H.R. 3749: The Medicare Demonstration of Coverage for Low Vision Devices Act of 2013

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Mark Richert in Congress

Guest blogger Mark Richert, Esq. is an attorney with extensive experience in public policy and governmental relations in the vision loss field and is the Director of the Public Policy Center of the American Foundation for the Blind (AFB).

The AFB Public Policy Center, in Washington, DC, collaborates with policy makers in Congress and the Executive Branch to ensure that Americans with vision loss have equal rights and opportunities to fully participate in society.

As Director, Mark is AFB's primary representative to the United States Congress and to federal agencies with oversight of programs and services of key importance to individuals with vision loss. You can read his full biography at the AFB website.

Medicare and Low Vision Devices

For decades, the vision loss community has been advocating for Medicare's coverage of assistive technologies, particularly low vision devices. Currently, Medicare will not pay for any device that happens to use a lens, regardless of whether the device incorporates any other features. The Centers for Medicare and Medicaid Services (CMS), the federal agency responsible for the management of Medicare, has ruled that devices containing a lens – such as low vision devices – are excluded from coverage, just as are eyeglasses or contact lenses, except in very narrow circumstances.

New Legislation Introduced

Now, for the first time, federal legislation would begin to change this unacceptable national policy by establishing a nationwide Medicare demonstration project to evaluate the fiscal impact of a permanent change in Medicare coverage to pay for low vision devices.

The legislation, H.R. 3749, the Medicare Demonstration of Coverage for Low Vision Devices Act of 2013, was introduced by Representatives Carolyn Maloney (D-NY) and Gus Bilirakis (R-FL). It would initiate a five-year demonstration project that would put low vision devices in the hands of Medicare beneficiaries who, after a clinical evaluation by an ophthalmologist or optometrist, can benefit from a low vision device and for whom these devices are medically necessary.

The legislation is careful to require that the demonstration project be genuinely national in scope and is explicitly designed to yield reliable data and meaningful results. Once the legislation is enacted and the demonstration project is successfully completed, Congress will have significantly richer data upon which to consider changes to the Medicare program to make coverage of low vision devices, especially the most costly devices, a permanent feature of the program.

Precisely how many individuals will receive low vision devices and how many physicians across the country will participate in the demonstration project will need to be determined by CMS, working in consultation with stakeholder groups, as it develops and implements the project. The legislation makes $12.5 million available for the project over five years.

The Blindness Field Collaborates on H.R. 3749

The work that has led to the introduction of this important legislation should serve as a primer on how our field can effectively influence the policy process through joint labor:

  • American Council of the Blind (ACB) initiated the national effort to refocus our field's attention on the need to address Medicare coverage for low vision devices. The nationally representative team of consumer, professional, and industry advocates that ACB brought together considered a variety of approaches to tackling the low vision device coverage issue.
  • American Foundation for the Blind, as a participant in the ACB initiative, proposed that our field pursue a national Medicare demonstration project and prepared the legislative text that has been introduced in Congress.
  • VisionServe Alliance made this issue one of its principal legislative priorities at ACB's request when VisionServe members visited Capitol Hill last April.
  • Lighthouse Guild International, supported by other VisionServe leadership and member organizations, was instrumental in securing our congressional supporters and advocates. This field-wide collaboration exemplifies the kind of effort that is best positioned to achieve results.

What You Can Do

Advocates are encouraged to contact their members of the U.S. House of Representatives and urge them to co-sponsor H.R. 3749. We are actively working on Senate champions and will keep you updated as progress is made.

More Information

For more information, contact Mark Richert, Esq. by email at MRichert@afb.net or phone at 202-469-6833. You can also read American Council of the Blind Commends U.S. House of Representatives at EIN Presswire.


Topics:
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There are currently 5 comments

Re: H.R. 3749: The Medicare Demonstration of Coverage for Low Vision Devices Act of 2013



I think this proposal is a great step forward. Those of us who work with clients know the importance of identifying funding sources for these folks. We also recognize the significant cost savings over time, providing access to these devices and the retention of independence, access to employment, etc. This is an excellent use of tax dollars and Medicare funding.

That said, I am curious how the logistics of this demonstration project will work out with regard to VRT and LVT professionals, who are most experienced at providing the necessary assessments and recommendations for these devices. From my reading of the blog post it is the eye docs who must make the recommendation. Any thoughts on this part of the equation?


Re: H.R. 3749: The Medicare Demonstration of Coverage for Low Vision Devices Act of 2013



Yes, I agree with you and happy to see a positive move in the right direction toward funding for low vision aids. I work at a blind rehab center and have found it very challenging to find dollars for people to pay for aids and devices. A lot of our population is people who are low income and/or seniors on a fixed income. Unfortunately devices can be very expensive but very necessary to bring independence to a visually impaired person’s life. When our clients get their aids it is amazing how their perspective on life changes. They now see that they can still go on with life after vision loss. They can read again. They can write and fill out forms again. They can see their computer or watch TV again. They can read important medication labels again. The impact of a low vision aid is immeasurable.


Re: H.R. 3749: The Medicare Demonstration of Coverage for Low Vision Devices Act of 2013



Hello Steve:

Maureen here. You asked this question, which is one that many professionals are asking:

"That said, I am curious how the logistics of this demonstration project will work out with regard to VRT and LVT professionals, who are most experienced at providing the necessary assessments and recommendations for these devices. From my reading of the blog post it is the eye docs who must make the recommendation."

I have been following Listserv discussions about this issue closely, especially the AOTA and AAO Listservs. What I can tell you at this point in the development of the wording and particulars of H.R. 3749 is that this question is still an open one.

I did read this announcement, written by the American Council of the Blind, the initiator of this legislation:

"This legislation seeks to do the following:

Individuals would be eligible to participate in the demonstration project only after completing a low vision exam performed by a physician who would then deem a low vision device as medically necessary.

It would allow reimbursement for certain low vision devices that cost five hundred dollars or more as durable medical equipment.

The legislation would evaluate, through a five-year national demonstration project administered by the Department of Health and Human Services, the fiscal impact of a permanent change to the Social Security Act."

I will, of course, keep providing updates as I learn more details about the structure of H.R. 3749. As you know, a prior iteration of the five-year Medicare Demonstration Project concluded unsatisfactorily in 2011, due, in some part, to a problematic project design. I can hope that we as a field have learned how to circumvent the issues that hobbled the prior project.

Maureen


Re: H.R. 3749: The Medicare Demonstration of Coverage for Low Vision Devices Act of 2013



The ACB wording is a great starting point and I think it will require additional lobbying and education of docs, consumers, and legislators to be sure the VRTs and LVTs are included and a vital part of the assessment and prescription process. What might be an effective strategy to keep this discussion an active part of the dialogue surrounding this legislation from the outset? This has the potential to be an excellent opportunity to promote our profession.


Re: H.R. 3749: The Medicare Demonstration of Coverage for Low Vision Devices Act of 2013



Hello Steve:

Regarding strategies: I know that occupational therapists and the AOTA are actively discussing this issue and developing strategies. You might want to check/follow their professional and legislative efforts. My other, more immediate, suggestion is to contact Mark Richert at the email address listed in his blog post. I'm quite certain that Mark could offer a number of helpful strategies, since he is following the "big picture" at this point in time.

Maureen


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