Medicare SGD Policy Open for Comment

Medicare Releases Draft Speech-Generating Device Policy for Comment The Centers for Medicare & Medicaid Services (CMS) released a draft of the revised National Coverage Determination 50.1: Speech Generating Devices with a comment period ending May 29, 2015. CMS is proposing to expand the type of communication and features of the speech-generating device (SGD) to allow for more “remote” speech in the form of “audible and written communications.” CMS also agrees that the term “dedication” is too restrictive, and indicates if only patients with severe speech impairments use the device, the qualification of being a speech-generating only device is unnecessary. Medicare clarifies that Internet or phone services, such as plans for Internet coverage or landline use, are not covered, along with any additional computer functions that are not directly related to communication. Equipment and software for video communication or conference is also not a Medicare covered benefit. Suppliers are encouraged to furnish the beneficiary with an Advanced Beneficiary Notice informing the patient of the features not covered by Medicare and that the patient is liable for the expenses of those additional features. The proposed policy is anticipated to be effective July 28, 2015. This policy revision is the result of collaborative advocacy efforts by ASHA and ASHA members, the Amyotrophic Lateral Sclerosis (ALS) Association, the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, and the speech-generating device manufacturers. Background The coverage issues for SGDs arose in February 2014, when the Medicare contractors that administer Durable Medical Equipment (DME) claims issued a "coverage reminder" that prohibited SGDs from having any non-speech capabilities (e.g., e-mail, Internet, environmental control) or the ability to for the patient to upgrade for those features at their 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. Due to advocacy efforts by ASHA’s members, the coverage reminder was delayed and then rescinded. Meetings with CMS officials resulted in revision of the National Coverage Determination and comments were accepted from November 6-December 6, 2014. The introduction to the draft policy states that 2,290 comments were received in the 30-day comment period and commenters were unified in supporting coverage of devices that allow other types of communication, such as e-mail or other written messages. SGDs continue to be subject to the CMS “capped-rental” policy, which requires a 13-month rental period prior to the transfer of ownership. ASHA will continue to work with the ALS Association and other key stakeholders to advocate for the exemption of SGDs to the capped-rental policy through legislation that has passed in the Senate and has been introduced in the House, H.R. 1919. ASHA Resources 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. Lemmietta G. McNeilly, PhD, CCC-SLP, CAE, ASHA Fellow Chief Staff Officer, Speech-Language Pathology American Speech-Language-Hearing Association 2200 Research Boulevard, #229 Rockville, MD 20850-3289 +1 301-296-5705 telephone 301-296-8577 fax lmcneilly@asha.org Follow ASHA Advocacy

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