TL;DR
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Two audiologists and the Academy of Doctors of Audiology sued the federal government on October 14, 2026, challenging Medicare’s exclusion of audiologists from the option to opt out and make private-pay agreements with patients. The plaintiffs argue the rule violates equal protection and due process; the court has not ruled on the claims.
Two private-practice audiologists and the Academy of Doctors of Audiology filed a federal lawsuit on October 14 challenging a Medicare rule that bars audiologists from opting out of the program and making private-pay agreements with patients. The case, filed as Academy of Doctors of Audiology, et al. v. Kennedy, argues that the restriction treats audiologists differently from several other health professionals and violates constitutional protections; those are the plaintiffs’ claims, and the court has not decided them.
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 without charge. The lawsuit seeks to challenge the federal government’s treatment of audiologists under Medicare’s opt-out rules.
According to the lawsuit as described by The Hearing Review, federal law allows physicians and several other provider groups—including nurse practitioners, physician assistants, clinical psychologists, registered dietitians, marriage and family therapists, and mental health counselors—to opt out of Medicare. Providers who opt out can contract directly with patients who choose to pay for care themselves. Audiologists, the plaintiffs say, are excluded from that option.
The complaint alleges that there is no rational basis for treating audiologists differently from those other providers, and that the distinction violates equal protection and due process. Those arguments have not been tested or accepted by a court. The lawsuit is active in federal court, and the complaint is available through Pacific Legal Foundation.
How the Rule Affects Audiology Practices
The case could affect how audiologists who serve Medicare patients arrange payment for care. If the plaintiffs prevail, audiologists could gain the ability to formally leave Medicare and make direct payment agreements with patients who prefer that arrangement. That would change the options available to practices and patients, though the lawsuit’s outcome and any practical effects remain uncertain.
The plaintiffs point to the way Medicare coverage is structured for hearing care. Medicare covers some diagnostic hearing and balance tests, but it does not cover hearing aids or the exams required to fit them, according to the source report. The same type of test may be covered or excluded depending on the clinical reason for it. The plaintiffs also argue that reimbursement rates for covered services can fall below the cost of delivering care, placing pressure on small practices.
Davis says the average patient at her practice is 70 years old, making Medicare rules a regular operational concern. The source report also notes that Medicare requires patients to obtain a physician’s order before seeing an audiologist. The lawsuit challenges the opt-out restriction; the details about coverage, referral requirements, and practice costs provide context for the plaintiffs’ concerns but do not establish that the court will find the rule unlawful.
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Medicare’s Opt-Out Rules for Providers
Medicare’s opt-out framework allows certain types of providers to step outside the program’s billing rules and payment limits for services covered by Medicare, while patients pay those providers directly. Under the policy challenged in this case, audiologists cannot use that route for covered services, even when the provider and patient both want a private-pay arrangement. Many audiology services that Medicare does not cover are already paid for directly by patients, the source report says.
Direct access to audiologists and Medicare referral requirements have been subjects of professional debate. The Hearing Review has previously covered proposals including the Medicare Audiology Access Improvement Act. The ADA has also pursued professional initiatives, including a recently launched audiology practice accreditation program. Those developments help explain why the association joined the lawsuit, but they are separate from the legal question now before the court: whether Medicare may exclude audiologists from opting out.
“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, attorney with Pacific Legal Foundation, in a release
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The Court Has Yet to Rule
The lawsuit has been filed, but the source report does not identify a ruling, a court schedule, or a response from the federal government. It is not yet clear how the government will defend the rule, what remedies the plaintiffs are seeking beyond challenging the exclusion, or when the court may consider the case. The constitutional allegations remain disputed claims until resolved through the legal process.
It is also uncertain whether a decision for the plaintiffs would immediately change Medicare policy nationwide, or whether further agency action or legal proceedings would follow. The source material describes the possible impact as a change to audiologists’ ability to opt out and contract directly with patients, but does not provide details about implementation.
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Next Steps in Federal Court
The case will proceed in federal court, where the parties can present their arguments about Medicare’s opt-out rules and the constitutional claims. No hearing date or decision timeline is specified in the available report. The next concrete developments will be court filings, any government response, and scheduling information released by the court.
Until a court rules or the federal government changes the policy, audiologists remain subject to the existing restriction described in the lawsuit. Any ruling could clarify whether audiologists may opt out and make direct private-pay agreements for covered care.
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Key Questions
Who filed the lawsuit?
Dr. Jill Davis, Dr. Alicia Spoor, and the Academy of Doctors of Audiology filed the case against the federal government. Pacific Legal Foundation is representing the plaintiffs without charge.
What Medicare rule are they challenging?
The plaintiffs challenge a rule that bars audiologists from opting out of Medicare and contracting directly with patients who choose to pay out of pocket for covered services.
What do the plaintiffs say is unconstitutional?
They argue that excluding audiologists from the opt-out option, while allowing it for several other provider groups, violates equal protection and due process. These are allegations in the lawsuit; the court has not ruled on them.
Has the court changed Medicare policy?
No change is reported. The lawsuit is active in federal court, and audiologists remain subject to the existing rule unless it is changed through a court decision or government action.
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