Creating the better caths for Iowa Act including a review of the use and reimbursement of certain catheters under the Medicaid program

The bill provides the Medicaid program shall not reimburse claims for catheters made with DEHP, until after the completion and the results of the review required under the bill including the recommendation of the Medicaid director regarding reimbursement of catheters under the Medicaid program. Pending completion of the review under the bill, the use of catheters made with DEHP is deemed unsafe for Iowa Medicaid recipients; any rules previously adopted prescribing the conditions under which any catheter made with DEHP may be safely used are void, and shall have no force or effect; the Medicaid director shall object to any notification of an intended use of catheters made with DEHP and shall not adopt rules prescribing any conditions under which any catheter made with DEHP may be safely used as an invasive medical device; and in establishing the safety of alternatives to catheters made with DEHP that may be used and reimbursed under the Iowa Medicaid program, the Medicaid director shall consider, in addition to criteria provided under federal law, the potential adverse effects of exposure to an alternative substance on vulnerable populations, including pregnant women, infants, children, persons with disabilities, the elderly, and populations with high exposure, including workers who are exposed through production practices or clinical handling of the final product. The Medicaid director is required to inform Medicaid providers and recipients of the prohibition against reimbursement of catheters made with DEHP during the pendency of the review and make available to Medicaid recipients and providers 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. The Medicaid director shall cause a review to be conducted of catheters, including a historical records review of Medicaid recipients who used catheters made with phthalate chemicals including DEHP, to determine whether Iowa Medicaid recipients who use these medical devices 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; 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; consideration of the disproportionate exposure of invasive medical devices containing phthalate chemicals on members of communities of color and with disabilities, and the health effects of such exposure on members of such communities, including any increased risk of cancer, endocrine disruption, effects on reproductive health, and other risks to human health. No later than July 1, 2025, the Medicaid director shall issue a report on the findings of the review, submit the report to the governor and the general assembly, and post the report on the department of health and human services internet site. The report shall include a recommendation as to whether catheters made with DEHP should be reimbursed under the Medicaid program. Under the bill, catheters include intermittent and indwelling catheters.