AMERICAN-SPEECH-LANGUAGE-HEARING ASSOCIATION

Vision: Making effective communication, a human right, accessible and achievable for all.

We are your constituents!

Audiologists specialize in preventing and assessing
hearing and balance disorders as well as providing
audiologic treatment, including hearing aids.
Speech-language pathologists identify, assess, and
treat speech and language problems, including
swallowing disorders.

The American Speech-Language-Hearing Association (ASHA) is the national professional,

scientific, and credentialing association for 182,000 members and affiliates who are
audiologists; speech-language pathologists; speech, language, and hearing scientists;
audiology and speech-language pathology support personnel; and students.

KEY LEGISLATIVE PRIORITIES in 2015

Education Issues

Support Alternatives to Applied Behavior Analysis (ABA) Therapy

Support Reducing Special Education Paperwork

Support Reauthorization of the Elementary and Secondary Education Act (ESEA)

Support Restoring Funding for the Individuals with Disabilities Education Act (IDEA)

Support Preserving Medicaid Coverage for Audiology and Speech-Language Pathology Services

Health Care Issues

Support Medicare Telehealth Coverage for Audiology and Speech-Language Pathology Services

Support the Repeal of the Medicare Outpatient Therapy Cap

Support the Hearing Aid Assistance Tax Credit

Support Medicare Coverage of Audiology Services

Oppose the Appointment of Hearing Aid Specialists to the VA

Support Reauthorization of the Early Hearing Detection and Intervention (EHDI) Program

Support Medicare Beneficiary Access to Speech-Generating Devices (SGDs)

Join the Congressional Hearing Health Caucus

EDUCATION ISSUES
Support Alternatives to Applied
Behavior Analysis (ABA) Therapy
All appropriate therapies should be provided to
children with autism spectrum disorder (ASD). There
is a growing trend in both education and health care
to solely utilize applied behavioral analysis (ABA)
specialists to provide services to children identified
with autism spectrum disorder. Although ABA may
be an effective therapy, so are others, such as
speech-language pathology. In many cases,
insurance companies are denying speech-language
pathology claims where children are receiving ABA
services. ASHA does not oppose the use of ABA
services; however, singling it out in legislation as the
only treatment for behavioral health issues for
individuals with developmental disabilities, including
those with ASD, limits consumer choice.
Congress should not pass health care or education
legislation that could have the unintended
consequence of designating applied behavioral
analysis (ABA) therapy as the sole means by which
to treat ASD.

Reduce Special Education Paperwork

Federal statutes and regulations from ESEA, IDEA, Medicaid, and
several other smaller programs generate paperwork and
administrative burdens. State laws add additional burdens. In
December 2013, the General Accountability Office (GAO) was
requested to issue a report that will delve into various special
education paperwork issues. GAO is expected to release a report on
its findings and recommendations sometime in late summer or early
fall 2015.
Adverse effects of the paperwork and administrative burden include
difficulty in:
recruiting and retaining qualified audiologists and speechlanguage pathologists
managing caseload/workload
As audiologists and speech-language pathologists struggle to
maintain paperwork, they forgo opportunities to:
collaborate with classroom teachers and other related services
providers
develop and implement innovative treatment plans and best
practices
collaborate and communicate with families
tailor curricula and therapy as needed to achieve academic
success.

Restore IDEA Funding

In October of 2013, Congress provided a $579 million increase for
fiscal year 2014 for IDEA programs. This was the first significant
increase since the stimulus program. For fiscal year 2015,
Representatives John Kline (R-MN), Todd Rokita (R-IN), Cathy
McMorris Rodgers (R-WA), and Pete Sessions (R-TX) requested an
additional $1.5 billion for IDEA Part B State Grants. Unfortunately, in
December of 2014, Congress provided additional Part B funding of
only $27 milliona figure significantly lower than the previous
years. This action undermined the efforts of schools that have relied
on these additional funds to maintain levels of services.
Congress is urged to increase the federal investment in children with
disabilities by adding $1.5 billion for IDEA state grants when the
budget for fiscal year 2016 comes up for consideration later this year.
The demands and requirements of providing the necessary services
so that children with disabilities can achieve academically never go
away.
Members of Congress can demonstrate their commitment to
children with disabilities by supporting H.R. 551, the IDEA Full
Funding Act, which would gradually increase IDEA funding from its
current annual appropriation of $11.6 billion to $35.6 billion by fiscal
year 2025.

Preserve Medicaid Coverage for

Audiology & Speech-Language
Pathology Services
Currently, audiology and speech-language pathology
services are required under Medicaid for children up
to 21 years of age. Under the Early Periodic Screening
Diagnostic and Treatment (EPSDT) provisions of the
Social Security Act, states are required to provide
comprehensive services and furnish all eligible
Medicaid recipients (i.e., up to age 21) with services
that are medically necessary to correct and ameliorate
health conditions identified through screening and
diagnostic services.
Many reports indicate that Congress is considering
moving Medicaid to a block grant program, which
would provide states with a lump sum payment and
allow states to run programs as they deem
appropriate. States would no longer be mandated to
provide EPSDT services.
This could put children at risk of not receiving
medically necessary services, if states decide to cut
Medicaid funding.

Reauthorization of Elementary and Secondary Education Act (ESEA)

Give local school districts the flexibility to use qualified education professionals, such as audiologists and speechlanguage pathologists, as recognized providers of service under federal literacy and reading legislation and programs.
Audiologists and speech-language pathologists (SLPs) are qualified and certified education professionals, working in
school settings, with expertise in hearing, language, and speech. House and Senate bills to reauthorize the Elementary
and Secondary Education Act (ESEA) should be amended to reflect the integral role that audiologists and SLPs play in
improving literacy and reading skills in children.
Audiologists play an important role in the identification and management of hearing loss and auditory processing
disorders, a frequent cause of language delay and reading difficulties. Audiologists are involved in the identification
and diagnosis of hearing disorders, the provision of auditory training, and the selection and fitting of appropriate
personal and classroom amplification systems (e.g., hearing aids, cochlear implants, and FM and sound field systems).
The ability to hear and recognize all of the phonetic aspects of speech is critical for the development of early literacy
skills.
SLPs possess the foundational knowledge of language and its subsystems: phonology (speech sound systems),
morphology (word structures), syntax (grammar), semantics (vocabulary), and pragmatics (social language). This
enables them to design emergent literacy programs in phonological awareness, memory, retrieval, and vocabulary
that significantly improve an individuals ability to learn to read.

HEALTH ISSUES
Repeal the Medicare Outpatient Therapy Cap
Support the Medicare Access to Rehabilitation Services Act of 2015 (H.R.
775/S. 539), legislation that would repeal the Medicare outpatient therapy
cap and ensure Medicare patients continue to have access to medically
necessary speech-language pathology, occupational therapy, and physical
therapy services. A repeal of the Medicare therapy cap should also be
included in any Sustainable Growth Rate (SGR) reform package.
Under the cap for speech-language pathology and physical therapy
services, Medicare beneficiaries who suffer from speech-language disorders
due to life-altering events (e.g., stroke, head injury, Alzheimer's,
Parkinson's) risk being denied therapy and/or forced to pay out-of-pocket
for services to help them regain their ability to communicate effectively.

Hearing Aid Assistance Tax

Credit
Support the Hearing Aid Assistance Tax
Credit Act of 2015 (S. 315), is legislation that
would allow for an income tax credit for the
purchase of hearing aids. Members of
Congress are encouraged to cosponsor this
important legislation. The proposed
legislation would provide for a tax credit of
$500 per hearing aid every 5 years. This
legislation has received strong bipartisan
support. It is meant to offer assistance to
those who have the greatest need for these
devices, but are unable to afford them.

Medicare Telehealth Coverage for Audiology and Speech-Language Pathology Services

Support Medicare Telehealth coverage. Telehealth is the delivery of audiology and speech-language pathology services from a
distance via telecommunications technology. Research and reports to date confirm that appropriately delivered telehealth
services are comparable to those delivered face-to-face. That is, the services provided must be equivalent to the quality of
services delivered face-to-face.
The services that can be administered via telehealth include, but are not limited to, the following activities.

Audiologyadult hearing screening, hearing aid and cochlear implant programming and counseling, and auditory
brainstem response testing

Speech-Language Pathologyreal time, interactive assessment and treatment for beneficiaries with stroke, brain injury,
cancer, Parkinson's, and other medical conditions, such as disorders in swallowing (dysphagia), speech (dysarthria or
apraxia), language (aphasia), cognitive communication, and voice (dysphonia)

Telehealth expands Medicare beneficiaries access to audiology and speech-language pathology services and can alleviate
provider shortages by extending clinical services to remote, rural, or underserved populations.

Medicare Coverage of Audiology Services

Support and promote the Medicare Audiology Services Enhancement Act
of 2015 (H.R. 1116), which would provide senior citizens with a Medicare
audiology benefit that would allow access to both diagnostic and
rehabilitative services.
Currently, Medicare covers only diagnostic tests that focus on hearing and
balance assessment services. Under the Medicare Audiology Services
Enhancement Act of 2015, covered services would be expanded to include
hearing and balance assessment, auditory treatment, and vestibular
treatment. In addition, the proposal would allow direct payment of
intraoperative neurophysiologic monitoring (IONM) performed in the
hospital inpatient setting. All of these services are currently covered under
Medicare when provided by other practitioners. The proposed legislation
would continue to exclude services provided in the dispensing of hearing
aids and would maintain the current requirement for a physician referral.

Oppose the Appointment of

Hearing Aid Specialists to
the VA
Oppose H.R. 353, legislation that would
allow for the appointment of hearing aid
specialists to the Veterans Health
Administration (VA). This legislation is
redundant and unnecessary, because
current VA policies already allow for
hiring and using hearing aid specialists.
The legislation could lead to fragmented
care and will not serve the intended
purpose of allowing greater access to
hearing health care services.

Join the Congressional

Hearing Health Caucus

Reauthorization of the Early Hearing Detection and

Intervention (EHDI) Program

The Congressional Hearing Health

Caucus (CHHC) is chaired by
Representatives David McKinley (R-WV)
and Mike Thompson (D-CA). The focus
of the CHHC is to broaden support and
knowledge of hearing health care issues
within Congress and provide an
educational setting for discussion of
issues related to hearing health.

Support legislation that would reauthorize the Early Hearing Detection and
Intervention (EHDI) program. This legislation would reauthorize the federal
portion of this important and highly successful initiative for the next 5 years.

Medicare Beneficiary
Devices (SGDs)

to

Access

EHDI grants to states have significantly increased the number of infants

screened for hearing loss, the CDC reports EHDI federal grants have resulted
in about 97% of infants being screened for hearing loss within the first month
of life.
Although great strides have been made, significant work remains to be done
to ensure that newborns with hearing loss receive timely and appropriate
services.

Speech-Generating

Support the Steve Gleason Act of 2015 (H.R. 628), legislation that allows for the
immediate purchase and transfer of ownership of speech-generating devices (SGDs)
to the Medicare beneficiary and remove the devices from the Medicare capped-rental
requirements.
CMS has applied a capped-rental rule, requiring patients to rent SGDs over a
13-month period before owning the device.
Capped-rental adversely affects patients in an extended hospital stay or in a
skilled nursing facility, becausewhile the patient is in the rental period
Medicare will not cover the rental fees.
The agency has indicated that the capped-rental issue must be addressed
through legislation.
H.R. 628 will resolve this issue by removing the capped-rental requirement for speechgenerating devices and ensure that beneficiaries have access to eye-tracking
accessories for the devices.

Contact Us
Give us a call or e-mail us
for more information
ASHA
444 North Capitol St. NW
Suite 715
Washington, DC 20001
202-624-5951
ilusis@asha.org
Visit us on the web at
www.asha.org/advocacy