HCFA Audiology Regulation
mullert at primenet.com
Fri Apr 26 10:37:01 EST 1996
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
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
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