A new sign-on letter targeting Republican members of the U.S. House of Representatives asserts that the Medicare competitive bidding program described in July’s home health proposed rule contradicts Trump administration goals.
The effort is being led by Rep. Mariannette Miller-Meeks (R-Iowa) and Rep. Dan Meuser (R-Pa.), whose letter is addressed to Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz, M.D.
The American Association for Homecare (AAHomecare) shared the letter with stakeholders on Oct. 23 and urged home medical equipment industry members to ask Republican members of the House to sign on as soon as possible.
“As members of Congress committed to advancing President Trump’s America First agenda, we write to express serious concern that the Centers for Medicare and Medicaid Services’ proposed rule (CMS-1828-P) to expand and redesign the durable medical equipment, prosthetics, orthotics and supplies competitive bidding program may conflict with the president’s directives on deregulation, trade and domestic industrial strength,” the letter said. “We respectfully urge CMS to pause and reevaluate these provisions to ensure that they fully align with the administration’s goal of rebuilding American
manufacturing, protecting Main Street businesses and fostering innovation.”
The letter added that the competitive bidding program described in the proposed rule would be “reviving methodologies deliberately replaced by the first Trump administration,” and that the proposed rule “appears to move in the opposite direction” from the administration’s orders “to strengthen American workers and industries and remove unnecessary regulatory burdens that restricts competition.”
Including “highly specialized product categories” such as urological, tracheostomy, and ostomy supplies “would give an advantage to cheap foreign-made goods compared to the quality and professional delivery offered by U.S. suppliers and manufacturers” because competitive bidding is based on “the cheapest bids,” the letter said.
Statistics from past competitive bidding rounds
The letter noted how previous iterations of competitive bidding hurt American businesses: a 49% drop in new U.S. market entrants and a 90% decline in domestic manufacturer participation, as examples.
“New FDA [U.S. Food & Drug Administration] product submissions fell by a quarter, patent filings by three-quarters, and U.S. research and development investment by more than half, while repair and replacement rates for equipment more than doubled,” the letter said. “Extending the program to
technologies such as continuous glucose monitors and insulin pumps — fields with only a handful of U.S. manufacturers — would further discourage investment and threaten America’s leadership in advanced medical devices.
“Even strong tariff protection could not offset the disadvantage created by a reimbursement model that rewards the cheapest bid and favors foreign over quality domestic manufacturers.”
The letter predicted the new competitive bidding program as described would hurt small businesses and result in participation consolidated “among a few large suppliers, displacing community-based providers that employ local workers and serve seniors and veterans directly.”
“We fully support strong, targeted action to combat fraud, waste and abuse, but competitive bidding is not a proven anti-fraud tool,” the letter said, instead suggesting artificial intelligence-based analytics that could flag unusual billing and utilization patterns, among other better remedies.
AAHomecare said in its bulletin that it does “seek and embrace bipartisan support for reining in the numerous problematic issues with the proposed rule,” but that this letter “is specifically focused on enlisting House Republicans to weigh in with Dr. Oz.”
The association asked stakeholders with Republican representatives to share the letter and ask for their members of Congress to sign on in support. AAHomecare provided a link — visible to Congressional staff — that provides the letter and access to sign on.
