eInsights - July 15, 2008

Medicare Changes Reimbursement Policy on Intermittent Catheterization

On April 1, the Centers for Medicare and Medicaid Services (CMS) changed its reimbursement policy on intermittent catheterization. The previous policy allowed reimbursement for only one intermittent catheter per week unless an individual user could prove the existence of at least two urinary tract infections in the course of one calendar year. The revised policy now allows reimbursement for up to 200 catheters per month per individual which means no re-use.

This change was advocated for by medical equipment companies, health organizations, and universities which saw the manufacturer's term “single-use” to mean that the sterile catheter should be used one time and then discarded, not thoroughly cleaned for further catheterization use, which is what many users were forced to do.

Among the advocates for change were the Coloplast Corporation and Hollister Incorporated both suppliers of intermittent catheters. These companies, joined by the Spina Bifida Association^®, began work on changing the policy in early 2005 and are delighted with the change for their end-users.

“Ultimately, the new policy better supports an individual's desire to void their bladder with a new catheter on a more consistent basis than once a week,” said Cindy Brownstein, Chief Executive Officer of the Spina Bifida Association.

All of the companies and the supporting organizations are pleased with the outcome. Coloplast and Hollister continue to work vigilantly on intermittent catheterization policies across the US for patients needing such quality care.

For more information on the reimbursement policy change log on to www.medicarenhic.com.

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