Washington, D.C.: The Centers for Medicare and Medicare (CMS) published its final rule to expand cochlear implant (CI) coverage for older adults who are Medicare beneficiaries on September 26. Hearing loss has been in the news with the rollout of Over-the-Counter hearing aids for individuals with mild or moderate hearing loss. This decision provides a significant improvement in access to care for older adults with profound hearing loss who are Medicare beneficiaries.
This important outcome was the result of a National Coverage Determination (NCD) process that was initiated by the newly organized ACI Alliance in 2013 with a multi-center study to explore and document CI outcomes in older adults who had more residual hearing than was allowed for Medicare coverage. This decision is effective immediately and brings Medicare CI criteria more in line with those of the FDA. Principal investigators Terry Zwolan PhD, Craig Buchman MD, and John Niparko MD led the multi-center study effort. Undertreated hearing loss in adults is associated with greater risk for other health issues including cognitive decline.
The final rule noted:
We have concluded that the evidence is sufficient to determine that cochlear implantation may be covered for treatment of bilateral pre- or post-linguistic, sensorineural, moderate-to profound hearing loss in individuals who demonstrate limited benefit from amplification.
Drs. Zwolan and Buchman expressed gratitude to the CI clinicians and patients who participated in the study effort as well as CMS officials involved in the NCD process as they sought to balance care in provision of the CI intervention for older adults with documented outcomes in communication and overall quality of life.
*Find additional background at www.acialliance.org/page/MedicareExpansion.
ACI Alliance is a not-for-profit membership organization created with the purpose of eliminating barriers to cochlear implantation by sponsoring research, driving heightened awareness, and advocating for improved access to cochlear implants for patients of all ages across the US.
