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Medicare Policy for Ostomy Supplies Improved

The four Durable Medical Equipment Regional Carriers (DMERCs) have adopted recommendations for improving their Medicare Ostomy policy. The specific improvements are listed below.

Utilization of Supplies
The DMERCs have increased the number of items you can use per month without the need for additional justifying documentation. The monthly utilization guidelines have changes as follows:

	Drainable pouches have increased from up to 10 to up to 20/month
	Urinary pouches have increased from up to 10 to up to 20/month
	Closed pouches have increased from up to 31 to up to 60/month
	Irrigation sleeves have increased from 1 to up to 4/month
	Solid skin barriers/skin barriers with flange have increased from up to 10 to up to 20/month
	You can now also use one ostomy belt per month.

Medical Justification

	Basic documentation continues to be required for the dispensing of supplies. This continues to be a doctor's order or prescription.
	If you have a colostomy and choose to use dosed pooches to manage your ostomy, you do not need to provide any additional medical justification for the use of closed pouches
	If you still need more supplies than the new increased guideline amounts, the DMERCs have streamlined the process for providing the required medical justification:
	You will simply be required to obtain a letter from your doctor explaining the medical reason for needing more supplies than the usual maximum quantities as listed above. Your supplier does not need to routinely submit this letter with your claim, but must keep it on file in your records as a copy may be requested in the future by the DMERC.

The changes took effect for the whole country on October 1, 2000.
Remember: You are entitled to obtain 1, 2, or 3 months supply at a time if you live at home and 1 months supply if you are in a nursing home. Please share this information with your doctor.

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