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MED-EL - Implant Experience - August 2023

AG Bell Launches Effort to Improve Reimbursement

October 2001 (Washington, DC)— Is a misguided attempt at economy depriving children of the ability to hear? The Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell) fears that it is, and has begun to take important steps to ensure that all families who wish to provide their deaf child with access to sound have the option of doing so. Medicaid does not fully cover the cost of a cochlear implant in many states, a device that currently provides access to sound for 25,000 children and adults in the Unites States.

A cochlear implant provides access to sound for people who are unable to gain meaningful benefit from hearing aids. Unlike a hearing aid that delivers amplified sounds to the ear, cochlear implants bypass the damaged part of the ear and send electrical signals directly to the auditory nerve, which relays the information directly to the part of the brain that is responsible for hearing. Children are important beneficiaries of cochlear implants, which have been approved for their use since 1990.

Most private and group medical insurance policies cover the cost of the device and surgery. Medicaid, which covers the cost of medical care for children in lower income families, does not cover the full cost of a cochlear implant in many states. For a child from a family with limited means to receive the benefit of this life-enhancing device, the surgeon and hospital must make up the costs from other sources. Some clinics are closing because they can no longer afford to subsidize the procedure.

This means that there are children who could have had the opportunity to hear and speak who are being denied that ability because of efforts by state Medicaid officials to save money. One recent survey1 found that only 5 states had Medicaid reimbursement rates that fully covered the cost of inpatient cochlear implant surgery.

''Denying such services to children by limiting insurance coverage actually costs society more money,'' said AG Bell Executive Director Donna L. Sorkin. A study published in the Journal of the American Medical Association2 demonstrated that giving a child a cochlear implant not only greatly improves the quality of his or her life, but also results in other important monetary benefits such as a reduced cost of primary education and increased life-long earnings.

The members of AG Bell have taken action to remedy this inequitable situation. AG Bell recently launched a campaign to improve Medicaid coverage for cochlear implants in children. A training seminar was held for AG Bell State Chapters on October 26-27, 2001 in Washington, DC. AG Bell Chapters will, in concert with other organizations, work with state Medicaid agencies and state legislators to improve Medicaid reimbursement rates for cochlear implants and thereby ensure full access to this important medical technology that provides extraordinary benefits for children who are deaf.

Founded in 1890 by Dr. Alexander Graham Bell (best known for his invention of the telephone), the Alexander Graham Bell Association for the Deaf and Hard of Hearing is a unique organization dedicated to improving opportunities for people with hearing loss. AG Bell's mission is to promote early identification of hearing loss and to encourage individuals who are deaf or hard of hearing to learn to listen, speak, speechread, and maximize the use of technology and their residual hearing to communicate and succeed in the hearing world. Members include parents of children with hearing loss, individuals who are deaf or hard of hearing, educators, audiologists, speech-language pathologists, otologists, psychologists, and other professionals in fields relating to hearing loss.

1Cochlear Corporation, ''Medicaid Coverage and Payment for Cochlear Implants and Associated Professional Services,'' 2000.

2A.K. Cheng et al., ''Cost Utility Analysis of the Cochlear Implant in Children,'' The Journal of the American Medical Association, August 16, 2000.
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