautiful Bill Act, now referred to as HR1., cleared the Senate today in a dramatic 51–50 vote, with Vice President JD Vance casting the tie-breaking vote. The bill now returns to the House, where lawmakers must decide whether to adopt the Senate's revised version or negotiate further changes before it can reach the president's desk. Several Prominent Medicaid Provisions in Senate's Budget Bill Deemed in Violation of Byrd Rule thumbnail Several Prominent Medicaid Provisions in Senate's Budget Bill Deemed in Violation of Byrd Rule Senate Parliamentarian Elizabeth MacDonough advised this week that multiple Medicaid provisions in the Senate's reconciliation bill would violate Senate procedure by violating the Byrd Rule. The Byrd Rule is a Senate-specific procedural process that allows Senators to prevent or block inclusion of extraneous provisions in reconciliation bills. Other provisions are still under review. Evaluating the Value of a Payer Contract thumbnail Evaluating the Value of a Payer Contract In our last article, Key Payers Denied Your Application Citing Their Network Is Closed – Now What?, we discussed strategies for addressing payer contracting denials due to a closed network. As indicated, this process can be an extremely time-consuming exercise with no guarantees and mixed results. Below are a few things to consider as you evaluate whether a contract is worth the extra effort.