Advocacy in action: An overview of federal and state legislative priorities

April 2019 – Vol. 38, No. 3

The American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) is committed to the enactment of legislation that will strengthen the delivery of, and access to, quality healthcare. In 2019, the AAO-HNS anticipates action on the following issues at the federal and state levels:

Scope of practice/patient safety

The AAO-HNS believes a physician-led hearing healthcare team, with coordination of services, is the best approach for providing the highest quality care to patients. The AAO-HNS strongly opposes legislation that would inappropriately expand the scope of practice of nonphysician providers, particularly proposals that would permit non-physicians to “diagnose,” provide audiologists with unlimited “direct access” to Medicare patients without a physician referral, and/or inappropriately include audiologists in Medicare’s definition of “physician.”

Interstate licensure compacts

Interstate compacts are contractual agreements between two or more states often used to standardize professional licensure among an increasingly mobile workforce. However, the AAO-HNS strongly objects to the use of such compacts to inappropriately expand a profession’s scope of practice and/or to extend the governing commission’s rule-making authority over existing laws and regulations.

Truth in advertising

Patients are often confused about the training and education of their healthcare providers when making healthcare decisions. Providers’ credentials, licenses, and training should be accurately portrayed in all advertisements and patient interactions. As part of a coalition effort, the AAO-HNS works with other physician organizations to advocate for increased transparency in the delivery of healthcare.

Hearing aid services

The coverage of, sale, and dispensing of hearing aids is an issue considered by many states in various forms each legislative year. The AAO-HNS, in collaboration with our physician state trackers, works to ensure the inclusion of otolaryngologists in the diagnosis/treatment of hearing loss and the dispensing of hearing aids.

Infant newborn screening for cytomegalovirus (CMV)

An estimated one in every 200 babies is born with CMV, a congenital viral infection that has been associated with sensorineural hearing loss. Early identification of CMV-related hearing loss is crucial to the long-term developmental success of speech, cognitive, and psycho-social abilities in children. The AAO-HNS supports screening and prevention efforts to educate pregnant women and their families regarding this common, yet preventable, viral infection.

Maintenance of certification

Maintenance of certification (MOC) requirements for physicians are under increased scrutiny from policymakers and the medical community. The process required for recertification has become time consuming, expensive, and not directly relevant to patient care. The AAO-HNS believes professional self-regulation through continuous learning and assessment must fit within the normal flow of a physician’s practice, be available at a reasonable expense, improve patient care, and not undermine existing specialty-board authority. As such, the AAO-HNS is supportive of legislation that opposes the use of MOC requirements for the purposes of hospital privileging, licensing, and payer participation and reimbursement.

Tobacco control efforts

As part of the PARTNERS coalition’s public health campaign, the AAO-HNS advances legislation and regulations that will help reduce the use of tobacco products (including e-cigarettes) and exposure to secondhand smoke in order to promote healthy environments and lifestyles for the public. The AAO-HNS tracks legislation that seeks to strengthen or weaken smoking ban laws, limits access to tobacco products and other nicotine-delivery devices, particularly by youth, as well as proposals to mandate insurance coverage and/or benefits for tobacco cessation.

Medical liability reform

Each year, lawmakers consider various tort reform measures, including those related to affidavits of merit, alternative reforms, caps on non-economic damages, defensive medicine issues, expert witnesses, health courts, and/or pre-trial screening panels. The AAO-HNS strongly supports comprehensive medical liability reforms to stabilize and reduce professional liability premiums, ensure continued access to care by patients, and eliminate frivolous lawsuits.

For more information on the Academy’s legislative priorities, contact the Advocacy team at