Bill introduced in Iowa addresses catheters made with DEHP

DES MOINES, Iowa – Democratic Iowa State Representative Josh Turek has introduced the Better Caths for Iowa Act (H.F. 387) to review the use and reimbursement of certain catheters under the Medicaid program, specifically urinary catheters made with the harmful chemical DEHP.  

A four-time Paralympian who was born with spina bifida, Josh and his basketball team most recently brought home gold from the 2020 Tokyo Paralympics.  

 "Bladder cancer took the life of Dale Ericksen, my wheelchair basketball coach at Southwestern Minnesota State University," said Turek. "I introduced this bill to improve health equity for Iowans with disabilities," he adds. "I encourage state and federal representatives, nationwide, to introduce similar legislation." 

 Per the bill: 

• The Iowa Medicaid program shall not reimburse claims for catheters made with DEHP until after the completion and pending the results of a historical rate of bladder cancer review that includes the Medicaid director’s recommendation regarding which catheters should be reimbursable. 
• The Medicaid director shall inform Medicaid providers and patients of the prohibition against reimbursement of catheters made with DEHP during the pendency of the review and shall make available to Medicaid providers and patients a list of alternative products that are not made with DEHP and that are reimbursable under Medicaid when provided to Medicaid recipients during the pendency of the review. 
•  A historical records review of Medicaid recipients who used catheters made with phthalate chemicals like DEHP to determine whether Iowa Medicaid recipients who use these medical devices made with phthalate chemicals have a higher incidence rate of bladder cancer than the general population. 
• Identification of the brands of catheters with DEHP that are correlated with higher levels of bladder cancer in the Iowa Medicaid population of catheter users by comparing the diagnosis codes associated with bladder cancer against individual patient-level data that includes catheter billing at the stock keeping unit level. 
• A comparison of the average lifetime cost of care for a Medicaid recipient who uses catheters with the average lifetime cost of care for a Medicaid recipient who has bladder cancer treatment. 

The legislation is supported by the BetterCaths Health Equity Coalition, a grassroots volunteer organization of bladder cancer survivors who use catheters, disability advocates, and urological industry experts. It assisted in drafting the bill's language and provided supporting clinical evidence. 

The BetterCaths legislative effort was established in honor of Karen Fernbaugh Roy, a licensed clinical social worker who was paralyzed while being robbed at gun point as a college student. She served as the 2019 Ms. Wheelchair America and has advocated for health equity and health access for people with disabilities for decades. Roy used urinary catheters made with DEHP, a known carcinogen, for more than 20 years before discovering her invasive medical supplies had a cancer warning label on them.