Medicare Delays New SGD Policies Medicare has given a three-month reprieve to reimbursement of speech-generating devices that can be connected to e-mail or the Internet, postponing tightened restrictions until Dec. 1. Medicare’s Feb. 27 Coverage Reminder reiterated and expanded the “dedicated” device rule: Medicare does not pay for an SGD if the device could operate ... News in Brief
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News in Brief  |   October 01, 2014
Medicare Delays New SGD Policies
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Practice Management / News in Brief
News in Brief   |   October 01, 2014
Medicare Delays New SGD Policies
The ASHA Leader, October 2014, Vol. 19, 12. doi:10.1044/leader.NIB4.19102014.12
The ASHA Leader, October 2014, Vol. 19, 12. doi:10.1044/leader.NIB4.19102014.12
Medicare has given a three-month reprieve to reimbursement of speech-generating devices that can be connected to e-mail or the Internet, postponing tightened restrictions until Dec. 1.
Medicare’s Feb. 27 Coverage Reminder reiterated and expanded the “dedicated” device rule: Medicare does not pay for an SGD if the device could operate as a computer.
SGDs became a “covered benefit” in 2001. With technological advances, even the most physically challenged individuals can use an SGD to communicate with small movements, even eye gaze.
If, however, the SGD can perform as a computer (for example, Internet connectivity, e-mail), it is not covered. To comply with the restrictions, manufacturers created “dedicated” SGDs with those features locked out. However, once the patient owned the device, he or she could “unlock” the device—and the additional features—with a code purchased from the manufacturer.
The coverage reminder has two significant changes: any non-speech feature (such as the ability to control a telephone) will disqualify an SGD from Medicare, and SGDs that can be unlocked at any time during the life of the device also are disqualified from coverage.
ASHA, the ALS Association and other stakeholders have been working with the Centers for Medicare and Medicaid Services and members of Congress to revise the policy. CMS responded in late August with the three-month postponement. Stakeholders also have worked with Congress on a bicameral, bipartisan letter asking for answers to specific questions related to the “dedicated device” and other policies, including the rent-to-own policy that became effective April 1, 2014, and increased denials of eye-gaze technology.
The delay gives stakeholders and Congress more time to advocate for permanent change. The postponement does not, however, address the rent-to-own provision that could interrupt a patient’s use of an SGD or force the patient to pay out-of-pocket to continue using it.
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October 2014
Volume 19, Issue 10