Changes to the Hearing Services Program - FAQ
The Department of Health (the department) is responsible for managing and administering the Australian Government Hearing Services Program (the program).
These pages contain answers to frequently asked questions (FAQs) about the changes to the program. This should be read in conjunction with the Provider Factsheet – Hearing Services Program Changes Update.
In the October 2020 budget, changes were announced to the program. To support the implementation of the changes, the program has sought feedback from stakeholders as part of the Hearing Services Program review. The program thanks all stakeholders who have provided feedback which has assisted us draft these FAQs. A number of program changes will take effect on 1 July 2021.
Contents
General
What is changing?
Voucher Period: Client vouchers, which entitle eligible persons to subsidised hearing services through the program, will be extended from three to five years.
Client Reviews: Clients who are not fitted with a hearing device will now be entitled to an annual review appointment. This will allow their hearing to be monitored over time and improve access to services for these clients. Clients fitted with Assistive Listening Devices (ALDs) will be eligible for the current client review.
Maintenance: Consumables will continue to be paid for initial fittings where a client has a maintenance agreement. Maintenance will not be claimable in the first 12 months after refittings. There will also be changes to the amount paid for client relocations.
Why have these changes been made?
The Australian Government is committed to ensuring that the program reflects best practice in terms of the consumer experience and service delivery and efficiency in the hearing support sector. The change in voucher length from three to five years is to align with the five year expected life of a hearing aid. A longer voucher period will also reduce the burden on providers in reissuing vouchers.
The program is focused on enabling quality hearing services for all clients, not just those with hearing devices. The changes are part of the renewal of the program, which includes the Hearing Services Program Review and the initiatives funded through the Roadmap for Hearing Health.
When will these changes take effect?
Program changes will take effect from 1 July 2021.
What happened to the voucher of a client already on the program?
Vouchers issued from 1 July 2021 will have a length of five years. All existing vouchers due to expire after 30 June 2021 will be extended from three to five years.
When will Schedule of Fees information be available to providers?
The program will release information about the revised Schedule of Fees shortly.
Client Review
How does the review work for unaided clients?
The new annual review for unaided clients will give Contracted Service Providers (providers) the opportunity to review the hearing and goals of their unaided clients annually. It will be claimable 12 months from the date of assessment or reassessment and can be performed every 12 months for unaided clients. This will be a new claim item. The current client review claims available to aided clients (930/940) will remain.
Are there changes to the client review service for aided clients?
Currently clients fitted with ALDs are not eligible for client reviews. Effective 1 July 2021, clients fitted with ALDs will be eligible for an annual client review under item 930. Further information will be available in the 930 service item in the Schedule of Service Items and Fees. There will be no changes to the 940 client review.
Maintenance
What are the changes to maintenance payments?
There will be no changes to the timing of maintenance payments. Maintenance payments will continue to be paid annually to providers in advance.
Are there changes to maintenance claims?
Hearing aid maintenance claim items and numbers will remain the same. There will be no change to the number of maintenance claims. If a client is on a maintenance agreement, the provider will be able to claim standard maintenance 12 months after the date of fitting. Maintenance arrangements will remain the same for replacement devices and spare aid claims. The monaural maintenance payment will be increased to half the amount of the binaural maintenance. The amount paid for relocated maintenance is also being amended.
What happens to maintenance when a client relocates?
When a client moves or changes providers, they will continue to enter new maintenance agreements with new providers without having to make another co-payment. Currently, if a client relocates to a new provider, the program pays an additional 12 month maintenance claim to the new provider. This is despite a 12 month maintenance payment being paid to the client’s previous service provider, which may overlap with the new maintenance timeframe. From 1 July 2021 onwards, the new provider will be paid a quarter of the standard maintenance plus the client co-payment for relocated clients. This is only claimable if the client has signed a new maintenance agreement with their new provider. Standard maintenance will be claimable again after the previous maintenance agreement expiry date.
Are there any changes to the client co-payment?
No, the voluntary client hearing aid maintenance charge (co-payment) will remain the same and will continue to be optional to clients on an annual basis.
Will there be changes to an initial fitting claim?
No, if the client is on a maintenance agreement, providers can still claim initial fittings which include the consumables component.
Who will cover the warranty for the hearing devices in the first 12 months?
Device suppliers are required to provide a warranty for new hearing devices for 12 months after the date of supply. This means that for any defects or component failures, the device supplier will remedy the issue at no additional cost to providers.
Are there any changes for clients who have a device previously fitted before entering the program?
No, these arrangements are not changing. Clients who choose to use hearing devices that were fitted before they joined the program will continue to have the same supports available to them for the life of that device. Providers will submit a claim for maintenance for each device listed under the program. The current claim items for Private Maintenance will remain the same.
Revalidated Services
What if my client has a change in hearing and requires a full hearing test before 5 years?
Program clients will continue to have access to a review of their hearing and devices annually (currently claimed as a 930 or 940). For instances where a client has a significant deterioration in hearing, service providers can submit an application for Reassessment; Reason A - hearing thresholds have permanently deteriorated by 15dB or more at two or more frequencies between 500 Hz and 4000 Hz in at least one ear. This will allow service providers to perform a full assessment and claim an 800/810 as needed.
What if my client needs a refitting during the voucher period? Will this be through revalidation only?
The program acknowledges that a client's hearing may deteriorate significantly or their needs may change during their voucher period. As a fitting can only be claimed once per voucher, a revalidated service will need to be requested to fit a client with new devices.
Providers will need to determine if a client's circumstances in hearing or health have changed significantly. You may then complete a Request for a Revalidated Service form. If your client meets Eligibility for Refitting (ECR) (Reason B), you will need to identify how this criteria has been met as well as the intended item number.
Note: Currently due to COVID-19, special rules surrounding requesting a revalidated service are in effect.
Software
What changes will be needed for claiming systems?
On a five year voucher, the services that may be available to clients will include one assessment, rehabilitation services, a fitting and follow-up, annual client reviews, optional maintenance, and replacements.
All existing service items will be retained, however some items will have new fee amounts set.
Specific Changes
- From 1 July 2021 there will be a new 920 service item for the new unaided client review service. (Refer to the Unaided Client Review FAQ).
- Standard maintenance (700/710) will not be claimable for the first 12 months from the date of refitting, noting that standard maintenance is already not claimable for initial fittings. (Refer to the Maintenance FAQs).
- Relocated maintenance will be one quarter of standard maintenance plus the client co-payment. Standard maintenance is then claimable at the expiry of the client’s previous maintenance agreement. (Refer to the Relocated Maintenance FAQ).
- Clients with an ALD will now be able to receive annual client reviews (service item 930). (Refer to the Client Review FAQs).
What support is available for software vendors and providers?
The program will be liaising with software vendors and providers who have their own claiming system as occurred with the changes to the HSO payment system. Factsheets and quick reference guides will be made available and the program will provide online demonstrations. If vendors or providers have specific questions about the system changes please email hearing@health.gov.au.
Hearing Services Program Review
Where can I get more information about the review?
On 14 August 2020, the Hon Mark Coulton, Minister for Regional Health, Regional Communications and Local Government (the Minister), announced a review into the Hearing Services Program to be conducted by an Expert Panel consisting of Professor Michael Woods (Chair) and Dr Zena Burgess
The Review will examine:
- whether the program delivers services aligned with clinical need and contemporary service delivery;
- how the Voucher and device maintenance payment system compares with advances in the manufacturing sector and product offering;
- how technology is changing the provision of services through the program; and
- how program services are currently delivered and whether access can be enhanced for vulnerable Australians and in thin markets, such as regional, rural and remote areas.
The review is well underway and has received feedback from stakeholders on the Hearing Services Program Review Consultation Paper. The final report will be provided to the Australian Government in July 2021
More information can be found online at www.health.gov.au/hearing-review.
More Information
How can I get information about the changes to the program?
For more information regarding the changes, please visit www.hearingservices.com.au. Alternatively, you may contact the program by email at hearing@health.gov.au.
Changes to the Hearing Services Program - FAQ (PDF 233 KB)