Medicare Audiology Services Enhancement Act of 2015

To amend title XVIII of the Social Security Act to provide comprehensive audiology services to Medicare beneficiaries, and for other purposes. 1. Short title This Act may be cited as the Medicare Audiology Services Enhancement Act of 2015 2. Comprehensive audiology services for Medicare beneficiaries (a) In general Section 1861 of the Social Security Act ( 42 U.S.C. 1395x (1) in subsection (s)(2)— (A) in subparagraph (EE), by striking and (B) in subparagraph (FF), by adding and (C) by adding at the end the following new subparagraph: (GG) audiology services (as defined in subsection (ll)(3)); ; and (2) by amending paragraph (3) of subsection (ll) to read as follows: (3) The term audiology services (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. . (b) 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) (2)(GG), (3), (c) 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) and services of a certified registered nurse anesthetist 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)) (d) Requirements of service Section 1835(a)(2) of the Social Security Act ( 42 U.S.C. 1395n(a)(2) (1) in subparagraph (B), by striking and (D) (D), and (GG) (2) by striking and (3) by striking the period at the end of subparagraph (F) and inserting ; and (4) 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. . (e) 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) (M) Audiology services (as defined in section 1861(ll)(3)). . (f) 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) 42 U.S.C. 1395 et seq. (g) Effective date The amendments made by this section shall apply to services furnished on or after January 1, 2016.

Summary: Medicare Audiology Services Enhancement Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to: limit covered auditory services to only auditory treatment, vestibular treatment, and intraoperative neurophysiologic monitoring services in addition to currently covered hearing and balance assessment services; exclude inter-operative neurophysiological monitoring provided by a physician or qualified audiologist in hospitals from covered inpatient hospital services; revise the requirements and procedure for payment of outpatient auditory services claims of service providers; include audiology services under the limitation on certain physician referrals for designated health services; and declare that nothing shall be construed to require a qualified audiologist to participate in Medicare.