Due to the overwhelming response and efforts from members of our industry and others being affected by proposed changes to reimbursement policy, DHCS will be holding off on implementing changes for now and will take the following actions:

*       The Department continues to believe that it is inappropriate to reimburse providers for more than the cost of the hearing aid and that therefore it is necessary to account for rebates received by providers.T

*         It is our understanding from providers that they are utilizing these rebate amounts to cover other reimbursable costs such as those that are contained in the mark-up, however the costs they experience for those services exceed the amount currently contained in the reimbursement amount.

*        The Department intends to adjust the reimbursement amounts for the mark-up, and other covered items as necessary, to ensure that reimbursement is reasonable and appropriate, based on information we are requesting from providers. We only intend to adjust reimbursement amounts for covered items or services.

*       However, given the immediate access concerns and to ensure beneficiaries are able to receive the services they need, the Department has decided to delay the change in reimbursement for hearing aids that went into place on January 15^th for 3 months, to April 15^th, to allow additional time to determine other appropriate reimbursement changes.  The Department will retroactively adjust reimbursement for services back to January 15^th through April 15^th to the policy in place prior to January 15^th.

*        The hearing aid policy will be reinstituted as of April 15^th, along with appropriate increases to the mark-up, repairs, replacements, ear molds, and other covered services as determined by the Department's review of data being provided by providers.   Adjustments to the mark-up or reimbursement for other covered services cannot consider the cost of non-covered services.

*      These actions are designed to ensure that reimbursement for the hearing aid units and associated services/products are reasonable and appropriate and that no longer will providers, who have received differing amounts of rebates for hearing aids, be using rebates to cover the costs of other services/products.