Choice of incontinence products still faces uncertainty

It’s the problem no one talks about. It involves a product many people with disabilities cannot live without. The incontinence […]

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It’s the problem no one talks about. It involves a product many people with disabilities cannot live without. The incontinence supplies available to Minnesotans with disabilities could dramatically change, unless state lawmakers take action before the 2018 legislative session ends May 21.

The fight to repeal a 2017 law requiring Minnesota to bid out incontinence products continues, led by the Midwest Association of Medical Equipment Supplies (MAMES). Other disability groups and self-advocates have lined up in support of the change.

The change would affect approximately 14,000 Minnesotans who rely on the Medicaid incontinence benefit. The Minnesota Department of Human Services hasn’t unveiled its ideas for a program yet.

The measure was passed in the waning hours of the 2017 legislative session, without public comment or discussion. The bid program takes effect July 1, 2018 and would result in an estimated 35 percent cut in costs. But the tradeoff is likely lower-quality products that could force people to stay home or worse, create health issues. Bidding out incontinence products has met poor results in other states.

The program also is criticized for not being person-centered and for not supporting access to choice.

The Midwest Association of Medical Equipment Services and Supplies (MAMES) is leading the charge to overturn the bid requirement. What frustrated MAMES, advocates and consumers is that the bid requirement was tucked into the 2017 health and human services omnibus bill without any public notice or debate.

MAMES and other groups had hoped that overturning the Medicaid Preferred Incontinence Product Program (MPIPP) could be done in the early days of the 2018 session. But that hasn’t happened.

Instead, there was much disappointment when Gov. Mark Dayton failed to address the measure in his supplemental budget released in March. Dropping the bid program has an estimated budget impact of $2.4 million. Advocates contend that is a pittance in a $45 billion supplemental budget.

But those rallying against the incontinence products proposal face a daunting state and national trend, as more and more products needed for everyday living are subjected to competitive bidding requirements. That’s especially true of needs overseen by the Centers for Medicare and Medicaid Services. While competitive bidding provides the benefit of saving government dollars, it has restricted what products people can use for everyday needs. It has also had a huge negative impact on medical supply and durable goods providers, forcing some out of business. One fear is that MPIPP could continue this trend and lead to job loss.

Members of the Minnesota Consortium for Citizens with Disabilities (MNCCD) said they’ve received assurances that the repeal will be addressed, either with a hearing or with an amendment to another bill. But that was uncertain as legislators prepared for their spring break.

The incontinence products issue has attracted attention from a bipartisan group that wants to repeal the bid program. Sen. Jim Abeler (R-Anoka) introduced a bill seeking repeal, and was joined by co-authors on both sides of the aisle. That also happened in the House, where Rep. Nick Zerwas (R-Elk River) is the lead author.

Bill Amberg, who works for both MAMES and MNCCD, said hearings were promised. “We’ve been told by legislators that this never should have happened.” “It’s a priority to get this fixed,” said Amberg.

The bill numbers are Senate File 2725 and House File 3252.



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