Testimony Urges Bilateral CI Coverage Bilateral cochlear implants (CIs) offer improved health outcomes, increased ability to localize sound, and improved speech understanding in background noise. But for Medicare beneficiaries, their cost is out-of-pocket. ASHA is striving to change that reimbursement rule, and presented testimony in May to a federal government group that recommends which medical ... Policy Analysis
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Policy Analysis  |   June 01, 2011
Testimony Urges Bilateral CI Coverage
Author Notes
  • Kate Romanow, JD, director of health care regulatory advocacy, can be reached at kromanow@asha.org.
    Kate Romanow, JD, director of health care regulatory advocacy, can be reached at kromanow@asha.org.×
Article Information
Regulatory, Legislative & Advocacy / Policy Analysis
Policy Analysis   |   June 01, 2011
Testimony Urges Bilateral CI Coverage
The ASHA Leader, June 2011, Vol. 16, 6. doi:10.1044/leader.PA2.16062011.6
The ASHA Leader, June 2011, Vol. 16, 6. doi:10.1044/leader.PA2.16062011.6
Bilateral cochlear implants (CIs) offer improved health outcomes, increased ability to localize sound, and improved speech understanding in background noise. But for Medicare beneficiaries, their cost is out-of-pocket. ASHA is striving to change that reimbursement rule, and presented testimony in May to a federal government group that recommends which medical services and items should be covered under Medicare.
Audiologist Richard Tyler, a well-known University of Iowa researcher and scholar in the area of cochlear implants, stressed the benefits of bilateral CIs in his testimony on behalf of ASHA to the Medicare Evidence Development and Coverage Advisory Committee (MEDCAC). The group convened May 11 to review available evidence on outcomes associated with the use of unilateral and bilateral cochlear implants for hearing loss.
Current regulations, established in 2005, limit CI coverage to patients who derive limited benefit from current means of sound amplification. Limited benefit is defined as 40% or less correct in the best-aided listening condition on tape-recorded tests of open-set sentence recognition. CI coverage for patients who demonstrate hearing test scores of greater than 40% and less than or equal to 60% (and who meet Medicare's other coverage criteria) is limited to those participating in federal clinical trials of CIs. There is no coverage for bilateral CIs.
Based on the testimony at the hearing, MEDCAC will make a recommendation to the Centers for Medicare and Medicaid Services concerning Medicare coverage of bilateral CIs.
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June 2011
Volume 16, Issue 6