Legislation in Action

Current Legislative/Regulatory Activity

Contact your Representatives to Increase Access to Audiologists' Services

Audiology, Healthcare, Private Practice/Non-Profit Practice Areas

On July 25, Rep. Tom Rice (R-SC) and Rep. Matt Cartwright (D-PA), along with nine other members of Congress, introduced the bipartisan Medicare Audiologist Access and Services Act of 2019 (H.R. 4056). The bill will expand coverage to include all Medicare covered diagnostic and treatment services that correspond to audiology’s scope of practice; remove the unnecessary physician referral in order for Medicare beneficiaries to access audiology services; and reclassify audiologists from “supplier” to “practitioner” to better recognize the role audiologists play in providing hearing health care services. ASHA expects an identical bill in the Senate to be introduced in early September.

Contact your members of Congress today and ask them to cosponsor the Medicare Audiologist Access and Services Act of 2019 (H.R. 4056).


Joint Habilitation/Rehabilitation Benefit Coverage Statement & Guide Made Available by ASHA

All Practice Areas

The American Speech-Language-Hearing Association (ASHA), American Occupational Therapy Association and American Physical Therapy Association has a new resource for public and private insurers, employers, consumers, state regulators and other stakeholders to evaluate the appropriateness of rehabilitation and habilitation benefit design. The document Joint Habilitation/Rehabilitation Benefit Coverage Statement: Guide to Assessing Adequacy of Benefits outlines the principles that should be evaluated when determining whether an insurance product provides adequate coverage of habilitation and rehabilitation services and devices. Rehabilitation and habilitation address function, communication, participation, mobility, and engagement limitations that result from illness, injury, disability, or other conditions. Habilitation and rehabilitation benefits are cost effective, representing only 2% of the premium for a silver marketplace plan.

ASHA also has a guide entitled Speech, Language, and Hearing Services: Essential Coverage of Habilitation and Rehabilitation. The guide discusses steps that Ohio can take to protect individuals needing medically necessary habilitative and rehabilitative services and devices.

If you have any questions or would like to further discuss the importance of habilitation and rehabilitation coverage, please do not hesitate to contact Susan Adams (ASHA’s Director of State Legislative & Regulatory Affairs) at 301-296-5665, sadams@asha.org or Daneen Sekoni, ASHA’s Director of Health Care Policy, Health Care Reform at 301-296-5651, dsekoni@asha.org


The Dept. of Medicaid Puts Out a Request for Information to Gather Public Input

Healthcare Practice Area

The Ohio Department of Medicaid (ODM) has released a request for information (RFI) to gather public input as it begins the process to select managed care partners. ODM’s first step in the process is collecting feedback on current Medicaid services, what is working and ideas for improvement. The mission in this process is to focus on the individual rather than on the business of managed care, and this request seeks information specifically from individuals receiving Medicaid services, providers and advocates.

Feedback is being sought in multiple areas, including:

  • How managed care organizations communicate and support individuals and providers
  • What benefits and services are most helpful
  • How to best coordinate individual care
  • How to file complaints and appeal managed care organization decisions

Submit feedback through the RFI webpage.

Error Identified in the Recently Published NCCI (National Correct Coding Initiative) Manual

All Practice Areas
An error was identified in the 2019 NCCI (National Correct Coding Initiative) manual. This manual updates the lists all the billing codes each new year. In the 2019 manual, it states that GO515, the new cognitive billing code, is NOT valid for use by speech-language pathologists!!! THIS IS WRONG!!
ASHA met with leaders responsible for this manual. They acknowledged the error and further acknowledged that speech-language pathologists can, indeed, treat cognition. They also said that the manual cannot be corrected until they do the 2020 edition.
If you get a denial for using GO515, there is a letter that was written by CMS (Centers for Medicare and Medicaid Services) that can be submitted with your appeals to help overturn the denial. The letter is available at the following link:

Changes to Medicare Physician Fee Schedule

 All Practice Areas

The Centers for Medicare & Medicaid Services (CMS) reversed course in their 2019 Medicare Physician Fee Schedule Final Rule [PDF] and included audiologists and speech-language pathologists as eligible professionals for the Merit-Based Incentive Payment System (MIPS). The program, which is effective January 1, 2019, requires eligible clinicians to report quality and improvement activity data to CMS that will be used to positively and negatively adjust Medicare payments. ASHA expects MIPS reporting to apply to less than 1% of ASHA members because of low volume thresholds and site of service exclusions. However, inclusion in the program has significant implications for those that must report and for the professions moving forward. To learn more, visit ASHA’s website.

ASHA Develops a New Advocacy Tool for Protecting Therapy Coverage Under the ACA

 Healthcare, Schools, Audiology, Telehealth, DD, Private Practice, CLD Practice Areas

Recent changes by the federal government give states more leeway to determine what services are covered or excluded in ACA health plans. Speech, Language, and Hearing Services: Essential Coverage of Habilitation and Rehabilitation is a tool developed by ASHA for ASHA-recognized state associations and Habilitation Advocates to use when speaking with exchange officials, insurance commissioners, and state legislators about the value of audiology and speech-language pathology services as an essential health benefit. We encourage you to use this tool as an educational resource!

Interstate Compact Update

 All Practice Areas

ASHA participated in a meeting with staff from the U.S. Department of Defense-State Liaison Office (DSLO) to discuss how interstate compacts will address the needs of service members and military families. DSLO staff discussed their historical involvement in promoting expedited licensure for military spouses and shared their interest in interstate compacts. Representatives from current health interstate compacts and those in development, including representatives from ASHA, discussed ways to work with the state liaison office to promote compacts. Learn more about the speech-language-hearing interstate compact.

CMS Issues Guidance Regarding Medicare Therapy Service (Post Therapy Cap)

Healthcare Practice Area

Read the ASHA Headline on This Topic

ASHA Releases Position Statements on Facilitated Communication (FC) & Rapid Prompting Method (RPM)

CMS Proposes Overhaul to the Home Health Prospective Payment System in 2020

Healthcare, Telehealth, Private Practice Practice Areas

 Learn More about this proposal

FDA Approves Telepractice Option for Cochlear Implants

Audiology, Telehealth, Healthcare, DD, Private Practice Practice Areas

Read the FDA News Release

Medicaid and CHIP Payment & Access Commission (MACPAC) Publishes Update on Current Status of School-Based Services

 Schools, Supervision Practice Areas

Read More on This Topic

Reimbursement for Transgender Voice Therapy Services

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