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American Cochlear Implant Alliance
| Medicare Expansion |
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ACI Alliance Submits Formal Request for Medicare Coverage of Cochlear Implantation in Single-Sided Deafness and Asymmetric Hearing Loss 11/1/2024 ACI Alliance submitted a formal request on November 1, 2024 to the Centers for Medicare and Medicaid Services (CMS) to expand the Medicare program’s coverage policy on cochlear implantation for individuals with post-linguistic sensorineural hearing loss. The organization submitted a formal Request for Reconsideration of Medicare coverage (a National Coverage Determination or NCD) based on the clinical presentation of the ear to be implanted. Medicare Expansion
The first major initiative undertaken by the then newly organized American Cochlear Implant Alliance (ACI Alliance) in 2013 was a research project related to CI candidacy in older adults. In 2020, the results of the study were published with the results supporting expansion of the Centers for Medicare & Medicaid Services (CMS) current indications for cochlear implants. Following the publication of that study, ACI Alliance began working with CMS to formally support a National Coverage Determination (NCD) to reconsider cochlear implant coverage under Medicare. In September 2022 CMS published its final rule to expand coverage for cochlear implants under Medicare. Read more information on the background/study OUTCOMECMS Publishes Coverage Expansion For Cochlear Implants Under Medicare 9/26/2022 On September 26, the Centers for Medicare & Medicaid Services (CMS) published details on its decision to expand coverage for cochlear implants under Medicare. This provides a significant improvement in access to care for older adults who are Medicare beneficiaries allowing individuals with hearing test scores between >40% and ≤60% to qualify for cochlear implantation. After reviewing the evidence submitted as part of the National Coverage Determination (NCD) process, CMS found that the evidence was sufficient to determine that cochlear implantation may be covered for a broader spectrum of hearing loss. The policy change is effective immediately. Read more here. NEWS & ARTICLESMedicare Expansion Benefits Seniors with Hearing Loss 4/5/2023 A recently published article details what the new Medicare expansion for cochlear implant coverage means for beneficiaries with hearing loss, and tells the story of Ann, a cochlear implant recipient who did not qualify under the previous Medicare coverage rules but received her life-changing cochlear implant through the clinical trial.
Access Accessibility of Cochlear Implants for Older Adults 2/20/2023 Hearinglikeme.com included an article on the expanded access by Abigail Russell, a second-year medical school student at Indiana University School of Medicine. She is a bilateral hearing technology user, utilizing both a Phonak Naída and Cochlear Implant. Ever since she was diagnosed as a little girl, she has been an advocate for those with hearing loss. She writes, "Notably, this influential change would not have been possible without the American Cochlear Implant Alliance. This Alliance strives to remove the barriers for implantation. They saw the need to investigate these qualification measurements to see if they were truly appropriate." Expanded Medicare Coverage for CI Improves Access 1/31/2023 Hearing Loss Association of America (HLAA) produces a quarterly publication, Hearing Life, that helps people live better with hearing loss. HLAA's winter issue includes an article by Donna Sorkin and Laura Odato, discussing the expanded Medicare Coverage and how it improves access for cochlear implants. This article provides excellent content to share with adult patients who may be eligible for a CI. Read the article here.
Cochlear Implants Now More Accessible to Older Adults
12/22/2022 The January issue of The Hearing Journal featured an article by ACI Alliance Executive Director Donna Sorkin and Dr. Craig Buchman “Cochlear Implants Now More Accessible to Older Adults.” CMS worked with the study investigators and conducted reviews throughout. Findings were published in JAMA -Otolaryngology-Head & Neck Surgery in 2020, and subsequently a formal request to revise the NCD was submitted. Find the full article here. Medicare Expansion of CI Candidacy Is ‘Life Changing’ for Older Patients 12/3/2022 In December the ASHA LeaderLive published “Medicare Expansion of CI Candidacy Is ‘Life Changing’ for Older Patients,” featuring testimonials of individuals who participated in the initial research study. Cochlear Implant Basics 11/1/2022 ACI Alliance Executive Director Donna Sorkin spoke with the Cochlear Implant Basics podcast about the changes in the criteria for adults covered by Medicare. Listen to the podcast here.
Cochlear implants can be life-changing, but few receive them. Medicare expansion could help 10/24/2022 Mariane Fahlman, 68 of Warren, shows off the exterior part of the cochlear implant Henry Ford Health Dr. Kristen Angster surgically installed in March. A Medicare expansion could make it possible for more people with hearing loss to have the implants, electronic medical devices designed to restore the ability to perceive sound and understand speech. (Courtesy of Henry Ford Health). Read more here.
Medicare Expands Coverage for Cochlear Implants 9/27/2022 The Centers for Medicare & Medicaid Services (CMS) has expanded coverage for cochlear implantation, making the procedure available to millions of additional individuals with hearing loss. Washington University faculty, including Lindburg Professor and Chair Craig A. Buchman, MD, have spent years working in support of the expanded coverage. Read the full article here. Cochlear Implants and the Continuum of Care 6/6/2022
In this episode of This Week in Hearing, Donna Sorkin sits down with Brian Taylor for an interview that touches on the ACI Alliance’s mission, the broadening cochlear implant (CI) candidacy requirements for children and adults and how CIs are an integral part of the continuum of care. Listen to the full interview here. Media outreachCMS Publishes Expanded Coverage for Cochlear Implants Under Medicare 10/18/2022 ACI Alliance urges all clinics and hospitals to reach out to local media in an effort to spread awareness of this important change. ACI Alliance staff are available to answer questions or provide resources on media outreach. ACI Alliance Guidance for Outreach to Local Media on CMS Medicare Coverage Update The Centers for Medicare & Medicaid Services (CMS) published the final decision memo September 26th broadening Medicare candidacy criteria for cochlear implants for individuals with bilateral moderate to profound hearing loss. This decision broadens coverage to more closely align with typical insurance indications for adults younger than age 65. Below are suggested talking points, quotes and resources about the policy update that your clinic can use to communicate this policy change to your patients and families, community and local media. Outreach Resources
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