2002 Annual Meeting on Successful Statewide
Early Hearing Detection and Intervention Programs
- Roundtable Summaries -

Roundtable Topic: Third-party payments for EHDI interventions
Session: 2:45 PM
Moderator: .


Each state's EHDI program is unique. Some are mandated; others are voluntary. Some are just beginning implementation; others have had well-established programs for many years. The purpose of this Round Table is to share information that might be helpful to others about insurance coverage for screening, follow-up assessment and intervention.

Some of the state mandates for universal newborn hearing screening include a mandate for insurance and/or Medicaid coverage. The political climate within the state at the time they were proposed was a major influence in this decision. What works for one state or program may not be an option for others.

To help with this informal exchange, will you respond to the statements and questions below? Please feel free to add others.

Does your state currently have mandates for coverage?

  • Newborn hearing screening
  • Follow-up assessment
  • Intervention
  • Amplification

If not, how are these services covered?

  • Newborn hearing screening
  • Follow-up assessment
  • Intervention
  • Amplification

Strategies for Involving/Influencing Insurance Carriers

Strategies for Working With Medicaid

What strategy has worked best for you? Why?

What was least successful for you? Why?

There were 11 people at this Round Table discussion. States represented were Maine, Maryland, South Dakota, North Dakota, Indiana, Utah, Alabama, DC and Virginia. The facilitator took notes. The discussion was somewhat difficult, as folks joined us at varying intervals. We did not cover all the points on the fact sheet.

Participants felt that the best way to have screening, follow-up and intervention covered was to mandate it.

Maryland has an excellent mandate for hearing aid coverage. They also have a mandated hearing aid loaner bank In order to access that information, go to www.mlis.state.md.us and click on enrolled bills, then 2001, and search for HB 160 (insurance) and HB 282 (bank). The other resources utilized by states are the CSHCN Program and the Part C Early Intervention System. Other states known to have mandates are Missouri (screening to amplification), Oklahoma (amplification), Connecticut (amplification) and Virginia screening and follow-up-not amplification). PLEASE NOTE: information on MD and VA is correct; the other is anecdotal, as those states were not represented at the table.

Insurance issues affect all aspects of an EHDI Program. There needs to be a central source of shared information covering all states.

Strategies used to obtain coverage for EHDI:

  • Arizona Task Force conducted a survey of re-imbursement
  • Maryland brought in all players, especially the insurers. Parents were well represented. The insurers were not treated as "bad guys". Compromise was necessary. The question was always, "Can you live with this?" A non-state agency group took the lead in the effort. An accurate cost-benefit analysis was crucial.