---
title: "Unlawful Denial of Medically Necessary Audiologic Diagnostic Services—Medicare Advantage Claims"
description: "ADA offers programming and support to audiologists and students who are or who desire to be autonomous practitioners in the field of Audiology."
url: "https://audiologist.org/resources/communicate/latest-news/unlawful-denial-of-medically-necessary-audiologic-diagnostic-services-medicare-advantage-claims"
date: "2026-06-25T06:36:45+00:00"
language: "en-GB"
---

#  Unlawful Denial of Medically Necessary Audiologic Diagnostic Services—Medicare Advantage Claims

![](https://audiologist.org/_resources/images/news/2025/2025-12-16-medicare.webp)ADA is actively addressing widespread denials of medically necessary diagnostic audiology services by Anthem Medicare Advantage plans that began in mid-2025. Despite clear federal requirements that Medicare Advantage plans cover all medically necessary diagnostic audiology services, Anthem has denied claims across multiple states and improperly redirected providers to a third-party administrator that does not process these services. After repeated attempts to resolve the issue informally, [ADA has issued a formal demand letter to Anthem](https://audiologist.org/_resources/documents/news/2025/ADA-Demand-Ltr-to-Anthem-RE-Medicare-Advantage.pdf) and escalated the matter to the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS).

 ---

  [BACK TO NEWS](https://audiologist.org/news)

## Schema

```json
{
    "@context": "https://schema.org",
    "@type": "BreadcrumbList",
    "itemListElement": [
        {
            "@type": "ListItem",
            "position": 1,
            "name": "Home",
            "item": "https://audiologist.org"
        },
        {
            "@type": "ListItem",
            "position": 2,
            "name": "Latest News",
            "item": "https://audiologist.org/resources/communicate/latest-news"
        },
        {
            "@type": "ListItem",
            "position": 3,
            "name": "Unlawful Denial of Medically Necessary Audiologic Diagnostic Services—Medicare Advantage Claims",
            "item": "https://audiologist.org/resources/communicate/latest-news/unlawful-denial-of-medically-necessary-audiologic-diagnostic-services-medicare-advantage-claims"
        }
    ]
}
```

```json
{
    "@context": "https://schema.org",
    "@type": "Organization",
    "@id": "https://audiologist.org/resources/communicate/latest-news/unlawful-denial-of-medically-necessary-audiologic-diagnostic-services-medicare-advantage-claims#organization3",
    "name": "Academy of Doctors of Audiology",
    "alternateName": "Agentis",
    "legalName": "Agentis Management",
    "email": "info@audiologist.org",
    "url": "https://audiologist.org",
    "telephone": "(859) 977-7454",
    "foundingDate": "1977-01-01",
    "logo": "https://audiologist.org//images/favicon.png",
    "image": "https://audiologist.org//images/favicon.png",
    "address": {
        "@type": "PostalAddress",
        "streetAddress": "1024 Capital Center Drive, Suite 205, Frankfort, Kentucky",
        "postalCode": "40601"
    }
}
```

```json
{
    "@context": "https://schema.org",
    "@type": "Article",
    "mainEntityOfPage": {
        "@type": "WebPage",
        "@id": "https://audiologist.org/resources/communicate/latest-news/unlawful-denial-of-medically-necessary-audiologic-diagnostic-services-medicare-advantage-claims"
    },
    "headline": "Unlawful Denial of Medically Necessary Audiologic Diagnostic Services—Medicare Advantage Claims",
    "description": "ADA is actively addressing widespread denials of medically necessary diagnostic audiology services by Anthem Medicare Advantage plans that began in mid-2025. Despite clear federal requirements that Medicare Advantage plans cover all medically necessary diagnostic audiology services, Anthem has denied claims across multiple states and improperly redirected providers to a third-party administrator that does not process these services. After repeated attempts to resolve the issue informally, ADA has issued a formal demand letter to Anthem and escalated the matter to the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS).  BACK TO NEWS",
    "image": {
        "@type": "ImageObject",
        "url": "https://audiologist.org/_resources/images/news/2025/2025-12-16-medicare.webp"
    },
    "publisher": {
        "@type": "Organization",
        "name": "Academy of Doctors of Audiology",
        "logo": {
            "@type": "ImageObject",
            "url": "https://audiologist.org//images/favicon.png"
        }
    },
    "author": {
        "@type": "Person",
        "name": "Paul Scarnegie",
        "url": "https://audiologist.org/resources/communicate/latest-news/unlawful-denial-of-medically-necessary-audiologic-diagnostic-services-medicare-advantage-claims"
    },
    "datePublished": "2025-12-16T00:00:00+00:00",
    "dateCreated": "2025-12-16T00:00:00+00:00",
    "dateModified": "2025-12-16T21:21:49+00:00"
}
```