2018 ASHA Public Policy Agenda: Summaries

Health Care Coverage and Reimbursement Issues

Audiologists and speech-language pathologists provide medically necessary services that result in positive health outcomes and an enhanced quality of life for persons served. Comprehensive coverage of audiology and speech-language pathology services with fair and equitable reimbursement is essential for the professions.

Health care issues will continue to be debated and scrutinized. ASHA is committed to active advocacy strategies to ensure appropriate access, coverage, and reimbursement for audiology and speech-language pathology services.

Priorities

Medicaid

  • Oppose financing mechanisms, such as block grants and per capita caps, that result in significant cuts to Medicaid or restrictions to access.
  • Support and preserve Medicaid expansion.
  • Advocate for fair and equitable coverage and reimbursement across the states.

Medicare

  • Support an appropriate payment model to replace the current therapy cap under Medicare Part B.
  • Seek fair and equitable coverage and reimbursement in post–acute care settings, such as skilled nursing facilities and home health settings.
  • Advocate for comprehensive access, coverage, and reimbursement under Medicare—including Medicare Advantage plans—for audiology and speech-language pathology services.
  • Advocate for audiology and speech-language pathology services to be included in alternative payment models.

Private and Other Payers

  • Promote the inclusion of habilitation and rehabilitation services and devices as essential health benefits.
  • Advocate for payers to abide by established policy and contractual agreements.
  • Advocate for expanded access, coverage, and reimbursement for telepractice/telehealth.

Education Issues

Effective communication skills are essential for all children to access educational curricula and achieve academic success. Audiologists and speech-language pathologists play an important role in ensuring a free appropriate public education (FAPE) for students with disabilities and for students at risk. Students should have access to audiologists and speech-language pathologists in all educational programs, both public and private. Parents have the right to make an informed choice for the education of their child.

Reduced funding streams, service delivery changes, scope-of-practice issues, constraints on access to services, and parental choice require ASHA to commit to active advocacy strategies to promote the value and need for audiology and speech-language pathology services in educational settings.

Priorities

  • Advocate for the continuing roles of the federal and state governments in education policy and standards.
  • Ensure access to and coverage and reimbursement for audiology and speech-language pathology services in early intervention and education settings, including maintenance of Medicaid formulae in schools, and the promotion of greater state-level use of funding flexibility for audiology and speech-language pathology services in general education.
  • Incorporate policies for Parents’ Right to Choose that maintain federal oversight of education standards, FAPE, protections required under the Individuals with Disabilities Education Act, qualified personnel, privacy standards, adequate funding for public schools, and assurance that funding follows the student.

Professional Practice Issues

Audiologists and speech-language pathologists are autonomous professionals with defined scopes of practice based on their education, training, and skills. As uniquely qualified professionals, audiologists and speech-language pathologists provide the highest quality of service and are recognized as valued and integral members of educational and health care teams.  

Challenges to the professions require outcomes data and quality indicators that demonstrate the value of audiology and speech-language pathology services in all settings. ASHA is committed to active advocacy strategies to protect licensure requirements that define scope of practice, maintain licensing boards, and support service delivery models.  

Priorities

Promote the value and quality for the professions of audiology and speech-language pathology. 

  • Promote and maintain a defined scope of practice for each profession.
  • Respond to efforts that would expand the scope of practice for professions lacking the knowledge and skills to assess, treat, and manage speech, language, and hearing disorders.
  • Support and promote dedicated state consultants for audiology and speech-language pathology professionals.

Continue the focus on service delivery models for hearing health care.

  • Promote safe, effective audiological hearing health care services, devices (e.g., over-the-counter hearing aids, personal sound amplification products), and environments.
  • Advocate for audiological intervention services in the management of hearing loss—these services include therapeutic hearing rehabilitation, counseling, and assistive technology.

Advance licensure.

  • Facilitate interstate compact agreements for service delivery and supervision.
  • Promote comprehensive state licensure for the professions.
  • Maintain independent state licensing boards.
  • Advocate for laws that support appropriate licensing standards for telepractice, including across state lines.

Issues to Monitor

  • Audiology and SLP Assistants
  • Research
  • Workforce

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