The State Insurance Regulatory Authority (SIRA), which manages workers’ compensation in NSW, has proposed dramatic cost cutting for hearing aid fitting and rehabilitation for people who sustain workplace-related hearing loss.
Changes proposed in an updated hearing aid workers compensation fees order include slashing the hearing aid fitting cap from $2,500 to $1,750, forcing providers to fit lower levels of technology.
“The cost price of hearing aid/s, including remote control, charger, batteries and consumables will change from a maximum of $2,500 per aid to a maximum of $1,750 per aid,” SIRA’s Consultation Paper for the Hearing Aid Fee Order 2024 states.
“The rationale is this price is set to match icare’s maximum so it is equal across all insurers. This price point captures the RRP of most hearing aids on WorkSafe Victoria’s Approved List.”
Also proposed is a change for in-person and telehealth hearing rehabilitation from a flat fee of $686.90 to a per consultation fee (30 minutes) of $85.80, “to align with other jurisdictions”.
A hearing aid handling fee of $349.70 will be abolished and incorporated into a supply fee, comparable with other jurisdictions.
‘No clinical justificication’
The Hearing Care Industry Association (HCIA) said the changes would adversely affect consumers and hearing practitioners. HCIA members fit about 60% of hearing devices in Australia and the organisation represents Amplifon, Audika, Bay Audio, Bloom, Connect Hearing, National Hearing Care, Starkey, ihear and Neurosensory.
“There is no clinical justification for these cost cutting measures which contradict even SIRA’s own published research on the complexity of occupational noise-induced hearing loss,” HCIA said.
“Clinicians and consumers should be very concerned about these proposed changes and how they will degrade outcomes for injured workers. By reducing funding, the proposed cuts will leave patients with suboptimal hearing solutions that do not meet their needs, leading to continued difficulties in communication and a slower, less effective rehabilitation process.”
HCIA claimed the cost-cutting relied on an unknown need for fee harmonisation across different state jurisdictions – each with different premiums, benefits, employers and rules – in what ‘appears to be a race to the bottom’.
“The complexity of work-related noise-induced hearing loss compared to general age-related hearing loss is significant and requires significantly more investment by clinicians, consumers and insurers,” it said.
“Similarly, these workers experience greater difficulty performing job-specific tasks than those with age-related hearing loss, necessitating more robust support systems.
“It’s proven that work-related hearing loss is associated with more severe functional and communication challenges, necessitating rehabilitation plans that go beyond standard age-related interventions, requiring longer sessions, multiple follow-ups and tailored counselling that address the specific demands of occupational settings.”
More complex hearing issues
Industrial deafness was also tied to higher rates of emotional and psychological distress, HCIA said.
“Workers’ compensation patients often present with more complex hearing issues, such as tinnitus and steeply sloping hearing losses. These require more effective background noise reduction and more in-depth rehabilitation,” HCIA said.
Injured workers were generally younger, typically more active than HSP clients and still working, often in noisy environments and difficult listening situations, it added. Their lifestyles demanded further considerations, such as outdoor support and wind noise reduction.
A SIRA spokesman told HPA that NSW had the highest rate for supply of hearing aids of any Australian jurisdiction. Benchmarking fees was a standard process to understand market rates when reviewing fees and was only one factor SIRA took into consideration when reviewing fees, he said.
HCIA said the consultation was not published on the SIRA website, and SIRA conducted limited consultation on proposals with few stakeholders.
SIRA said it conducted targeted consultation with stakeholders which included industry peak bodies to reach a large representation of businesses, audiologists and insurers.
The authority received 20 submissions including from the HCIA, insurers, associations and providers. It is considering this feedback to inform decisions but has not yet decided on the outcome, the SIRA spokesman said.
“SIRA will continue to engage with industry as this work progresses and it delivers its initiatives to achieve value-based heath care for people with an injury and the Workers Compensation and Compulsory Third-Party schemes,” he said.
“Any changes to the Fees Order are planned to take effect on 1 April 2025 and will be communicated in advance to give stakeholders time to adjust and accommodate any new fee structure.”
SIRA was committed to conducting work on fee reforms that contributed to value-based health care for people with a workplace injury and the financial viability of the Workers Compensation Scheme, he said.
“The scheme is designed to enable people to access support and treatments that respond to their individual circumstances within legislative requirements,” he said.
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