Direct access

1. Direct access A Deliberate Approach to Reaching Audiology’s Goals

2. What is direct access? • Currently Medicare patients must obtain a physician order prior to seeing an audiologist to have the services reimbursed by Medicare. Direct Access, as the legislation is commonly referred to, eliminates the need for the order.

3. Why direct access? • Eliminating the physician order requirement in the current Medicare model would afford audiologists greater professional autonomy and is an important first step towards achieving additional goals of the profession. • Improves access to hearing health care for Medicare beneficiaries. • It is a pragmatic approach, cultivated over several years with input from leading independent consultants who are experts in policy and political strategy, audiologists and American Academy of Audiology staff. • Relationship building is essential to any successful legislative initiative. Academy members, leaders, staff and consultants are building upon a rich history of fellowship with key elected representatives and their staff and these representatives have supported and have pledged continued support of Direct Access. Continuity demonstrates a mature and respected presence on Capitol Hill and a sound and calculated advocacy plan.

4. What direct access does not do • Direct Access does NOT change or expand scope of practice • Why not? Eliminating the current “gatekeeper” model is the most essential first step that must be taken before further steps are made towards the long term goals of the profession. • Direct Access does NOT address every goal that the profession of audiology would like to achieve • Why not? Consultants and policy experts maintain that an incremental approach is more effective in garnering support from policymakers and employs a more traditional strategy of “earning” additional benefits as opposed to demanding them all at one time which can be polarizing and ineffective.

5. Myths and truths about direct access • MYTH: Direct Access has failed • TRUTH: Efforts towards Direct Access have been underway for around 10 years. Each Congressional session (two years), thousands of bills are introduced and most are not passed, meaning they must be reintroduced and re-tried in the next session. The hearing aid tax credit bill, for example, has been in existence for a few years longer than direct access. • MYTH: If Direct Access were to pass, it would be years before we could re-approach Congress on another initiative • TRUTH: There is no statute of limitations in place for lobbying Capitol Hill. A more conventional strategy would be to approach Congressional leaders in the session immediately following the passage of direct access, for example, to build on the momentum and success of the initiative.

6. Why hasn’t direct access passed? • The single most determining factor in successful legislation versus unsuccessful legislation is the constituency behind it: THAT MEANS YOU! Without contact by audiologists to their representatives, no audiology initiatives will ever be realized. Health care professionals in other fields are mobilizing in droves and their voices will be louder than ours unless each audiologist takes just two minutes out of their day to contact their member of Congress. Anyone can access the Legislative Action Center through the American Academy of Audiology’s website (http://capwiz.com/audiology/home/) or through the Advocacy drop-down menu on the homepage (www.audiology.org). There you can locate your representatives and send an editable email indicating your support for audiology issues.

7. What else can we do? • Ask Your State Academy to Endorse Direct Access. Send letters of support indicating your endorsement to your elected officials. • Schedule a Meeting with Your Elected Officials. Familiarize them with audiology and issues important to the profession. Contact American Academy of Audiology staff if you would like assistance in setting up a meeting or additional information (msinden@audiology.org). • Send an Email to Your Representatives. This message bears repeating as it is critical to the success of any legislative initiative. If you are not actively advocating for the profession, you are not investing wisely in your future!