Beneficiaries who seek Medicare coverage for expanded types and features of Speech Generating Devices (SGDs) have reason to be optimistic. Electronic devices that meet the definition of a Speech Generating Device will be coverable. This could include a tablet, computer, or smart phone.
On April 29, 2015 the Centers for Medicare and Medicaid Services (CMS) proposed changes to the National Coverage Determination (NCD) for SGDs. In an eloquently written analysis, CMS moved from a narrow interpretation of coverage as “the generation of audible speech communications with someone in close proximity who can hear the speech generated by the device,” to a broader interpretation “to cover speech generating devices that allow for more remote speech in the form of both audible and written communications…we believe that a device that generates speech for a patient with severe speech impairment and is also capable of generating written messages or phone messages to allow the patient to communicate remotely with individuals still meets the definition of DME.” [emphasis added]
Internet, phone service, and patient home modifications would still not be covered by Medicare. CMS has proposed to allow the capability of these features on the SGDs so that beneficiaries will be able to access them, while remaining liable for the expense of using those features.
The proposed revisions to the NCD do not include allowing SGDs to go into care settings such as skilled nursing facilities, long term care hospitals, or hospice. Nor does the NCD address problems with access to eye gaze/tracking technology. Resolution of those barriers must be made legislatively through Congress in the form of the Steve Gleason Act of 2015. The Gleason Act has passed the Senate. Please follow this link to contact your representative in the House of Representatives to urge passage of the Bill that will remove barriers to people who need these devices with them at all times in order to communicate.