Medicare's Catheter Policy Shift: A Win for Dignity and Preventive Tech

LIBERTYVILLE, IL – November 24, 2025 – In a monumental shift toward preventive healthcare, Medicare has finalized a policy change that promises to dramatically improve the quality of life for thousands of Americans living with spinal cord injuries (SCI). Effective January 1, 2026, a restrictive, decades-old rule will be eliminated, granting these individuals immediate access to closed system intermittent catheters—a crucial piece of medical technology designed to prevent infection before it starts. The decision marks a significant victory for patient advocacy, championed by MedTech leader Hollister Incorporated after a tireless three-year campaign.

A Decades-Old Barrier Falls

For over fifty years, Medicare beneficiaries with spinal cord injuries faced a cruel paradox. To qualify for closed system intermittent catheters, which are sterile, pre-lubricated, and housed in a self-contained collection bag to enable a “no-touch” technique, they first had to prove they were susceptible to infection. The policy, administered by the Durable Medical Equipment Medicare Administrative Contractors (DME MACs), required patients to suffer and document at least two urinary tract infections (UTIs) within a 12-month period. In essence, patients had to get sick to receive the technology that could keep them well.

This requirement placed an immense burden on one of the most vulnerable patient populations. UTIs are not a minor inconvenience for individuals with SCI; they are a leading cause of serious illness, hospitalization, and even mortality. Studies show that 30-45% of people with SCI are hospitalized annually due to UTIs, which can lead to life-threatening complications like kidney infection and septicemia. Beyond the physical toll, the cycle of recurrent infections severely impacts quality of life, leading to lost time from work, social isolation, and a constant state of health anxiety.

Clinicians have long understood the absurdity of this policy. “It was a frustrating cycle,” explained a rehabilitation specialist who works extensively with SCI patients. “We knew the best practice was to prevent infections, but our hands were tied by reimbursement rules. We were forced to watch our patients suffer preventable complications before we could prescribe the most effective tools.” The old policy created a reactive healthcare model that ran counter to modern clinical evidence, which overwhelmingly supports proactive, preventive care.

The New Horizon of Preventive Care

The updated policy completely reverses this outdated logic. As of January 1, 2026, a diagnosis of spinal cord injury at any level will be sufficient for a Medicare beneficiary to qualify for a closed system intermittent catheter. The “two UTIs” rule is gone. This change recognizes the inherent risk of infection in this population and aligns Medicare coverage with the clinical consensus on best practices.

Closed system catheters are a key innovation in continence care. Unlike basic catheters that require separate lubrication and handling of the tube, a closed system is an all-in-one, sterile kit. The catheter tube is often housed within a protective sleeve or guide, allowing the user to insert it without ever touching the part that enters the body. This no-touch technique is clinically proven to reduce the introduction of bacteria into the urinary tract, significantly lowering the risk of UTIs.

For healthcare professionals, this policy change streamlines the ability to provide optimal care. It removes bureaucratic hurdles, reduces paperwork, and allows prescribing decisions to be based on patient needs and clinical judgment rather than arbitrary infection counts. Most importantly, it empowers patients and their care teams to choose the best technology to support long-term health and independence.

The Anatomy of a Policy Victory

This landmark transformation was not accidental; it was the result of a deliberate, multi-year advocacy campaign led by Hollister Incorporated. Under the leadership of Casey Haan, Senior Director of Market Access and Government Affairs, the company embarked on a three-year mission to dismantle the long-standing barrier. The team worked relentlessly with the DME MACs, presenting a compelling case built on clinical evidence, patient impact, and the economic sense of prevention.

This effort reflects a growing trend of MedTech companies acting as agents of systemic change. “Expanding access to closed system intermittent catheters is more than a policy victory— it's a powerful step forward in fulfilling our mission to make life more rewarding and dignified for people who use our products and services,” said Abinash Nayak, President and CEO of Hollister, in a statement. “This change reflects our unwavering dedication to making a meaningful difference for our customers.”

The successful campaign serves as a powerful case study in strategic corporate advocacy. It demonstrates how a company can leverage its expertise and resources not just to market products, but to reshape the healthcare landscape for the better, ensuring that policy keeps pace with technological innovation.

“This historical transformation represents a significant step forward in Continence Care and patient advocacy, allowing for the clinician and patient to make the best product choice to meet their individual and specific needs,” noted Casey Haan.

The Economic and Clinical Calculus of Prevention

While providing a more advanced technology to more people may seem like a cost increase for Medicare, the economic analysis points to significant long-term savings. The cost of treating recurrent UTIs—including hospitalizations, emergency room visits, physician appointments, and courses of antibiotics—far outweighs the marginal increase in the cost of the catheters themselves.

Health economics data reveals the stark financial reality of the old policy. Individuals with a UTI incur healthcare payments 2.48 times higher over two years than those without. Even a single minor UTI can add over $7,700 to the cost of an acute hospital admission for an SCI patient. By preventing these infections, Medicare can avoid these substantial downstream costs, making the policy shift not only compassionate but also fiscally prudent.

Furthermore, the change has a critical public health benefit. Reducing the frequency of UTIs decreases the overall use of antibiotics in the SCI community. This is a vital step in the global fight against antibiotic resistance, a growing crisis that threatens the effectiveness of modern medicine. Improved health also allows individuals with SCI to lead more independent, productive lives, reducing the indirect economic costs associated with lost wages and caregiver burden.

Reshaping the Continence Care Market

The policy update is poised to send ripples across the entire continence care industry. The expanded access will undoubtedly fuel demand for closed system catheters, encouraging market growth and further innovation in this segment. Competitors and industry coalitions, some of whom have also advocated for improved catheter access in the past, will now operate in a market where preventive technology is recognized and properly reimbursed for this key patient group.

This is further evidenced by the simultaneous creation of new HCPCS codes that specifically recognize hydrophilic-coated catheters, another technological advancement that improves ease of use and comfort. This signals a broader move by regulators to acknowledge and support innovation that delivers tangible patient benefits.

For MedTech companies, the lesson is clear: demonstrating improved patient outcomes and long-term economic value is the most effective path to influencing policy and driving market adoption. As a result of this change, the standard of care for thousands has been elevated, proving that when patient dignity is placed at the forefront, the entire healthcare ecosystem benefits.