Medicaid Time-line
Complied by Craig Johnson
The path to changing the Medicaid definition of an audiologist: Elimination of the need for the CCC's for reimbursement
The key ingredients to the professions' success was Marshall Matz, lobbyist for AAA, changing the effort from a legislative initiative to a regulatory process in 2001 and David Fabry's relationship with Secretary Thompson.
March 10, 1999 Congressmen Whitfield (R-KY) and Brown (D-OH) introduce HR 1068 - "The Medicaid Audiology Act of 1999" in the House of Representatives.
ADA supports AAA's introduction of the legislation - ASHA in conjunction with AAO-HNS oppose the bill.
1999-2000 - 15 co-sponsors support the legislation in the House of Representatives.
March 16, 2000 - AAA's convention in Chicago features Congressman Whitfield at the opening session. His participation represents the first time that a member of Congress was asked to participate in an Academy convention and in addition, it was the first time that the audiology profession held a fundraiser.
April 6, 2001 - Secretary of Health and Human Services, Tommy Thompson, was the featured speaker at AAA's convention in San Diego. He tells over 4,500 enthusiastic audiologists that he intends to "Get the job done" (first government commitment to change the definition). He invites the "stakeholders" to meet Medicaid officials to move the process forward.
June 1, 2000 - Representative Rosa DeLauro (D-CT) proposes and Congress approves report language (House Report 106-645) that stipulated, "In 1994, Congress enacted a statutory definition of the term audiologist for the Medicare program, which relies primarily on state licensure and registration as the mechanism for identifying audiologists who are qualified to participate in that program. The Committee urges HCFA to promulgate regulations for the Medicaid program using the same definition of audiologist that exists in the Medicare program."
July 16, 2001 - Upon the direction of Secretary Thompson, Medicaid officials host a meeting to discuss the change in the definition of an audiologist. The stakeholders include representatives from AAA (Dave Fabry), ADA (Craig Johnson) and ASHA (John Bernthal, Vic Gladstone, Jim Potter and Larry Higdon). At this meeting, ASHA indicates that their certification program should continue as the criteria for defining audiologists. Mr. Thomas Hamilton, representative for Medicaid, tells the participants that the agency intends to issue a "notice of rulemaking", thereby allowing all interested parties to provide input concerning the proposed change.
April 4, 2002 - Director of Medicaid, Dennis Smith was the featured speaker at AAA's convention in Philadelphia. He tells over 5,000 audiologists that Secretary Thompson wants the agency to update the definition of an audiologist.
February 13, 2003 - Congress passes Conference Report (108-10) that for the second time urged HCFA to utilize the Medicare definition of an audiologist for Medicaid. Once again Representative DeLauro was instrumental in the passage of the Conference Report.
March 28, 2003 - ASHA sends a letter to members imploring them to strongly oppose any change in the Medicaid definition.
April, 2, 2003 - Medicaid publishes the proposed rule that eliminates the need for ASHA CCC's.
April 3, 2003 - Senator Bob Dole is the featured speaker at AAA's convention in San Antonio. He tells audiologists that the definition of an audiologist in the Medicare and Medicaid programs should be consistent. The Medicaid definition should be updated.
April 4, 2003 - ASHA suddenly reverses its decision to oppose the change in the Medicaid definition of an audiologist - they now claim to support the proposed change.
June 2, 2003 - The comment period for the notice of rulemaking is closed. Medicaid officials must compile the findings and produce a final rule in the Federal Register.
April 28, 2004 - Medicaid published its notice of final rulemaking in the Federal Register. This new definition of an audiologist eliminates the need for an audiologist to obtain or maintain the CCC-A. Audiologists can now be reimbursed if they are licensed or registered to practice audiology. In Idaho and the District of Columbia, the last two localities without licensure, an audiologist must have a master's degree, 350 clock hours, serve a 9-month supervised practice and pass a national examination.
June 28, 2004 - The Medicaid definition of an audiologist became effective.
