Friday Audiogram: Medicare Audiology Access Improvement Act feat. Dr. Amit Gosalia

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Chapters

• 0:00 Framing High-Impact Advocacy
• 0:22 The MAIAA Bill Explained
• 1:14 Direct Access And Practitioner Status
• 2:15 Billing For Full Scope Of Care
• 2:46 One-Click Advocacy Tools
• 3:36 Bipartisan Case For Hearing Health
• 4:05 Data Versus Stories On The Hill
• 5:24 The Patient Story That Lands
• 6:33 Consequences Of Untreated Hearing Loss
• 7:48 Local Lobbying And Office Visits
• 9:08 Invite Policymakers To Your Clinic
• 10:00 Policymakers Work For The Community

Transcript

Blaise M. Delfino, M.S. - HIS : 0:00

This is the Friday Audiogram. Let's go. What are some of like the simplest, highest impact advocacy actions any provider can take today?

Dr. Amit Gosalia: 0:12

I think the first thing is recognizing who do you need to talk to and what do you need to support? So coming from the audiologist side, I'll share, you know, the audiology stuff. So for example, there's a bill in Washington that we've been working on. All three national audiology organizations have come together, which is kind of rare. We we rarely see all three. Usually it's one by themselves or two. This is one that all three audiology organizations and a bunch of other organizations have actually supported. So it's called the Maya Bill, M-A-A-I-A. So that's actually called the Medicare Audiology Access Improvement Act. It actually has three tenets. The first one is direct access. I think everybody that's watching this would probably agree that you don't have to go see a primary care physician for them to say, okay, yes, you can go get a hearing test. That's ridiculous. It's outdated. So the first tenet is to be able to provide direct access so we can provide better hearing and balance care to our patients without any speed bumps or barriers. Number two, when we first joined CMS, the Center for Medicare and Medicaid Services, when we first did that many decades ago, we kind of let them dictate a lot of things instead of us telling them what needs to be there. So for example, audiologists are currently listed as suppliers at CMS, suppliers, versus a physician. Well, there's one in between called a practitioner. So the second tenet that we are promoting, and it will get past at some point, is that we are no longer suppliers, but that we are practitioners under Medicare. Number three is we have the ability under our scope of practice to do serumen removal and oral rehab and some other services. We should be able to bill and not only bill, we can always bill. We also should be able to collect payments from CMS. So the idea is that those are the three tenets. And, you know, there's many, you know, ways for us to support that, you know, as a busy clinician. Number one, very simply, is going on to one of our national organizations' websites and literally, for example, the American Academy of Audiology, AAA, they have a legislative action center. You can go there, you click on this little window. I was just showing this to my student the other day. You click on this little window that talks about Maya, it takes you to another page. It has some text already pre-written. So if you don't want to write anything, it's already pre-written saying the pros of this bill. You just put your name in there, you put your zip code or your address, it'll find your representatives to send it to. And you basically hit send. It can't get any easier than that. Okay. So that's, you know, you talk about busy clinics. I'm a partner in our clinic in LA and we're super busy. And then I also run three other companies on the side. So I'm the busiest person, one of the busiest people around. And I find time to make sure that I go on those sites and I will edit the text because I like to add my own flavor and then submit it. And that's the easiest thing you can do. And don't get me wrong, Asha has something. I know IHS has links as well. So, you know, whatever your leadership is promoting to help you as a provider doing the things that you need to be able to do to take care of your patients, you gotta support it. There's no question. You have to support it. And you have to do just do the bare minimum.

Blaise M. Delfino, M.S. - HIS : 3:37

Dr. Gasalia, thank you so much for bringing up the Maya bill. For our listeners tuned in, that is a bipartisan bill. I mean, how do we continue to communicate to our policymakers that hearing healthcare, it's not just about audibility. It's not just about turning our hearing aids on and hearing to the best that we can, but it's about quality of life, relationships, long-term health. Bring us through that. How do we communicate this or continue to?

Dr. Amit Gosalia: 4:05

So I think the bottom line is, you know, we have all the statistics like the ones you just mentioned. I feel uh obviously that's very relevant, very important information. I find that telling stories about patients hits even closer to home. So back in 20, I think it was 2018 or 2019, I can't remember, I was in Washington, D.C. for a conference and we did some lobbying. And I had an opportunity to meet with Kamala Harris when she was a senator at the time. She was there, and again, it doesn't matter if the person is Republican or Democrat, I went in there with the mindset of, okay, I'm gonna, I'm gonna wow these senators and representatives with all this data. And when I did, it really didn't hit home. What hit home were stories. And so the next time I went to lobby, instead of just sharing data saying, hey, look at all these Americans, these are your constituents, we got to help them. Instead of that, I started telling stories. And one of the stories I like to tell, and it's not really a story, it's more of an example. And I'll say, now picture this. Uh so an example, we have a representative here, he's my representative for wherever our clinic is. His name is Brad Sherman, and he's a Democrat. And so we went, I went to his office and I walked in and I said, So I want to, I want to ask you a question. Imagine your mother lives 55 minutes away from my office, and now she makes the trip all the way to my office for an appointment for a hearing test. And I have to tell her, or our team has to tell her, hey, we don't have the referral from your primary care doctor to do a hearing test. That means now she has to go to her primary care doctor, go back home, and eventually at some point come back to my office for a hearing test. Let me tell you what a hearing test involves. I look inside their ears, I do a quick test of their eardrums, I run through some air pure tones. Of course, I'm saying these terms because, Blaze, you know these and most of your listeners do, but those that don't, an air pure tone test is heckphones or inserts, and you push a button when you hear beeps. Then we do some speech testing, we do some speech and noise testing, we'll do some more objective measures and maybe a couple of other tests, and that's it. There's nothing invasive about what we do, nobody gets hurt, there's no bleeding involved as long as we know what we're doing. Um, I'm kidding. So the idea there is it's not a very difficult thing, and there's no patient safety issues here. Now, would you rather your mother came in and I took care of her on that first visit because she made this trip all the way out, or do you think she needs to go through all these hoops just to come in and get a hearing test? And 100% of the legislators, senators, representative that I talk to will say, obviously, it sounds like that you should just take care of them. And I'll say, Great, I agree. Co-sponsor this bill. That's the easiest thing you can do. There's hundreds of audiologists, hundreds who are making these same connections with the policymakers, the folks that make the impact. You know, it's we know, we know the side effects of untreated hearing loss. You know, we know that there's a high risk of un you know, folks that have untreated hearing loss. There's a high risk in adults that they could, okay. I don't want to, I don't want to sugarcoat this or even uh uh exaggerate it, but there's a potential that there's some cognitive decline issues that can happen, right? We know that there's some social isolation things that happen. We know that there's anxiety that can occur, there's depression. So these are things that we want to avoid. I mean, we talk about this on a national scale. We know that you know the Alzheimer's Association has statistics on how many people have Alzheimer's and dementia and how it just it is they suffer through these things. So, what can we do, even if it's the littlest thing, what can we do to help? We could have these conversations with legislators. Now, I don't, I'm not saying that everyone needs to go to Washington, D.C. I understand that most can't make that trip, right? Whether it's financial, whether it's time, whether it's whatever. The reality is that you can find time when they're on what's called recess, right? So they're back home. So a couple of years ago, I was working with a group of students here in California, along with the California Academy of Audiology, and we created this Google uh document, and we created a list of every representative in the state of California, and we DVD it up into different areas of California, and we found audiologists who were in those areas, and 100% of them we were we were gonna go out and visit. Last second, things got stalled. Of course, I'm so busy and I screwed up. Long story short, we never did it. However, we still have the data. The data was basically here's the representative, here's where their office is, here's their contact information, here's when they're in town, and here are the steps to get into their office. Now, what most people don't realize is your representatives, they want to come to your office. They want to come to your office, they want to get photos, they want to show the community that, hey, they are involved in the community, they are supporting these good things that we are doing on the ground. So whether you go to their office or you invite them to your office or you do an event, I know some people do open houses or ribbon cuttings or whatever events you're gonna have. Invite the policymakers, give them an opportunity to speak, because of course these folks love to speak. Let them speak, you know, say a few words, give them a hearing test, take a photo, you know, while you're doing autoscopy or whatever else. They want to be involved in this. And so it's not hard. Having these conversations is not hard. You know, I hate to use a phrase, they're just like you and me. They are just like you and me. Okay. It's just their position is supposed to be to represent us in the community and they work for us, right? It's not the other way around that I should be begging them to do things, they should be begging us as the community, saying, Hey, what can I do to support you?