ALS Patients Win Fight Over Medicare Reimbursement For Speech Devices
After strong pushback from ALS patients and lawmakers, the government has reversed a decision that could have blocked Medicare reimbursement for certain speech generation devices beginning Dec. 1.
The decision announced Thursday by the Centers for Medicare & Medicaid Services means Medicare will continue a longstanding policy to cover most of the cost of devices that can be upgraded by patients at their own expense.
Speech generation equipment is critically important to patients with ALS and similar neurodegenerative disorders 鈥 conditions that limit their capacity for movement and speech. Patients, since 2001, have had the option of paying themselves for upgrades, including those that enable them to connect to the Internet and open doors or adjust room temperatures. But in February, Medicare announced that would have precluded coverage of the cost of upgradable devices.
Patients with ALS, amyotrophic lateral sclerosis, and their advocates strongly objected. On Thursday, the government .
In reversing course, CMS 鈥渆mphasized the importance of technology and how critical it really is, at this point, I think, to not make a new policy immediately,鈥 said Kathleen Holt, associate director at the Center for Medicare Advocacy, which advocates for Medicare beneficiaries.
Advocates are still worried about the future. Medicare its National Coverage Determination 鈥 the federal rule that determines what Medicare can cover 鈥 so as to incorporate technological advances that weren鈥檛 around in 2001. Public comment will be solicited, and a revised rule is likely by July 2015, said Patrick Wildman, director of public policy at the ALS Association.
That means 鈥渢here鈥檚 still the uncertainty of what is the coverage policy going to look like, come July 2015,鈥 Wildman said. 鈥淲ill it be something different?鈥
鈥淥ne of the things I would say to beneficiaries is, we’ve got a temporary reprieve on this, but don’t stop fighting,鈥 Holt said.
CMS spokesman Aaron Albright said the agency 鈥渋s committed to beneficiaries鈥 access to needed technologies to improve their quality of life, including the coverage of speech-generating devices for individuals with a severe speech impairment.鈥 He added that CMS is assessing the evolution of that technology since 2001.
ALS patients had aggressive support from Congress on the question of speech generating devices. Some 聽200 members signed a bipartisan 鈥淒ear Colleague鈥 letter in September, asking CMS to respond to patients鈥 concerns. On Tuesday, Rep. Tim Murphy, R-Pa., sent the agency another letter.
The letters also expressed concern about a recent pattern of Medicare denials of coverage of eye-tracking technology, which uses eye movements to generate commands for the speech devices. Those claim denials are routinely reversed on appeal, but the appeals process can take months.
