HCFA Audiology Regulation

[Tom Muller]

Hello to All,

I am a long time watcher but first time poster  --  I love the group, and it 
is really beginning to get interesting.  Thanks to all of you for your input 
and thought.

Anyway, I heard something at AAA this past week that blew my mind.  Given 
it's importance, I can't beleive more people aren't talking about it.  The 
fact that they aren't makes me wonder if I understood it correctly.  Please 
comment and clarify if you can.

It is my understanding that HCFA recently adopted a regulation that states 
that ANY HCFA APPROVED HEALTH PLAN CAN ONLY HAVE AUDIOLOGISTS PROVIDING 
HEARING SERVICES, NOT HEARING AID DEALERS.  If this is true, it is the best 
thing to happen to our profession it years, but no one is talking about it.

Well, here is a specific example upon which I need an opinion:  An HMO in 
Arizona has recently signed a contract with a hearing IPA (Individual 
Provider Association) to have them provide services for their medicare risk 
insurance plan  -  an HMO policy for medicare patients, HCFA approved.  The 
agreement states that the IPA members will provide FREE hearing tests, and 
also a 30% discount on hearing aids to all members.  Right off the bat, of 
course, I am furious about the idea of a FREE hearing test  -  aren't we 
sending the wrong message?  Anyway, as you might suspect, the majority of the 
providers in the network are hearing aid dealers, most conspicuously Beltone.

This plan does not involve any payment from the insurance provider, just an 
agreement to refer patients to the network.  The do advertise it as a hearing 
benefit covered under the health plan, and have sent letters and information 
to all the patients to explaining this.

I need feedback.  First, have I correctly understood the regulation?  Can 
anyone get me a copy of the actual rule, or better yet, post it here and on 
the ASHA Audiology listserv?  Second, does the relationship that I have 
described fall under the rule, an as such, is it illigal?

Thanks for your help.  

Tom Muller, MS, FAAA
Thomas-Davis Medical Center
Tucson, AZ