,,ii #aafth ,,congress #ast ,session ,s4 #bddf ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,september #i1 #bjai ,ms4 ,warren 7for herself1 ,mr4 ,paul1 ,mr4 ,brown1 and ,mr4 ,wicker7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to provide certain coverage of audiologist services under the ,medicare program1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,medicare ,audiologist ,access and ,services ,act of #bjai4 #b4 ,findings ,congress finds the following3 7#a7 ,individuals with mild hearing loss are #c times more likely to experience a fall1 and falls are the leading cause of fatal injury for ,americans over #fe4 7#b7 ,seniors with hearing loss are more likely to develop cognitive problems and experience cognitive decline up to #dj percent faster than those without hearing loss4 7#c7 ,untreated hearing loss can lead to depression1 anxiety1 and social isolation4 7#d7 ,timely access to diagnosis and treatment for hearing and vestibular conditions can improve outcomes for beneficiaries and reduce overall cost of care4 7#e7 ,licensed audiologists in all #ej ,states and the ,district of ,columbia are health care professionals trained in the diagnosis1 treatment1 and rehabilitation of individuals with hearing1 balance1 and related disorders4 7#f7 ,the ,medicare program covers a range of hearing health services1 including diagnostic and therapeutic services4 ,however1 ,medicare will only reimburse audiologists for a narrow set of diagnostic services--even when ,medicare-covered treatment services are in the scope of practice of audiologists4 ,medicare also requires patients to receive a physician order before even receiving diagnostic services from audiologists in order for those services to be covered by ,medicare4 7#g7 ,the ,department of ,defense ,medical ,health ,system1 the ,veterans ,health ,administration1 the ,office of ,personnel ,management 7through many of its ,federal ,employees ,health ,benefits plans71 and many ,medicaid and private health plans provide patients direct access to audiologists and do not condition reimbursement on referral by a physician4 7#h7 ,the ,national ,academy of ,sciences1 ,engineering1 and ,medicine issued a report1 entitled 1,hearing ,health ,care for ,adults3 ,priorities for ,improving ,access and ,affordability1 which recommended that the ,centers for ,medicare ,medicaid ,services examine pathways for enhancing access to assessment for and delivery of auditory rehabilitation services through ,medicare1 including reimbursement to audiologists for these services4 7#i7 ,administrative requirements for referral1 plan of care1 consultation with the attending physician or other health care practitioner1 and oversight unnecessarily delay care and may increase costs4 7#aj7 ,medicare beneficiaries should have access to the same level of audiologic care as is available in the ,veterans ,administration1 under the ,federal ,employees ,health ,benefits ,program1 and under private insurance4 #c4 ,medicare coverage of audiologist services 7a7 ,in general ,section #ahfa7s7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7s77 is amended-- 7#a7 in paragraph 7#b7-- 7,a7 in subparagraph 7,a71 by inserting but excluding services furnished by a qualified audiologist before the semicolon2 7,b7 in subparagraph 7,,gg71 by striking and at the end2 7,c7 in subparagraph 7#b77;,,hh71 by striking the period at the end and inserting 2 and2 and 7,d7 by adding at the end the following new subparagraph3 7,,ii7 audiologist services 7as defined in subsection 7ll77#c774 2 and 7#b7 in paragraph 7#c71 by inserting 7including services supervised by a qualified audiologist but excluding services supervised by a qualified audiologist under the supervision of a physician or other health care practitioner7 before the semicolon4 7b7 ,improved access to audiologist services ,paragraph 7#c7 of section #ahfa7ll7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7ll77 is amended to read as follows3 7#c7 ,the term audiologist services means such diagnostic or treatment services furnished by a qualified audiologist which the qualified audiologist is legally authorized to perform under ,state law 7or the regulatory mechanism provided by ,state law71 as would otherwise be covered if furnished by a physician or as an incident to a physician's service1 without regard to any requirement that the individual receiving such audiologist services is under the care of 7or referred by7 a physician or other health care practitioner or that such services are furnished under the supervision of a physician or other health care practitioner4 4 7c7 ,payment under the physician fee schedule 7#a7 ,provision for payment under part ,b ,section #ahcb7;a77#b77;,b77iii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciek7a77#b77;,b77iii77 is amended by inserting audiologist services1 after qualified psychologist services14 7#b7 ,payment amount and coinsurance ,section #ahcc7;a77#a7 of such ,act 7#db ,u4,s4,c4 #aciel7a77#a77 is amended-- 7,a7 by striking and before 7,,cc72 and 7,b7 by inserting before the semicolon at the end the following3 2 and 7,,dd7 with respect to audiologist services furnished under section #ahfa7s77#b77;,,ii71 the amounts paid shall be #hj percent of the lesser of the actual charge for the services or the fee schedule amount provided under section #ahdh4 7#c7 ,payment on assignment-related basis ,section #ahdb7;b77#ah77;,c7 of such ,act 7#db ,u4,s4,c4 #acieu7b77#ah77;,c77 is amended by adding at the end the following new clause3 7vii7 ,an audiologist4 4 7#d7 ,payment under physician fee schedule ,section #ahdh7;j77#c7 of such ,act 7#db ,u4,s4,c4 #aciew-#d7;j77#c77 is amended by inserting 7#b77;,,ii71 before 7#c714 #d4 ,rule of construction ,nothing in the amendments made by this ,act shall be construed to expand the scope of audiologist services or services for which payment may be made to other providers under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 beyond those services for which such payment may be made as of ,december #ca1 #bjai4 #e4 ,effective date ,the amendments made by this ,act shall apply to items and services furnished on or after ,january #a1 #bjbj4