Audiology-related Legislative Landscape Takes Shape
Opposition to federal legislation designed to inappropriately expand the scope of practice of audiologists has long been one of the AAO-HNS’ key legislative priorities. For years, the national organizations representing the audiology community sought passage of federal legislation that would provide audiologists with unlimited “direct access” to Medicare patients without a physician referral. However, in late 2012, we learned the audiology community was no longer coalesced around the direct access issue, and the three groups representing audiologists would instead pursue separate legislative initiatives. As expected, dueling pieces of audiology legislation have been introduced in the 113th Congress, with yet another bill on the horizon. They are: American Academy of Audiology (AAA)—H.R. 4035/S. 2046, a recycled bill to provide audiologists with unlimited direct access to Medicare patients without a physician referral. Introduced in February 2014 by Rep. Jim McDermott (D-WA) and Sen. Sherrod Brown (D-OH). AAO-HNS opposes. American Speech-Language-Hearing Association (ASHA)—H.R. 2330, a bill designed to align Medicare coverage of comprehensive audiology services with current billing and reimbursement standards of other non-physician therapeutic services covered by Medicare (PT, OT, SLP). This bill specifically retains the requirement for a physician referral, as well as physician oversight of plans of care. Introduced in June 2013 by Rep. Gus Bilirakis (R-FL). AAO-HNS supports. Academy of Doctors of Audiology (ADA)—Legislation not yet introduced. Expected to move forward with its new “18 x 18” campaign—an effort to pass legislation by 2018 that would amend Title XVIII (18) of the Social Security Act to include audiologists in the definition of “physician.” This new initiative would also provide direct access similar to the AAA legislation and the comprehensive benefits outlined in the ASHA proposal. AAO-HNS will oppose. The shift in the audiology community’s strategy is not an anomaly. Since passage of the Affordable Care Act and the President’s subsequent reelection, there has been a slightly more favorable environment on Capitol Hill regarding efforts to expand access to non-physician healthcare providers to help fill perceived gaps in care. Given these evolving legislative “environment” variables, and the strategic shift within the audiology community, the AAO-HNS has remained proactive in its approach to ensuring Members of Congress (and their staffs) are well educated on the various audiology initiatives. In addition to several AAO-HNS letters to Capitol Hill and numerous meetings with legislative and committee staffs, the Academy spearheaded two coalition sign-on letters opposing the direct access effort (H.R. 4035/S. 2046). We are pleased to report that nearly 110 national, state, and local medical societies—including the American Medical Association and the AmericanCollege of Surgeons—are signatories to our letters. Thus far, our efforts have received a positive response from many Capitol Hill offices. However, our success should not breed complacency. The AAO-HNS urges its members to follow these issues closely. As these legislative efforts continue to unfold, applicable legislative “action alerts” and other advocacy-related materials will be communicated to AAO-HNS members. For more information regarding audiology legislation in the 113th Congress, contact legfederal@entnet.org. Or, visit the Legislative and Political Affairs webpage at www.entnet.org/advocacy for access to the Academy’s position letters and/or additional resources pertaining to these issues.
Opposition to federal legislation designed to inappropriately expand the scope of practice of audiologists has long been one of the AAO-HNS’ key legislative priorities. For years, the national organizations representing the audiology community sought passage of federal legislation that would provide audiologists with unlimited “direct access” to Medicare patients without a physician referral. However, in late 2012, we learned the audiology community was no longer coalesced around the direct access issue, and the three groups representing audiologists would instead pursue separate legislative initiatives. As expected, dueling pieces of audiology legislation have been introduced in the 113th Congress, with yet another bill on the horizon. They are:
- American Academy of Audiology (AAA)—H.R. 4035/S. 2046, a recycled bill to provide audiologists with unlimited direct access to Medicare patients without a physician referral. Introduced in February 2014 by Rep. Jim McDermott (D-WA) and Sen. Sherrod Brown (D-OH). AAO-HNS opposes.
- American Speech-Language-Hearing Association (ASHA)—H.R. 2330, a bill designed to align Medicare coverage of comprehensive audiology services with current billing and reimbursement standards of other non-physician therapeutic services covered by Medicare (PT, OT, SLP). This bill specifically retains the requirement for a physician referral, as well as physician oversight of plans of care. Introduced in June 2013 by Rep. Gus Bilirakis (R-FL). AAO-HNS supports.
- Academy of Doctors of Audiology (ADA)—Legislation not yet introduced. Expected to move forward with its new “18 x 18” campaign—an effort to pass legislation by 2018 that would amend Title XVIII (18) of the Social Security Act to include audiologists in the definition of “physician.” This new initiative would also provide direct access similar to the AAA legislation and the comprehensive benefits outlined in the ASHA proposal. AAO-HNS will oppose.
The shift in the audiology community’s strategy is not an anomaly. Since passage of the Affordable Care Act and the President’s subsequent reelection, there has been a slightly more favorable environment on Capitol Hill regarding efforts to expand access to non-physician healthcare providers to help fill perceived gaps in care.
Given these evolving legislative “environment” variables, and the strategic shift within the audiology community, the AAO-HNS has remained proactive in its approach to ensuring Members of Congress (and their staffs) are well educated on the various audiology initiatives. In addition to several AAO-HNS letters to Capitol Hill and numerous meetings with legislative and committee staffs, the Academy spearheaded two coalition sign-on letters opposing the direct access effort (H.R. 4035/S. 2046). We are pleased to report that nearly 110 national, state, and local medical societies—including the American Medical Association and the AmericanCollege of Surgeons—are signatories to our letters.
Thus far, our efforts have received a positive response from many Capitol Hill offices. However, our success should not breed complacency. The AAO-HNS urges its members to follow these issues closely. As these legislative efforts continue to unfold, applicable legislative “action alerts” and other advocacy-related materials will be communicated to AAO-HNS members.
For more information regarding audiology legislation in the 113th Congress, contact legfederal@entnet.org. Or, visit the Legislative and Political Affairs webpage at www.entnet.org/advocacy for access to the Academy’s position letters and/or additional resources pertaining to these issues.