Maryland Medicaid to cover cochlear implants & hearing aids for adults

From Diasabilty Rights Maryland:

Subject: [NHeLP Confidential] Maryland Medicaid to cover cochlear implants & hearing aids for adults

 I’m thrilled to share that effective July 1, Maryland Medicaid will be covering hearing aids and cochlear implants for adults, which until now were only provided under EPSDT.

 1.       Coverage policy and impact on other states

The CMS-approved SPA includes extensive information about the coverage policy. Hearing aids will be covered as medical equipment, and cochlear implants as prosthetics.

 Disability Rights Maryland (DRM)’s position is that both hearing aids and cochlear implants qualify as “medical equipment” under CMS’s 2016 Home Health Rule (available here; FAQ on the Rule by the National Assistive Technology Advocacy Project is here) and therefore are included in the mandatory home health services benefit. Cochlear implants are classified as prosthetics under Medicare, so it makes some sense that CMS approved them in that category here as well; however, the Home Health Rule also states that if an item could be placed in two categories, including home health, it must still be covered under the home health benefit. This matters because while prosthetics are an optional category, home health is mandatory.

 Because CMS approved coverage of hearing aids as medical equipment, they are subject to the mandatory Home Health Rule that is applicable to all states. In other words, this SPA should help advocates in other states argue for adult coverage of hearing aids as well.

 2.       Proposed regulations

Maryland’s proposed regulations to implement this change are available at http://www.dsd.state.md.us/MDR/4513.pdf (starting at p.671; they amend COMAR 10.09.51, available here). They were issued on June 22 and are subject to a 30-day public comment period through July 23 (which is admittedly after coverage will have already begun). If anyone has thoughts or questions about the regulations, I’d certainly appreciate your input as we’re drafting our comments. Happy to discuss by phone as well.

 3.       HUGE thanks & follow-up discussions

DRM has worked on this project with a team of DC-based Sidley Austin attorneys since 2013. Thanks so much to NHeLP and several others on this list who’ve provided invaluable guidance and brainstorming several times since then.

 If folks have questions about how this came about or would like to discuss our arguments for covering hearing aids and/or cochlear implants under the Home Health Rule, please let me know.

Further information:

Maryland Medicaid provider transmittal: https://mmcp.health.maryland.gov/MCOupdates/Documents/pt_31-18.pdf (noting the Provider Manual online will be updated by 7/1/18)

 Sarah Steege

Attorney
Disability Rights Maryland, formerly Maryland Disability Law Center
1500 Union Ave., Suite 2000
Baltimore, MD 21211

Tel 443-692-2497

Fax 410-727-6389
SarahS@DisabilityRightsMD.org

Visit our new website at www.DisabilityRightsMD.org

 

Feedback

We welcome your comments and suggestions