Will providers say no thanks to next round of CBP?

YARMOUTH, Maine – A majority of respondents to a recent HME Newspoll say they plan to skip the next round of Medicare’s competitive bidding program (CBP), citing concerns that it puts smaller providers at a disadvantage. 

In November, the Centers for Medicare & Medicaid Services (CMS) finalized a rule introducing new policies, additional product categories and a revised methodology for calculating single payment amounts (SPAs) under the CBP. The agency has tentatively set Jan. 1, 2028, as the start date for the next round. 

Why many providers are opting out 

Fifty-eight percent of poll respondents say they don’t plan to submit a bid. Instead, they intend to avoid categories like continuous glucose monitors (CGMs), urological and ostomy supplies, hydrophilic urinary catheters, and off-the-shelf braces, and diversify their payer mix. 

“We plan to avoid competitive bid items for Medicare and plan our business model around that strategy,” wrote one respondent. “(We are) focusing on continuing to build on payers other than Medicare.” 

Legacy bid items such as oxygen concentrators, CPAP machines, and mobility equipment are not included in the upcoming round—at least for now. 

Concerns over vertical integration 

Among the 42% of respondents who plan to submit bids, some worry about the impact of an increasingly vertical industry. One respondent noted that distributors with patient-facing divisions may have an advantage in bidding. 

“We will be speaking with manufacturer reps regarding direct accounts to reduce costs, and distributors to know what they are planning,” wrote Jason Housenbold, president, MAR-J Medical Supply in Boca Raton, Fla. “(Some) distributors have a patient facing side to their business. This will be a disadvantage to smaller suppliers because distributors can use their purchase price from manufacturers vs. the marked-up price small suppliers have to pay.” 

RID model could reshape competition 

Another concern: whether CMS will implement a remote-item delivery (RID) model nationally rather than regionally, which could favor larger companies. Despite this, 67% of respondents say they have no plans to scale their businesses to improve their chances of winning a contract. 

“We have one location and are only licensed for DMEPOS in our own state,” wrote one respondent. “If a RID is multi-state, then I don't see how any small store stays in business.” 

Annual accreditation adds pressure 

Beyond bidding, CMS will now require annual resurveys and re-accreditation—a significant change from the previous three-year cycle. This requirement will affect all providers, regardless of CBP participation. 

“Our main concern is changes to provider enrollment and annual accreditation,” wrote Erin Dolan, vice president, Med-Essentials, New Hartford, Conn. “We will be focusing on adjusting (our) budget to account for additional cost of annual accreditation.”