Action Alert: Help Protect SGD Access for Medicare Patients

August 20, 2014

Speech-language pathologists are needed to garner support for a letter opposing Medicare's SGD regulations! Please contact your members of Congress TODAY and ask them to sign on to this important letter.

Over the past 5 months, access to speech-generating devices (SGDs) and SGD accessories has been significantly limited by Medicare to the patients that need them the most. Even after multiple meetings with the Centers for Medicare and Medicaid Services (CMS) and contractor staff as well as nearly 200 comments opposing the new regulations, there have been no changes in policy. Therefore, Congresswoman Cathy McMorris Rodgers is preparing a bicameral sign on letter to CMS asking for their rationale on these issues.

This is a time sensitive issue. Your members of Congress must request to sign on to the letter before this coming Monday, August 25. On September 1, if the devices and accessories continue to have non-speech capabilities, they will no longer be approved for use by Medicare beneficiaries. Don't let CMS deny much needed patient access to these devices!

Background

In February, the Medicare contractors that administer Durable Medical Equipment (DME) claims issued a "coverage reminder" that prohibits SGDs from having any non-speech capabilities (e.g., e-mail, internet, environmental control) or the ability to upgrade in the future at the patient's own expense. Related to the coverage reminder prohibitions, Medicare's contractors are routinely denying coverage for eye-gaze, a technology that is needed by patients with limited or absent mobility in the arms and hands. Contractors indicate the denials are due to the ability of the eye-tracking to be used for other purposes or plugged into devices that are not SGDs.

Then in April, CMS changed the manner in which it pays for SGDs, requiring patients to rent them over a 13-month period before owning the device. "Capped Rental" adversely affects patients in an extended hospital stay or in skilled nursing facility because while the patient is in the rental period, Medicare will not cover the rental fees. Instead, the device is returned to the manufacturer while the patient would have to obtain a new one from the hospital or hospice or pay the entire monthly rental fee out-of-pocket. The regulation has left many patients with no way to communicate at a time when they need it most.

ASHA Resource

For more information on SGD issues please contact Lisa Satterfield, ASHA's director of health care regulatory advocacy, at lsatterfield@asha.org or Ingrida Lusis, ASHA's director of federal and political advocacy, at ilusis@asha.org.


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