[Congressional Record Volume 146, Number 61 (Wednesday, May 17, 2000)]
[Extensions of Remarks]
[Page E755]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




    INTRODUCTION OF LEGISLATION TO COVER AAC DEVICES UNDER MEDICARE

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                          HON. JERROLD NADLER

                              of new york

                    in the house of representatives

                        Wednesday, May 17, 2000

  Mr. NADLER. Mr. Speaker, today I join Representative Cunningham in 
introducing an important bill to rectify a fundamental unfairness for 
seniors stricken with Amyotrophic Lateral Sclerosis, ALS, and other 
debilitating diseases that render one unable to speak. Our bill would 
extend Medicare coverage to Augmentative and Alternative Communication, 
or AAC Devices, which have been previously unavailable to seniors who 
cannot afford the enormous cost, so that all seniors may enjoy the 
benefits of communication.
  AAC devices are remarkable machines that allow a severely speech-
impaired person to speak through a computer. Perhaps the most famous 
user of these devices is physicist Stephen Hawking, who relies on this 
device to conduct his brilliant work. Fortunately, he is able to afford 
an AAC device, but countless others who are stricken with ALS, and 
similarly debilitating diseases, find themselves without the means to 
purchase these expensive, yet invaluable, devices.
  Amazingly, HCFA, the Health Care Financing Administration, has 
refused to cover these devices, labeling them ``a convenience item.'' 
Is it merely a convenience to be able to communicate with your family, 
your friends, or your caretaker? Is it just a luxury for people 
suffering with ALS to lead safe, healthy, and productive lives? That is 
what HCFA must believe by refusing to cover AAC devices.
  HCFA's resistance toward covering AAC devices is made even more 
inexplicable by the fact that every other federal health care provider, 
like the Veterans' Administration, every state Medicaid program, as 
well as hundreds of commercial providers cover these unique devices, 
recognizing that communication is more than a convenience, it's a 
necessity. It is a cruelty to deny individuals the power of speech, 
when then devices are readily available.
  I first became interested in this cause after meeting with the wife 
of the late actor Michael Lazlo, a constituent of mine, who first told 
me of HCFA's refusal to cover AAC devices. Over the last year and a 
half many of my colleagues, particularly Mr. Cunningham, and I have 
worked to reverse this short-sighted decision. I am pleased that 
recently they removed their non-coverage decision, allowing local 
carriers to cover AAC devices if they determine it is appropriate. 
However, this decision goes only half-way toward what is necessary. 
While I have no doubt that coverage is the only reasonable decision 
these local providers could reach, I feel we must affirmatively cover 
these devices.
  According to HCFA itself, AAC Devices ``can greatly improve the 
quality of life of people who either cannot speak or whose speech is 
unintelligible to most listeners . . . this technology gives severely 
speech-impaired people ways to communicate their thoughts to others.'' 
I ask them today to listen to their own words and cover AAC devices.
  Mr. Speaker, I ask my collegues to join us in providing the power of 
speech to those who could benefit from these devices and cosponsor this 
important legislation.

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