November 7, 2018
My name is Dr. Casey Rutledge Roof and I am the President-Elect of the Kentucky Academy of Audiology (KAA).
I’m writing to you today to give a brief update on KAA’s pursuit of audiologic coverage for Medicaid recipients over the age of 21. Currently, adults aged 21 years and older with Medicaid as their insurer are excluded from coverage of diagnostic audiologic services unless the services are billed by an otorhinolaryngologist or in the case of some managed care plans, billed incident to the physician.
As we all know, approving direct audiologic coverage for adults without the need for physician oversight will minimize expenses to the Medicaid system by eliminating unnecessary or redundant medical appointments, and allow patients that have expressed hearing or balance related concerns to be evaluated by an audiologist (and be subsequently referred to a physician as medically needed after the audiologist's evaluation). This population is currently underserved by a lack of access to audiologic care and will benefit greatly from the services that audiologists can offer.
I’m happy to report that, on behalf of KAA, I have met successfully with the Cabinet for Health and Family Services’ (CHFS) Physician Technical Advisory Committee (TAC) about this issue. The Technical Advisory Committees (TAC) were established for the purpose of acting in an advisory capacity to the Advisory Council for Medical Assistance. The Advisory Council for Medical Assistance (MAC) is an advisory committee comprised of health professionals, providers, advocates and Medicaid recipients that offer policy recommendations to CFHS. A formal recommendation was created on November 2 from the Physician TAC committee that acted in our favor, recommending audiologic coverage be created for KY Medicaid recipients over the age of 21 for diagnostic services. This formal recommendation was sent to the head of the Department of Medicaid Services (DMS) for review before the next MAC meeting that may help expedite implementation of TAC's formal recommendation.
On Thursday, November 15, the Physician TAC will present the formal recommendation to the MAC that direct audiologic coverage should be approved for Medicaid patients over 21. We will have representatives from KAA at this meeting if any questions should arise. Based on our interactions with contacts from these organizations, this seems like a "common sense" adjustment in Medicaid policy. If this adjustment in policy is approved, the timeline is still uncertain as to when this will be effective, but we will update you on this as we get information. As KAA continues to grow, we want to ensure our members have a voice in the state’s regulatory and legislative issues. Stay tuned for more government affairs updates, and please don’t hesitate to reach out to our office with any questions or concerns.
Casey Rutledge Roof, Au.D.