the American Speech-Language-Hearing Association (ASHA) continues to maintain
that the best model of hearing health care features audiologists and consumers
collaborating on treatment options, it recognizes instances where that model
can be modified. There may be advantages to making hearing aids directly
available to some consumers with mild hearing loss. Less costly
over-the-counter (OTC) hearing aids could serve as an early gateway for users
with mild hearing loss to explore whether they could eventually adapt to
hearing technology without significant financial outlay. It is already the case
that consumers with perceived mild hearing loss can seek amplification on their
own, without professional involvement, by purchasing unregulated personal sound
amplification products or other products and devices that are indirectly
marketed for hearing loss.
ASHA will support proposed legislation related to OTC hearing aids for mild
hearing loss only, given that the following provisions are included in the
- Require the
- establish limited gain and output thresholds for these hearing aids;
- ensure that OTC hearing aids are only available for adults;
- establish a means for collecting information on consumer safety and other potential complaints;
- require labeling that strongly recommends seeking audiologic diagnostic and rehabilitative services; and
- require labels that provide consumers with warning signs for conditions that require medical treatment.
- Ensure that current insurance coverage of hearing aids is not
undermined. Currently, some states mandate that insurers, including
Medicaid, provide coverage for hearing aids for adults; the U.S.
Department of Veterans Affairs and the Federal Employees Health Benefits Program
also provide coverage for hearing aids. Any new OTC model should not be
seen as a substitute for hearing aid benefits under third-party plans.
ASHA strongly encourages Senator Chuck Grassley (R-IA) and Senator Elizabeth
Warren (D-MA) to take a more holistic approach to access to and affordability
of hearing aids. While we can support the creation of a new OTC hearing aid
category for mild hearing loss, we believe this represents only part of the
solution. A parallel effort must be undertaken to ensure the establishment of both
public and private insurance coverage for patients with hearing loss who do not
benefit from an OTC device. These additional categories of services would
include coverage of the professional auditory rehabilitation services of an
audiologist that would allow a person with hearing loss to maximize their
communication abilities with amplification. Without meaningful coverage of all
hearing health care services for all individuals with hearing loss, there is a
high probability that these individuals will inappropriately self-prescribe OTC
devices and fail to receive appropriate care—thereby not achieving the
sufficient benefit from OTC hearing aids.
will work with other stakeholder to encourage the Centers for Medicare &
Medicaid Services and private health plans to achieve these goals. We urge
Congress to review and develop legislation to address Medicare and Medicaid
coverage of audiologic services and hearing aids simultaneously with
consideration of a new category of OTC hearing aids.
more information, contact Ingrida Lusis, ASHA's director of federal and
political advocacy, at [email protected].