Section 1 Short title
This Act may be cited as the “Medicare Audiology Services Enhancement Act of 2015”.
Medicare Audiology Services Enhancement Act of 2015
A BILL
To amend title XVIII of the Social Security Act to provide comprehensive audiology services to Medicare beneficiaries, and for other purposes.
Sec. 2 Comprehensive audiology services for Medicare beneficiaries
in subsection (s)(2)—
in subparagraph (EE), by striking “and” at the end;
in subparagraph (FF), by adding “and” at the end; and
by adding at the end the following new subparagraph:
“(GG) audiology services (as defined in subsection (ll)(3));”
by amending paragraph (3) of subsection (ll) to read as follows:
“(3) The term audiology services means only the following services furnished by a qualified audiologist as the audiologist is legally authorized to perform under State law (or the State regulatory mechanism provided by State law), pursuant to an order or referral by a physician, as would otherwise be covered if furnished by a physician:
“(A) Hearing and balance assessment services.
“(B) Auditory treatment services, including auditory processing and auditory rehabilitation treatment.
“(C) Vestibular treatment services.
“(D) Intraoperative neurophysiologic monitoring services.”
Payment under part B under physician fee schedule for comprehensive audiology services— Section 1848(j)(3) of the Social Security Act (42 U.S.C. 1395w–4(j)(3)) is amended by inserting “(2)(GG),” before “(3),”.
Audiology services performed in hospitals excluded from inpatient hospital services— Section 1861(b)(4) of the Social Security Act (42 U.S.C. 1395x(b)(4)) is amended by striking “and services of a certified registered nurse anesthetist” and inserting “services of a certified registered nurse anesthetist, and inter-operative neurophysiological monitoring provided by a physician or qualified audiologist (as defined in subsection (ll)(4)(B))”.
Requirements of service— Section 1835(a)(2) of the Social Security Act (42 U.S.C. 1395n(a)(2)) is amended—
in subparagraph (B), by striking “and (D)” and inserting “(D), and (GG)”;
by striking “and” at the end of subparagraph (E);
by striking the period at the end of subparagraph (F) and inserting “; and”; and
by inserting after subparagraph (F) the following new subparagraph:
“(G) in the case of outpatient audiology services, (i) such services are or were required because the individual needed the specialized services of a physician or qualified audiologist to furnish such audiology services, (ii) a plan of care for furnishing such services has been established by the physician or qualified audiologist and is submitted to and periodically reviewed by the referring or ordering physician, and (iii) such services are or were furnished while the individual is or was under the care of a physician.”
Audiology services included as designated health services for purposes of limitation on certain physician referrals— Section 1877(h)(6) of the Social Security Act (42 U.S.C. 1395nn(h)(6)) is amended by adding at the end the following new subparagraph:
“(M) Audiology services (as defined in section 1861(ll)(3)).”
Participation in Medicare— Nothing in this section shall be construed to require a qualified audiologist (as defined in section 1861(ll)(4)(B) of the Social Security Act (42 U.S.C. 1395x(ll)(4)(B))) to participate in the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).
Effective date— The amendments made by this section shall apply to services furnished on or after January 1, 2016.