Good News for Ostomates with Medicaid in Some States

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By Jeanine Gleba, UOAA Advocacy Manager

Too many people living with an ostomy have the worry that due to a need for frequent pouch changes or a high output stoma they will run out of their monthly Medicaid allowable ostomy supplies.  For the past year, UOAA has been supporting efforts, led by Coloplast, to expand Medicaid coverage of extended wear products in states with remaining access problems across the country. 

UOAA’s advocacy work has included:

  • Raising awareness on this important issue
  • Recruiting Affiliated Support Group leaders that are also WOC nurses and other local clinicians to provide clinical support and insight
  • Sending letters to state divisions of Medicaid services urging them to review the ostomy supply policy regarding coverage of ostomy supplies for HCPCS codes and quantities, specifically for extended wear products. 

As the voice and leading organization advocating for people living with an ostomy, we know first-hand how important access to ostomy supplies are for our patient population. We share the patient perspective with testimonials from advocates as well as explaining patients’ unique needs, such as those who are unable to achieve normal wear time with a standard barrier. Improved access to extended wear barriers will assist those who do not have an optimal fit or have a high-output stoma and go through more standard wear barriers and pouch changes. For these individuals extended wear products would be the prescribed solution. 

As a result of the collaboration between Coloplast, UOAA, State Home Medical Equipment (HME)/Durable Medical Equipment (DME) Associations, local clinicians and other advocates, we have expanded patient access to extended wear products in seven states as noted in the above map. This is excellent news for Medicaid beneficiaries living with an ostomy in these states! (Note: States that are grey/light blue on the map were not seen to have any state Medicaid extended wear access challenges.)

More advocacy efforts are underway in Alabama, Arkansas, Georgia, Louisiana, Maryland, Missouri, Ohio, and Wisconsin to remove the current barrier to access in those states. These states have Medicaid coverage that is much less than the current Medicare standards.

1 reply
  1. Paige
    Paige says:

    I am a Family Nurse Practitioner and have an ostomy. I would love to provide services in my rural community to ostomy patients. There is nothing to help them really. I don’t know where to start.

    Reply

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