Access to needed medical equipment and supplies continues to cause problems for many people with disabilities. The latest fight in Minnesota is to repeal a law which affects incontinence supplies. The law takes effect July 1, 2018.

The Midwest Association of Medical Equipment Suppliers (MAMES), its members and other advocates are asking to overturn a law requiring Minnesota to bid out incontinence products. The law was tucked into the 2017 health and human service omnibus bill in the final hours of the legislative session. Bill Amberg, who is MAMES’ lobbyist, said member medical supply dealers are frustrated that the bill addition came without debate or discussing. “There wasn’t even a conversation with stakeholders.”

MAMES and its allies are working to overturn the bid requirement before it takes effect next year. That could happen during the 2018 legislative session.

Amberg said that if the change goes into effect next year, it would be yet another blow to Minnesota’s medical supply and durable medical equipment providers. More than half a dozen companies have closed during the past year including longtime Twin Cities firm Key Medical Supply. Key had waged a long and ultimately unsuccessful legal battle over the Centers for Medicare and Medicaid Services’ (CMS) competitive bidding program as it related to enteral nutrition supplies or feeding tubes.

It will also inconvenience many people who need the incontinence supplies for daily living. “It just gets tougher for people with disabilities and senior citizens,” Amberg said. “They can’t find caregivers, they can’t have reliable supplies and medical equipment for their daily lives. It’s hard to talk about people staying in their home communities on one hand and forcing them out on the other.”

The trend at the state and federal level is to move more and more equipment and supplies to competitive bidding. Competitive bidding is promoted as providing savings for government as well as ease in working with fewer vendors, as well as helping suppliers deal with price reductions.

The Iowa-based advocacy group People for Quality Care has been tracking the issues around competitive bidding. Over the summer the group posted a survey for people who use home medical equipment. The survey asks clients about their satisfaction with delivery of home medical equipment and supplies, what they use, and how changes have affected their lives. The survey is here.

Competitive bidding has been rolled out around the nation since 2011, area by area and item by item. Successful bidders won exclusive contracts to provide home medical equipment and supplies. The auction program has been criticized for ending long-time relationships between suppliers and their clients, and forcing people to work with out-of-state suppliers for their everyday needs. Quality of some supplies provided by new vendors has also met criticism. Delays in delivery have been a frequent complaint around the country. Another objection is the difficulty in getting items repaired. Disability and elder advocacy groups, providers and others criticized the competitive bidding program because of its focus on the cheapest prices.

In January 2016, CMS began a six-month, phased expansion from cities into suburban and rural areas, even though these areas never participated in an auction process. All Medicare beneficiaries are now affected across the country People for Quality Care noted, “Failing to factor the unique costs of accessing and caring for medically fragile Medicare patients across rural America, CMS slashed reimbursement rates for medical equipment.”

People for Quality Care has also been involved in efforts to inform members of Congress about how people in rural areas have been adversely affected by Medicare cuts to medical equipment. The cuts had been delayed but are now back in effect. The group and other advocates from around the nation are asking that the cuts not be imposed.