[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1587 Introduced in House (IH)]
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117th CONGRESS
1st Session
H. R. 1587
To provide certain coverage of audiologist services under the Medicare
program, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 3, 2021
Mr. Rice of South Carolina (for himself, Mr. Cartwright, Mr. Kelly of
Pennsylvania, Mr. Young, Mr. Cole, Mr. Bilirakis, Mr. Rodney Davis of
Illinois, Ms. Underwood, Mr. Norman, Mr. Cohen, Mr. McKinley, Mr.
Fitzpatrick, Ms. Wild, Ms. McCollum, Mr. Butterfield, Mr.
Reschenthaler, Mr. Welch, Mr. Rutherford, Mr. Massie, Mr. Yarmuth, Ms.
Blunt Rochester, Mr. O'Halleran, Mrs. McBath, Mr. Neguse, Ms.
Schakowsky, and Mr. Foster) introduced the following bill; which was
referred to the Committee on Energy and Commerce, and in addition to
the Committee on Ways and Means, for a period to be subsequently
determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To provide certain coverage of audiologist services under the Medicare
program, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medicare Audiologist Access and
Services Act of 2021''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Individuals with mild hearing loss are 3 times more
likely to experience a fall, and falls are the leading cause of
fatal injury for Americans over 65.
(2) Seniors with hearing loss are more likely to develop
cognitive problems and experience cognitive decline up to 40
percent faster than those without hearing loss.
(3) Untreated hearing loss can lead to depression, anxiety,
and social isolation.
(4) Timely access to diagnosis and treatment for hearing
and vestibular conditions can improve outcomes for
beneficiaries and reduce overall cost of care.
(5) Licensed audiologists in all 50 States and the District
of Columbia are health care professionals that are trained in
the diagnosis, treatment and rehabilitation of individuals with
hearing, balance, and related disorders.
(6) The Medicare program covers a range of hearing health
services, including diagnostic and therapeutic services.
However, 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
audiologists. 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 the
Medicare program.
(7) The Department of Defense Medical Health System, the
Veterans Health Administration, the Office of Personnel
Management (through many of its Federal Employees Benefit
plans), and many Medicaid and private health plans provide
patients ``direct access'' to audiologists and do not condition
reimbursement on referral by a physician.
(8) The National Academy of Sciences, Engineering, and
Medicine issued a report, entitled ``Hearing Health Care for
Adults: Priorities for Improving Access and Affordability,''
which recommended that the Centers for Medicare and Medicaid
Services ``examine pathways for enhancing access to assessment
for and delivery of auditory rehabilitation services'' through
Medicare, ``including reimbursement to audiologists for these
services''.
(9) Administrative requirements for referral, plan of care,
consultation with the attending physician or other health care
practitioner, and oversight unnecessarily delay care and may
increase costs.
(10) Medicare beneficiaries should have access to the same
level of audiologic care as is available in the Veterans
Administration, under the Federal Employees Health Benefits
Program, and under private insurance.
SEC. 3. MEDICARE COVERAGE OF AUDIOLOGIST SERVICES.
(a) In General.--Section 1861(s) of the Social Security Act (42
U.S.C. 1395x(s)) is amended--
(1) in paragraph (2)--
(A) in subparagraph (A), by inserting ``but
excluding services furnished by a qualified
audiologist'' before the semicolon;
(B) in subparagraph (GG), by striking ``and'' at
the end;
(C) in subparagraph (HH), by striking the period at
the end and inserting ``; and''; and
(D) by adding at the end the following new
subparagraph:
``(II) audiologist services (as defined in
subsection (ll)(3)).''; and
(2) in paragraph (3), by inserting ``(including services
supervised by a qualified audiologist but excluding services
supervised by a qualified audiologist under the supervision of
a physician or other health care practitioner)'' before the
semicolon.
(b) Improved Access to Audiologist Services.--Paragraph (3) of
section 1861(ll) of the Social Security Act (42 U.S.C. 1395x(ll)) is
amended to read as follows:
``(3) 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
(or the regulatory mechanism provided by State law), as would otherwise
be covered if furnished by a physician or as an incident to a
physician's service, without regard to any requirement that the
individual receiving such audiologist services is under the care of (or
referred by) a physician or other health care practitioner or that such
services are furnished under the supervision of a physician or other
health care practitioner.''.
(c) Payment Under the Physician Fee Schedule.--
(1) Provision for payment under part B.--Section
1832(a)(2)(B)(iii) of the Social Security Act (42 U.S.C.
1395k(a)(2)(B)(iii)) is amended by inserting ``audiologist
services,'' after ``qualified psychologist services,''.
(2) Payment amount and coinsurance.--Section 1833(a)(1) of
such Act (42 U.S.C. 1395l(a)(1)) is amended--
(A) by striking ``and'' before (DD); and
(B) by inserting before the semicolon at the end
the following: ``, and (EE) with respect to audiologist
services furnished under section 1861(s)(2)(II), the
amounts paid shall be 80 percent of the lesser of the
actual charge for the services or the fee schedule
amount provided under section 1848''.
(3) Payment on assignment-related basis.--Section
1842(b)(18)(C) of such Act (42 U.S.C. 1395u(b)(18)(C)) is
amended by adding at the end the following new clause:
``(vii) An audiologist.''.
(4) Payment under physician fee schedule.--Section
1848(j)(3) of such Act (42 U.S.C. 1395w-4(j)(3)) is amended by
inserting ``(2)(II),'' before ``(3),''.
SEC. 4. RULE OF CONSTRUCTION.
Nothing in the amendments made by this Act shall be construed to
expand the scope of audiologist services or the services for which
payment may be made to other providers who may receive payment under
title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) beyond
those services for which such payment may be made as of December 31,
2021.
SEC. 5. EFFECTIVE DATE.
The amendments made by this Act shall apply to items and services
furnished on or after January 1, 2022.
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