Australian Government - Department of Health - Office of Hearing Services
Hearing Services Program

Provider Factsheet - Conditions for Claiming Update - 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 about the criteria outlined by the program for fitting of devices by providers. This should be read in conjunction with Conditions for Claiming.

What has changed?

The Schedule of Service Items has been updated to include a new condition for claiming. This update is applicable to all fittings under the program, with the exception of Assistive Listening Devices. The new criterion advises providers to fit devices to program clients with a fitting range that will accommodate for the expected deterioration in hearing thresholds over the lifespan of the devices.

The new condition for claiming, as detailed, is subject to audit and compliance activity.

Why has this change been made?

The program is committed to ensuring quality hearing services are delivered to program clients, and the program supports providers in the delivery of these services. In 2019-20, the Compliance Monitoring Program has identified that some program clients have been fitted with devices that did not take into account their hearing loss and individual circumstances. As a result, the hearing needs and long-term rehabilitation outcome of these program clients were compromised.

The new criterion in the Schedule of Service Items was updated to support providers in the delivery of quality hearing services. The new criterion would assist providers in the fitting of devices to account for the expected deterioration in the client’s hearing thresholds over the lifespan of the devices, which is five (5) years. This will allow providers assisting program clients to achieve their long-term goals and outcomes from their hearing plans.

What is the expected deterioration in hearing thresholds?

As a large proportion of program clients are over 65 years of age, the program takes into consideration the rate of deterioration in hearing thresholds for age-related hearing loss. Current research and historical data obtained from the program in relation to age related hearing loss suggests a rate of deterioration in 3 frequency average hearing thresholds (3FAHL) of 1dBHL per year after the age of sixty (60). Given the test-retest variability in pure tone audiometry of ±5dBHL, program clients with age related hearing loss should be fitted with devices that allow for a deterioration of at least 10dBHL over the lifespan of the devices which is five (5) years.

What is the recommendation procedure moving forward?

Service providers are encouraged to check the fitting range of the devices against the latest audiogram for program clients as a part of the provision of hearing devices. The fitting range should allow for an expected deterioration of 10dBHL across 500Hz to 4000Hz, this means the devices should have fitting range headroom of 10dB or more to account for this.

When will this change take effect?

The new condition for claiming will take effect from 1 November 2020 onwards, and will apply to all program clients. This change will not be retrospective, this means program clients who have been fitted already are not affected.

What about program clients with fluctuating hearing loss?

The program acknowledges this update will not be applicable in exceptional cases such as fluctuating hearing loss.

In the case of clients with fluctuating hearing loss, service providers are encouraged to use their clinical expertise and provide recommendation on the devices most suitable for the client’s needs. In this instance, it is recommended that they are fitted with devices with a fitting range that allows for a greater variation in hearing thresholds to accommodate for the fluctuation.

What about program clients with profound hearing losses where allowing for a 10dB deterioration is not possible?

If your client has a profound hearing loss such that the most powerful device on the schedule does not allow for a deterioration of 10dB in the client’s thresholds then you should fit them with the device on the schedule that offers them the best outcome and most flexibility available.

What about refitting of devices?

The program acknowledges that sometimes a client’s hearing may change unexpectedly throughout the five (5) year lifespan of the devices.

If such an unexpected change occurs and the client’s last fitting and the devices are no longer suitable then the client will likely be eligible for a refitting. Refittings must meet the program’s standard Eligibility Criteria for Refitting (ECR), including the requirement to assess the suitability of the client’s current device/s before considering a refitting. Evidence supporting the program clients’ refittings must be kept on client records. Please refer to the Evidence Guide for Compliance Monitoring for more information.

Where can I get more information?

Peer-reviewed journal articles are available for further reading on the rate of deterioration of hearing thresholds in age-related hearing loss.

Bogo, Renata, Ahmed Farah, Ann-Christin Johnson, Kjell K. Karlsson, Nancy L. Pedersen, Magnus Svartengren and Åsa Skjönsberg. 2015. “The Role of Genetic Factors for Hearing Deterioration Across 20 Years: A Twin Study.” The Journals of Gerontology https://doi.org/10.1093/gerona/glu245

Rigters, Stephanie C, Marc P. van der Schroeff, Grigorios Papageorgiou, Robert J. Baatenburg de Jong, André Goedegebure, 2018. “Progression of Hearing Loss in the Aging Population: Repeated Auditory Measurements in the Rotterdam Study.” Audiology and Neurotology https://doi.org/10.1159/000492203

 

 

Conditions for Claiming Update - FAQ (PDF 159 KB)

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