Why the Academy Opposes the Medicare Audiology Services Enhancement Act
In late February, Congressman Gus Bilirakis (R-FL) reintroduced the Medicare Audiology Services Enhancement Act (HR 1116). This legislation is identical to HR 2330, which he first introduced in the 113th Congress. HR 1116 is supported primarily by the American Speech-Language-Hearing Association (ASHA) and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS).
After careful research, review by subject matter experts from the Academy’s Government Relations and Coding and Reimbursement Committees, and an overwhelming response from its membership at large, the Academy made the decision not to support the Medicare Audiology Services Enhancement Act (HR 2330) in the 113th Congress. The Academy will oppose this legislation (HR 1116), in the 114th Congress because it does not advance our overarching goal of achieving autonomous practice for audiologists.
For years, the Academy has worked to remove the physician referral requirement from Medicare so that patients can seek hearing and balance care directly from an audiologist. The Academy has also supported the Audiology Patient Choice Act, which would define audiologists as limited license physicians under Medicare and effectively eliminate the need for physician referral.
HR 1116 does not provide direct access to audiologic services currently covered by Medicare. Instead, the legislation adds an unnecessary and unacceptable level of physician oversight to an audiologist’s ability to provide high quality hearing and balance care. HR 1116 requires audiologists to develop a physician approved plan of care when providing assessment or certain specified treatment services under Medicare. The plan of care must be submitted to and periodically reviewed by the referring physician. And, services must be provided while the patient is or was under the care of a physician.
The legislation extends Medicare coverage to a limited number of audiologic treatment services, which require both a physician referral and plan of care. Treatment services include auditory processing and rehabilitation, vestibular treatment, and intraoperative neurophysiologic monitoring. HR 1116 excludes important treatments such as tinnitus and cerumen removal, and thus does not recognize an audiologist’s full scope practice.
The Academy believes that HR 1116 creates another layer of physician involvement for audiologists performing services that are already within their scope of practice. This is a step in the wrong direction. Audiologists are already licensed in all 50 states, the District of Columbia, and Puerto Rico to provide assessment and treatment services directly to patients, within their scope of practice, without physician oversight.
The Academy strongly opposes HR 1116 because it is contrary to our pursuit of professional autonomy and improved access to audiologists for Medicare patients.
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