Medicare Priorities Demand Congressional Action

September 19, 2025

Audiologists and speech-language pathologists (SLPs) who provide services to Medicare beneficiaries are having an increasingly difficult time making ends meet. Insufficient and delayed reimbursement, limitations on the types of services they can provide, and administrative burden have created an unsustainable environment for providers to serve Medicare patients. Access to care is being threatened, and Congress needs to act.

ASHA continues to advocate for the following federal legislative priorities to improve coverage of and payment for services audiologists and SLPs provide to seniors. Join ASHA’s efforts by taking action in the campaigns listed below.

Preserve Medicare Telehealth Access Beyond September 30

Over years of delivering telehealth services to Medicare beneficiaries, the evidence has become clear that telehealth works for the audiology and speech-language pathology patients who pursue it. Without congressional action, audiologists’ and SLPs’ ability to provide telehealth services—extended earlier this year through H.R. 1968—will expire on September 30, 2025. If Congress fails to act, Medicare patients will have to either return to in-person services, pay for telehealth services out of pocket, or forgo care entirely.

Short-term solution: A recently introduced continuing resolution to fund the federal government proposes to extend telehealth authority until November 21, 2025.

Long-term solution: The Telehealth Modernization Act (H.R. 5081), recently introduced in the U.S. House, would extend telehealth authority for two years.

Permanent solution: Congress must pass H.R. 1614 to permanently make audiologists and SLPs recognized Medicare telehealth providers.

What ASHA Is Doing

ASHA continues to urge lawmakers to pass bipartisan legislation that would permanently authorize audiologists and SLPs to bill for Medicare Part B telehealth services. However, we also support efforts to temporarily extend telehealth authority as we continue to advocate.

As a result of persistent advocacy [PDF] by ASHA and many of its volunteer leaders, CMS has proposed to make many audiology and speech-language pathology telehealth services permanent.

What You Can Do

Contact your legislators today to urge them to make telehealth access permanent for Medicare beneficiaries.

Provide Relief From Medicare Payment Cuts

Audiologists could see Medicare payment reductions as high as 7% and SLPs could see reductions as high as 8% in 2026. The recently passed One Big Beautiful Bill Act (OBBBA) includes a 2.5% Medicare provider payment update for 2026. Although this is an important step toward stabilizing Medicare payment rates, it doesn’t address the erosion of Medicare provider pay due to rising inflation and several legislative and regulatory mechanisms.

These mechanisms include an “efficiency adjustment” put forward by CMS in its 2026 Medicare Physician Fee Schedule (MPFS) proposed rule. If finalized, this proposal would further reduce payments for certain audiology and speech-language pathology services, as would ongoing challenges stemming from budget neutrality constraints in the MPFS.

What ASHA Is Doing

ASHA has long advocated for inflationary updates tied to the Medicare Economic Index (MEI) to ensure sustainable reimbursement under the MPFS. The MEI for 2026 is estimated to be 2.7%, eliminating the positive impact of the OBBBA update. As ASHA Advocacy works with policymakers toward long-term, sustainable reforms to the Medicare provider payment system, Congress should put in place an annual MEI adjustment to all services paid under the MPFS.

What You Can Do

Contact your legislators today to urge them to reverse Medicare Part B payment cuts.

Improve Medicare Access to Audiology Services

Despite the prevalence of hearing and balance disorders among older adults, Medicare coverage of audiology services remains outdated and overly restrictive. Current law covers diagnostic audiology services only when ordered by a physician and does not recognize audiologists as “practitioners” under Medicare statute. It also places Medicare beneficiaries at a distinct disadvantage compared to their peers covered under private insurance and Medicaid.

These barriers delay diagnosis and treatment and hinder patient access to care, particularly in rural and underserved areas. Coverage for medically necessary services should be equitable, regardless of a patient’s form of insurance.

What ASHA Is Doing

ASHA is urging Congress to pass the Medicare Audiology Access Improvement Act (H.R. 2757/S. 1996), bipartisan legislation that would allow Medicare beneficiaries to have unrestricted access to audiologists, authorize audiologists to be reimbursed for Medicare-covered treatment services under Part B, and reclassify audiologists from “suppliers” to “practitioners,” aligning their status with other nonphysician providers like nurse practitioners and clinical psychologists and ensuring audiologists can provide Medicare telehealth services.

This legislation would ensure beneficiaries have timely access to critical hearing and balance services, improve the quality and outcomes of care for patients, and save the Medicare program and beneficiaries money.

What You Can Do

Contact your legislators today to urge them to support the Medicare Audiology Access Improvement Act.

Ensure Timely and Fair Reimbursement From Medicare Advantage Plans

Audiologists and SLPs increasingly report delayed, reduced, or inconsistent payments from Medicare Advantage (MA) plans. These experiences are supported by data from Congress and the Department of Health and Human Services [PDF] showing MA utilization management practices are ineffective and reduce access to care. These delays and underpayments jeopardize access to care for MA beneficiaries as providers see less and less financial stability in contracting with MA plans.

What ASHA Is Doing

ASHA supports the Prompt and Fair Pay Act (H.R. 4559), which would (1) require MA plans to reimburse providers at no less than traditional Medicare fee-for-service rate for the same services and (2) create prompt payment standards, including payment within 30 days for “clean” claims (meaning claims that have no defect, impropriety, or lack of any required documentation).

ASHA also supports the Improving Seniors’ Timely Access to Care Act (H.R. 3514/S. 1816), which would reform burdensome prior authorization practices in MA. This bill focuses on enhancing transparency and oversight, improving communication, and streamlining administrative processes for prior authorization that would help ensure MA beneficiaries have timely access to audiology and speech-language pathology services.

What You Can Do

Urge your legislators to pass the Prompt and Fair Pay Act and the Improving Seniors’ Timely Access to Care Act. These important bills would help align MA with traditional Medicare payment policies, reduce administrative burden, and ensure clinicians are paid on time and at a fair rate.

Support Provider and Patient Flexibility Through Medicare Opt-Out Reform

Current Medicare statute prohibits audiologists and SLPs from opting out of the Medicare program and entering into private contracts with program beneficiaries, even though physicians and several other providers can exercise that option. This means Medicare beneficiaries can’t continue seeing trusted and long-standing providers if those providers choose not to participate in Medicare, which needlessly interferes with patients’ continuity of care.

What ASHA Is Doing

ASHA is advocating for legislators to pass the Medicare Patient Choice Act (H.R. 4204), which would extend opt-out rights to audiologists, SLPs, physical therapists, occupational therapists, and chiropractors. The Medicare Patient Choice Act would give patients the freedom to continue care with providers they know and trust and seek out care from more providers, which would improve accessibility to care and reduce administrative burden on providers.

ASHA strongly supports this reform to preserve patient choice, reduce compliance risk, and increase provider flexibility.

What You Can Do

Contact your legislators today to urge them to support the Medicare Patient Choice Act.

Want to Do More?

ASHA provides resources to help members take action on these issues, including easy-to-use template messages that you can personalize and send to your members of Congress within minutes. We can also help you set up virtual or in-person meetings with your members of Congress in Washington, DC, or at their home offices in your state. Consistent advocacy helps ensure Congress maintains focus on issues critical to our members and their patients.