Protecting Patient Safety and Preserving Physician-Led Care
The Academy battles legislative efforts expanding audiologists' scope into medical diagnosis and treatment.
Lance A. Manning, MD, AAO-HNS Coordinator for Advocacy
Maryland: Addressing Recent Legislative Changes
A top priority for the AAO-HNS was to amend a Maryland law that took effect in late 2024. The Maryland legislature enacted a measure (without the governor's signature) that inappropriately expanded the scope of practice for audiologists. The law changed the definition of audiology practice to include a broad range of services beyond those granted in other states. Concerning language added "evaluate, diagnose, manage, and treat" to the "practice of audiology;" language that traditionally falls within the practice of medicine. Additional practice privileges contained within the Maryland law that constitute an inappropriate scope of expansion include:
- Ordering of cultures and bloodwork testing, as it relates to the auditory or vestibular conditions
- Ordering and performing in-office, nonradiographic scanning or imaging of the auditory canal
- Ordering of radiographic imaging as it relates to the auditory or vestibular conditions
Maryland Governor Wes Moore formally requested that stakeholders, including the AAO-HNS, work with the legislature to refine the enacted language. The Maryland Medical Society (MedChi), in partnership with the Academy, received an advocacy grant from the American Medical Association (AMA) Scope of Practice Partnership to work on a legislative fix in this session.
During the 2025 Maryland legislative session, two bills—SB 919 and HB 1298—were introduced to amend the 2024 enacted audiology scope-of-practice law. Annette M. Pham, MD, AAO-HNS physician advocate and current Chair of the Otolaryngology Private Practice Section, testified on behalf of MedChi and the Maryland State Otolaryngology Society on the proposed changes. Despite negotiations, no agreement was reached, and both bills stalled in committee. Although the 2024 law remains in effect for now, the AAO-HNS will continue to work with MedChi to pursue the necessary changes needed to the law to protect patient safety and preserve physician-led care.
Progress in Arkansas and Oregon
Arkansas lawmakers recently considered SB 118, which was modeled after the Maryland legislation. Through our advocacy efforts, the AAO-HNS successfully amended the bill to temper its most problematic provisions.
Our team testified on behalf of AAO-HNS in opposition to SB 118, which proposed expanding the scope of practice for audiologists in my home state, including conducting health screenings, ordering cultures, blood testing, and more. The Academy also launched an action alert to our members in Arkansas, urging them to contact their state legislators to oppose this bill. These Academy-led efforts, along with a formal letter of opposition, successfully limited the scope expansion. Governor Sarah Huckabee Sanders signed the significantly amended SB 118 into law on April 10.
In Oregon, proposed legislation (SB 943) containing similar provisions to expand audiologists' scope of practice failed to move out of committee this session. The AAO-HNS submitted testimony, and the Oregon Medical Association testified in opposition.
Ongoing Vigilance Needed as Scope Crosses into More States
Similar measures affecting audiology scope are being considered in Louisiana and North Carolina. Colorado, Kansas, Kentucky, and Washington state are expected to introduce comparable legislation in the coming year.
Scope-of-practice concerns expand beyond audiology. Across the 50 states this year, the AAO-HNS is monitoring nearly 500 state regulatory and legislative proposals affecting medical scope-of-practice laws. The Academy works collaboratively with the AMA Scope of Practice Partnership, which includes 105 national, state, and specialty medical associations dedicated to safeguarding patient care quality by ensuring that care is led by highly trained physicians. This partnership provides valuable resources, including research, health workforce mapping, issue briefs, and advocacy webinars.
Beyond Scope of Practice: A Call to Action
The Academy's state advocacy efforts extend beyond fighting inappropriate scope expansion. Other key issues include burdensome surgical regulations, insurance denials, and medical liability laws affecting your practice and patients daily.
We cannot succeed alone—our advocacy is only as strong as our engaged membership, who not only stands behind it but participates in it. Whether you are already involved or considering participation, now is the critical time to join the State Tracker program. Your involvement is essential to defending our specialty, influencing policy, and upholding the highest standards of patient care.
Resources:
State Tracker program
The State-mENT is an at-a-glance, one-page resource outlining the Academy's state legislative activity from the previous month. Sign up as a State Tracker and become part of the discussion!
