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Labyrinthine Reimbursement for Hearing Aids: Navigating the Puzzle

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1.  Commercialization of hearing aids began in the: 1920s 1930s 1940s 1950s

2.  What are some of the early technology brands in the 1950s? Siemens Acousticon Beltone All of the above

3.  Medicaid is a joint federal-state program of health care. As such, the following is true: The federal government imposes all operational guidelines on state Medicaid operations. All states are required to provide the entire scope of hearing services to all Medicaid recipients. Audiologists can see a Medicaid patient without a physician referral or physician involvement. State legislatures can choose which hearing services to offer Medicaid patients, with the exception of those services for children.

4.  In order to save money, state Medicaid agencies have increasingly contracted with what kind of entity regarding hearing services: Utilization management review companies who are subcontracted with Medicaid HMOs. Hearing aid buying groups to get volume discounts on hearing aids. Other government entities (e.g., VA system) to obtain hearing aids at a discount. Commercial insurers who make their own hearing aids

5.  Looking at the totality of hearing aid reimbursement: Insurances have become very good about covering all but just a few dollars of hearing aid costs. Out of pocket expenses are negligible as a portion of total hearing aid related costs. Overall, out of pocket expenses are greater than the amount paid by insurers or HMOs. In general, audiologists must accept insurance or HMO payment as “payment in full”.

6.  Social Security Act was modified in ____ to include insurance-type medical benefits for Medicare and Medicaid. 1965 1970 1975 1980

7.  Fully digital hearing aids were introduced in the: 1960s 1970s 1980s 1990s

8.  What is the advantage of charging separately for the diagnostic evaluation? It is identified as “professional services” rather than a component of hearing aid “sales” in the eyes of consumers. It is typically not eligible for refund to the consumer if the hearing aid is returned following the trial period. The requirement for separate diagnostic service charge is becoming more prevalent by Medicaid and HMOs. All of the above

9.  Two national committees examined access to hearing health care. Perhaps their most significant conclusion, shared by both committees was: Access to hearing aids is cost-prohibitive. Hearing aid technology has not advanced sufficiently to provide benefit to older individuals. More physicians need to be involved with hearing aid dispensing. The FDA Medical Clearance guidance must continue to apply to all patients.

10.  Whether bunding or unbundling, the single most important ingredient for decision-making is: Whether to accept Medicaid. The cost of service delivery. The desire of the practice owner. Adherence to the PCAST report.