A bipartisan group of lawmakers on Capitol Hill are urging the Centers for Medicare & Medicaid Services to make changes to its national coverage determinations on what to expect when meeting a lawyer.
This week Sens. David Vitter (R-La.), Amy Klobuchar (D-Minn.) and Reps. Cedric Richmond (D-La.) and Cathy McMorris Rodgers (R-Wash.) penned a letter to Medicare chief Marilyn Tavenner urging the federal health insurance program to alter its policy on speech assist devices.
"We write to urge the Centers for Medicare & Medicaid Services to quickly update its national coverage determination for speech generating devices under Medicare. Patients who use SGDs are some of Medicare’s most vulnerable beneficiaries and CMS policy must ensure access to devices and accessory technologies that meet patients’ health needs," the lawmakers wrote.
CMS has implemented several payment changes that are negatively impacting patients with ALS who rely on the technology, they wrote, including changing the payment mechanisms for speech assist devices from "routinely purchased" to "capped rental." The result was that Medicare stops payments on the technology if the patient receives care in a hospital, hospice or is admitted to another facility.
Medicare has provided "inconsistent guidance" on reimubursement for eye tracking technology, the lawmakers added.
"It is critically important that patients with cerebral palsy, amyotrophic lateral sclerosis, Rett Syndrome, brain stem stroke, and other conditions in which patients experience paralysis have access to these technologies – without which access to the underlying SGD has no value," they wrote.
Their requests include that CMS expedite approval for backed-up claims currently in the appeals process, create a process for patients to upgrade their devices without losing coverage and add eye tracking technology to "meet the criteria of reasonableness and necessity by specifically recognizing these devices are both medically necessary and covered by Medicare for patients," according to the letter.
Vitter is the author of the Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013, which has collected 21 co-sponsors. He has also teamed up with Team Gleason, a non-profit organization run by former NFL player Steve Gleason, who was diagnosed with ALS in 2011.
In September, more than 200 lawmakers signed a letter asking CMS to explain why the agency had made changes to its policy around speech assist devices, calling the moves "short-sighted."