The ALS Association

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Coping with Medicare Coverage Changes in Speech Generating Devices

Staying connected with friends and loved ones might get trickier for people living with ALS that rely on Medicare. Presently, there is speculation regarding whether Medicare will continue to cover the cost of speech generating devices (SGD’s), including eye gaze equipment.

Cause for Concern

The Centers for Medicare and Medicaid Services (CMS) issued a “coverage reminder” on February 27, 2014, addressing the types of SGD’s and the features of these devices that Medicare will cover.

http://www.medicare.gov/what-medicare-covers/part-b/durable-medical-equipment.html

It’s important to know that communication devices covered by Medicare are restricted from providing access to non-medical applications, which includes word processing, Internet access and telephone calls.

In the past, “unlocking” SGD’s to gain access to the Internet required paying the manufacturer a fee, typically around $69, which was not covered by Medicare. The person using the device was then given access to a code that unlocked their device’s connection to the Internet. The ALS Association is concerned that this vital workaround feature may soon be blocked.

More Changes Ahead

In addition, Medicare now requires SGD’s to be rented for a period of 13 months as part of a new capped rental program, which has costly implications for people with ALS. During the rental period, the equipment is still technically owned by the government, which also bars the manufacturer from issuing Internet workarounds to renters. There are concerns that Medicare may continue to enforce this restriction even when the rental period is over. The later is still an unknown factor.

To learn more about potential out of pocket costs associated with the capped rental program, please visit: http://www.alsa.org/als-care/augmentative-communication/medicare-sgd.html.

We’re Here to Help!

If you or someone you know experiences any difficulty accessing SGD’s or other durable medical equipment, such as power wheelchairs, Hoyer Lifts, hospital beds, oxygen or feeding devices, just to name a few, please contact your local ALS Association Chapter. Contact information is available here: http://www.alsa.org/community/.

If you do not have a local Chapter, please send an email to The ALS Association’s Public Policy Department at advocacy@alsa-national.org. The Association is pleased to provide assistance to anyone experiencing difficulties accessing these devices.

Advocating for Change

The ALS Association is leading the fight against these policy changes and has outlined for CMS the impact their decision will have on people with ALS. We are pursuing both regulatory and legislative solutions, and are working with members of Congress, speech language pathologists and equipment manufactures to enlist their support as we advocate for a reversal of these policies.

You can make a difference by becoming an ALS advocate. Simply sign up here to begin receiving updates and alerts:

http://capwiz.com/alsa/mlm/signup/ 

Getting More Out of Your iPad in Changing Time

While not considered an SGD replacement, Apple’s new IOS 7 system allows users hands free access. The ALS Association’s Assistive Technology Specialist, Alisa Brownlee explains in her blog how to make your iPad, iPhone or iTouch an adaptable communication device

http://alsassistivetechnology.blogspot.com/search?q=ios

Other Technology Options for Staying in Touch

Note there are many other mainstream devices such as laptops and tablets that can be converted into speech generating devices and can continue to be used even if the person loses hand function. If you’d like more information about how to setup these options, please contact The ALS Association’s assistive technology specialists Alisa Brownlee at abrownlee@alsa-national.org.

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