ASHA Commends Congress on Passage of Two Critical Health Initiatives for Medicare Beneficiaries

Continuing Resolution Includes Permanent Repeal of Therapy Caps and Permanent Coverage of Speech-Generating Devices Under Medicare

February 9, 2018

(Rockville, MD) The American Speech-Language-Hearing Association (ASHA) congratulates Congress on today's vote that permanently repeals the annual limit on per-patient therapy expenditures (therapy caps) under Medicare Part B and makes permanent (under Medicare) the coverage of speech-generating devices as routinely purchased durable medical equipment. Both provisions were included in the final version of the Continuing Resolution (CR) to fund the government for the next 2 years. 

Therapy caps unduly impact the most vulnerable patients, who may have suffered serious medical issues such as a stroke or who may have chronic conditions that require life-altering rehabilitation services. These caps have existed for 20 years, but annual temporary fixes were put into effect to keep them from being implemented in 16 instances. On January 1, an annual hard cap of $2,010 combined for speech and physical therapy services for 2018 went into effect—and reports from ASHA members confirmed that it had already begun to impact patient care. 

"Millions of Medicare beneficiaries can now—finally—breathe a bit easier when it comes to getting access to critical rehabilitation services they require following a serious health episode," said Elise Davis-McFarland, PhD, CCC-SLP, 2018 ASHA President. "The last thing these patients need in the face of serious illness or injury is to have to choose between financial ruin or forgoing much-needed care that has a strong potential to transform their life. We are grateful that Congress has taken action on the therapy caps."

Also included in the CR is a provision to permanently cover the purchase of speech-generating devices (SGDs) under Medicare, based on the Steve Gleason Enduring Voices Act of 2017. SGDs are highly customized electronic augmentative and alternative communication (AAC) devices—which are used to supplement or replace speech, allowing people with functional communication impairments to verbally communicate their needs. The largest population of those who need SGDs are individuals with neurodegenerative diseases (e.g., amyotrophic lateral sclerosis [ALS], Parkinson's disease, multiple sclerosis [MS]). These are conditions where cognitive function and the need for communication is intact, but the physiological ability to speak diminishes. SGDs are the only effective communication means for these people. 

Prior to passage of the original bill in 2015, if an SGD user resided in a nursing home, hospice, or hospital, Medicare payment for their SGD stopped because the item needed to be rented rather than purchased. Many of these facilities did not and could not supply beneficiaries with a uniquely customized substitute.

"We deeply appreciate that Congress addressed speech-generating devices in the Continuing Resolution," added Davis-McFarland. "These devices are truly lifelines for patients with conditions that would otherwise rob them of their ability to effectively communicate—and they deserve access to them."

Among other key provisions in the CR were an additional 4-year extension to fund the Children's Health Insurance Program (CHIP), ensuring that it is funded through 2027, and further funding for the National Health Service Corps to help support graduate education for health care professionals—including audiologists and speech-language pathologists.  

About the American Speech-Language-Hearing Association (ASHA) 

ASHA is the national professional, scientific, and credentialing association for 191,500 members and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology support personnel; and students. Audiologists specialize in preventing and assessing hearing and balance disorders as well as providing audiologic treatment, including hearing aids. Speech-language pathologists identify, assess, and treat speech and language problems, including swallowing disorders.

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