3/9/2015

Government Relations & Public Policy:

Advocacy, Technical Assistance,
Issue Analyses that Affect Our Professions
Advisory Councils
March 14, 2015

Joan Mele-McCarthy
ASHA Vice President for
Government Relations & Public Policy

George Lyons, Jr.

Ingrid Lusis
ASHAs Government
Relations & Public Policy Cluster

Public Policy Agenda (PPA)

GRPPB develops with member input
Thousands of comments reviewed
Three broad issue areas of advocacy:
federal
federal and state level
state level
Legislative and regulatory advocacy

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2015 PPA ISSUES AND

PRINCIPLES

Annual Development Process

BasedonASHAmemberinputtothe
GovernmentRelations&PublicPolicyBoard

MarchMay

JuneJuly

DevelopmentofSurveyandRequesttoASHA
Committees,Boards, CSAP,State Associations,
AdvisoryCouncils,andSIGs.
Surveydisseminatedtoallmembers.
ReviewofComments
inputfrom2,391Respondentson11Issues
(Lastyearinamoretargeted survey,ASHAheard
from1,662respondents.)

August

GRPPBoardDeliberationsonSurveyandPolicies

October

ASHABoardofDirectorsReview&Vote

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2015 PPA Survey Results Top 10

TABLE1.2015PPA
ALLRESPONDENTS
Inorderofmeanrating,highesttolowest

IssueObjective
Fundingandpracticeissuesforearlyinterventionand
schoolbasedservices
Medicaidreimbursementandcoveragepolicies
PatientprotectionandAffordableCareAct/privatehealth
plansreimbursementandcoveragepolicies
Medicarereimbursementandcoveragepolicies
Professionalinfringement
Hearinghealthcare
Stateconsultants
Comprehensive(universal)licensure
Loanforgivenessasarecruitmentandretentiontool
Servicecontinuum
Telepractice

n=

2316

Veryimportant

Somewhatimportant

70.8%

21.3%

2303

61.7%

32.2%

2305

60.3%

31.6%

2323
2289
2315
2290
2300
2307
2296
2303

60.7%
52.6%
34.1%
37.7%
34.2%
32.2%
25.1%
18.8%

29.4%
27.8%
44.8%
40.0%
35.1%
37.2%
35.1%
40.8%

2015 PPA Survey Results Top 6 for

Audiologists
1. Hearing health care
2. Medicare reimbursement and coverage policies
3. Medicaid reimbursement and coverage policies
4. Patient Protection and Affordable Care Act/ private
health plans reimbursement and coverage policies

5. Scope of practice
6. Funding and practice issues for early intervention
and school-based services

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2015 PPA Survey Results Top 6 for

SLPs
1. Funding and practice issues for early
intervention and school-based services

2. Medicaid reimbursement and coverage policies

3. Patient Protection and Affordable Care Act/
private health plans reimbursement and coverage
policies

4. Medicare reimbursement and coverage policies

5. Scope of Practice
6. State Consultants

Board Approved 2015 PPA

Blueprint for Action
Federal Level
Medicare Reimbursement and Coverage Policies
Reauthorization of Federal Education Legislation

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2015 Federal Legislation

Medicare Audiology Services Enhancement Act of 2015,

H.R. 116
Hearing Aid Assistance Tax Credit, S. 315
Veterans Access to Healthy Hearing Act, H.R. 353
Medicare Access to Rehabilitative Services Act of 2015,
H.R. 775
Steve Gleason Act of 2015, H.R. 628

Advocacy: Medicare Reimbursement

and Coverage
Equitable reimbursement for audiologists and SLPs
Coverage of services and devices for beneficiaries of Medicare health plans
Alternative payment policy to Medicare therapy caps
Reform of Sustainable Growth Rate formula in determining reimbursement
under Medicare Part B fee schedule
Medicare coverage of audiologic diagnostic and treatment services, and the
right of audiologists to opt out of Medicare (HR 1116)
Represent the professions before CMS for maintenance or expansion of
appropriate values and coverage and representation on AMA coding
committees

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Advocacy: Reauthorization of
Federal Education Legislation
Inclusion and funding of speech, language, literacy, and
hearing services and devices in all federal education
legislation
Consistent language and common terminology, including
the use of the term highest qualified provider in ESEA
and IDEA
Include SLPs in federal literacy policies
Include audiologists and SLPs in HEA provisions

Board Approved 2015 PPA

Blueprint for Action
Federal and State Level
Funding and Practice Issues for School-Based and Early

Intervention Services
Hearing Health Care
Medicaid Reimbursement and Coverage Policies
Patient Protection and Affordable Care Act (ACA)
Private Health Plans Reimbursement and Coverage Policies
Telepractice
Loan Forgiveness as a Recruitment and Retention Tool
Demonstrating Value and Quality of Services
Scope of Practice

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Advocacy: Funding and Practice Issues for

School-Based and Early Intervention Services
Adoption of appropriate accountability/ evaluation measures for
specialized instructional support personnel in educational settings
Oppose cuts in education funding
Reduce the paperwork and administrative burden on school-based
audiologists and SLPs
Educate administrators/decision-makers about workload
requirements in determining caseload and funding needs
Advocate with states to implement federal standards related to
IDEA Part B and ESEA

Advocacy: Funding and Practice Issues for

School-Based and Early Intervention Services
States to implement IDEA Part C Infants & Families Program
requirements
Ensure role of audiologists and SLPs in the identification and
treatment of children in early intervention programs
Increased funding for Part C services
Timely reimbursement for early intervention services
Reallocation of IDEA Part D funds so that they align with the
needs of ASHAs school-based members and graduate
academic programs
Audiologists and SLPs roles in the diagnostic, intervention,
and management teams related to concussion and/or in student
athletes

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Advocacy: Hearing Health Care

Hearing aid tax credit legislation
Stronger FDA regulations
regarding sale of hearing aids and PSAPs
FTC oversight of deceptive advertising relative to the sale of PSAPs
legislative efforts related to classroom acoustics
Reasonable, cost-effective OSHA and ANSI regulations and standards to
prevent noise-induced hearing loss
Comprehensive system of childrens hearing health care services
implementation of EHDI
adoption of state hearing screening standards for school-age children,
provision of insurance coverage of hearing aids
cochlear implants, other related devices
equipment and diagnostic and treatment services for children

Advocacy: Medicaid Reimbursement \

and Coverage Policies
Advocate for coverage and reimbursement of services provided by
audiologists and SLPs, including funding for mandated EPSDT program
services
Advocate for appropriate coding and reimbursement for coverage of
audiology and SLP services
Advocate for appropriate policies and regulations of Medicaid covered
services in schools and other settings
Promote reimbursement for devices, including hearing aids, cochlear
implants, AAC and other devices

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Advocacy: Telepractice
Recognition and coverage of appropriate services delivered
through telepractice and, if necessary, ensure that such legislation
includes appropriate licensing standards
Medicare and Medicaid coverage of appropriate services delivered accomplished
Funding through federal and state legislation and regulation with
private health plans
State registration or limited licensure that ensures consumer protection
when receiving telehealth services provided by audiologists and SLPs
across state lines

Advocacy: Loan Forgiveness as a

Recruitment and Retention Tool
ASHA supports strategies to increase recruitment and retention of
audiologists and SLPs through financial aid and loan forgiveness
ASHA will continue to support federal and state legislative efforts to
adopt loan forgiveness provisions for audiologists and SLPs

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Demonstrating Value and

Quality of Services
Coordinate advocacy strategies with health care and school-based payers
Utilize data to support advocacy efforts related to adequate
reimbursement across payers
Empower members and state association leaders to effectively
demonstrate the value of audiology and SLP services in achieving
desired client outcomes that reflect payer demands
Take leading role in establishing policies that define quality and desired
outcomes of audiology and SLP services reflecting the needs of the
clients and professions

Advocacy: Scope of Practice

Empower members to advocate with payers and educate consumers on the
value and expertise of audiologists and SLPs
Recognition of the ASHA CCCs and advocate for policies that require use
of the highest qualified provider
Oppose practice acts and licensure efforts that would expand the scope of
practice of other professionals and practitioners into the scope of practice of
audiologists and SLPs
Engage and inform other professional organizations about the unique
training, value, and expertise of audiologists and SLPs

10

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Advocacy: Assistants within the

Service Continuum

Advocate for state regulations including education, training, and

supervision requirements to promote standards for audiology and
speech-language pathology assistants
Promote the delivery of quality services to individuals with
communication disorders
Explore ways to demonstrate basic competencies of audiology
assistants and speech-language pathology assistants

Advocacy: State Consultants

ASHA, in collaboration with state associations and organizations, will:

Support member efforts and states seeking qualified audiologists and

SLPs as consultants to state departments of education

Promote retention of qualified audiologists and SLPs who are

currently serving as employees and/or consultants to state agencies

Provide departments of education with information about the

importance of audiology and speech-language pathology services

11

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Board Approved 2015 PPA

Blueprint for Action
State Level

Comprehensive Licensure
Audiology and Speech-Language Pathology Assistants

within the Service Continuum

State Consultants

Continuum of Service Delivery

Developed state model language for audiologists, speech

language pathologists and audiology and speech-language

pathology assistants
Support state regulations to promote uniform standards for
the full continuum of audiology and speech-language
pathology providers
Promoted new scope of practice for
speech-language-pathology assistants

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