An Update Regarding Medicare: Feedback from ASHA
June 1, 2017



     With the start of Aphasia Awareness Month, we write to share an update on Aphasia Access’ advocacy regarding Medicare reimbursement for LPAA services. This update focuses on the ongoing dialogue between Aphasia Access and ASHA’s Government Relations and Public Policy Board (GRPPB)

     In March, Aphasia Access sent a letter endorsed by many in our membership to the GRPPB. This letter summarized the Medicare-related issues currently facing aphasia-care providers and requested that the GRPPB advocate for a “careful study (on this issue) …to identify the best possible solutions for optimizing client access to aphasia services across the care continuum.”

     This letter was part of the agenda at the GRPPB’s late April meeting. Aphasia Access has received a detailed written response to the concerns raised. Your Board views the response as a positive step forward in this important dialogue.

     The GRPPB notes in its letter to Aphasia Access that “the issue of what is a Medicare covered service is the point upon which the whole issue turns.” Within their letter, the GRPPB also underscores the importance of client access to aphasia services throughout the continuum of care. They acknowledge the need to work toward "the best possible solutions to challenges and barriers that you (Aphasia Access) have voiced." The GRPPB goes on to support the need to meet "beneficiaries’' therapeutic needs and to facilitate the training and education of clinicians."

     The letter closes with Mary Jo Schill, chair of the GRPPB, sharing that her committee will indeed undertake the study that Aphasia Access had requested. That study will include efforts that area focused on:

  • ensuring “that programs subject to Medicare rules are in compliance while clearly articulating the coverage criteria of programs to determine applicability of the rules to their own satisfaction on an individual basis”

  • identifying “possible strategies that could clarify Medicare rules and regulations in areas where medical necessity and/or the provision of skilled care may be unclear”

  • exploring “advocacy opportunities to change statutory or regulatory requirements to meet beneficiaries therapeutic needs and to facilitate the training and education of clinicians”

     We see this as the best possible outcome for this stage of our advocacy efforts. Meaningful change requires thoughtful dialogue to identify what is truly the best solution to a complex challenge. There is a delicate balance to strike and we share the GRPPB's wish to avoid “any unintended consequences that would run counter to our intent…”

     Thank you to all who added support by signing the letter to the GRPPB. This small, yet crucial, step forward would not have been possible without the power of our collective voice.

     Aphasia Access is committed to continuing to play a leadership role on this critical issue for anyone who provides aphasia care. We are in the process of reaching out to ASHA leadership to better understand the next steps and the timeline. We will share those updates with you as soon as know more.