Change increases catheter quantities
MINNEAPOLIS--A recent Medicare policy change eliminates the mandatory re-use of intermittent catheters for beneficiaries, a change that could ultimately save the healthcare system billions of dollars.
Effective April 1, 2008, Medicare allows a new catheter for each episode of approved catheterization; covers all single-use catheters; and eliminates the need to prove history of infection.
“For years it’s been a battle,” said Dave Doubek, president of Doubek Medical Supply in Alsip, Ill. “It’s a nice change for the patients.”
Since 1970, patients have had to clean and reuse the catheters, which are labeled single-use only by the Food and Drug Administration. That puts users at high risk for developing urinary tract infections (UTIs), says Dave Amerson, vice president of sales and marketing for urology and continence care at Minneapolis-based manufacturer Coloplast.
“Patients typically need a catheter five to eight times per day,” he said. “Now they are able to use a new one every time, up to 200 per month.”
Sixty-five percent of intermittent catheter users experience a urinary tract infection (UTI) at least once a year, compared to 14% in the general Medicare population. The catheters are used by people with spinal cord injuries, multiple sclerosis, spina bifida and other chronic conditions.
“A patient is five times more likely to have an infection,” said Amerson. “The cost of treating UTIs is $3.5 billion a year.”
Coloplast has reached out to 7,000 HME providers to educate them on the policy change. The company has developed a policy packet that includes a reimbursement guide describing the change. It includes documentation requirements, coding information, talking points and FAQs. Providers can access the information at www.coloplastmedicare.com.
“We think the dealers are a critical resource,” said Amerson. “We want to work with the dealers to educate the patients, but we keep the end users as our No. 1 focus. The patient stays at the top of the list.”