As of Jan. 13, Medicare will cover bowel management devices, also known as transanal irrigation devices. All TAI systems that have a sealing function (balloon or cone-shaped rectal catheters) — including the Peristeen and Peristeen Plus by Coloplast and the Navina Classic by Wellspect — are now classified as prosthetic devices under Medicare.  

I started using the Peristeen TAI system 27 years into my journey as a T10 para. It was such a game-changer that I wrote a column about it for New Mobility. TAI puts tap water into the bowel via a manual pump-operated enema system and the system prevents water from leaking out with a rectal balloon catheter (or cone-shaped device) — the water stimulates bowel emptying.  

In my experience, and the experiences of other wheelchairs users I interviewed, TAI was a game-changer. It emptied the bowel so completely it gave a 24-hour window — and in my case 48 — of not having to worry about accidents. But until now, insurance coverage has been a major barrier. Medicare agreeing to cover TAI is even more important because other forms of insurance tend to follow Medicare’s lead.   

“This is exciting coverage because TAI gives people an important tool for management of neurogenic bowel,” says Alexandra Bennewith, vice president, government relations for United Spinal Association. This coverage is the result of a joint policy and advocacy efforts of United Spinal Association’s Access & Care Coalition along with Coloplast, Wellspect and the Spina Bifida Association, says Bennewith.  

“A big part of the success was having meetings with members of Congress where advocates who use TAI explained how their lives had been impacted with or without access to TAI,” says Bennewith. “Advocates’ stories and their lived experience are always so powerful, and our policymakers always need to hear from us.” 

It will take Medicare some time to finalize reimbursement amounts, however, billing codes should be assigned in early April and temporary reimbursement levels should be published in late April.  As United Spinal continues to fight for this important issue, stay tuned for any updates.  If you have any questions, contact policy@unitedspinal.org.