2023 Early Hearing Detection & Intervention Conference
March 5-7, 2023 • Cincinnati, OH
3/06/2012 | 9:40 AM - 10:40 AM | Impacting Medicaid Policy at the State Level | Regency Ballroom B | 9
Impacting Medicaid Policy at the State Level
State budget shortfalls continue to plague states around the country due to high levels of unemployment, declines in consumer spending, and reductions in real estate value from years past. Medicaid in many states has become the fastest growing category of cost. States are coping with the spiraling cost of Medicaid by narrowing coverage for services, eliminating some services entirely, and reducing payment rates to providers. Cochlear and bone anchored implants have not been exempt from such cost cutting efforts at the state level. Pediatric patients receiving cochlear implants with straight Medicaid varies by state ranging from 15% to 50%. At present, children are covered for implant surgery in all 50 states because of Early Periodic Screening Diagnosis and Treatment (EPSDT), the child health component of Medicaid. But since implants are an optional service and states are now seeking changes in Medicaid policy from the Federal government, it is safe to assume that nothing is exempt from cost-cutting.
While surgery for cochlear implants is currently covered, follow up services by states are quite variable. For example, some states provide no Medicaid coverage for equipment upgrades and consequently children are using outdated technology held together with duct tape. There is rationing of follow-up services including the setting of unrealistic limits on the number of therapy sessions covered for children by Medicaid and the number of batteries issued to a child in a given timeframe.
Parents, early intervention professionals and clinicians in several states have formed coalitions with the purpose of mitigating Medicaid changes by working within their state’s political system. Such initiatives can be successful in ameliorating or reversing actions by states regarding coverage of, or reimbursement for, auditory implants and/or the provision of related services such as audiology, auditory therapy, or purchase of external equipment.
- At the end of the session, participants will be able to assess and consider the impact of Medicaid policies on appropriate access to care for children in their state. At the end of the session, participants will be able initiate Medicaid advocacy efforts in their own states.
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Presenters/Authors
Donna Sorkin
(), Cochlear Americas, dsorkin@cochlear.com;
Donna Sorkin, M.A. is Vice President, Consumer Affairs at Cochlear Americas. She leads a range of activities at Cochlear aimed at the broad life needs of the cochlear implant community including educational options for children, accessibility, and insurance reimbursement. Ms. Sorkin conducts periodic surveys of parents to better understand the needs of children with hearing loss at school as well as parental experiences with early intervention programs.
Ms. Sorkin was executive director of Self Help for Hard of Hearing People and she served as executive director of the Alexander Graham Bell Association for the Deaf and Hard of Hearing. She has served on a number of federal, corporate and university boards including the U.S. Access Board, the National Institute on Deafness (NIH) Advisory Board, and Gallaudet University. She has written and spoken extensively on educational and access issues for children and adults who are deaf and hard of hearing.
ASHA DISCLOSURE:
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Nonfinancial -