AUDIOLOGY ADVOCATE | Honing the Message in Advocacy: Member Engagement for Making Change

This article is a part of the July/August 2022, Volume 34, Number 4, Audiology Today issue. 

When the American Academy of Audiology came together with the American Speech-Language-Hearing Association (ASHA) and the Academy of Doctors of Audiology (ADA) to build the Medicare Audiologist Access and Services Act (H.R. 1587/S. 1731) in 2018, it was critical to craft legislation that would address all three of the main components of legislation that each organization had been pursuing. The goal was to modernize Medicare to allow direct access to audiologists by removing the physician referral requirement, reclassify audiologists as practitioners, and expand covered audiological services beyond diagnosis to treatment. These changes would give audiologists additional opportunities under Medicare and also help align audiologists with other doctoral-level health professionals. 

With only several months remaining in the legislative session, the clock is ticking to find a legislative vehicle to which to attach the provisions of H.R. 1587/S. 1731 or to advance the bill itself. Some comprehensive health-care bills are in development in lieu of the Build Back Better Act bill (H.R. 5376); however, at the time of writing of this article, the three organizations have not yet secured a firm commitment for the inclusion of any of the H.R. 1587/S. 1731 provisions. The H.R. 1587/S. 1731 legislative sponsors remain committed to the bill, and we are optimistic that these champions will help us prevail in garnering additional, bipartisan support for the components of the bill. Falling short of this aspiration will leave the three organizations in a position to decide next steps for H.R. 1587/S. 1731 in the new legislative session. The recent news that Representative David B. McKinley (R-WV), co-chair of the Congressional Hearing Health Caucus, lost his primary bid for re-election points to the prospect of new leadership in the House to carry the banner of hearing-health-care issues.

Advocating for the provisions of H.R. 1587/S. 1731 includes connecting them to the policy implications of other legislation and regulations. With the imminent release of final regulations for over-the-counter (OTC) hearing aids and the likelihood of a defined benefit for hearing aid coverage under Medicare sooner rather than never, the Academy is focused on highlighting to legislators, regulators, and payors the critical distinction between the devices and the audiology services needed for successful outcomes. We are helping them understand that a device is simply technology, and the audiologist is here to assist the consumer with that device and with many more services. 

Studies, such as that by Humes et al (2017), have looked at the direct-to-consumer delivery model and shown that many individuals still require assistance with both the use and the selection of devices. The rapport that the audiologist establishes with the consumer helps inform decision-making, and the audiologist can support individuals in the use of a device. The removal of barriers to access audiology services (e.g., direct access) and the proper classification of audiologists to support coverage of treatment services are necessary measures to maximize the benefit of the OTC legislation, as well as any forthcoming Medicare benefit for hearing aids. 

More than ever before, the audiology profession needs to be a collective force in driving home the message about the pivotal services of the audiologist in the evolving delivery of hearing-health services and related devices. 

We need to define the range of audiology services in clinical guidelines, practice protocols, and literature; we need to educate patients, policymakers, payers, and other health-care professionals on what audiologists do; and we need to be vigilant in seeking and creating opportunities to advocate for recognition of the services audiologists provide. The strategic priorities of the Academy include these activities, and the members can do their part too.