ASHA Focused Iniatives

Reimbursement in Health and Education

Third Quarter Progress Report
July-September 2007

For each of the 2007 Focused Initiatives, a work plan that includes the strategies to be completed in 2007 was developed. During the 3^rd quarter of the year, the strategy implementation teams initiated activities necessary to complete the strategies by the dates indicated.

The following report highlights some of the actions that were initiated during the 3^rd quarter and includes information on the status of all strategies included in the work plan at the end of the 3^rd quarter.

For additional information related to ASHA's Focused Initiatives please contact Stan Dublinske, Senior Advisor for Planning at sdublinske@asha.org.

3^rd Quarter Highlights

• Met with a representative of Mercer Health & Benefits to discuss advocacy strategies to increase coverage for speech-language pathology and audiology services in private health plans.
• Met with representatives of Prince George's County and Harford County Public Schools in Maryland to discuss coverage for speech-language pathology and audiology services. They were sent information about hearing aid preferred provider networks.
• It was determined that developing a tracking system for denials and complaints against private health plans was is feasible and that it would be best to begin populating the system with information previously gathered.
• The IDEA/Medicaid Side-by-Side document detailing the differences in regulations between the two federal programs has been posted on the ASHA Medicaid Web site.
• A contract has been signed with Milliman to develop a white paper regarding the return on investment from health plan coverage for comprehensive speech and hearing services and provide actuarial data.
• Presented a session on audiologic rehabilitation (AR) advocacy at the Academy of Rehabilitative Audiology (ARA). Medicare coverage of AR provided by audiologists appears to be the dominant issue.
• ASHA's Model Benefits for Audiology and Speech-Language Pathology was updated and posted to the ASHA Web site.
• The Legislating Health Plan Coverage packet was also posted to the ASHA Web site both on the members-only and public side and can be accessed online. The packet was advertised in the GRPP Advocates and Access SLP e-newsletters.
• A PowerPoint presentation that informs professionals about materials related to Audiologic Rehabilitation (AR) and reimbursement for audiologic rehabilitation can be accessed online and has been included in Have You Heard, a resource book on AR.

There are 28 strategies in the Reimbursement in Health and Education work plan. Following is the status for the 1^st, 2^nd, and 3^rd quarters.