WELCOMEA Complimentary Professional Development Opportunity

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Presenter:

IHS Policy Perspectives and Updates for the Hearing Health Professional

Alissa ParadyDirector of Government and Chapter AffairsInternational Hearing Society

Kathleen MennilloExecutive Director

Diana CheruvilAssociate Director of Marketing

Housekeeping

• This presentation is being recorded

• CE credit is available. Take the quiz here:https://bit.ly/April29Quiz2Parady

• Feel free to download today’s presentation in the Handouts section on your webinar dashboard now!

Agenda

• US and International Advocacy Update– COVID-19 Response– Fit to Serve– Medicare coverage of hearing aids– Status of Over-the-Counter Hearing Aids– International Activity– and more

• Business Tools and Professional Development

• Q&A (enter your questions in the Question Box any time)

PROTECTION

Provides tools & guidance

on best practices and

business standards

GROWTH

Meeting the increasing demand

through new training

programs & education

ADVOCACY

Sole national organization fighting for hearing aid

professionals & getting

results

NETWORK

Peer-to-peer learning and interaction

through virtual & in-person platforms

WHAT IS

Modernized annual convention & magazine

Launched webinars

First Congressional briefing

Launched online member forum

First federal bill signed into law

Federal training standards adopted

Appointed to international workgroups

Trainee course and ILE updated and modernized

Launched trainer manual and online toolkit

New partnerships with other industry groups

Established in 1951, IHS

continues to evolve and

grow the profession.

JUST IN THE LAST 10 YEARS…

Demand for hearing healthcare continuing to rise

Increased consumer awareness of hearing loss as a critical health and wellness function

Increased use of hearing devices leading to both noise exposure and better acceptance of ear-worn devices

Delivery models expanding to include OTC, telehealth, big box/drugstore (Walmart, CVS)

Rise in insurance coverage and discount plans

Possible Medicare expansion to include hearing aid coverage

New research that will drive policy and best practices

What futures are IHS strategically planning for?

Advocacy Report

• IHS launched COVID-19 Resource Center: bit.ly/IHSCovid19ResourceCenter• IHS is performing ongoing outreach to Congressional leaders and key

Committees alerting them to the affect on hearing aid dispensing businesses and need for help• CARES Act and subsequent “Paycheck Protection Program and Health

Care Enhancement Act” authorized small business loans/paycheck protection act and funding

• IHS is continuing to monitor additional action by U.S. Congress/White House on COVID-19 relief for small businesses and other relevant issues

• Meeting (virtually) weekly with hearing organizations to share information and coordinate as appropriate

COVID-19 Response

Public Law 114-256, signed into law December 2016:• Adds HAS to list of professions VA can hire

• Requires annual report to Congress on wait times, staffing #s (including HAS), and contracting for 5 yrs

• Requires VA to convene stakeholders meeting on HAS qualifications

• First step towards goal of enabling veterans to access VA care through hearing aid specialists

Fit to Serve: Working to Help Veterans

• IHS follow up to December 2018 VA Stakeholders Meeting outlining proposed qualifications• Sen. Jerry Moran submits questions for the record regarding MISSION Act oversight• VA advises IHS to create national educational program• Rep. David McKinley sends letter to VA Secretary urging action• Rep. John Carter questions VA officials during budget hearing• IHS leaders meet with 13 offices during Hearing on the Hill to encourage Congressional action/oversight on PL 114-256

implementation & contracting• Sen. Moran questions VA officials during two hearings• Congressional & committee staff meet with VA re: PL 114-256 implementation• Sen. Moran staff again meets with VA staff• 33 House members send letter to VA Secretary demanding action; letter led by House VA Committee Chair Mark

Takano • IHS submits comments regarding provider credentialing and Community Care program (MISSION Act) participation

Fit to Serve: Working to Help Veterans2019 Activity

It was a busy year…Senator Jerry Moran questions VA leaders

Rep. John Carter questions VA during budget hearing

IHS has been highly engaged with Senate and House leaders to move this priority in 2020. January: IHS Champion Senator Jerry Moran (R-KS) named Chair of the

Senate Veterans Affairs Committee (SVAC). January: SVAC unanimously passed S. 785, the Commander John Scott

Hannon Veterans Mental Health Care Improvement Act of 2019, on January 29, 2020.

April: House Veterans Affairs Committee Chair Mark Takano (D-CA) and Ranking Member Phil Roe (R-TN) introduce House companion, H.R 6612.

2020 Activity

Uniform language in both bills directs the VA to:• Within 180 days of the bill's enactment, establish qualifications for

hearing aid specialists to work for the VA,• By September 30, 2022, appoint at least one licensed hearing aid

specialist at all VA medical centers, and• Submit an annual report to Congress assessing the VA's progress in

hiring hearing aid specialists, as well as any potential conflicts or obstacles affecting hiring.

2020 Activity

• Passage of language included in S. 785 by Senate and H.R. 6612 • Working with VA on technical qualifications for hearing aid specialists• Pursuing change to audiology directive, which is under development, to

lift restrictions on when hearing aid specialists can be contracted with• Pursuing ways to use MISSION Act to deliver hearing aids through

contract network

Visit www.fittoserve.us to stay connected and send an email to your Congressperson!

Fit to Serve: Priorities Going Forward

IHS saw the need to be proactive, and we began gathering facts and meeting with key stakeholders in early 2019.In September 2019, IHS adopted four guiding principles for its Medicare policy approach:1. Hearing Aid Specialists be added to the list of Medicare providers to

provide hearing evaluations and hearing aid dispensing services, including aural rehabilitation.

2. Coverage include both hearing aids and hearing aid dispensing services, including those services consistent with the standard of care

Medicare Coverage of Hearing Aids

In September 2019, IHS adopted four guiding principles for its Medicare policy approach:3. Hearing aids be defined to, at minimum, include capability for

assistive device connectivity/ interoperability; and beneficiaries be granted the ability to “top up” (contribute to the cost of more advanced technology)

4. Hearing Aid Specialists and Audiologists be treated equally as it relates to requirements for/against a physician order prior to dispensing a hearing aid

Medicare Coverage of Hearing Aids

H.R. 4618, Medicare Hearing Act of 2019

• Introduced October 2019 by Rep. Lucy McBath (D-GA)• Seeks to:

–expand the services audiologists could provide for Medicare reimbursement to include aural rehabilitation and treatment services.

–expand Medicare Part B coverage to include non-OTC hearing aids and examinations therefor for adults who have been diagnosed with severe to profound loss every 5 years, beginning January 1, 2022.

• In October 2019 House Speaker Pelosi (D-CA) indicated H.R. 4618 would be added to H.R. 3, a drug pricing bill with large estimated savings. H.R. 3 presented an ideal vehicle for costly Medicare expansion to vision, dental, and hearing services with early estimates of $350B in savings.

• H.R. 3 and H.R. 4618 were passed through relevant committees over the course of a two-week period; amendments were highly limited.

• On December 12, the House passed H.R. 3 with hearing language included by a vote of 230-192.

Medicare Coverage of Hearing Aids

What would H.R. 4618/H.R. 3 do?

The bill was amended with two additions: To reclassify audiologists as “practitioners” under Medicare* To require a report two years from enactment from the Department

of Health and Human Services on the feasibility of eliminating the physician order for audiology services considering program integrity and overutilization concerns.

*Practitioners under Medicare currently include PAs, NPs, nurse anesthetists, nurse-midwives, social workers, psychologists, dietitians, nutrition professionals

IHS-Sought Amendments

1) Add hearing aid specialists as providers of treatment and aural rehabilitation services under Medicare

2) Direct DHHS to conduct a study on access problems stemming from the exclusion of hearing aid specialists from Medicare.

While there was general agreement with the principles, House leaders unwilling to derail timing/cost.

Cost Estimates

The Congressional Budget Office estimated the amended bill would result in a net $5 billion in savings over 10 years.• The cost of hearing care/hearing aid benefits, as defined, over this

period is estimated to be $89 billion.• To control the costs, House Democrats excluded coverage for those

with mild to moderate hearing loss, and opted to limit access to include only half of the qualified providers – audiologists only.

• If hearing aids were covered for all Medicare beneficiaries with a documented hearing loss and all access points available, this number would go much higher.

• In the Senate there are a few drug pricing bills and potential vehicles – none of which contain the expansion of Medicare to cover hearing aids.

• If a Senate drug pricing bill were to pass, House and Senate leaders would need to negotiate the two bills and resolve differences between their two versions. This is a chance for us to influence the outcome in pursuit of more deliberate policy discussions.

• Hearing aid expansion being included in a Senate package/bill in 2020 is unlikely. IHS has been watching a “health extenders” package that needs to be reauthorized in November, which could serve as a vehicle.

• Note: House passage was significant. Should a change in party control in Senate and White House occur, continued debate and possible action are more likely.

What’s Next

• IHS will continue to monitor potential for action in 2020 and beyond, and is meeting with the Friends of the Congressional Hearing Health Caucus to identify shared priorities.

• In April 2020, six organizations – IHS, AG Bell, ATA, Ear Community, HIA, and HLAA co-signed a letter to CMS supporting:1) Expanded use of covered Medicare telehealth services by SLPs and

audiologists during COVID-19 emergency response2) Comprehensive coverage for hearing care and hearing aids by all providers

under Medicare Part B, including the use of hearing aid specialists as Medicare providers

Visit our Medicare webpage to stay up-to-date, and access news and calls to action: http://bit.ly/IHSMedicare

What’s Next

• Proposed rules on over-the-counter hearing aid classification due (according to Congressional timeline) no later than August 2020

• FDA had released notice that it was aiming for November 2019 but the review process fell behind

• IHS will communicate action/calls to action upon release of proposed rules• Comment period likely 30-60 days• Proposed rule in August 2020 would mean final rules in March/April 2021

Over-the-Counter Hearing Aids

As a reminder, IHS and AAA, ADA, ASHA jointly released five recommendations for FDA, met with FDA, met with Congressional offices, and obtained support from Chairs of Congressional Hearing Health Caucus, HIA, ACI Alliance for recommendations.

View the recommendations and updates at https://bit.ly/IHSOTCWebpage

Over-the-Counter Hearing Aids

International Activity

IHS joined and attended the first assembly of the World Health Organization’s World Hearing Forum, a new group of hearing-related organizations, individuals, stakeholders, with an interest in driving awareness and good policy for the prevention, identification, and treatment of hearing loss. IHS was appointed to assist its Champions Committee on public awareness activities. World Report on Hearing due out in May; THP for more.

The International Organization for Standardization (ISO) finalized the very first international standard for hearing aid fitting management. Past IHS President Rick Giles, ACA, BC-HIS, represented the US on the workgroup on behalf of ANSI/Acoustical Society of America.

• The National Academies of Science, Engineering, and Medicine is intending to hold a workshop in 2020 regarding insurance payment for hearing healthcare/devices in light of the incoming over-the-counter hearing device regulation/market.

• IHS provided feedback to the workshop organizers, is planning to sponsor the workshop, and is pursuing opportunities to play a formal role.

• (This is the organization that in 2016 released 12 recommendations, including support for the creation of an OTC hearing aid category.

Other Critical Activity

• USPSTF is considering making recommendations for asymptomatic adults aged 50+ to obtain screenings in primary settings

• Congress and physicians looks to USPSTF for standards• Final research plan released

• Focuses on effectiveness and accuracy of screening, and efficacy and harm of interventions for hearing loss, based on various populations

• Recommendations are in process• IHS has encouraged a recommendation supporting hearing

screenings, which would increase identification and referral for treatment

http://bit.ly/USPSTFHearingScreening

U.S. Preventative Services Task Force Activity

Reminder! IHS successfully advocated for hearing aid business owners to potentially be eligible to utilize a new 20% tax deduction, effective for tax years 2018-2025. Find out if you are eligible via the IHS Member Advisory on our advocacy webpage.

Tax day has been extended to July 15.

All our advocacy work is funded through

voluntary donations.• Give today and help us do more.

• bit.ly/ihsdonate

Business Tools and Professional Development

How do you plan to grow your practice to meet the demand?

According to the U.S. Census, “The population is projected to grow by an average of 2.3 million people per year until 2030,” and they predict that

around 2034, there will be more older adults (65+) vs. children.

Will you… Invest in growing your professional staff to address consumer demand? Obtain high-quality and high-value continuing education, and interact with peers

to solve challenges and identify opportunities? Enhance your practice by becoming a Tinnitus Care Provider? Observe and maintain best practices in hearing aid dispensing? Expand participation in managed care, following legal requirements to protect

your practice? Elevate your professional brand through IHS membership and NBC-HIS board

certification?

How do you plan to grow your practice to meet the demand?

National Apprenticeship Program for Hiring/Training

Learn how to: Grow your practice with new and talented staff Enhance your existing training program Receive financial incentives & benefits

• Learn more at: bit.ly/IHSDOLApprenticeship• Become an Employer Volunteer: bit.ly/DOLEmployerInterest

U.S. DOL Apprenticeship

Subscribers get instant access to:200+ previously-used exam questionsTopic-level feedbackFlashcards relevant to ILE questionsA brief practice exam with instant results

Prepare. Perfect. Pass.The first and only official PREP tool available for the International Licensing Examination (ILE)

ihsinfo.org/testprep

• Companion to the Distance Learning for Professionals in Hearing Health Sciences course

• Trainer Toolbox resources include: Best practices for recruiting and hiring, leadership and management,

and skills for mentoring IHS Clinical Practice Guidelines and policy statements Key links to industry newsHelpful tools to share with your apprentice(s)Webinars for clinical and business skills

Watch the video at ihsinfo.org/trainermanual

Trainer Manual 3rd Edition and NEW Trainer Toolbox

Did you know IHS maintains national standards and guidelines for hearing aid dispensing? You should! Check out the Best Practices Guidelines at ihsinfo.org > Professional Development > Best Practice GuidelinesIncludes Best Practices for:

• Fitting and Dispensing Hearing Aids• Bridge-and-Brace Technique for Patient Safety• Verification and Validation• And more!

IHS Professional Practice Guidelines

This comprehensive, yet easy-to-follow guide arms hearing aid dispensing professionals, office staff, and business owners with the knowledge they need related to:

Credentialing Pricing models Hearing aid dispensing superbill Pending claims Responding to denials Applicable laws and rules And more!

Available for purchase at IHS Shop!

Hearing Healthcare Professional’s Guide to Third Party Participation Aka “the Insurance Guide”

PricingIHS Members: Free!

Non-Members: $325 (or join and save!)

A new “for cost” edition is under development. Members,

get your free copy now!

*Funded by IHS Advocacy Alliance

What is it?A compliance plan is a formalized statement of a business’ intent to act ethically and legally in its business operations in accordance with government laws and regulations and in delivering patient care and services. (It’s required by various health plans for participation.)

New Product Alert!

IHS Compliance Plan Development Guide

Effective use of a compliance plan contributes to: • Minimizing organizational and individual risk• Avoiding serious sanctions through plan

implementation and observance• Preventing and detecting unethical/illegal conduct• Establishing a uniform process and procedures for

staff and business associates to follow

This is an exclusive resource for IHS Members only! Visit Resources section of IHS website:

myhome.ihsinfo.org

New Product Alert!

IHS Compliance Plan Development Guide

Thank you for your support and membership in IHS!Not yet a member? Join at ihsinfo.org!

QuestionsEnter your question in the QUESTION BOX on your webinar dashboard.

Obtain a 1 CE credit by passing the quiz!

Thank you for attending!

Contact our Presenter:

advocacy@ihsinfo.org

https://bit.ly/April29Quiz2Parady

A Special THANK YOU to CareCredit for Sponsoring this Event!

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