Follow by Email

Friday, September 19, 2014

Medicare Coverage of Speech Generating Devices (SGD)

The Centers for Medicare and Medicaid Services (CMS) has issued a number of different policy changes regarding coverage for speech generating devices (SGDs) that have created some confusion and raised significant concerns within the ALS community. The ALS Association’s Public Policy Department has worked on these issues since they first arose and continues to advocate to ensure that people with ALS have access to communications devices that are so vital to living with this disease. The issues are summarized below and include what action The Association is taking and what people with ALS can do to help.

Capped Rental:

Beginning on April 1, 2014, Medicare is changing how it pays for SGDs, switching to a system called “capped rental.” Since 2001, people with ALS always have had the option of renting SGDs; however the overwhelming majority purchases them. Beginning on April 1, people no longer will have that option. Instead, they will be required to rent the device over a 13 month period. During the capped rental period, people with ALS will be contacted each month by the manufacturer to ask whether the SGD will be needed during the next month. As long as the answer is yes, the patient can keep the device. After the 13th month, these monthly questions about further use will stop and the patient will own the device. The payment system change does not apply to anyone on Medicare who currently owns an SGD. Capped rental also does not affect which devices Medicare will cover, or the evaluation and documentation required to support Medicare coverage.
The ALS Association has been actively engaged on this issue since CMS first proposed the change in the summer of 2013. We have submitted formal comments to CMS and have partnered with other organizations, those in industry and with Members of Congress who share our concerns to urge CMS not to make this change. Our concerns are outlined in the comments to CMS, here They include:
  • Access: If people have an extended hospital stay or are in hospice while they are in the rental period, Medicare will not cover the rental fees. Instead, the device could be returned to the manufacturer while the patient would have to obtain a new one from the hospital or hospice or pay the entire monthly rental fee out-of-pocket.
  • Cost: People who rent SGDs for the full 13 month rental period will pay 5% more out of pocket than if they had purchased the device up front. Most recently, several Members of Congress sent a letter ( to CMS urging them to: 1) delay the implementation date; 2) reevaluate the data on which their decision was based (CMS relied on 1987 claims data); and 3) meet with stakeholders. A number of meetings have taken place with CMS and a number of scenarios are possible. Those include:
  • Full implementation on April 1
  • Delay implementation
  • Grandfather certain DME introduced to the market after 1987
  • Grandfather all SGDs since the devices are not intended for short-term use
The ALS Association continues to partner with other organizations to oppose the switch to capped rental and we will continue to strongly communicate that message to CMS. As the regulatory process moves forward, we will provide additional information and will alert the ALS community if grassroots action is needed. If CMS does not act to address our concerns, The Association will pursue other options, potentially including legislation, to ensure people with ALS have access to SGDs that play a critical role in their lives.
In the meantime, if you or someone you know experiences any difficulty accessing SGDs or other Durable Medical Equipment, such as power wheelchairs or accessories, please contact your local ALS Association Chapter immediately. Chapter contact information is available here: If you do not have a local Chapter, please contact The ALS Association’s Public Policy Department at The Association will actively provide assistance to anyone experiencing difficulties accessing these devices and also will share these difficulties with CMS officials and Members of Congress so that they fully understand how policy changes impact people with ALS and why they must change.

Dedicated Devices

On February 27, 2014, CMS issued a guideline titled a "coverage reminder" that addresses the types of SGDs and the features of the devices that Medicare will cover. This guideline raises several questions about the features of currently available SGDs, and about the temporary "locking" or "dedication" practice that has been in place since 2001 for computer-based devices. Under current practice, non-medical applications such as email and word processing software, are “locked” on computer-based devices because Medicare will not cover those applications. However, people with ALS subsequently may have the manufacturer “unlock” these additional features by paying a fee, which again is not covered by Medicare.
Both the wording of the document and the manner in which it was issued (coverage reminder as opposed to amending coverage policy) make it unclear exactly what implications it has for SGD coverage now and in the future. There is some speculation that this guideline would end coverage for SGDs or disallow coverage for devices that include non-medical applications such as word processing software, regardless of whether those applications are “locked.” At this time it is just speculation and it is not clear exactly how the guideline impacts current coverage policy. However, it is clear that this guideline does not end Medicare coverage of SGDs and it does not end coverage for computer-based devices, which have been available to Medicare recipients since May 2001. It also does not change the evaluation or documentation required to support Medicare coverage.
As with “capped rental,” The Association is working with other organizations and with industry partners who share our concerns about the potential implications of the guideline. Together we will be working with CMS to clarify the meaning of the guideline and to ensure that people with ALS will continue to have access to SGDs, including computer-based devices. We also will keep the ALS community updated as the regulatory process moves forward and will alert the community if action is necessary.
In the meantime, if you or someone you know experiences any difficulty accessing SGDs, including computer-based devices, please contact your local ALS Association Chapter immediately. Chapter contact information is available here: If you do not have a local Chapter, please contact The ALS Association’s Public Policy Department at The Association will actively provide assistance to anyone experiencing difficulties accessing these devices and also will share these difficulties with CMS officials and Members of Congress so that they fully understand how policy changes impact people with ALS and why they must change.
If you have any questions about these issues or would like additional information, please contact the Public Policy Department at


  1. Great post. Its very interesting and enjoyable. Its must be helpful for us. Thanks for sharing your nice post.
    disable people

  2. Wow, Excellent post. This article is really very interesting and effective. I think its must be helpful for us. Thanks for sharing your informative.

  3. First of all let me tell you, you have got a great blog .I am interested in looking for more of such topics and would like to have further information. Hope to see the next blog soon.

    newest technology

  4. offers a list of best 4 packers and movers in Delhi after verifying their quality and reliable. Compare 4 movers and packers of Delhi to choose the right one.

    movers and packers delhi
    packers and movers in delhi

  5. I Thought to admit that your blog is truly interesting. I have spent a lot of my free time reading your content. Thank you a lot! Daily Live TV

  6. . Not only this, one need not to panic to carry major cartons with regard to supplying material. This kind of group of packers and also movers would likely take their particular appearance supplies.

    Click Here:
    packers and movers pune
    packers and movers in pune
    movers and packers pune
    movers and packers in pune


  7. The contents existing in this genuinely awesome for people experience, well, keep up the nice work. packers and movers kukatpally . packers and movers hyderabad kukatpally

  8. Thanks you very much for your informative and effective post. Again thanks for sharing. xnxx

  9. Thanks for share this information !!

    I am using one android call recorder application, This application facilitates you with an option of auto upload which allows you to mechanically upload files on server, including Google drive, Dropbox, Gmail inbox, Evernote and sound cloud.


  10. hey good work man!!!

    Der Vögele-Shoes Online Shop bietet Ihnen für jeden Anlass den passenden Schuh. Mit wenigen Klicks finden Sie hochwertige Trekking-Sandalen für ausgiebige Wandertouren, wasserdichte Stiefel für Wind und Wetter, komfortable Ballerina für den nächsten Städtetrip und vieles mehrDoch eine grosse Auswahl ist bei Vögele-Shoes noch längst nicht alles: Bei uns können Sie sicher, einfach und rund um die Uhr Ihr Wunschmodell bestellen.

    Thanks a lot for sharing such a wonderful post, it is a very nice site i really enjoyed to visit this site,

    Grosse Auswahl.

  11. Great and a brilliant and mindful post. this packers and Movers is one the well known and reliable packing and moving company that serves best experience. packers and movers in jaipur . packers and movers jaipur

  12. We have Indian escorts,pakistani escort in dubai (Uae).We provide Cheap Sexy Desi Night Call Girls in Dubai.For Contact,Rates Call +971552244915. Indian Escort In Dubai // Pakistani Escort In Dubai // Arab Escort In Dubai // Russian Escort In Dubai //

  13. Good day very cool website Man Excellent Amazing I will bookmark your site and take the feeds also.
    I'm happy to seek out a lot of useful info right here within the submit we want work out extra techniques
    on this regard thanks for sharing.
    Prop hire

  14. This is a great post. Thanks for your wonderful article! I think this is valuable and useful to us.

    ceasuri de mana, ceasuri barbatesti, ceasuri dama, ceasuri ieftine

  15. Youre so cool! I dont supposeL'Reve 24k Ive learn anything like this before. So good to seek out any individual with some unique ideas on this subject.

  16. Nice blog post..Packing, Moving and Shifting is not an easy task one place to another place.than we hire best Packers Movers, packers and movers in marathahalli . packers and movers marathahalli bangalore

  17. This website has lots of really useful stuff on it. Thanks for informing me.What I wouldnt give to have a debate with you about this. Prolongz You just say so many things that come from nowhere that Im pretty sure Id have a fair shot. Your blog is great visually, I mean people wont be bored. But others who can see past the videos and the layout wont be so impressed with your generic understanding of this topic.

  18. Your services are too good but i am looking for Professional Movers Dubai Services.... Have you any service about Professional Movers Dubai Services???

  19. Your services are too good but i am looking for Storage services dubai .... Have you any service about Storage services dubai???

  20. I am glad to see that people are actually writing about this issue in such a smart way, showing us all different sides to it. Thanks for sharing, please keep it up.

    Also checkout our happy new year 2017 SMS new collections.

  21. I read blog thoroughly; it’s quite informative and well written post. You covered the topic very well. Thanks for sharing.
    Also checkout Pakistani chat rooms

  22. I recently came across your blog. It’s quite interesting and nice blog .You’re truly well informed. Thanks for sharing.
    Also checkout Game Killer APK Free Download

  23. Nice post.Great blog.Thanks for sharing. It was very interesting and meaningful.
    Also checkout Surgical instruments Australia

  24. Very informative and well written post! Quite interesting and nice topic chosen for the post.
    Also checkout Surgical Instrument

  25. I read your whole blog. Your work is really good and inseparable .Thanks for sharing.
    Also checkout Security services Melbourne

  26. Marie We aim to be the premiere Seattle moving company! With our great customer service and the excellent seattle movers, you can trust us to meet all of your Seattle moving needs!

  27. Foldable WheelchairThe World’s Best Motorized Electric Wheelchair...