As you may have heard, The Centers for Medicare and Medicaid Services (CMS), the governing body that runs Medicare, is proposing to eliminate the coverage for bone anchored hearing devices in 2015. The proposal’s aim is to classify bone anchored hearing systems as hearing aids, which are specifically not covered under Medicare. If this proposal is passed, it will effectively terminate all Medicare coverage for new bone anchored implant surgeries as well as terminate funding for replacement processors for current bone anchored implant users under Medicare.
Equally disturbing is the potential ripple effect this proposal will have on non-governmental private payers and state Medicaid policies. These groups routinely look to Medicare as the standard for their policies and use Medicare coverage guidelines for justification of coverage, or removal of coverage for treatment options. It is not overstating a concern to say if this proposal passes, coverage for everyone using a bone anchored system is threatened.