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The State of the Academy--An Advocacy Update
As part of our commitment to ensure ongoing communication and transparency for Academy members regarding the Academy's advocacy agenda, I would like to take the opportunity to provide an update on legislative initiatives that stand to impact our profession. I would also encourage all members to review the numerous materials the Academy has published regarding our legislative agenda, available on the Academy's Web site.
With regard to H.R. 2330 (the ASHA comprehensive Medicare audiology bill), the Academy believes ASHA's legislative approach in this initiative is counter-productive to attaining a collective goal—increased professional autonomy. The Academy has been working to achieve direct access to audiology services for Medicare beneficiaries for 10 years. Ultimately, our aim is to achieve recognition and reimbursement for audiology's full scope of practice without increasing physician oversight, but it is our belief that any such effort must be preceded by increased autonomy. Stated differently, we must first increase our autonomy so that when we do achieve coverage for our full scope of practice, audiologists will enjoy not only full recognition of all services we are trained to provide, but also the ability to evaluate and manage these patients without physician oversight. We are disappointed that ASHA moved forward with their legislation without any attempt to collaborate with the Academy. The Academy was last approached by ASHA about this initiative in 2010. The draft legislation that was presented to us at that time included a direct access component as well as a Medicare opt-out provision. The current comprehensive benefit bill, introduced in June 2013, bears little resemblance to the proposal previously shared with us. The content of H.R. 2330, which reinforces the physician order requirement under Medicare and increases physician oversight of audiologists, is of great concern to the Academy and has drawn strong public opposition from audiologists.
The Academy continues to advocate for direct access to audiologists for Medicare beneficiaries. We believe this is the most important "first step" toward ensuring quality hearing and balance care for all stakeholders and reducing costs to the health-care system while concurrently increasing professional autonomy for audiologists. Academy leadership understands the concerns that direct access has not yet been achieved, but we would reiterate that the legislative process for this type of change is typically a lengthy one. Thousands of bills are introduced each Congress and very few are passed; other pieces of legislation, such as the hearing aid tax credit bill, have been in progress longer than direct access. Two actions that will increase the chance of success for any bill are: (1) maintaining a consistent presence for the legislation on Capitol Hill and (2) constituent support for the bill. To abandon an initiative because it has not yet passed sends a message to our allies in Congress that we are not committed to the policy and might jeopardize the future of the initiative or any other audiology-focused legislation.
Academy and SAA leadership, as well as Academy staff and consultants have met with over 100 congressional offices since the beginning of the 113th Congress. Based on our discussions with these offices, we do not view physician opposition to direct access as insurmountable. We do, however, face significant challenges. First, the division within the profession, evidenced by significantly different "asks" to lawmakers, is creating much confusion and, second, congressional offices are not hearing from sufficient numbers of audiologists. The Academy leadership and staff are making every effort to educate congressional staff about the profession of audiology and current initiatives. Every Academy member can assist in this endeavor and contribute to the success of direct access by sending an e-mail through the Academy's Legislative Action Center and voicing your support. I would encourage you to edit the form letter provided to describe how direct access would positively impact you and your patients specifically. Rest assured that other provider groups are making these contacts. It is time for audiology's voice to be heard, and who can speak more effectively than members of the largest organization solely of, by, and for audiologists?
We will continue to do everything possible to ensure transparency to our members regarding the Academy's advocacy decision-making process, and to communicate accurate information regarding all initiatives that may impact audiology.