Minnesotans with disabilities who rely on incontinence products can continue to choose items that best meet their needs. A controversial medical supply program that was to start September 1 was dropped by the Minnesota Department of Human Services (DHS). The decision to drop the Medicaid PreferredIncontinence Products Program was made just before a temporary restraining order was issued against the program August 24.

The Midwest Association for Medical Equipment Services and Supplies (MAMES) took DHS and DHS Commissioner Emily Johnson Piper to court to stop the program. MAMES’ intent was to prevent DHS from granting bids to a supplier or suppliers. A hearing was held before Ramsey County District Court Judge Leonardo Castro August 16 in St. Paul, with more than two dozen people looking on. After listening to both sides and asking a number of procedural and technical questions about the proposed state program, how the program was created and the
program’s potential impacts, Castro took the matter under advisement before issuing his ruling.

“DHS decided to pull back the request for proposals before the court acted,” Piper said in a statement. “We are committed to ensuring that Medicaid enrollees receive high-quality products and that state funds are used responsibly as we comply with the legislative mandate to purchase incontinence products in bulk.” While there is satisfaction with the outcome, medical supply companies and disability advocates around Minnesota are still unhappy with the entire process. “MAMES members are grateful that the court issued the injunction, but are extremely frustrated that the (Department of Human Services) forced the provider and disability communities to spend so much time, energy and money fighting this ill-conceived program,” said Tom Jamison, president of Lake
Superior Medical Equipment, Inc. in Duluth. Jamison chairs the MAMES Legislative Committee.

Castro’s August 24 ruling put a halt to the program until certain conditions were met. Those included asking DHS to amend the provider program rate to be consistent with state rules, and for the state to initiate rule-making procedures to allow for a modified payment rate to product providers. But the DHS decision puts an end to a controversy that began in 2017. That’s when the Minnesota Legislature made a last-minute decision to add the supply program into human services legislation. The change was signed into law without any legislative hearings or public discussions, which angered medical suppliers and disability rights advocates.

Activists argued that having the state control product supplies would limit choice and in turn affect the daily lives of many Minnesotans. One objection raised was that a state supply could be lower-quality products, which would affect peoples’ daily lives and possibly,their health. Another objection is that creating such a program is contrary to the movement toward person-centered care, and for not supporting access to choice.

It was estimated that about 14,000 Minnesotans would have been affected by the change. Another argument made was that move to a state program would only generate about $2.4 million in savings, out of a much larger state budget. Many lawmakers worked during the 2018 legislative session to eliminate the incontinence products program. They agreed with MAMES and disability community members’ objections centering on how the incontinence products program was created.

Measures to eliminate the program were included in bills passed by the House and Senate. But Gov. Mark Dayton, frustrated by state lawmakers’ penchant for wrapping numerous items into tax and spending bills, vetoed both in the spring.

Medical suppliers and disability rights advocates point out that the incontinence product issue, and other medical supply issues, are part of state and national trends. Supply needs overseen by the Centers for Medicare and Medicaid Services have increasing been subjected to competitive bidding programs.

The bidding processes, which have stepped up in recent years, do provides the benefit of saving government dollars. But not only do they restrict which products people can use for everyday needs, the move toward bidding has had significant and negative effects on many medical supply and durable goods providers. Some longtime firms have been forced out of business. People needing supplies have had to deal with suppliers they don’t know.

To read more about MAMES and its work, go to www.mames.com