Hi Steve,

We were against the change when it was sought out solely for special interest groups and isolated categories of patients.  What we are delighted to see is that CMS made a policy change that broadly accommodates many situations and many types of individuals.  The only stumbling block I hear about is that doctors must document in their records how many times a patient catheterizes himself or herself in order to obtain the needed prescription, as this will be subject to Medicare audits to help prevent fraud.  It's difficult for some patients to supply this information because it can vary for a variety of circumstances.  But those with an established routine are more likely to be able to help the doctor do this.  Having said that, there remain millions of people who are not Medicare beneficiaries, who do not have private insurance that covers such supplies, who have private insurance with high deductibles that cause them to pay for these and other expenses out of pocket until thousands are expended, or have no medical insurance.  For these, clean technique often needs to be mastered so that the risk of UTI is minimized.  At NAFC, we still have a continuing role to play in providing comprehensive information about self-catheterization techniques, options, and considerations.   Nancy