In a recently released report to Congress, the Centers for Medicare and Medicaid Services (CMS) has determined that the agency does not have the legal authority to make changes to Medicare regulations allowing for direct access to audiology services. CMS was required to conduct a study on the feasibility of a regulatory fix through conference report language related to the 2006 Labor, Health and Human Services, and Education and Related Agencies Appropriations Act (PL 109-149).
 
In the report, which can be accessed at www.asha.org/NR/rdonlyres/D1F8BAD4-4555-4BB4-98AA-A32609385B84/0/07AudiologistReport.pdf, CMS also expressed concern that, without a medical referral, it would be difficult for the agency to determine whether the audiology services were medically necessary to determine an underlying medical condition versus asymptomatic screening tests which are not covered by Medicare.

CMS stated, “Medicare has used the ordering requirement for diagnostic tests as the principal means to ensure that Medicare does not pay for medically unnecessary screening tests in contravention of the statute and regulations.”
 
The CMS determination now places the direct access issue directly in the hands of Congress. Medicare beneficiary access to audiologists remains a top priority for the American Speech-Language-Hearing Association. The association will review the findings in the CMS report and develop strategies to respond to CMS concerns.

Audiologists are urged to contact their members of Congress via ASHA’s Take Action site and request that they co-sponsor H.R. 1665, the Medicare Hearing Health Care Enhancement Act, at http://takeaction.asha.org/asha2/issues/alert/?alertid=10115636. For more information, please contact Deborah Darcy, ASHA’s director of grassroots advocacy, via e-mail at ddarcy@asha.org or by phone at 800-498-2071, ext. 4427.

Source: American Speech-Language-Hearing Association