Health Care Authority moves to single source for incontinence supplies

Published 1:30 am Thursday, March 19, 2026

OLYMPIA — The state-run Health Care Authority is transferring all Medicaid recipients to receive incontinence and urological supplies from a single company, estimating it would save the agency $4 million to $8 million.

But more than a dozen local Washington businesses who supply these products say they would go out of business or be significantly hurt by this. Their bigger concern, however, is the lower quality care patients would receive.

The Health Care Authority (HCA) said in an email statement that moving towards a single provider would save the agency millions.

“HCA is seeking a preferred provider to enhance efficiency, improve health outcomes, and streamline purchasing processes of incontinence and urinary supplies,” the request reads. “This approach aligns with HCA’s goals of improving healthcare quality and equity while reducing administrative and financial burdens.”

Medicaid covers the costs of incontinence supplies — pull-ups and pads for bladder leakage, and urological supplies like catheters for draining the bladder — to as many as 20,000 people receiving Medicaid benefits across Washington.

Companies are applying to win the mail-order “bid” and become that single supplier. Applications are due March 26, and the contract would begin January 1, 2027. Business operators expect the winner will be based out of state because few businesses in Washington could feasibly take on all the Medicaid recipients.

In 2024, the HCA paid businesses more than $30 million for Medicaid patients’ incontinence supplies, according to public billing records. For some businesses, this makes up most of their revenue, and the loss could force them to shut down.

MyMedSupplies in Lacey and Spokane and Soundview Medical Supply in Mukilteo would fully close their Washington locations should the request go through, officials from each business said. Even if Medicaid would pay them for incontinence products again, it would be nearly impossible for those businesses to reopen because of an accreditation process that requires an existing track record of providing medical equipment.

Operators of five other businesses preferred to stay anonymous for fear of retaliation from the HCA.

Bryce Schaffner, vice president of business development at Bellevue Healthcare, said his business would not see an immediate financial impact, but it would be a challenge to absorb the non-Medicaid incontinence product demand as well as meet the demand for the other products that the closed businesses could no longer supply.

The HCA’s request doesn’t account for those downstream effects on all patients seeking medical equipment and products, he said, whether they are on Medicaid or not.

Schaffner added that budgetary pressures from state cuts have relaxed only during periods like the COVID-19 pandemic, when these businesses supplied essential N95 masks and respiratory supplements.

“It takes kind of an emergency for us to really be seen,” he said. “And that’s kind of where this is headed with HCA.”

Business operators said this will hurt patients the most.

Amy Degon is the community relations director of the MyMedSupplies location in Lacey, and has been involved with the store for almost 30 years. The Lacey location would close should the request go through, she said, because 45% of its sales come from supplying more than 2,000 Medicaid patients with incontinence and urological supplies.

MyMedSupplies offers a wide range of medical equipment — wheelchairs, bathtub benches, adaptive silverware for shaky hands — with specialized sizing that can be difficult to find elsewhere, Degon said. If the company closes, demand for those supplies will shift to other providers.

“It gets down to people who have a need,” Degon said. “We’re trying to take care of that need. We have a current solution that seems to be working, and all of a sudden that’s ripped out, and then all of this is at risk.”

Current competition between the local providers has given Medicaid patients individualized, equitable, high-quality care that reduces hospitalizations, Degon and other business operators said.

Every business receives the same payment for the products they sell to Medicaid patients, no matter the quality. The competition, operators said, has pushed businesses to offer better brands and high levels of customer service while absorbing rising costs and wages.

Patients on Medicaid have benefitted from the high-quality products, operators said.

With a single supplier, competition is eliminated, and the winning company will take orders online or over the phone and deliver supplies by mail.

The Pacific Association for Medical Equipment Services, or PAMES, is the businesses’ collective voice and has been speaking out to the HCA and lawmakers repeatedly about the issue.

Barb Stockert, executive director of PAMES, said whatever business becomes the single provider would not feasibly be able to provide the care patients get from local businesses.

“They have relationships with their current suppliers and providers,” Stockert said. “They can trust them, they know them, and they can call if they need something.”

In 2025, when the Washington legislature passed a budget with $9 million in cuts to durable medical equipment suppliers, PAMES reached out to the HCA with concerns about the forthcoming single supplier request.

“We want to have a good relationship with HCA,” Stockert said. “This is what our members are asking for, you know, just work with us. Let us try to make those savings for you.”

In the request, the HCA lists the standards the winning provider must meet. The supplier must provide at least three options for pad and diaper products and at least two options of catheters.

Current suppliers provide dozens of options for these things, operators said.

The request does not list a required quality standard that the products must meet.

Business operators said this will cost the state more in the long run because low-quality products can lead to skin degradation and ulcers. These wounds take months to heal if they heal at all, Degon said, increasing hospital and caregiver costs.

When asked by businesses about providing more choice in product quality and absorption “to improve health outcomes,” HCA replied in an email statement that it does not provide additional reimbursement for higher-quality items, even if nursing assessments identify patients who could benefit from higher-quality products.

HCA did not respond to questions from the Washington State Journal by publication time. A spokesperson who said answers would be provided in time was no longer with the agency when a follow-up email was sent.

Olympic Pharmacy, based in Gig Harbor and serving Western Washington, has provided pediatric services, medications, wheelchairs, incontinence supplies and more since 1961. Tammy Kvinsland, chief operating officer, has worked there for more than 30 years.

“It’s going to hurt not only our business, but it’s going to hurt our patients,” Kvinsland said. “We are involved holistically with them…we know our patients, we call them every month and make sure that they are getting what they need.”

Kvinsland predicts the bid will go to a distant out-of-state supplier who can’t provide the comprehensive care Olympic Pharmacy and other suppliers do.

“They’re not going to know the patients,” Kvinsland said of whoever will win. “Using catheters is very personal, and limiting what’s available or only offering the most cost effective item and not really looking at individual cases and what people need, that’s not going to be good patient care.

“If something goes wrong with this plan,” she said, “which is very likely, you’ve destroyed the ecosystem of healthcare providers.”

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