President's Message: We Have Friends in High Places Talking About the Importance of Audiologists

Author: Victor Bray, MSC, Ph.D., FNAP

In parallel with the transition to the Au.D. degree, audiology organizations have, for over two decades, been regularly introducing legislation that would allow our new doctoring profession to play a greater role in the nation’s hearing healthcare. Frankly, for two decades, no advancements have been made. With the recent unification of ADA, AAA, and ASHA behind the Medicare Audiologist Access and Services Act (MAASA), the possibility is real that positive change can happen, in 2021, for audiology and the patients we serve.

While it may seem incredulous to you (and certainly is to me), there are still thousands of our colleagues who do not know about MAASA, know why MAASA is important, and know what MAASA means to the Au.D. movement. It is important that you share with all your colleagues and patients the important provisions in MAASA and obtain their buy-in and support. One way to describe MAASA is from this recent Senate testimony which lays out the big picture:

Senator Elizabeth Warren: “Audiologists provide critical services to people with hearing loss. That’s why I am joining Senator Paul and Senator Grassley in reintroducing the Medicare Audiologist Access and Services Act [S. 1731]. This is a bill that would expand senior’s access to hearing services by reclassifying audiologists as practitioners in the Medicare program and that will allow them to bill for services without a physician referral and to provide patients with both the kind of diagnostic and treatment services that are within an audiologist’s scope of practice. It seems to me that the COVID-19 pandemic has forced us all to reconsider bureaucratic limitations to health care, including hearing care. So, I believe the Senate should prioritize the passage of our bill to help seniors get the care that they need.”

Of the three components to MAASA – direct access, treatment services, and practitioner status – two are focused on today’s Medicare Part B beneficiaries (direct access and treatment services) and one is aimed at the future of our profession (practitioner status). ‘Practitioner status,’ as opposed to ‘diagnostic, other, supplier status’, advances the professional recognition, rights, and responsibilities commensurate with a doctoring healthcare profession. For example, with practitioner status comes the ability to be reimbursed for telehealth services, something we have been granted on a temporary basis during the COVID-19 public health emergency (but will end with the expiration of the national public health emergency order). The importance of telehealth, and direct access, to hearing healthcare patients in rural populations was addressed in this recent House testimony:

Congressman Tom Rice: “I’ve got three very rural counties with majority-minority populations that are very much underserved in terms of healthcare facilities and telehealth has been a very big boon to them, particularly in a time of COVID.” …  “I have a bill up [H.R. 1587] that would allow people to have direct access to audiologists because, again, I’ve got very rural populations that are very much underserved by primary care physicians and the requirement that they have to go to get a referral is very onerous to them.”

MAASA is not the only federal legislation currently in play that is of importance to audiologists and their patients. The proposed budget reconciliation bill being considered by Congress, if enacted, would authorize Medicare to provide hearing aids to beneficiaries with severe-to-profound hearing losses. This, coupled with the coming implementation of the OTC Hearing Aid Act for persons with perceived mild-to-moderate loss, would dramatically change device-delivery models and accentuate the need for our professional services. The need for these services, and needed legislative change for coverage by Medicare of our services, was addressed in this recent STAT First Opinion podcast: 

Physician Frank Lin: “To this day, audiologists can be reimbursed for doing testing, but sadly enough, they are not covered to provide any treatment services around hearing loss. It seems like a pretty bitter paradox, a bitter pill to swallow, that you can see an audiologist to be told you have a hearing loss but yet to do nothing about it.” … “Audiologists get paid to do your hearing test and that’s it; not to even teach you about hearing, tell you what it means, how it can impact you, how to communicate better, anything about a hearing aid. Zip, zero, none.” … “[With regard to new OTC hearing aids and possible inclusion of hearing aids in Medicare] Medicare would begin covering hearing care services for anybody with hearing loss, so basically the services of an audiologist to educate [the patient], to provide counseling, to say possibly what kind of devices would you need, where are you struggling with communication help, to provide unbiased guidance from audiologists.”

Over the next one hundred days in the fall legislative session, the future of audiology may be transformed, or potential advancement once again may be stalled. Now, more than ever, all of us must take action to see that the three MAASA provisions of direct access, recognition for treatment services, and achievement of practitioner status, pass through Congress and are signed into legislation.

Act now! This call to action is about you, your colleagues, your patients, your friends, your family, and all who care about the future of audiology and hearing healthcare. Go to chooseaudiology.org, select Congressional Connect, select the Legislative Issue MAASA, choose the appropriate Letter Template (Audiologist Urges Support …, Audiology Student Urges Support …, Citizen Urges Support …, or Medicare Patient Urges Enactment), identify your Legislators, and send your Letters of Support now for MAASA, the Au.D. movement, and your profession. Seize the unique opportunity we have today and act in advocacy for your future!    

References
Congressional testimony, Senate Finance Committee, 19 May 2021.
Congressional testimony, House Ways and Means Committee, 08 June 2021.
STAT First Opinion Podcast, Episode 28: An ENT physician and patient on the high cost of hearing loss. 18 August 2021.