Hearing Device Coverage Clarification Act
H.R. 1921, the Hearing Device Coverage Clarification Act, would require the Administrator of the Centers for Medicare & Medicaid Services (CMS) to issue guidance within 60 days after enactment clarifying that fully implanted active middle ear hearing devices are prosthetics and therefore are not subject to the Medicare hearing aid coverage exclusion found in 1862(a)(7) of the Social Security Act. The bill defines “prosthetic” by referencing the standard definition in 42 CFR 414.202. In effect, the bill aims to reclassify implanted middle ear devices from something that could be treated as excluded “hearing aids” to prosthetic devices that may be covered under Medicare’s prosthetics rules. Potential impact: If CMS issues the required clarification, it could reduce ambiguity about coverage for these implanted devices and may make them eligible for Medicare prosthetic coverage rather than being barred by the hearing aid exclusion. The bill does not itself appropriate funds or guarantee coverage beyond clarifying the device’s classification under existing Medicare rules.
Key Points
- 1The bill establishes a mandatory clarification by CMS within 60 days of enactment about the coverage status of fully implanted active middle ear hearing devices.
- 2It states that these devices are prosthetics, not subject to the Medicare hearing aid coverage exclusion (1862(a)(7) of the Social Security Act).
- 3The term “prosthetic” for purposes of this bill is defined by the meaning in 42 CFR 414.202.
- 4The measure explicitly ties the classification to existing Medicare rules, rather than creating new funding or direct coverage guarantees.
- 5The bill is titled the “Hearing Device Coverage Clarification Act” and was introduced in the 119th Congress, with sponsors Mrs. Fischbach and Ms. Craig, and referred to the relevant committees (Energy and Commerce; Ways and Means).