Audiologists, ADA File Federal Lawsuit Challenging Medicare’s Private-Pay Exclusion
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Two private-practice audiologists and the Academy of Doctors of Audiology filed a federal lawsuit on October 14, 2026, challenging Medicare’s exclusion of audiologists from its opt-out system. The plaintiffs argue the rule unfairly denies them and their patients the option of private-pay contracts for care. The case is active; no ruling or change to Medicare policy has been reported.

Two private-practice audiologists and the Academy of Doctors of Audiology filed a federal lawsuit on October 14, 2026, challenging a Medicare rule that prevents audiologists from opting out of the program and making private-pay agreements with patients. The suit, filed as Academy of Doctors of Audiology, et al. v. Kennedy, argues that the restriction treats audiologists differently from several other healthcare providers and limits patients’ ability to pay directly for care.

The plaintiffs are Dr. Jill Davis, president of the ADA and owner of Victory Hearing & Balance in Austin, Texas; Dr. Alicia Spoor, a former ADA president and co-owner of a private audiology practice; and the ADA. Pacific Legal Foundation is representing them at no charge. The case is pending in federal court.

The complaint alleges that the exclusion violates constitutional guarantees of equal protection and due process. The plaintiffs say physicians, nurse practitioners, physician assistants and several other provider groups can opt out of Medicare and contract privately with patients, while audiologists cannot. They argue the government has no rational basis for that distinction. These are allegations in the lawsuit, not findings by a court.

The source report says Medicare covers some diagnostic hearing and balance testing but does not cover hearing aids or the examinations needed to fit them. Coverage for a test can depend on the clinical reason it is performed. Audiologists also face a Medicare requirement for a physician’s order before a patient can see them, as well as billing and reimbursement rules. The lawsuit challenges the private-pay restriction; the filing does not itself change those requirements or Medicare coverage.

At a glance
reportWhen: Filed October 14, 2026; active in feder…
The developmentTwo audiologists and the Academy of Doctors of Audiology filed a federal lawsuit challenging Medicare’s rule that prevents audiologists from opting out and contracting directly with patients.

What a Ruling Could Change

If the plaintiffs prevail, audiologists could be allowed to opt out of Medicare and enter private-pay contracts with patients who agree to pay directly. That could give practices and patients another way to arrange care for services covered by Medicare, though the precise effects would depend on the court’s decision and any resulting policy changes.

The dispute matters to audiology practices because, according to the source report, reimbursement for some services can fall below the cost of providing them. Practices may respond by charging more for services Medicare does not cover or by limiting spending on equipment and staffing. Those pressures are described in the report; the lawsuit’s outcome and any effect on prices, access or practice finances remain unknown.

Patients who rely on Medicare are directly implicated by the legal question, but a private-pay option would not mean Medicare began covering hearing aids or other currently excluded services. It would concern whether audiologists and willing patients can contract outside Medicare for care under the rules governing an opt-out.

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Medicare’s Audiology Rules

Medicare allows certain healthcare professionals to opt out of the program, freeing them from its billing requirements and payment limits for covered services when they make private agreements with patients. The plaintiffs say audiologists are among the provider groups excluded from that option, unlike physicians and several other listed professions.

The source report describes longstanding concerns in the audiology field about the requirement for a physician’s order and the division between covered diagnostic services and uncovered hearing aids and fitting exams. The ADA has also pursued broader practice-rights initiatives, including accreditation standards. Those issues provide background to the case, but the lawsuit described here specifically contests audiologists’ inability to opt out and contract privately.

“Medicare’s rule forces audiologists and patients into a government-controlled system, even when both sides want the freedom to work together directly.”

— Joshua Polk, Pacific Legal Foundation attorney, in a release cited by The Hearing Review

Court Ruling and Policy Effects

The case is active, and the source material does not report a ruling, hearing schedule, government response or requested timetable for a decision. It is also unclear whether the defendants will contest the plaintiffs’ account of how the opt-out rules apply or how the constitutional claims should be assessed.

No change to Medicare’s rules is reported. Even if the plaintiffs win, the scope of any remedy—and whether it would affect existing referral, coverage or billing requirements—would depend on the court’s order and subsequent implementation. The complaint is available through Pacific Legal Foundation, according to The Hearing Review.

The Federal Case Proceeds

The next development is expected to come through proceedings in federal court, including any response from the government and decisions on the case’s legal claims. No hearing date or ruling date is provided in the source material.

Until a court issues a decision or Medicare changes its policy, audiologists remain subject to the current rule described in the lawsuit. Patients and practices should not treat the filing itself as permission to make private-pay contracts for services covered by Medicare.

Key Questions

Who filed the lawsuit?

Dr. Jill Davis, Dr. Alicia Spoor and the Academy of Doctors of Audiology filed the case. Pacific Legal Foundation is representing them at no charge, according to The Hearing Review.

What Medicare rule are they challenging?

The plaintiffs challenge the rule that bars audiologists from opting out of Medicare to contract directly with patients who choose to pay privately for care.

What do the plaintiffs claim is unconstitutional?

They allege that excluding audiologists from the opt-out option violates equal protection and due process because other provider groups can use it. Those claims have not been decided by a court.

Does the lawsuit change Medicare coverage now?

No change is reported. The case is active, and audiologists remain subject to the existing rule unless a court decision or policy change alters it.

When will the court decide the case?

The source material gives no hearing or decision date. The litigation is ongoing in federal court.

Source: rss

This article is for informational purposes only and is not medical advice. Always consult a qualified healthcare professional about your specific situation.
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