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Action Alert
Take Action AAO-HNS Members: Act Now to Oppose "Physician" Status for Audiologists!
Contact your federal legislators TODAY and urge them to oppose "direct access" and "limited license physician" status for audiologists in the Medicare program!

A "kitchen sink" audiology bill (H.R. 2276) was recently introduced in Congress, and the AAO-HNS needs your help! If enacted, the proposed bill would not only grant audiologists their long-sought unlimited direct access to Medicare patients without a physician referral, but it would also establish audiologists as "limited license physicians" under the Medicare program.

The AAO-HNS strongly opposes H.R. 2276 and is working to communicate our concerns to lawmakers. And, we're not alone in our position. In the previous Congress, more than 120 national, state, and local medical societies joined the AAO-HNS in opposing similar legislation. Given the continued inclusion of "limited license physician" status in H.R. 2276, we expect to maintain, if not expand, the support for our position, a fact that underscores the serious issues associated with direct access and other misguided provider changes to the Medicare program.

To call your legislators, contact the Capitol Switchboard at 1-202-224-3121. You will be asked for the name of your U.S. Representative, which you can find here. Once you are connected to a legislator's office, tell him/her you are a constituent and leave your name, phone number, and address, along with the following message, "As an otolaryngologist-head and neck surgeon (or ENT physician) and a constituent, I strongly urge you to refrain from co-sponsoring H.R. 2276, and oppose any efforts to advance the bill."

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Subject:
Patient Safety is at Risk - Don't be Misled by the Audiology Patient Choice Act (H.R. 2276)
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As a practicing otolaryngologist-head and neck surgeon and a constituent, I am writing you today to oppose H.R. 2276. This legislation would inappropriately grant audiologists unlimited direct access to Medicare patients without a physician referral, as well as amend Title XVIII of the Social Security Act to provide "limited license physician" status for audiologists under the Medicare program. Last Congress, similar legislation garnered opposition by more than 120 national and state organizations. We expect a similar response to H.R. 2276.

This is not a "turf" issue - it is a patient safety issue, and the Centers for Medicare and Medicaid Services (CMS) agrees. For years, CMS has maintained a position regarding the direct access issue that physician referral is a "key means by which the Medicare program assures that beneficiaries are receiving medically necessary services, and avoids potential payment for asymptomatic screening tests that are not covered by Medicare ...." And, in a June 2016 report by the National Academies of Medicine on older Americans and hearing health, the authors noted their recommendation "excludes direct access to audiologic testing for assessment of vestibular and balance disorders and dizziness, which require physician referral."

Unfortunately, H.R. 2276 and its proposed "direct access" represents an escalation in the audiology community's efforts to inappropriately expand their scope of practice to include the medical diagnosis and treatment of hearing and balance disorders. To ensure an accurate medical diagnosis, these conditions require a full patient history and physical examination by an MD/DO physician. The aspirations of some audiologists to independently make a medical diagnosis to treat hearing and balance disorders transcends their level of training and expertise.

Notwithstanding the patient safety concerns associated with direct access, the inclusion of audiologists in Medicare's definition of "physician" will create confusion regarding the qualifications and training of various healthcare providers. Audiologists and many other non-physician providers with doctoral degrees can now call themselves "doctor." However, audiologists are not physicians and should not be considered as such under the Medicare program. And, broadening the term "physician" to include non-physician healthcare providers encroaches on the "expert" status achieved by MD/DO physicians.

In conclusion, Otolaryngologists are dedicated to ensuring patients have access to the highest quality and affordable hearing healthcare, but H.R. 2276 will not help to further advance this goal. I urge you to refrain from co-sponsoring this misguided legislation and oppose any efforts to advance the bill. If you or your staff have any questions, please contact me or the American Academy of Otolaryngology-Head and Neck Surgery's Legislative Advocacy team at legfederal@entnet.org.
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