,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #bddf  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #i1 #bjai    
,ms4 ,w>r5 7= h]self1 ,mr4 ,paul1 ,mr4  
,br[n1 & ,mr4 ,wick]7 introduc$ ! foll[+
 bill2 :i* 0 read twice & ref]r$ to !   
,committee on ,f9ance  ,a ,,bill  ,to   
provide c]ta9 cov]age ( audiologi/      
s]vices "u ! ,m$ic>e program1 & = o!r   
purposes4  #a4 ,%ort title  ,?is ,act   
may be cit$ z ! ,m$ic>e ,audiologi/     
,access & ,s]vices ,act ( #bjai4  #b4   
,f9d+s ,congress f9ds ! foll[+3 7#a7    
,individuals ) mild he>+ loss are #c    
times m likely to exp]i5ce a fall1 &    
falls are ! lead+ cause ( fatal injury =
 ,am]icans ov] #fe4  7#b7 ,s5iors ) he>+
 loss are m likely to develop cognitive 
problems & exp]i5ce cognitive decl9e up 
to #dj p]c5t fa/] ?an ^? )\t he>+ loss4 
7#c7 ,untreat$ he>+ loss c lead to      
depression1 anxiety1 & social isolation4
  7#d7 ,timely access to diagnosis &    
treatm5t = he>+ & ve/ibul> conditions c 
improve outcomes = b5efici>ies & r$uce  

ov]all co/ ( c>e4  7#e7 ,lic5s$         
audiologi/s 9 all #ej ,/ates & !        
,di/rict ( ,columbia are heal? c>e      
pr(essionals tra9$ 9 ! diagnosis1       
treatm5t1 & rehabilitation ( individuals
 ) he>+1 balance1 & relat$ disord]s4    
7#f7 ,! ,m$ic>e program cov]s a range ( 
he>+ heal? s]vices1 includ+ diagno/ic & 
!rapeutic s]vices4 ,h[ev]1 ,m$ic>e w    
only reimburse audiologi/s = a n>r[ set 
( diagno/ic s]vices--ev5 :5             
,m$ic>e-cov]$ treatm5t s]vices are 9 !  
scope ( practice ( audiologi/s4 ,m$ic>e 
also requires pati5ts to receive a      
physician ord] be=e ev5 receiv+         
diagno/ic s]vices f audiologi/s 9 ord] =
 ^? s]vices to be cov]$ by ,m$ic>e4     
7#g7 ,! ,dep>tm5t ( ,def5se ,m$ical     
,heal? ,sy/em1 ! ,vet]ans ,heal?        
,adm9i/ration1 ! ,(fice ( ,p]sonnel     
,managem5t 7?r\gh _m ( its ,f$]al       
,employees ,heal? ,b5efits plans71 & _m 
,m$icaid & private heal? plans provide  
pati5ts direct access to audiologi/s & d
 n condition reimbursem5t on ref]ral by 

a physician4  7#h7 ,! ,national ,academy
 ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e issu$ a
 report1 entitl$ 1,he>+ ,heal? ,c>e =   
,adults3 ,priorities = ,improv+ ,access 
& ,af=dability1 :i* recomm5d$ t ! ,c5t]s
 = ,m$ic>e  ,m$icaid ,s]vices exam9e    
pa?ways = enhanc+ access to assessm5t = 
& deliv]y ( auditory rehabilitation     
s]vices ?r\gh ,m$ic>e1 includ+          
reimbursem5t to audiologi/s = ^!        
s]vices4  7#i7 ,adm9i/rative requirem5ts
 = ref]ral1 plan ( c>e1 consultation ) !
 att5d+ physician or o!r heal? c>e      
practition]1 & ov]sight unnecess>ily    
delay c>e & may increase co/s4  7#aj7   
,m$ic>e b5efici>ies %\ld h access to !  
same level ( audiologic c>e z is        
available 9 ! ,vet]ans ,adm9i/ration1 "u
 ! ,f$]al ,employees ,heal? ,b5efits    
,program1 & "u private insurance4  #c4  
,m$ic>e cov]age ( audiologi/ s]vices    
7a7 ,9 g5]al ,section #ahfa7s7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7s77 is am5d$-- 7#a7 9 p>agraph   
7#b7--  7,a7 9 subp>agraph 7,a71 by     

ins]t+ b exclud+ s]vices furni%$ by a   
qualifi$ audiologi/ be=e ! semicolon2   
7,b7 9 subp>agraph 7,,gg71 by /rik+ & at
 ! end2  7,c7 9 subp>agraph 7#b77;,,hh71
 by /rik+ ! p]iod at ! end & ins]t+ 2 &2
 &  7,d7 by add+ at ! end ! foll[+ new  
subp>agraph3  7,,ii7 audiologi/ s]vices 
7z def9$ 9 subsection 7ll77#c774  2 &   
7#b7 9 p>agraph 7#c71 by ins]t+ 7includ+
 s]vices sup]vis$ by a qualifi$         
audiologi/ b exclud+ s]vices sup]vis$ by
 a qualifi$ audiologi/ "u ! sup]vision (
 a physician or o!r heal? c>e           
practition]7 be=e ! semicolon4  7b7     
,improv$ access to audiologi/ s]vices   
,p>agraph 7#c7 ( section #ahfa7ll7 ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7ll77 is am5d$ to read z foll[s3  
7#c7 ,! t]m audiologi/ s]vices means su*
 diagno/ic or treatm5t s]vices furni%$  
by a qualifi$ audiologi/ :i* ! qualifi$ 
audiologi/ is legally au?oriz$ to p]=m  
"u ,/ate law 7or ! regulatory me*anism  
provid$ by ,/ate law71 z w\ld o!rwise be
 cov]$ if furni%$ by a physician or z an

 incid5t to a physician's s]vice1 )\t   
reg>d to any requirem5t t ! individual  
receiv+ su* audiologi/ s]vices is "u !  
c>e ( 7or ref]r$ by7 a physician or o!r 
heal? c>e practition] or t su* s]vices  
are furni%$ "u ! sup]vision ( a         
physician or o!r heal? c>e practition]4 
4  7c7 ,paym5t "u ! physician fee s*$ule
  7#a7 ,provision = paym5t "u "p ,b     
,section #ahcb7;a77#b77;,b77iii7 ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#aciek7a77#b77;,b77iii77 is am5d$ by    
ins]t+ audiologi/ s]vices1 aft] qualifi$
 psy*ologi/ s]vices14  7#b7 ,paym5t     
am\nt & co9surance ,section             
#ahcc7;a77#a7 ( su* ,act 7#db ,u4,s4,c4 
#aciel7a77#a77 is am5d$-- 7,a7 by /rik+ 
& be=e 7,,cc72 &  7,b7 by ins]t+ be=e ! 
semicolon at ! end ! foll[+3 2 & 7,,dd7 
) respect to audiologi/ s]vices furni%$ 
"u section #ahfa7s77#b77;,,ii71 ! am\nts
 paid %all be #hj p]c5t ( ! less] ( !   
actual *>ge = ! s]vices or ! fee s*$ule 
am\nt provid$ "u section #ahdh4  7#c7   
,paym5t on assignm5t-relat$ basis       

,section #ahdb7;b77#ah77;,c7 ( su* ,act 
7#db ,u4,s4,c4 #acieu7b77#ah77;,c77 is  
am5d$ by add+ at ! end ! foll[+ new     
clause3  7vii7 ,an audiologi/4  4  7#d7 
,paym5t "u physician fee s*$ule ,section
 #ahdh7;j77#c7 ( su* ,act 7#db ,u4,s4,c4
 #aciew-#d7;j77#c77 is am5d$ by ins]t+  
7#b77;,,ii71 be=e 7#c714  #d4 ,rule (   
con/ruction ,no?+ 9 ! am5dm5ts made by  
?is ,act %all be con/ru$ to exp& ! scope
 ( audiologi/ s]vices or s]vices = :i*  
paym5t may be made to o!r provid]s "u   
title ,,xviii ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie et seq47 beyond ^?
 s]vices = :i* su* paym5t may be made z 
( ,decemb] #ca1 #bjai4  #e4 ,effective  
date ,! am5dm5ts made by ?is ,act %all  
apply to items & s]vices furni%$ on or  
aft] ,janu>y #a1 #bjbj4