What is the issue behind this advocacy campaign?
The Centers for Medicare and Medicaid Services (CMS) released the CY 2026 Home Health and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) Competitive Bidding Program (CBP) Final Rule in the Federal Register late Friday, November 28, 2025. The final rule specifies that ostomy, tracheostomy, and urological supplies are medical equipment items mandated for inclusion under the DMEPOS CBP by section 1847(a)(2)(A) of the Act.
This was not the ruling response we had hoped for. CMS has largely finalized the rule as proposed, which is disappointing given all the comments submitted and Hill activity.
For those interested in reading the complete final rule, it can be found here. Most of the ostomy language can be found on pages 492-503. CMS also released a corresponding Fact Sheet for the DMEPOS CBP which can be found here.
The rule change does not have any immediate effect on ostomy supplies for Medicare beneficiaries. You should continue ordering your supplies as usual. The actual change that affects how you order supplies will not begin until January 1, 2028.
We recognize that you will have many questions. When we have had more time to thoroughly review the final ruling and discuss with stakeholders for a clear understanding, we will update our web page with a FAQ sheet that will hopefully address most of your questions.
Importantly, UOAA will continue to advocate and work with stakeholders to protect access to ostomy and urological supplies. Our work is not done!
What is Competitive Bidding?
The Medicare Competitive Bidding Program was created to lower Medicare spending on selected medical equipment and supplies by forcing suppliers to compete for limited contracts in designated areas. CMS awards contracts to the suppliers who bid the lowest most competitive price.
How does this affect access to ostomy supplies?
When this ruling goes into effect in 2028, it may harm patients and put their health at risk. Ostomy supplies are clinically prescribed and not one-size-fits-all. A precise fit is crucial to prevent leaks, odor, and severe skin complications. Inclusion in this program could seriously impact the quality of life of people who live with an ostomy or rely on urological supplies.
What if you only had access to one product or one brand? What if the products that you use for your pouching system aren’t sold by the suppliers who win the “bid” with CMS?
The ruling will restrict you to a limited number of suppliers leading to reduced access and lower quality products jeopardizing your ability to effectively manage your ostomy. You may not be able to get the specific products vital for your health, which could lead to serious health consequences. You will lose your freedom of choice. Additionally, there is the potential that this could override your healthcare professional’s prescribed treatment plan and disrupt your care.
Read this OpEd published in the Washington Times and read this OpEd published in MedPage Today explaining why these supplies should be protected and excluded from the Competitive Bidding Program. Here’s another good article explaining why CMS is playing a dangerous game with these prosthetic devices.
Although, CMS states in this Competitive Bidding Fact Sheet that the “Competitive Bidding Program includes a special beneficiary safeguard to ensure that beneficiaries have access to specific brands or modes of delivery of competitively bid items in the product category when needed to avoid an adverse medical outcome.”, UOAA remains concerned. We hope to work with CMS and share recommendations for stronger enhanced safeguards that should be implemented if this moves forward.
How are Ostomy Supplies Currently Covered Under Medicare?
Medicare Part B covers Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). As stated in the Local Coverage Determination Ostomy Supply Policy A52487, ostomy supplies are covered under the Prosthetic Device benefit (Social Security Act Section 1861(s)(8)).
Under the Social Security Act, ostomy and urological supplies are rightly categorized and defined as prosthetic devices (§1861(s)(8)) as they are restoring the lost organ functions of biological waste storage and elimination —and as such, were specifically excluded from CBP by Congress under §1847(a)(2)(A).
Congress deliberately confined the scope of the CBP to three specific categories:
- DME (durable medical equipment) and medical supplies used in conjunction with DME;
- Enteral nutrients, equipment, and supplies and;
- Off-the-shelf orthotics (no custom fabricated or fit orthotics or prosthetics)
In this ruling, CMS appears to advance an interpretation of the statute that ostomy and urological supplies fall under the first category.
🔗 UOAA Efforts and Additional Resources
- Link to UOAA Position Statement
- Link to UOAA’s Federal Comments
- Link to Understanding Competitive Bidding Impact on Ostomy Supplies
- Link to AAHomecare Consumer Engagement Toolkit
- Link to Congressional Sign-On Letter from Patient-Disability Communities
- UOAA also initiated an effort to submit Federal Comments in opposition to the proposed expansion of the Competitive Bidding Program to include ostomy and urological supplies from a group of non-profit organizations. In total, 48 groups from across the country signed-on including several UOAA Affiliated Support Groups, which is a very strong showing of support. These comments were submitted in August. You can read these comments here.
- Link to Sign-on Letter from Congress to CMS and OMB
- Link to UOAA Letter Sent to CMS and OMB on October 22
- Link to Sign-on Letter from Congress Sent to Dr. Oz on October 29
💡 Visit UOAA’s Action Center
At this time, we do not have any open action alerts for this advocacy effort. CMS has sent the proposal to the Office of Management and Budget (OMB) for review. It is at the final stage before release.
We will not know the outcome of these advocacy efforts until the final ruling is released in the coming days. We will keep you updated.
If we are not successful, please know that UOAA remains steadfast in its commitment to continuing advocating to ensure access to these crucial supplies.
Thank you for your support in our efforts to stop this proposal from becoming a final rule in November.
📚 UOAA is collecting stories
UOAA is also collecting stories to use in our advocacy materials such as federal comments, handouts with key decision-makers, social media graphics and more. You can submit your story to us on our #MyAccessMatters web page.
Do you have a personal relationship with your Federal Senator or Congressperson? If yes, please contact UOAA’s Advocacy Manager at advocacy@ostomy.org.
👍 Get Social!
Another way to get involved is to submit a letter to the editor in response to one of the many OpEds that have been published. Below are the three most recent OpEds:
https://www.forbes.com/sites/waynewinegarden/2025/09/12/cms-shouldnt-expand-its-broken-competitive-bidding-model/
https://www.stripes.com/opinion/2025-10-21/medicaid-rule-strategic-advantage-china-19498376.html
https://www.thewellnews.com/opinions/ostomy-supplies-are-not-one-size-fits-all-medicare-must-recognize-that/”
Let us know if your letter gets published!
You can also help raise awareness on your social media platforms.
Use the hashtags: #MyAccessMatters and #CompetitiveBidding
Download and share the following social media graphics on your social media platforms with your own message!
Thank You For Your Interest In
UOAA Advocacy Efforts
Please contact us to let us know the issues that are important to you at 1-800-826-0826 or email our Advocacy Manager at advocacy@ostomy.org. You can also follow our advocacy efforts on Twitter @UOAA_Advocate.
Advocates for a Positive Change
Contact Us
United Ostomy Associations of America
P.O. Box 2293
Biddeford, ME 04005-2293
Call us toll-free at: 1-800-826-0826.
Our Information Line hours are Monday-Friday, 9am to 3pm EST. If you have an emergency, please dial 911 or contact your local medical professional.
Please understand that UOAA is a private, nonprofit, advocacy and informational organization. We are not a medical facility and we do not have medical or legal professionals on staff. Therefore, UOAA does not provide Medical, Mental Health, Insurance or Legal Advice. Visit UOAA Virtual Ostomy Clinic provided by The Wound Company for non-emergency, virtual ostomy support.
