Medicare’s Competitive Bidding Program: The Hidden Threat to Home Medical Equipment Access
If you or a loved one relies on home medical equipment (HME)—such as oxygen therapy, wheelchairs, hospital beds, or other vital devices—Medicare’s proposed changes to its Competitive Bidding Program (CBP) could directly impact your ability to get the products, services, and support you need.
While Competitive Bidding may sound like a way to save taxpayer money, its past track record tells a very different story. In previous rounds, the program’s flawed design eliminated nearly 75% of HME companies from participation and led to the closure of 37% of HME locations nationwide. The result? Fewer choices, longer wait times, and in some cases, no access at all for patients.
Medicare paused the program in 2018 after recognizing the damage it caused—but now it’s looking to restart it with changes that could make the situation worse.
How Competitive Bidding Works—and Why It’s a Problem
Under CBP, Medicare awards a limited number of contracts to companies willing to accept the lowest payment rates for providing HME and related services. The proposed new version:
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Caps prices using outdated 2016 rates (with only a 10% increase, despite inflation rising over 33% since then).
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Removes safeguards that ensured bidders had experience in the product category or local presence.
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Expands to more product categories—including high-risk items—without proving the system can safely handle them.
This isn’t about finding a fair market price; it’s about forcing costs down below what it takes to deliver quality care.
What This Means for You
If implemented, the proposal could have sweeping consequences:
1. Fewer Companies = Less Choice
Medicare will cap the number of suppliers who can serve patients in each bid area. In some cases, only two companies may serve an entire product category in a region. If one shuts down or a disaster strikes, there’s no backup.
2. Lower Quality & Less Support
Artificially low prices mean companies may have to cut services, limit product options, or lower quality just to survive.
3. Inexperienced Suppliers
With guardrails removed, contracts could go to bidders with little or no experience serving your needs—leading to errors, delays, and poor outcomes.
4. Increased Health Risks
Reduced home-based care and support will push more patients toward hospitals, ER visits, and nursing facilities—adding strain to the healthcare system.
5. Loss of Local Support in Emergencies
When wildfires, hurricanes, or power outages hit, local suppliers often provide quick, community-based support. If those companies lose contracts, that safety net disappears.
6. Impact Beyond Medicare
Many Medicaid programs and private insurers base their payment rates on Medicare’s. If Medicare sets rates too low, access issues will ripple through the entire healthcare system.
The Bigger Picture
Medicare frames CBP as a way to combat fraud, but the truth is it’s a cost-cutting tool, not a fraud-prevention program. Real fraud prevention requires targeted oversight, not a system that risks cutting off patients from life-sustaining care.
Past program rounds already reduced claims by 10–20%, a sign that fewer people were able to get the care they needed. Restarting CBP under these new rules risks widening healthcare deserts and eliminating trusted suppliers for good.
What You Can Do
The public has a chance to speak out before the final rule is implemented. Patients, caregivers, and healthcare providers can submit comments to Medicare explaining how CBP could impact their lives.
The deadline for public comments is August 29, 2025.
Your voice matters—because once a local HME provider is gone, they’re gone for good.
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