Tele-audiology and Licensure Laws

Tele-audiology and Licensure Laws

In preparation for pursuing coverage of tele-audiology, it is important to understand general procedures as well as talking points in support of telehealth and talking points for rebutting common arguments opposing telehealth coverage.

Licensure laws are relatively straightforward: as with any service delivered by a health-care provider, in order to conduct remote diagnostic evaluations an audiologist must be licensed in the state where the patient is residing. Licensure is an issue as practitioners have begun not only servicing individuals in remote parts of their own state but can now provide assistance to those in other states or even other countries.

The Academy states that “diagnostic and rehabilitative telehealth/telemedicine services should always be provided by, or supervised by, a qualified practitioner.” Recognizing the challenges in accessing qualified specialists, the Academy’s 2008 guidelines state “telemedicine services should be primarily provided to individuals who have limited access to (specialists) in their communities.”

Considerations reviewed for audiology telehealth legislation include:

  • Telehealth, as a discipline, is so new to the scope of audiology services that there are not many guidelines through the licensure rules and regulations that monitor and control how tele-audiology is performed.
  • Audiology is regulated through each state, therefore it will depend on each state how it is managed and enforced.
  • With most state audiology licenses, practice is limited to within that state;treating patients across state lines is not currently permitted.
    • Here are some possible solutions to out-of-state patients:
      • The audiologist holds licenses for whichever state(s) in which the patients reside.
      • The patient could travel to a site (controlled clinic) that is within the state that the audiologist is licensed.
      • As tele-audiology becomes more prevalent, hopefully laws will be passed that support national certifications, national practicing licenses, or eliminate state lines.
  • Licensure and regulation should remain mostly unchanged and the same rules should apply overall. Tele-audiology is just a different way for the patients to access their hearing healthcare.

The American Telemedicine Association reports news on two pending bipartisan bills that would expand the “one state license” practice to other federal interstate telehealth programs. With these bills, a health-care professional would only need one state license to serve patients in any location who are covered by the federal health plan.

1. H.R. 2001 for the Department of Veterans Affairs with the VETS Act (Veterans E-Health & Telemedicine Support Act)

2. H.R. 3077 for Medicare with the TELE-MED Act (TELEmedicine for MEDicare Act)

Although these bills address specific services typically provided to an adult population, they would also set serious precedence for interstate licensure to support pediatric services.

Future licensure may not only cover audiologists but also participating assistants. Tele-audiology clinical technicians are people who, after appropriate training and demonstration of competency, provide patient/equipment interface support under the supervision of a licensed audiologist using secure real-time and/or “store-and-forward” audio/video technology to deliver audiology services from a site located at a distance from the actual patient-testing site. A tele-audiology clinical technician may also be an audiology assistant or other health-care professional who has had additional training to serve in this role. Tele-audiology clinical technicians are only currently being used in the Veteran’s Administration system.

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