WOCN Leads Response to Ostomy and Urological Supplies Policy Language Update

Dear Members,

We want to update you on an important policy development that came to our attention on March 27, 2025, regarding language changes to the Ostomy Policy Article (A52487) and the Urological Supplies Policy Article (A52521).

As soon as these updates were identified, the WOCN Society took swift, decisive action. Leading a coordinated response, our public policy and advocacy team worked in partnership with the United Ostomy Associations of America (UOAA) to submit a formal letter of concern to the CMS Director for Coverage and Analysis. We also reached out to key industry partners and organizations urging them to join us in voicing concerns about the revised language.

Thanks to this unified effort led by WOCN, we received a response from CMS on April 1, 2025. CMS clarified that the updated language does not represent a change in coverage policy. Instead, the revisions were intended to align the articles with existing CMS guidelines and clarify the application of the prosthetic device benefit.

Specifically, CMS confirmed that:

• The requirement for ostomy and urological supplies to meet the prosthetic device benefit remains unchanged.
• Coverage for prosthetic devices (excluding dental) that replace all or part of an internal body organ or its function is still valid with a physician’s order, even if future improvement is expected, provided the condition is documented as long and of indefinite duration.
• No new coverage restrictions have been introduced.

CMS has advised that any further updates will be posted on the CGS and Noridian websites, and we encourage members to monitor these sites regularly.

WOCN remains committed to advocating on behalf of our patients and members. We will continue to work closely with stakeholders to ensure policies remain clear, consistent, and supportive of the care our communities need.