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Policy Analysis  |   January 2014
Policy Analysis: Medicare Speech-Generating Devices Classified as Rent-to-Own
Author Notes
  • Mark Kander
    For answers to specific questions related to Medicare speech-generating devices, contact Mark Kander, ASHA’s director of health care regulatory analysis, at mkander@asha.org or reimbursement@asha.org.
Article Information
Regulatory, Legislative & Advocacy / Policy Analysis
Policy Analysis   |   January 2014
Policy Analysis: Medicare Speech-Generating Devices Classified as Rent-to-Own
The ASHA Leader, January 2014, Vol. 19, online only. doi:10.1044/leader.PA4.19012014.np
The ASHA Leader, January 2014, Vol. 19, online only. doi:10.1044/leader.PA4.19012014.np
Speech-generating devices provided under Medicare will be classified as rent-to-own beginning April 1, 2014, according to a final rule released by the Centers for Medicare and Medicaid Services in November.
Despite ASHA’s concerns about the rule, CMS made no changes to the proposed rule [http://www.asha.org/Publications/leader/2013/130901/Policy-Analysis--Rent-to-Own-May-Be-Only-Option-for-Medicare-Speech-Generating-Devices.htm], which classifies each of the six types of speech-generating devices—as well as 74 other pieces of durable medical equipment—as “capped rental” rather than purchased equipment.
Under this rent-to-own rule, Medicare pays the supplier (105 percent of the purchase price) over 13 months.The beneficiary’s cost is the standard 20 percent copay of the total rental payments. After 13 months, ownership is immediately assigned to the patient.
ASHA submitted comments to CMS emphasizing the danger posed by the Medicare requirement, which might prevent a beneficiary from keeping the device if the beneficiary spends time in a hospital, hospice or skilled nursing facility. The supplier may allow the patient to keep the SGD during inpatient stays, but will receive no monthly payment. ASHA objected to the continual use requirement, noting that under this policy a patient could lose functional communication as an inpatient—when the ability to communicate is critical.
The device supplier’s obligations remain the same as current rental requirements:
  • The supplier must maintain the SGD in good working order for five years.

  • The SGD cannot be issued unless the physician presents an order accompanied by an evaluation from a certified speech-language pathologist.

CMS staff encourage beneficiaries to examine rental contracts carefully if the supplier does not accept Medicare assignment. Contracts often allow the supplier to bill for extra services or features that are not medically necessary.
For more information, see the final regulation . Capped rental rules appear in Chapter 20, Sections 30.5–50, of the Medicare Claims Processing Manual.
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January 2014
Volume 19, Issue 1