Nebraska LB 154: The Academy Opposes Scope of Practice Expansion for Hearing Instrument Specialists

Background

In October 2023, the International Hearing Society (IHS) and the Nebraska Hearing Society proposed expanding the scope of practice for Hearing Instrument Specialists (HIS) to include procedures such as tinnitus care, cerumen management, tympanometry, cochlear implant candidacy assessments, and subjective test interpretations. This proposal was submitted through Nebraska’s credentialing review process, despite strong concerns about patient safety and professional qualifications.

The Academy immediately opposed this effort, warning that HIS do not have the advanced education and clinical training required for these procedures. The Academy mobilized members to submit comments and participate in the October 17, 2023, public hearing, emphasizing that these changes could lead to misdiagnoses, inadequate treatment, and lower-quality patient care. Despite these efforts, the credentialing review process was accepted, setting the stage for legislative bill (LB) 154, introduced in early 2025.

What LB 154 Would Do

If passed, LB 154 would allow HIS to perform services traditionally reserved for licensed audiologists, including:

• Tinnitus Care: A complex condition requiring specialized training and expertise.
• Cerumen Management: A delicate procedure that, if done incorrectly, can cause serious harm.
• Medical History Collection: HIS would be authorized to assess patient histories, a key step in diagnosing hearing loss and identifying other underlying medical conditions.

The Academy’s Opposition

The Academy opposes this legislation because it would lower patient care standards and create serious risks. Audiologists complete years of doctoral-level education, clinical training, and certification to ensure proper diagnosis and treatment of hearing and balance disorders. HIS, even with proposed training changes, do not meet these rigorous standards. By allowing HIS to provide these critical services without the necessary expertise, LB 154 puts patient safety in jeopardy. A hearing on LB 154 is scheduled for Wednesday, February 5. The Academy conducted outreach encouraging members in Nebraska to testify in opposition to this bill’s passage, and the Academy itself submitted formal written testimony. Additionally, the Academy followed up with all members of the committee via email, providing them with a copy of the testimony advocating for high standards in hearing-health-care while highlighting the risks of allowing untrained professionals to perform these services.