- Are hospitals required to provide documentation to the state describing their plan for conducting newborn hearing screening?
- Are hospitals required to complete and submit hearing related fields in the Electronic Birth Certificate?
- What is the hospital’s responsibility for ensuring that infants have follow-up after hospital discharge?
- When does the hospital’s responsibility for ensuring follow-up end?
- What about children who live in New Jersey , but receive follow-up care out of state?
- What about children who live out of state?
- How do hospitals get reimbursed for the cost of testing?
1. Are hospitals required to provide documentation to the state describing their plan for conducting newborn hearing screening?
According to P.L. 2001, c. 373, C:26:2-103.4:
Every hospital that provides inpatient maternity services and every birthing center licensed in the State pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) shall be required to provide for newborn screening for hearing loss for all newborns born at the facility. The hospital or birthing center shall file a plan with the department, in a manner and on forms prescribed by the commissioner, detailing how the hospital or birthing center will implement the newborn hearing screening requirements.
2.Are hospitals required to complete and submit hearing related fields in the Electronic Birth Certificate?
According to N.J.A.C. 8:19-1.6(a):
For each live newborn born at, or transferred to, a birthing facility that has elected to participate in the reporting of births to the State Registrar of Vital Statistics electronically by means of the Electronic Birth Certificate Registration System, the birthing facility shall report, within one week of the newborn's discharge or transfer, the EBC fields or information identified below by means of the Electronic Birth Certificate Registration System in the manner prescribed by the State Registrar of Vital Statistics for the submission of EBCs: the mother's first name; the mother's last name; the child's first name; the child's last name; sex; race; primary language; hearing screening results for each ear; the screening methodology used for each ear; the date of screening for each ear; and the existence or occurrence of the following neonatal conditions and procedures, as applicable: family history of hearing loss; congenital infections of toxoplasmosis, rubella, cytomegalovirus, herpes or syphilis; persistent pulmonary hypertension; stigmata and/or syndromes associated with hearing loss; hyperbilirubinemia; meningitis; exchange transfusion; extracorporeal membrane oxygenation; and ototoxic medication.
3. What is the hospital’s responsibility for ensuring that infants have follow-up after hospital discharge?
The newborn hearing screening law (PL 2001, Chapter 373, C.26.2.-103.4 (c)) states that hospitals should have “guidelines for the provision of follow-up services for infants identified as having or being at risk of developing a hearing loss.” The regulations at N.J.A.C. 8:19-1.9 indicate what form these guidelines should take or what activities should be considered sufficient:
(b) If hearing screening is not performed on one or both ears of an infant prior to discharge, then, prior to the infant‘s discharge home, the birthing facility shall:
- Notify the responsible physician by written documentation; and
- Notify and counsel the parent via face-to-face communication along with written documentation of the need for a follow-up hearing screening by a licensed audiologist, licensed physician, or other examiners under their direction and/or supervision.
(c) If an infant does not pass hearing screening on one or both ears prior to discharge, then, prior to the infant‘s discharge home, the birthing facility shall:
- Notify the responsible physician by written documentation; and
- Notify and counsel the parent via face-to-face communication along with written documentation of the need for follow-up hearing screening or audiologic evaluation in accordance with N.J.A.C. 8:19-1.3(k) and 1.5(b).
(d) If outpatient hearing screening, or rescreening is clinically indicated, the birthing facility shall advise the parent that screening or rescreening must be performed before the 28th day following the newborn‘s birth, or as soon thereafter as the infant is medically cleared for hearing screening.
(e) If outpatient audiologic evaluation is clinically indicated, the birthing facility shall advise the parent that audiologic evaluation must be performed before the 90th day following the infant‘s birth, or as soon as the infant is medically cleared for audiologic evaluation.
(f) If an infant presents with risk indicators associated with hearing loss as identified in the JCIH Position Statement, then, prior to the infant‘s discharge home, the birthing facility shall:
- Notify the responsible physician by written documentation;
- Notify the parents via face-to-face communication along with written documentation of the risk indicator(s) present; and
- Counsel parents to monitor their infant‘s hearing according to the time intervals specified in the JCIH Position Statement
(g) The birthing facility shall provide parents of infants for whom audiologic evaluation is clinically indicated with information identifying licensed providers of pediatric audiologic evaluation.
(h) If, prior to discharge of an infant home, the infant does not pass or receive hearing screening of one or both ears, the birthing facility shall make at least one documented attempt to remind the infant‘s parent of the infant‘s need to receive follow-up screening, rescreening, and/or audiologic evaluation by communicating to the parent by one or more of the following means:
- Letter to the parent sent using the United States Postal Service or a commercial letter or package delivery service, using the last known address of the parent;
- Telephone call or telefacsimile to the last known telephone or telefacsimile number of the parent, excluding busy signals or no answer; and/or
- Electronic mail to the last known electronic mail or text messaging address of the parent, provided the electronic mail is not returned as undeliverable.
4.When does the hospital’s responsibility for ensuring follow-up end?
When the hospital has established a plan for ensuring follow-up, their responsibility ends when that plan has been implemented to the best of their abilities. The New Jersey EHDI program expects hospitals to notify the EHDI program when known barriers to the receipt of follow-up care are encountered, such as letters returned undeliverable, families known to have moved out of state, or families refusing follow-up testing.
5.What about children who live in New Jersey , but receive follow-up care out of state?
It is the expectation of the New Jersey EHDI program that the guidelines in 8:19-1.9 are followed for children who receive out of state care.
Since the New Jersey EHDI program can not enforce compliance of out of state providers, the New Jersey EHDI program asks hospitals or physicians to report out of state evaluations to the New Jersey EHDI program.
6.What about children who live out of state?
The provisions of N.J.A.C. 8:19-1.9 for hospital responsibilities for follow-up noted above also apply to babies born in New Jersey but who reside out of state. Families can be referred to their home state’s EHDI program with questions regarding follow-up options in their area.
7.How do hospitals get reimbursed for the cost of testing?
New Jersey’s newborn hearing screening law specifically addresses reimbursement and reads: "Screening for newborn hearing loss by appropriate electrophysiologic screening measures and periodic monitoring of infants for delayed onset hearing loss, pursuant to PL 2001, c373 (C26:2-103 et al.). Payment for this screening service shall be separate and distinct from payment for routine new baby care in the form of a newborn hearing screening fee as negotiated with the provider and facility."
Providers are encouraged to bill insurance companies for the service to be appropriately compensated for this testing.