About this Campaign
We are a group of patient advocacy organizations concerned about the impact that competitive bidding will have on the millions of Americans who rely on highly specialized products like urological and ostomy supplies every day to go to work, take care of their families, and live healthy lives.
- Bladder Cancer Advocacy Network
- Color of Gastrointestinal Illnesses
- Crohn’s and Colitis Foundation
- Digestive Disease National Coalition
- Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition
- Embracing Ostomy Life
- Fight Colorectal Cancer
- Friends of Ostomates Worldwide – USA
- Spina Bifida Association
- Spina Bifida Association of Arizona
- Spina Bifida Association of North Texas
- Strategic Alliance for Intercultural Advocacy in GI (SAIA)
- United Ostomy Associations of America
- Wound, Ostomy, and Continence Nurses Society™ (WOCN®)
High Cost of Low Bids is funded by:
Competitive Bidding Doesn’t Save Money — It Shifts Costs Downstream
In 2025, CMS added urological and ostomy supplies to its competitive bidding program, which awards contracts to suppliers offering the lowest bids. This ruling, which will go into effect January 1, 2028, is intended to save Medicare money. If patients lose access to medically prescribed, individualized, high quality products, those savings will be threatened by increasing costs from rising infection rates, hospitalizations, and the onset of serious health complications. Saving a few dollars now will inevitably lead to a greater burden on Medicare as costs shift downstream.
Raise Your Voice
Lowering Costs Starts with Prevention
When patients are fitted with the right durable medical equipment for their unique anatomies, they avoid skin complications, infections, and hospitalizations. There are thousands of continence and ostomy products on the market today for a reason: patients’ anatomy and medical needs vary widely, and patients rely on individualized products to avoid urinary tract infections, leakage, renal failure, and other serious complications. We must ensure patients can continue to access the products they need to live healthy, independent lives.
Frequently asked questions
Competitive bidding is a process run by the Centers for Medicare and Medicaid (CMS) that requires medical device manufacturers to submit proposals to CMS for specific medical device contracts. The process is designed to encourage fair competition between bidders, lower prices, and allow CMS to choose the best products and proposals.
While competitive bidding may make sense for off-the-shelf products, ostomy and urological supplies are individualized prosthetics designed for specific patients. Competitive bidding isn’t designed for supplies that must be tailored to individual patients, and opening the program to these individualized medical supplies could negatively impact access, quality of life and health for Medicare patients.
The most common is a urinary catheter, which is a prosthetic device that drains urine from your bladder if you have a condition that makes it difficult or impossible to urinate. People with bladder control issues or other medical conditions may need to perform intermittent catheterization (self-catheterization) throughout each day to empty their bladders. Causes for needing an intermittent catheter include spinal cord injuries, neurological conditions like spina bifida or multiple sclerosis, obstruction, or chronic urinary retention.
An ostomy is a surgically created opening in the abdomen that allows stool or urine to exit when natural function is impaired. Ostomies may be necessary due to birth defects, cancer, inflammatory bowel disease, diverticulitis, incontinence and many other medical conditions.
Urological and ostomy supplies vary based on each patient’s anatomy, condition, needs, and lifestyle. For catheters, there are hundreds of unique products of different sizes, lengths, materials, and designs. They must fit properly to ensure that the bladder can be fully emptied. When they don’t, patients can develop Urinary Tract infections (UTIs), sepsis, or kidney failure. Ostomy supplies that don’t fit properly can leak — causing severe skin infections that lead to hospitalization.
Because every body is unique, there is no one-size-fits-all product when it comes to clinically managed durable medical equipment (DME) like catheters and ostomy supplies. Access to these specifically designed supplies is essential for patients to live on their own, hold jobs, and avoid more serious medical care.
If these products are opened up to competitive bidding, patients will have no option other than to use supplies that are contractually available, and less likely to fit their individualized needs – making complications and emergency care more likely. According to the CDC, catheter-associated urinary tract infections (CAUTIs) are one of the most common infections and are associated with increased morbidity, mortality, health care costs, and length of stay.
A single hospitalization for a catheter-related infection can cost Medicare far more than a year’s supply of properly fitting catheters. For this reason, it’s important that patients can access the wide variety of products currently on the market.
Competitive bidding on urological and ostomy supplies will affect millions of patients who use these products each day to live healthy, independent lives. This includes people with disabilities like spina bifida or multiple sclerosis, people with spinal cord injuries, cancer survivors, and those who face many other medical conditions.
The effects of competitive bidding won’t be limited to Medicare patients. Medicare serves as a market leader, setting benchmarks and clinical standards – and if Medicare limits the product pool for patients needing ostomy and urological supplies, the impact will be felt across our healthcare system.
When Congress authorized the competitive bidding process in the 2003 Medicare Modernization Act, it deliberately excluded prosthetics like urological and ostomy supplies due to their complexity and potential for patient risk. More than 20 years later, CMS is reversing this — despite having no new safety data.
Visit the Act Now page and write your member of Congress today!
The High Cost of Low Bids is supported by patient advocacy organizations that are concerned about the impact the inclusion of urological and ostomy products in competitive bidding will have on patients that require uninterrupted access to these clinically-prescribed products. Supporting organizations are listed on this page.
Support for this campaign is provided by BD, Coloplast, Convatec, and Hollister.