Hearing aid provider hi HealthInnovations, a subsidiary of United Healthcare (UHC), has begun sending a "hearing test kit" to physicians—despite concerns voiced by audiologists and professional hearing organizations about specific aspects of its online sales program.
The hi HealthInnovations Hearing Test Kit, which is mailed unsolicited to physicians, includes a USB sound card, adapter, ear buds in a range of sizes, instruction manual, quick reference card, and a branded carrying case. According to materials included with the kit, with the oversight of a physician the test can be administered by "a nurse practitioner, physician assistant, or any employee with licensed medical training in a medical and/or health field."
Although the instruction manual notes the types of hearing loss that should be treated by an audiologist (e.g., asymmetrical hearing loss, significant low-frequency loss), it gives minimal guidance in identifying such conditions. One of hi HealthInnovations' stated purposes in sending the kit to physicians is to "facilitate access by [hi HealthInnovations] members to their covered hearing benefit." To this end, hi HealthInnovations states that the hearing test is billable to UnitedHealthcare Medicare Advantage Plans under Current Procedural Terminology (CPT, ©American Medical Association) code 92552, the diagnostic code for pure tone audiometry.
Opposition to the hi HealthInnovations program is continuing and widespread. Most recently, attorneys representing the International Hearing Society (IHS) sent a letter requesting the Food and Drug Administration (FDA) conduct a review and investigation of hi HealthInnovations' service and techniques for compliance with FDA requirements. This letter follows another letter from the Hearing Industry Association (HIA) asking the FDA to investigate the program. The HIA letter asserts that the program is illegal and that hi HealthInnovations is:
- Characterizing its hearing aids as "personal sound amplification products" in an attempt to avoid hearing aid regulations.
- Using an invalid hearing test.
- Using a consumer waiver that does not meet FDA requirements.
The letter asks the FDA to suspend hi HealthInnovations' online marketing, and to prohibit the company from shipping hearing aids in the absence of valid audiologic examination results. The letter also includes 21 exhibits to support HIA's claims. HIA and IHS join several organizations—including ASHA, the American Academy of Audiology, the Academy of Doctors of Audiology, and the American Academy of Otolaryngology–Head and Neck Surgery—that have raised serious concerns about hi Health's direct-to-consumer online hearing aid sales program.
But one notable exception—the Hearing Loss Association of America (HLAA)—has come out in support of the hi HealthInnovations program, with its Executive Director Brenda Battat commenting on the need to lower hurdles to seeking and receiving hearing health care.
Audiologists concerned about the hi HealthInnovations program should ensure that local primary care physicians' offices are aware of them as referral sources. Audiologists also should maintain consistent practice policies and guidelines for hearing aids purchased from other sources—regardless of private pay/insurance types—and should be transparent about the services that are or are not included in their bundled prices.
With regard to hi HealthInnovations' hearing aids, audiologists should inform patients and other health care providers that they are not able to program the devices unless they become a UHC provider, and otherwise cannot offer services to those patients.
ASHA remains in conversations with hi HealthInnovations regarding its online hearing aid sales, in the hope it adopts ASHA's recommended changes. These changes include labeling the hi HealthInnovations online "hearing test" as a screening tool, and expanding its hearing benefit to include diagnostic and rehabilitation services provided by an audiologist. (See "ASHA Questions Online Adult Hearing Aid Program," The ASHA Leader, March 13, for a complete list of ASHA's suggested changes.)
ASHA also has updated its consumer information for hearing aid buyers. Check out "What You Should Know Before Buying Hearing Aids Online."
The status of the hi HealthInnovations hearing program continues to develop. For up-to-date information, check the "News Watch" section of The ASHA Leader Online.