Commission Approves Expansion of Hearing Program to Serve More Children and Adults

Staff Report From Georgia CEO

Tuesday, December 12th, 2017

More children and adults will be able to take advantage of the Commission managed Hearing Aid Distribution Program after the Georgia Public Service Commission renewal of its contract with the Georgia Lions Lighthouse Foundation. The GLLF operates the program under Commission supervision. The new contract includes a revised cost‐based reimbursement structure for devices and a continuance of the flat‐fee reimbursement for providers along with separate line‐items for administrative and outreach programs. This revised reimbursement structure will allow for the reduction of client copay rates in order to make the program more accessible to families in need and expand services to rural Georgia.  In 2016 the Program distributed 1,672 hearing aids to 898 applicants.
The Adult Program is capped at 1,000 patients annually with a $258 administrative fee per patient to cover all administrative fees and overhead for the Adult Program. Additionally, the reimbursement rate for audiologist fees has increased from $175 to $215 per patient. The Pediatric Program is capped at 120 patients annually with a $258 administrative fee per patient to cover all administrative fees and overhead for the Pediatric Program as well as $13,500 for the marketing plan. GLLF will serve only pediatric patients with household income that falls at or below 400% of the Federal Poverty Guideline and who do not qualify for Medicaid or PeachCare. Patients will need to submit proof of documentation of a private insurance denial letter.
Additionally, GLLF will serve pediatric patients who qualify for Medicaid or PeachCare, but have not yet been approved, provided that the patients have a pending application.  GLLF will serve such a pediatric patient until the date upon which the patient receives Medicaid or PeachCare assistance, provided that GLLF shall not serve such a patient for more than three years unless the patient becomes ineligible for Medicaid or PeachCare and the patient’s household income falls at or below 400% of the FPG.  GLLF will serve existing Medicaid and PeachCare patients who require a Bone Assisted Hearing Appliance on a softband (including those existing patients who require a BAHA and are under the age of five. It also includes those who require a BAHA but are medically unable to receive a surgical BAHA as Medicaid and PeachCare do not currently cover this hearing device.
The Commission administers the Hearing Program under Georgia law §O.C.G.A. 46-5-30. The program is funded through an surcharge on each telecommunications landline which is currently set at $0.11 per line.