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CMS Rescinds Restrictive Policy and Will Reconsider Technological Advances

CMS announced yesterday that it has begun the process of updating its Medicare coverage policy for Speech Generating Devices (SGDs). A new SGD National Coverage Determination (NCD) is expected to be completed by July 31, 2015.  While CMS considers a new coverage rule for SGDs, it announced that beneficiaries will “continue to have access to this critical technology.” 

Accordingly, CMS instructed its contractors to rescind a restrictive proposed "Coverage Reminder" and coding review that was to be effective on December 1, 2014.  The proposed Coverage Reminder would have limited Medicare coverage only to devices that were dedicated to speech, but were not capable of any other form of communication, such as text or email. The Center for Medicare Advocacy and other groups met with CMS to urge reconsideration of this harmful policy.

On November 6th, CMS backed away from this position, stating: “Since 2001, the technology of devices that generate speech and the ways in which the devices are used by patients to meet their medical needs has changed significantly.  For example, patients now use speech devices to generate text and email messages for the purpose of communicating with their caregivers and physicians.  Therefore, in light of the changes in technology and use of devices that generate speech, we are internally generating a reconsideration of this NCD to address coverage of devices that generate speech as well as other forms of communication.”

"The Center for Medicare Advocacy is grateful for and encouraged by CMS's announcement," says Judith Stein, Executive Director of the Center for Medicare Advocacy. "We applaud CMS leaders for reconsidering their position and articulating a plan that recognizes the importance of technological advances for the health and quality of life for all beneficiaries."  

CMS also announced a public comment period, from November 6, 2014 to December 6, 2015, to review its technology policies and coverage for augmentative and alternative communication devices, such as Speech Generating Devices.  "We look forward to participating in the comment period," says Kathleen Holt, an Associate Director at the Center for Medicare Advocacy. "We will continue to advocate for Medicare coverage of the full range of communication modalities so important to all people today – especially to people with debilitating and degenerative conditions." 

"There is no way to describe losing the ability to communicate,” said Steve Gleason, former NFL player living with ALS and founder of Team Gleason. "With the recent policy changes, communication for those with the greatest need were being left to fade away quietly and die.  But, with the help of the Center for Medicare Advocacy, we and others were able to launch a legislative email campaign resulting in over 40,000 emails submitted.” Gleason continued. “While we would all like to take credit for this news, I believe it was a unified effort that resulted in the policy reversal."

To further ensure access to SGDs, the Center continues to urge CMS to find ways to continue coverage for  beneficiaries in Skilled Nursing Facilities and to monitor contractors that  frequently deny Medicare for eye-tracking technology, needed by the most vulnerable beneficiaries to operate their SGDs.

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