A new Congress offers hope. The American Academy of Audiology (the Academy), the Academy of Doctors of Audiology (ADA), and the American Speech-Language-Hearing Association (ASHA) opted to seize the moment to move forward together to seek a legislative strategy for the 116th Congress. Rather than individually pursuing legislative initiatives for the profession, the three organizations committed to working together to draft a single Medicare bill to advance the recommendations of the National Academies of Science, Engineering, and Medicine (NASEM) report.
With each audiology-related bill that has been introduced in the past, we have gained increased congressional recognition of, and support for, audiology. We have also learned lessons—most importantly, that we are stronger in unity. Our members have expressed an expectation of collaboration across our organizations to represent their best interests. At the staff level, we have effectively worked together for a long time on an extensive range of issues. Yet a joint legislative strategy, specific to audiology interests, had eluded us in recent years. Leadership and staff of the three organizations recognized that interests are aligned sufficiently to support a single bill and agreed to move forward in figuring out how to do it.
Developing Draft Legislation
To avoid any potential misunderstandings about desired outcomes and the process of working together, the three groups first established a cooperative agreement. Effective February 2019 through December 2020 (the end of the 116th Congress), the agreement lays out the shared goals of legislation and the commitment of the three groups for advocacy efforts to advance the bill. ADA, ASHA, and the Academy all agreed to drafting and promoting a bill that would center on the following concepts:
Reclassification of audiologists from supplier to practitioner under the Medicare statute, with the understanding that the legislative language will ensure:
That audiologists are reimbursed at 100 percent of the physician fee schedule for all covered services, will continue to prohibit audiologists from billing incident to other providers, and will not seek to modify the Medicare definition of a qualified audiologist;
Direct access to audiology services under the Medicare statute without language requiring a physician order or plan of care; and
Expansion of Medicare coverage to include all Medicare-covered diagnostic and treatment services that correspond to audiology’s scope of practice.
The Academy, ADA, and ASHA were fortunate to have strong sponsors on both the Senate and House sides ready to work with us for introduction of the joint bill. The sponsors helped to move the bill language through legislative counsel and worked with our joint group in crafting final language.
On the House side, Representative Tom Rice (R-SC) joined July 25 with nine other co-sponsors to introduce the Medicare Audiologist Access and Services Act of 2019 (H.R. 4056). On September 9, the day that the Senate reconvened after summer recess, Senators Elizabeth Warren (D-MA), Rand Paul (R-KY), Sherrod Brown (D-OH), and Roger Wicker (R-MS) introduced the companion bill in the Senate.
All three organizations have mobilized advocacy efforts to solicit additional sponsors and to promote the benefits of the bill. Goals include attaining broad-based support; joint visits by the three organizations targeted committees of jurisdiction.
On the House side, the Energy and Commerce and Ways and Means committees received the bill. In the Senate, the bill was referred to the Finance Committee.
The leadership of ADA, ASHA, and the Academy engaged in advocacy outreach, including hosting a congressional briefing on October 18.
Members, too, can make the difference in the passage of the bills. Contact any of the three organizations to find out how you can advance the Medicare Audiologist Access and Services Act.
The process of developing the legislation and preparing for the next steps of grassroots advocacy reflects a true commitment of ASHA, ADA, and the Academy to work together for the benefit of the profession of audiology. Advancing this legislation will be a huge win for audiologists and their patients at the individual level; however, the reinforced collaboration among the three organizations is a win for the profession. In unity, we have hope for the future.