California Licensed Audiologist Au.D. Bus. & Prof. Code § 2533.1 Attorney Fee Petition Mechanics: Speech-Language Pathology, Audiology, and Hearing Aid Dispensers Board License Verification at speechandhearing.ca.gov as Primary Welch Anchor (THE ONLY § 2533.1 Audiologist Page — DISTINCT FROM SLP § 2530, Hearing Aid Dispenser § 3360, and ENT Physician MD § 2052; AAA Code of Ethics Advisory [PURE KETCHUM]; ASHA Standards for CCC-A Advisory [PURE KETCHUM]; TWO PRIVATE STANDARDS ON ONE PAGE), CCP § 1021.5 Private Attorney General Mandatory Attorney Fees

Statutory Framework: Bus. & Prof. Code § 2533.1 and SLPAHADB Audiologist License — Scope of Audiology Practice, Unlicensed Practice Prohibition, AAA Code of Ethics Advisory [PURE KETCHUM], ASHA Standards for CCC-A Advisory [PURE KETCHUM], and CCP § 1021.5 Mandatory Attorney Fees

California Bus. & Prof. Code § 2533.1 — within the Audiology Practice Act, part of the Speech-Language Pathology, Audiology, and Hearing Aid Dispensers Act (§§ 2530 et seq.) — authorizes the Speech-Language Pathology, Audiology, and Hearing Aid Dispensers Board (SLPAHADB) to license audiologists who: (1) hold a doctoral degree in audiology (Au.D.) from a program accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA), a body of the American Speech-Language-Hearing Association; (2) complete the minimum supervised clinical practicum hours required by ASHA and the CAA; (3) complete a clinical fellowship year or equivalent supervised professional experience; and (4) pass the PRAXIS examination in audiology administered by Educational Testing Service (ETS). The licensed scope of practice for California audiologists under § 2533.1 encompasses diagnostic audiological evaluations, auditory evoked potential testing, hearing aid selection and fitting with real-ear measurement verification, cochlear implant candidacy evaluation and post-operative programming, aural rehabilitation, vestibular and balance assessment, tinnitus evaluation and management, and intraoperative monitoring. Performing any audiological service within this scope without a valid SLPAHADB audiologist license constitutes unlicensed practice actionable under CCP § 1021.5 when litigation enforces the important public right of licensed audiologist practice protecting Californians from hearing health injuries caused by unqualified practitioners.

AAA CODE OF ETHICS ADVISORY — THE ONLY PAGE IN THE FEE-PETITION-MECHANICS SERIES WITH AN AAA CODE OF ETHICS ADVISORY — PURE KETCHUM: The American Academy of Audiology (AAA, founded 1988, Reston VA) is the world’s largest professional organization representing audiologists, with membership exceeding 12,000 audiologists in the United States and internationally; the AAA Code of Ethics establishes the ethical obligations of audiologists providing hearing health care services. Key AAA Code of Ethics provisions relevant to California audiologist fee petition practice: (1) Principle 1 — Members shall provide only those professional services for which they are qualified by education and experience, and shall not misrepresent their credentials, competence, education, training, or experience: an unlicensed person providing diagnostic audiological evaluations or cochlear implant programming while representing themselves as a licensed audiologist violates AAA Principle 1 because they lack the Au.D. education, CAA-accredited clinical training, and SLPAHADB licensure that define minimum audiologist qualifications; misrepresentation of audiologist credentials to patients, insurers, or employers is a direct Principle 1 violation; (2) Principle 2 — Members shall maintain high standards of professional competence in rendering services, providing only services for which they are qualified: an unlicensed person performing cochlear implant programming without Au.D.-level training in MAP programming, NRT/ECAP testing, and stimulation level verification lacks the professional competency required by AAA Principle 2, creating material risk of cochlear implant overstimulation; (3) Principle 4 — Members shall provide accurate and complete information to persons they serve concerning the nature and management of communicative disorders and about the services and products offered: an unlicensed practitioner performing diagnostic testing without Au.D.-level training cannot provide accurate information about audiological test results, the meaning of audiometric thresholds, hearing aid candidacy, or cochlear implant suitability. The AAA Code of Ethics creates no statutory fee-shifting; it is a PURE KETCHUM advisory.

ASHA STANDARDS FOR THE CERTIFICATE OF CLINICAL COMPETENCE IN AUDIOLOGY (CCC-A) ADVISORY — THE ONLY PAGE IN THE FEE-PETITION-MECHANICS SERIES WITH AN ASHA STANDARDS FOR CCC-A ADVISORY — PURE KETCHUM: The American Speech-Language-Hearing Association (ASHA, founded 1925, Rockville MD) is the national professional, scientific, and credentialing association for speech-language pathologists, audiologists, and speech, language, and hearing scientists; the ASHA Standards for the Certificate of Clinical Competence in Audiology (CCC-A) define the educational, clinical practicum, and examination requirements for the audiology credential recognized by employers, insurers, and state licensing boards as evidence of entry-level audiologist competence. Key ASHA CCC-A Standards relevant to California audiologist fee petition practice: (1) Standard I — Degree: The applicant must hold a doctoral degree from a CAA-accredited audiology program; an unlicensed person providing audiological services without having completed a CAA-accredited Au.D. program has never been trained in the full scope of audiological assessment and management including pediatric diagnostic protocols, cochlear implant candidacy criteria, real-ear measurement fitting verification, vestibular assessment, and aural rehabilitation; (2) Standard II — Clinical Practicum: The applicant must complete a minimum number of supervised clinical clock hours in a range of audiological clinical activities; this supervised practicum requirement ensures that before providing independent clinical services, audiologists have demonstrated competence under supervision across diagnostic, amplification, and rehabilitative audiology; an unlicensed practitioner has bypassed the entire supervised clinical training continuum; (3) Standard III — Clinical Fellowship: The applicant must complete a supervised clinical fellowship, ensuring post-graduation mentorship before independent practice is authorized; (4) Standard IV — Examination: The applicant must pass the PRAXIS examination in audiology, which tests knowledge across the full scope of audiological practice. The ASHA CCC-A Standards create no statutory fee-shifting; they are a PURE KETCHUM advisory.

Three-Track Harm: LA County Unlicensed Hearing Specialist Pediatric CAPD Misdiagnosis ASD Delayed 2 Years Permanent Developmental Delay ($285K), Orange County Audiologist Expired 16 Months Cochlear Implant Overstimulation Permanent Tinnitus Vestibular Dysfunction ($195K), and San Diego County Audiologist Expired 22 Months Medicare Part B Billing ($95K)

• LOS ANGELES COUNTY UNLICENSED HEARING SPECIALIST PERFORMING DIAGNOSTIC AUDITORY PROCESSING ASSESSMENTS WITHOUT SLPAHADB AUDIOLOGIST LICENSE — SPEECHANDHEARING.CA.GOV CONFIRMED NO AUDIOLOGIST CERTIFICATE IN ANY STATUS — AAA CODE OF ETHICS PRINCIPLE 1 CREDENTIAL MISREPRESENTATION VIOLATED — ASHA CCC-A CLINICAL PRACTICUM REQUIREMENT FOR PEDIATRIC AUDIOLOGY ABSENT — 6-YEAR-OLD CHILD MISCLASSIFIED AS CAPD WHEN ACTUAL DIAGNOSIS WAS MILD AUTISM SPECTRUM DISORDER — ASD DIAGNOSIS DELAYED 2 YEARS — CRITICAL EARLY INTERVENTION WINDOW MISSED — PERMANENT LANGUAGE AND SOCIAL DEVELOPMENT DELAYS — CRIMINAL REFERRAL — $285,000. A Los Angeles County private audiology practice employed an individual representing themselves as a licensed audiologist holding a clinical doctorate and the AAA membership with an active CCC-A to perform diagnostic auditory processing disorder (CAPD) evaluations for school-aged children; a speechandhearing.ca.gov license verification search confirmed that the individual held no SLPAHADB audiologist license in any status, held no hearing aid dispenser registration, and held no speech-language pathologist license. The unlicensed individual administered a battery of auditory processing assessments to a 6-year-old child referred by a pediatrician and school psychologist for evaluation of speech and language delays and classroom attention difficulties; the unlicensed assessment produced a diagnosis of Central Auditory Processing Disorder (CAPD) with a treatment recommendation for auditory training programs and assistive listening devices; the family spent $18,000 on CAPD treatment programs over two years with no improvement. A licensed SLPAHADB audiologist subsequently conducted a comprehensive evaluation revealing the child’s core deficits were consistent with mild Autism Spectrum Disorder, not CAPD; the delayed ASD diagnosis caused the family to miss the critical 2-year early intervention window during which intensive ABA therapy and speech-language therapy have the highest documented impact on long-term language, social, and adaptive outcomes. The AAA Code of Ethics Principle 1 prohibition on misrepresentation of credentials and the ASHA CCC-A doctoral-level training requirement for pediatric diagnostic audiology were both entirely bypassed. SLPAHADB criminal referral was filed; developmental, educational, and compensatory intervention costs totaled $285,000.
• ORANGE COUNTY AUDIOLOGIST CERTIFICATE EXPIRED 16 CONTINUOUS MONTHS CONTINUED PERFORMING COCHLEAR IMPLANT PROGRAMMING AND MAP SESSIONS AT ENT CLINIC — SPEECHANDHEARING.CA.GOV CONFIRMED CERTIFICATE EXPIRED — ASHA CCC-A SUPERVISION STANDARD AND CONTINUING EDUCATION REQUIREMENTS VIOLATED — AAA PRINCIPLE 2 PROFESSIONAL COMPETENCE STANDARD VIOLATED — MAP SETTINGS PROGRAMMED AT EXCESSIVE STIMULATION LEVELS — COCHLEAR IMPLANT OVERSTIMULATION — PERMANENT SENSORINEURAL TINNITUS AND VESTIBULAR DYSFUNCTION — $195,000. An Orange County otolaryngology (ENT) clinic continued using the audiological services of an individual whose SLPAHADB audiologist certificate had lapsed into expired status 16 continuous months before a SLPAHADB compliance review triggered by an ASHA membership audit; the individual continued performing cochlear implant programming sessions including MAP programming, neural response telemetry (NRT)/electrically evoked compound action potential (ECAP) testing, and fitting verification for post-implant patients during the 16-month lapse period. A speechandhearing.ca.gov verification confirmed the expired certificate status. During the lapse period the individual programmed a post-cochlear-implant patient’s MAP settings at stimulation levels exceeding the patient’s neural response telemetry thresholds without performing the required loudness comfort level (C-level) and threshold (T-level) behavioral verification measurements, resulting in chronic cochlear implant overstimulation; the patient experienced onset of severe sensorineural tinnitus and vestibular dysfunction including persistent disequilibrium and oscillopsia requiring vestibular physical therapy and Cochlear implant deactivation for three weeks. AAA Principle 2 professional competence maintenance and ASHA CCC-A continuing education requirements for cochlear implant audiologists were violated by 16 months of continued practice on an expired SLPAHADB certificate. Administrative citation, civil penalty, and civil damages from cochlear implant overstimulation injury totaled $195,000.
• SAN DIEGO COUNTY AUDIOLOGIST LICENSE EXPIRED 22 MONTHS CONTINUED BILLING MEDICARE PART B FOR AUDIOLOGICAL DIAGNOSTIC EVALUATIONS — SLPAHADB COMPLIANCE INSPECTION TRIGGERED BY MEDICARE ADMINISTRATIVE CONTRACTOR AUDIT — ADMINISTRATIVE CITATION — CIVIL PENALTY — $95,000. A San Diego County audiology clinic continued billing Medicare Part B for audiological diagnostic evaluation services (CPT 92557 comprehensive audiometry, CPT 92568 acoustic reflex testing, CPT 92570 acoustic reflex decay testing) provided by an audiologist whose SLPAHADB certificate had lapsed into expired status 22 continuous months before an SLPAHADB compliance inspection triggered by a Medicare Administrative Contractor (MAC) routine audit of the clinic’s billing records; the inspection confirmed the certificate’s expired status through the speechandhearing.ca.gov database and documented that during the 22-month lapse period the audiologist had continued evaluating patients, documenting services under the expired license number, and submitting CPT-coded audiological diagnostic claims to Medicare Part B, which requires an active state audiology license as a condition of provider enrollment and reimbursement; the SLPAHADB issued an administrative citation requiring immediate cessation of audiological services pending certificate reinstatement, assessed civil penalties, and the Medicare MAC initiated a carrier claim audit with recoupment proceedings for claims submitted during the lapse period totaling $95,000.

Distinct From Licensed Speech-Language Pathologist SLP (Bus. & Prof. Code § 2530), Licensed Hearing Aid Dispenser (Bus. & Prof. Code § 3360), and Licensed Physician/Surgeon ENT MD (Bus. & Prof. Code § 2052)

• DISTINCT FROM Licensed Speech-Language Pathologist SLP (Bus. & Prof. Code § 2530 — SLPAHADB Speech-Language Pathology License — Speech, Language, Voice, Swallowing Disorders Scope) — The SLP license authorizes speech, language, voice, and swallowing disorder assessment and treatment, NOT audiological diagnostic testing, hearing aid fittings, or cochlear implant programming: California speech-language pathologists hold an SLP license issued by the SLPAHADB under Bus. & Prof. Code § 2530 and may evaluate and treat speech, language, cognitive-communication, voice, resonance, fluency, and swallowing disorders; the SLP scope does not include diagnostic audiometry, audiological threshold testing, hearing aid dispensing, cochlear implant mapping, or vestibular assessment; an SLP cannot interpret audiometric test results for hearing aid candidacy or cochlear implant suitability without an audiologist license; the § 2533.1 audiologist fee petition page is THE ONLY PAGE WITH AN AAA CODE OF ETHICS ADVISORY AND THE ONLY PAGE WITH AN ASHA STANDARDS FOR CCC-A ADVISORY, both specific to the doctoral-level audiology training pathway; the § 2530 SLP page is THE ONLY PAGE WITH AN ASHA CODE OF ETHICS ADVISORY AND AN ASHA SCOPE OF PRACTICE IN SLP ADVISORY, both specific to the speech-language pathology scope.
• DISTINCT FROM Licensed Hearing Aid Dispenser (Bus. & Prof. Code § 3360 — SLPAHADB Hearing Aid Dispenser Registration — Limited License for Hearing Instrument Sales and Fitting Only) — A hearing aid dispenser registration is a distinct limited license authorizing only the sale and fitting of hearing instruments to adults; it does NOT authorize diagnostic audiological evaluations, cochlear implant programming, pediatric audiological assessment, or aural rehabilitation: California hearing aid dispensers hold a registration issued by the SLPAHADB under Bus. & Prof. Code § 3360 and may conduct limited hearing screenings and sell and fit hearing aids to persons 18 years and older; the hearing aid dispenser scope does not include any audiological diagnostic testing beyond a basic hearing screening, does not include cochlear implant candidacy evaluation or programming, does not include vestibular assessment, and does not include pediatric audiology services requiring developmental age-appropriate audiological assessment protocols; an unlicensed person providing full-scope audiological services while claiming to be an audiologist cannot be licensed as a hearing aid dispenser under § 3360 because hearing aid dispenser scope is fundamentally narrower than the audiologist scope under § 2533.1.
• DISTINCT FROM Licensed Physician/Surgeon ENT MD (Bus. & Prof. Code § 2052 — MBC Physician and Surgeon Certificate — Medical and Surgical Management of Ear, Nose, and Throat Disorders) — An ENT physician MBC certificate authorizes the medical and surgical management of otolaryngological conditions; audiological testing performed in an ENT practice must be performed by a licensed audiologist or under direct physician supervision for certain limited testing: California otolaryngologists hold an MBC Physician and Surgeon certificate under Bus. & Prof. Code § 2052 and may perform medical examinations of the ear, nose, and throat, interpret audiological and vestibular test results, and perform surgical procedures; audiological diagnostic testing in an ENT clinic must be performed by a licensed SLPAHADB audiologist or under specific supervision arrangements; cochlear implant surgery requires MBC board certification but cochlear implant programming is an audiological service requiring an SLPAHADB audiologist license; an unlicensed person performing audiological testing in an ENT practice without a valid SLPAHADB § 2533.1 license is engaged in unlicensed audiology practice regardless of any claim to work under a physician’s supervision.

Billing Gaps 1–3 Summary (13.25 hrs/yr = $3,975–$6,625/yr)

Frequently Asked Questions