For decades, the vision loss community has been advocating for Medicare's coverage of assistive technologies, particularly for devices for low-vision users. Currently, Medicare will not pay for any device that happens to use a lens, regardless of whether such 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, such as low-vision devices, that use a lens are excluded from coverage just as eyeglasses or contact lenses are, except in very narrow circumstances.
Now, for the first time, federal legislation may 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, introduced by Reps. Carolyn Maloney (D-NY) and Gus Bilirakis (R-FL), 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 such 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 demo 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 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. The 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. The American Foundation for the Blind (AFB), 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. In addition to ACB's extensive advocacy on Capitol Hill, the VisionServe Alliance made this issue one of its principle legislative priorities at ACB's request when VisionServe members visited Capitol Hill last April. Lighthouse International, supported by other VisionServe leadership and member organizations, was determinative in securing our congressional champions. This field-wide collaboration serves as an example of the kind of effort that is best positioned to achieve results.
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. Thank you for your advocacy!
For further information, please contact:
Mark Richert, Esq.
Director, Public Policy
American Foundation for the Blind
Phone: (202) 469-6833