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Patients and clinicians urge passage of H4162 to expand access to ostomy supplies and specialized care
Summary
Multiple ostomy nurses, patients, and nonprofit organizers told the committee that inconsistent insurance coverage and nonmedical product switching leave ostomy patients leaking, at risk of infection, and dependent on charitable assistance; they urged lawmakers to pass H4162 to ensure supply access and clinical support.
Four ostomy nurses, patients, and nonprofit providers told the committee that insurance limits, product switching and supply denials create medical and dignity harms for people living with ostomies and that House Bill H4162 would address those problems by ensuring access to individualized supplies and nursing support.
"Providing adequate and individualized ostomy supplies is not merely a matter of convenience. It is a medical necessity," said Martha Bernstetter, a certified wound, ostomy and continence nurse at Beth Israel Deaconess Medical Center.
Witnesses described frequent nonmedical product switching by suppliers and insurers that led to leakage, skin breakdown, infection risk and emergency department visits. Bernstetter cited a 2024 United Ostomy Association of America survey she said found 50 percent of respondents experienced nonmedical product switching, and among those patients 64 percent reported negative results such as leakage or emergency visits.
Patients described daily disruption and financial strain. A high‑school senior, Eva Hosey, said she needs an ostomy pouching supply regimen that amounts to roughly 60 pouches per month because of medication administration through her stoma; she said both MassHealth and Medicare routinely approve 20 pouches per month, forcing repeated appeals. Kayla Caba, founder of Connecting Pieces, described helping families who were discharged from cancer care or veterans who turned to her nonprofit when insurers failed to cover supplies.
Why it matters: witnesses argued that consistent access to clinically recommended ostomy supplies and timely certified ostomy nurse support prevents complications and costly emergency care, preserves dignity, and reduces overall health system costs.
Discussion versus action: testimony was supportive of H4162 and provided operational examples and data from clinical practice and nonprofit programs; no committee vote or action was recorded at the hearing.
Background and implementation issues: witnesses highlighted an estimated 1,000,000 ostomy patients in the U.S. and approximately 10,000 certified ostomy nurses, creating a workforce gap. Providers asked the committee to address insurer prior authorization, nonmedical switching, and reimbursement practices that limit supplier capacity and patient choice.
