UOAA urges legislators and federal agency officials to implement policy and regulations that benefit patient-centered access to care, strengthen the patient-provider decision-making relationship, and minimize patient out-of-pocket costs.

In conjunction with the Digestive Diseases National Coalition (DDNC) efforts we will continue to monitor any potential US healthcare reform and will work to ensure preservation of basic patient protections from the Affordable Care Act including eliminating insurer discrimination against pre-existing conditions, establishing out of pocket maximums for covered services, and allowing young adults to stay on their parents’ insurance until the age of 26. These protections have made it possible for persons living with an ostomy or continent diversion to obtain insurance coverage and protect them from stratospheric medical bills.

Here is legislation that we will be supporting in the new 117th Congress (Note – bill numbers will be added once reintroduced in the new Congress):

Safe Step Act: This is a balanced public policy proposal that works to reform step therapy. The bill requires that insurers implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. It also requires a group health plan respond to an exemption request within 72 hours in all circumstances, and 24 hours if the patient’s life is at risk.

UOAA advocates for and strives to ensure that any person living with a permanent or temporary ostomy has access to their prescribed choice of medical prosthetic technology. We are committed to preserving and promoting access, choice and value of ostomy and urological products.

UOAA supports these guiding principles.

UOAA Supports Medicare/Medicaid Supply Coverage for Fistulas

UOAA Supports Coverage of Disposable Irrigation Sleeves

UOAA Opposes Non-Medical Switching of Ostomy Prosthetic Supplies

DDNC White Paper on Patient Access to Care and Treatments in the Cost-Shifting Era

Opposition Statement On Medicare Competitive Bidding Program

Update on Competitive Bidding Program as of October 2020:

As a stakeholder in the Access and Care Coalition, UOAA is actively working with all of the stakeholder members to maintain the current Medicare reimbursement system for ostomy and urological products.

On October 27, 2020 in a CMS press release they stated that they are only awarding contracts for 2 of the product categories: (a) OTS Back Braces and (b) OTS Knee Braces. Medicare expects to save $600 million for the program and beneficiaries over the three year Round 2021 contract performance period.  Contracts will be in place effective 1/1/21.

They also shared that they heard from a range of stakeholders (including UOAA and the ACC coalition) requesting that the agency delay or cancel the Round 2021 DMEPOS CBP due to the ongoing COVID-19 Public Health Emergency. CMS considered that feedback in moving forward with the Round 2021 DMEPOS CBP. CMS is not awarding competitive bidding contracts for any of the 13 remaining product categories for Round 2021 that were previously competed because the payment amounts did not achieve expected savings. 

For now ostomy and urological supplies remain excluded from the CBP. We will continue to be vigilant on this issue and educate key decision-makers on how this impacts people living with an ostomy so that all ostomates have access to the ostomy supplies that they need.

No current action is necessary from ostomates at this time.

We will provide further updates as they become available.

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Read the White Paper >>

Read the Access and Care Coalition Position Statement >>