Medicare Repeals SGD Restrictions Medicare has lifted restrictions on speech-generating devices that can connect to e-mail or the Internet, rescinding a February 2014 ruling that eliminated them from coverage. Medicare’s actions followed intensive advocacy by ASHA and many other stakeholders, who worked with the Centers for Medicare and Medicaid Services and members of Congress ... News in Brief
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News in Brief  |   December 01, 2014
Medicare Repeals SGD Restrictions
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Practice Management / News in Brief
News in Brief   |   December 01, 2014
Medicare Repeals SGD Restrictions
The ASHA Leader, December 2014, Vol. 19, 11. doi:10.1044/leader.NIB2.19122014.11
The ASHA Leader, December 2014, Vol. 19, 11. doi:10.1044/leader.NIB2.19122014.11
Medicare has lifted restrictions on speech-generating devices that can connect to e-mail or the Internet, rescinding a February 2014 ruling that eliminated them from coverage.
Medicare’s actions followed intensive advocacy by ASHA and many other stakeholders, who worked with the Centers for Medicare and Medicaid Services and members of Congress to revise the policy. More than 200 members of Congress signed a letter to CMS questioning the rules.
Opposition to the change surfaced immediately after the February announcement. In response, Medicare postponed the effective date of the tightened restrictions—originally set for Sept. 1—for three months. In early November, however, Medicare rescinded the policy, opened up a 30-day comment period to the current set of coverage rules, and advised that new rules would be issued in July 2015.
“Dedicated” SGDs—those that can’t operate as a computer—became a Medicare-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), Medicare does not pay for it. To comply with those restrictions, manufacturers created “dedicated” SGDs with those features locked out. However, once the patient owns the device, he or she can “unlock” the device—and the additional features—with a code purchased from the manufacturer at the beneficiary’s expense. The February policy restricted SGDs from having even the capability, even if the device was provided in the “locked” mode.
Medicare’s actions do not, however, address the mandatory rent-to-own provision, “capped rental,” that went into effect in April. This policy continues to be problematic: If a beneficiary requires inpatient care during the 13-month rental period, Medicare does not allow payment to the supplier during the hospitalization, when Part A covers patient costs. Because the Part B payments to the supplier stop, the supplier could request that the device be returned. ASHA continues to advocate against this rule.
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December 2014
Volume 19, Issue 12