How do recent changes in Medicare rules affect access to Speech Generating Devices for patients?

Medicare has changed their coverage of Speech Generating Devices which affects many people’s access to devices they rely on to communicate.  In April of 2014, Medicare changed their categorization of Speech Generating Devices (SGDs) which electronically generate voices for patients who are unable to speak due to ALS or spinal cord injuries.  The policy change by Medicare had three major results:

• SGDs were no longer purchased for patients by Medicare.  Instead, they became “capped rental” items meaning Medicare would pay for their rental for 13 months, after which they became the property of the patient.
• SGDs would no longer be covered when a patient was in a hospital, nursing home, or home hospice program.
• SGDs which had been provided previous to September of 2014 would no longer be covered because they were considered to have extra communication features. These features include the ability to access the internet and communicate with people long-distance.  Previously, patients had been able to pay extra to access these features from their devices but under the new Medicare rules, no device could have these features.  Devices owned by patients after the rental period also could not be upgraded at the cost of the patient.

Many patients also need eye-gaze technology to use SGDs and, although Medicare had covered these costs to allow patients the ability to communicate in the past, after these rule changes they began routinely denying coverage of eye-gaze devices.

Advocates for patients in need of SGDs have been trying to enact change and in late April, 2015, succeeded in getting the Steve Gleason Act passed through the Senate.  This act would return the ability to upgrade devices to be able to use the internet and long-distance communications on SGDs to patients.  It would also allow patients to retain their devices and coverage when entering hospitals or care programs.  This legislation is awaiting approval in the House.  Also in late April, Medicare changed their definition of what technologies SGDs could access to allow again for patients to access the internet and other services through their SGDs.  Although this policy has not yet gone into effect and SGDs are still being rented by Medicare instead of purchased, advocates are hopeful that changes will take place soon to ensure patients are given the technologies they need to communicate.