(ROCKVILLE, MD- April 2003) The Center for Medicare and Medicaid Services (CMS) published a proposal rulemaking in today's Federal Register that mirrors policies advocated by the American Speech-Language-Hearing Association (ASHA) over the past year. ASHA worked with CMS to ensure that any changes in the qualifications for audiologists under Medicaid will not diminish the quality of hearing services provided to Medicaid recipients and that audiology services be provided or appropriately supervised by audiologists. The goal for CMS in revising the regulations was to develop standards that conformed with Medicare's qualifications while reflecting industry standards and holding individuals to specific standards in settings such as schools.
"For over 50 years, the Certificate of Clinical Competencies in Audiology (CCC-A) has been widely recognized as the industry standard developed by audiologists for audiologists," said Glenda Ochsner, CCC-SLP, ASHA president. "Maintaining the requirements of the CCC-A in Medicaid will ensure that Medicaid recipients continue to receive safe and effective services furnished by qualified audiologists operating within the bounds of prescribed laws and ethics."
The sole use of a State licensure definition of "qualified audiologist" presents special problems for Medicaid services furnished in school settings, especially where a teacher's certificate is used in lieu of a State license. In 44 states, school employees are exempt from state health care licensure laws because they already hold appropriate teaching credentials. Without the CCC-A in the Medicaid regulations, Medicaid audiology provider qualifications would vary greatly in schools and again allow much lesser qualified individuals to provide the hearing benefit services under Medicaid. ASHA asked CMS to strengthen the "under the direction of" requirements so that audiology services are provided or appropriately supervised by audiologists under Medicaid.
ASHA urged CMS to craft regulations that:
- Recognize audiology as an autonomous and distinct profession;
- Support standards in all state licensing laws and regulations involving the Medicaid population that is equal to or greater than the CCC-A;
- Tighten and conform the equivalency clause in the current regulations that has allowed states to have bachelors and lesser qualified individuals provide and directly bill for Medicaid services in schools; and
- Strengthen the regulations to ensure that only qualified audiologists provide or appropriately supervise audiology services for Medicaid beneficiaries.
ASHA is the national professional, scientific, and credentialing association for more than 108,000 audiologists, speech-language pathologists, and speech, language, and hearing scientists. ASHA's mission is to ensure that all people with speech, language, and hearing disorders have access to quality services to help them communicate more effectively.
