July 19, 2023

Senators Warren, Paul, Grassley Renew Push for the Medicare Audiology Access Improvement Act

Legislation would Expand Seniors' Access to Hearing Services by Reclassifying Audiologists as Practitioners in the Medicare program

Bill Text (PDF)

Washington, D.C. – United States Senators Elizabeth Warren (D-Mass), Rand Paul (R-Ky.), and Chuck Grassley (R-Iowa) led their colleagues in introducing the bipartisan Medicare Audiology Access Improvement Act, legislation to ensure that seniors and people with disabilities on Medicare are able to access a full range of hearing and balance health care services provided by licensed audiologists, who are trained and licensed in all 50 states and U.S. territories, including the District of Columbia. The legislation is co-sponsored by Senators Jeanne Shaheen (D-N.H.), Sherrod Brown (D-Ohio), Kyrsten Sinema (I-Ariz.), Roger Wicker (R-Miss.), Peter Welch (D-Vt.), and Angus King (I-Maine).

Hearing loss affects over 48 million Americans and particularly affects older Americans, with nearly one in three people between the ages of 65 and 75 and around half of adults 75 or older reporting difficulty hearing. Americans with hearing loss are at a greater risk of developing Alzheimer’s Disease and Alzheimer’s Disease Related Dementias, and they are also more likely to experience feelings of loneliness and isolation. A report issued earlier this year by Surgeon General Vivek Murthy raised the alarm about an epidemic of loneliness and social isolation and found that chronic loneliness and social isolation increases dementia risk in older adults by 50%. Though Medicare already covers a range of hearing health services, Medicare currently does not recognize audiologists as providers and will only allow reimbursement for a narrow set of tests to diagnose a hearing or balance disorder – and only if patients first obtain an order from a physician or nurse practitioner. 

“Outdated Medicare rules make it difficult for seniors with hearing loss to gain access to the critical services audiologists provide,” said Senator Elizabeth Warren. “I’m glad to be partnering with my colleagues in the Senate to reduce barriers to care and ensure that older Americans and people with disabilities have access to the full range of care they need.” 

“Our legislation gets government out of the decision-making process so Americans can seek treatment from audiologists more quickly, easily, and affordably,” said Senator Rand Paul. “It proves Congress can come together across the aisle to find solutions to improve our health care system.” 

“I’m proud to have improved access to high-quality and affordable hearing aids by shepherding the Over-the-Counter Hearing Aids Act through Congress in 2017 and holding the U.S. Food & Drug Administration accountable to implement the law,” said Senator Chuck Grassley. “I’ve seen firsthand the importance of accessing audiology services, which is why I’m glad to support this bill to make it easier for seniors to get help from an audiologist.”

“For Americans experiencing hearing loss, the pathway to seeking treatment is often blocked with unnecessary bureaucratic hurdles. We need to cut this red tape and expand Medicare coverage so providers like audiologists can finally extend their services to the millions of Americans who need it,” said Senator Jeanne Shaheen. “I’m helping to reintroduce this commonsense, bipartisan legislation to expand Medicare coverage for hearing loss and ensure seniors and patients with disabilities have access to a full range of hearing and balance health care services provided by licensed audiologists.” 

“Ohioans shouldn’t have to jump hurdles to access the quality healthcare they need,” said Senator Sherrod Brown. “This legislation removes outdated barriers and makes it easier for older Americans and people with disabilities to get the audiology care they need for early diagnoses, prevention and treatment for balance conditions and hearing loss.”

“Hearing loss can be an incredibly isolating condition that can affect a patient’s emotional, physical, and social well-being, yet many people that would qualify for hearing aids or implants simply cannot access the necessary care they can receive from audiologists,” said Senator Angus King. “Nearly 17% of Maine people have some sort of hearing loss and many veterans experience hearing problems as well—in fact, it’s the number one disability for veterans nationwide. The bipartisan Medicare Audiology Access Improvement Act will remove unnecessary bureaucratic hurdles so that Medicare beneficiaries experiencing hearing loss or balance changes can access expedited treatment by specialized medical professionals. I want to thank all of my colleagues for putting partisan differences aside to make policy that will improve the well-being of Americans all over the country.”

The Medicare Audiology Access Improvement Act is supported by the American Academy of Audiology, Academy of Doctors of Audiology, American Speech-Language-Hearing Association, and National Association of Rural Health Clinics.

“Advancing this legislation is necessary to remove outdated barriers that prevent older Americans from receiving the hearing health and balance care coverage that they need and deserve,” explains American Academy of Audiology President, Virginia Ramachandran, AuD, PhD.  “Treating hearing loss and balance disorders improves an individual’s ability to communicate and connect with loved ones, decreases risk for falls, and results in a greater overall quality of life.  Passage of this cost-effective legislation will give patients timely access to the services critical to accurate diagnosis and appropriate treatment.”

“The Medicare Audiology Access Improvement Act will bring Medicare policies into alignment with evidence-based practices in the delivery of hearing and balance care,” said Dawn Heiman, Au.D., ADA President. “We applaud Senator Warren, Senator Paul, and Senator Grassley for leading Congressional efforts to optimize outcomes for beneficiaries and the Medicare system.”

“The American Speech-Language-Hearing Association thanks Senators Warren, Paul, and Grassley for reintroducing this critical legislation, which will give seniors more timely and robust access to hearing and balance care provided by audiologists,” said 2023 ASHA President Robert Augustine, PhD, CCC-SLP. “Audiologists are best positioned to assess and treat hearing-related problems that can lead to loneliness, social isolation, depression, dementia, and cognitive decline—which diminish quality of life and impose significant costs on older Americans, further straining Medicare’s financial stability. ASHA looks forward to continued collaboration with these leaders and our allied partners to enact this bill as soon as possible and remove the unnecessary bureaucratic barriers that prevent seniors from getting the hearing and balance care they need, when they need it.”

Specifically, the Medicare Audiology Access Improvement Act:

  • Amends the definition of “audiology services” in the Medicare statute, which specifies the services that audiologists may provide, to include all services already covered by Medicare that are also within an audiologist's scope of practice;
  • Amends the Medicare definition of practitioner to include audiologists, which improves beneficiary access to audiologic and vestibular care, a change that is consistent with Medicare's classification of similar health care providers such as clinical social workers and clinical psychologists;
  • Makes technical changes to remove the pre-treatment order requirement, which does not exist with any other federal or commercial payer; 
  • Ensures seniors and people with disabilities can receive the full scope of audiology services covered by Medicare at Rural Health Centers and Federally Qualified Health Centers; and
  • Makes no changes to the scope of hearing health benefits covered by Medicare or the scope of practice of audiologists.