How to cite: Powley, Gina MSN. Drives Expanded Catheter Access for SCI Patients. Grand Rounds in Urology. December 10, 2025 Accessed Mar 2026. https://grandroundsinurology.com/drives-expanded-catheter-access-for-sci-patients/
Summary
Diane K. Newman, DNP, ANP-BC, FAAN, FAUNA, BCB-PMD, Urology and Pelvic Floor Nurse Specialist, University of Pennsylvania; Adjunct Professor of Surgery, Perelman School of Medicine, Emerita, University of Pennsylvania, Philadelphia, Pennsylvania, introduces Gina Powley, MSN, ANP-BC, CUNP, FAUNA, Clinical Resource Manager, Hollister Incorporated, Libertyville, Illinois, who explains how Hollister Incorporated secured a major policy change that expands Medicare access to closed system intermittent catheters for patients with spinal cord injury. Nurse Practitioner Powley describes how historically restrictive coverage rules developed under Local Coverage Determinations (LCDs) have now broadened eligibility.
Nurse Practitioner Powley first reviews the Centers for Medicare and Medicaid Services (CMS) and the role of Medicare Administrative Contractors in setting LCDs. She explains that LCDs define medical necessity, billing codes, coverage limits, and required documentation and are developed through a structured request, consultation, public comment, and finalization process. She then details the longstanding LCD requirements for sterile, closed system, intermittent catheters. She notes that the policy had been in place for decades and often required patients to become ill before qualifying for needed supplies.
She discusses why the requirements created practical problems. Many spinal cord injury patients are otherwise healthy and do not meet immunosuppression criteria. Some individuals may experience repeated urinary tract infections that are not fully documented because they are too ill to undergo cultures. Clinicians may know a closed system would benefit a patient, but are unable to secure coverage without strict proof.
Nurse Practitioner Powley then outlines Hollister’s initiative. Over the course of approximately three years, Hollister leaders and collaborators engaged with Medicare authorities, provided clinical evidence, participated in consultations, and contributed to public comments. She describes broad support from clinicians and organizations. She reports that in early November 2025, Medicare approved expanded access, so that, beginning January 1, 2026, all Medicare beneficiaries with a spinal cord injury, at any level, will qualify for closed system intermittent catheters. She emphasizes the importance of communication, so that clinicians and patients understand the change and note the expectations that private insurers may follow in time.
ABOUT THE AUTHOR
Gina Powley, MSN, ANP-BC, CUNP, FAUNA, is the Clinical Resource Manager at Hollister Incorporated in Libertyville, Illinois. Powley has been instrumental in advancing clinician education on bladder health, developing training materials, and hosting the nationally recognized “Coffee and Learn” webinar series featuring expert clinicians from across the country.
Powley earned her RN and MSN from the Jewish Hospital College of Nursing and Allied Health in St. Louis, Missouri. She practiced as a registered nurse for ten years before becoming a nurse practitioner. During her clinical career, she managed a busy urology practice and served as Director of Nursing, overseeing six advanced practice providers.
Powley served as National President of the Society of Urologic Nurses and Associates (SUNA) from 2021 to 2023. She is a Fellow of the Academy of Urologic Nurses and Associates (FAUNA). Powley has been invited as a speaker at national and international conferences. She has co-authored the chapter on benign prostatic hyperplasia (BPH) in The Nurse Practitioner in Urology: A Manual for Nurse Practitioners, Physician Assistants, and Allied Healthcare Providers, 2nd edition. Powley has also published numerous articles and has been featured in the Urologic Nursing Journal.
Dr. Diane K. Newman is an Adjunct Professor of Surgery at the Perelman School of Medicine at the University of Pennsylvania. She is the former Co-Director of the Penn Center for Continence and Pelvic Health, Division of Urology, Penn Medicine, in Philadelphia. She is a Fellow of the American Academy of Nursing and the Academy of Urologic Nurses and Associates. She is certified as an adult nurse practitioner by the American Nurses Credentialing Center and Board Certified in Biofeedback for Pelvic Muscle Dysfunction by the Biofeedback Certification Institute of America.
Dr. Newman has 35+ years of experience practicing as a urology advanced practice provider and continence nurse specialist. Her clinical expertise involves the evaluation, treatment, and management of urinary incontinence, bladder dysfunction, and related problems, including the use of catheters and other devices in the management of bladder and pelvic floor conditions. Throughout her career, she has evaluated and treated men and women with urologic disorders in multiple settings: acute care, long-term, and home care, with 23 years in an ambulatory practice at the Division of Urology at the University of Pennsylvania.
