Feds pull back on controversial speech device policy

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New CMS Policy on Speech Generating Devices

In response to backlash from disability advocates, the Center for Medicare and Medicaid Services has shelved a controversial policy that would have restricted the types of speech generating devices covered by federal health care programs.

Moreover, it has proposed a new policy, expanding options for people with severe speech limitations.

The CMS first began covering speech generating devices in 2001, reversing a previous policy that viewed communication devices as merely conveniences, as opposed to medical necessities.

These devices allow people with with speaking difficulties to generate audible messages and written messages via a laptop computer, PDA or other similar devices. While Medicare covers the cost of the devices, beneficiaries pay for upgrades, such as software allowing them to make text messages, emails and videos.

In April 2014, CMS imposed a 13-month rental period, prohibiting beneficiaries from installing these upgrades. Later, CMS announced it would no longer cover devices capable of installing these upgrades, according to Public Source.

In November, CMS opened a 30-day public comment period, which generated more than 2,900 comments.

In a new policy memo, proposed May 1, CMS expands the definition of speech generating devices to cover the costs of software that creates text messages, emails and other written communications.

In doing so, the CMS recognized the imperative of written communication for the safety and independence of people with speech disabilities.

“For example, expressing an urgent need, such as when thirst or pain becomes unbearable, to a caregiver who is not in the home at the time serves the same purpose as expressing the need to a caregiver who is in the home,” the memo states.

Although beneficiaries will still be required to pay for some features, such as those for creating videos and spreadsheets, the change represents a major victory for disability activists.

“When I am alone, text and email are my only means of getting non-emergency help. These functions aren’t just conveniences,” Mara Sweterlitsch, a  woman with ALS, told PublicSource. “The proposed policy finally recognizes all the interrelated needs of [speech-generating device] users and lets them leverage existing technology to cope.”

The CMS will accept public comments on the proposal until May 29.