ut-20260915-R156-46a: R156-46a. Hearing Instrument Specialist Licensing Act Rule

1. Agency Information

Title catchline: Commerce, Professional Licensing Building: Heber M Wells Building Street address: 160 E 300 S City, state: Salt Lake City, UT 84111 Mailing address: PO Box 146741 City, state and zip: Salt Lake City, UT 84114-6741

2. Contact Persons

Name: Phone: Email: Lisa Martin 801-530-7632 lmartin@utah.gov Please address questions regarding information on this notice to the persons listed above.

A. Rule or section catchline:

R156-46a. Hearing Instrument Specialist Licensing Act Rule

B. Purpose of the new rule or reason for the change:

The Division of Professional Licensing (Division) is filing these proposed amendments in accordance with statutory changes made by HB 374 that passed in the 2026 General Session and became effective on 05/06/2026. HB 374 (2026) allows an audiologist to supervise a hearing instrument specialist intern and aligns the unprofessional conduct standards of a hearing instrument specialist with the unprofessional conduct standards of audiologists. The proposed amendments also update the exam requirements and align this rule with the Office of Administrative Rules (OAR) drafting requirements and Division standards.

C. Summary of the new rule or change:

Section R156-46a-101 is amended to fix a citation to another section of Division rules. Section R156-46a-102 is amended to define acronyms used in this rule and unprofessional conduct. Section R156-46a-302 is amended to clarify the examination requirements and align the requirements with industry standards, specifying that an applicant for licensure as a hearing instrument specialist may pass either the International Licensing Examination (ILE) administered by the International Hearing Society (IHS) or the National Competency Exam (NCE) administered by the National Board for Certification in Hearing Instrument Sciences (NBC-HIS). 40 UTAH STATE BULLETIN, September 15, 2026, Vol. 2026, No. 18 NOTICES OF PROPOSED RULES Section R156-46a-302.5 is amended to include the statutory change permitting an audiologist to supervise a hearing instrument specialist intern. This section is also amended to remove the provisions relating to failed sections of the exam because the exam is no longer structured to permit retaking individual sections. Section R156-46a-303 is amended to include the calibration and continuing education requirements for license renewal. Section R156-46a-304 is amended to conform to Division drafting standards and to use the acronyms defined in Section R156- 46a-102. Section R156-46a-501 is renumbered and amended to remove a requirement that is no longer in the cited federal law and to update the code of ethics incorporated by reference. Section R156-46a-502 is renumbered and amended to match industry standard for hearing instrument examinations, remove outdated language, and clarify whether a licensee must accept a previous evaluation from another physician, audiologist, or hearing instrument specialist. Section R156-46a-502c is removed from the rule because the enabling section was removed from statute. The requirements of Section R156-46a-502c were moved to Section R156-46a-303 as a requirement for license renewal. Section R156-46a-503 is amended to remove the language of the Hearing Instrument Specialist Acknowledgement of Informed Consent Form out of this rule and to the Division's website, which is referenced in this rule. 4. Legislative Action Information

B. If yes, any bill number and HB 374 (2026 General Session)

session: 5. Fiscal Information Provide an estimate and written explanation of the aggregate anticipated cost or savings to:

A. State budget:

The Division does not anticipate any fiscal impact to the state budget beyond that determined by the fiscal note for HB 374 at: https://le.utah.gov/~2026/bills/static/HB0374.html, because the proposed amendments clarify and update this rule to be current and accurate for licensees.

B. Local governments:

The Division does not anticipate any cost or savings to local governments from the proposed amendments because the proposed amendments do not apply to local governments.

C. Small businesses ("small business" means a business employing 1-49 persons):

There are approximately 121 small businesses in Utah with hearing instrument specialists (NAICS 621999) and other similar licensees and who may employ those engaged in the profession (this NAICS code covers professions beyond hearing instrument specialists as well). However, the proposed amendments are not expected to have any measurable impact on small businesses' revenues or expenditures beyond the fiscal note for HB 374 (2026) because the amendments merely conform this rule to statutory changes enacted by HB 374 (2026), update examination requirements, and reorganize, streamline, and update this rule to provide more utility to licensees and to comply with OAR drafting requirements and Division standards.

D. Non-small businesses ("non-small business" means a business employing 50 or more persons):

There is approximately five non-small businesses in Utah with hearing instrument specialists (NAICS 621999) and other similar licensees and who may employ those engaged in the profession (this NAICS code covers professions beyond hearing instrument specialists as well). UTAH STATE BULLETIN, September 15, 2026, Vol. 2026, No. 18 41 NOTICES OF PROPOSED RULES However, the proposed amendments are not expected to have any measurable impact on non-small businesses' revenues or expenditures beyond the fiscal note for HB 374 (2026) because the amendments merely conform this rule to statutory changes enacted by HB 374 (2026), update examination requirements, and reorganize, streamline, and update this rule to provide more utility to licensees and to comply with OAR drafting requirements and Division standards. E. Persons other than small businesses, non-small businesses, state, or local government entities ("person" means any individual, partnership, corporation, association, governmental entity, or public or private organization of any character other than an agency): In Utah, there are approximately 164 licensed hearing instrument specialists and 42 licensed hearing instrument specialist interns. The Division does not anticipate any cost or savings from these proposed amendments to these persons or to additional persons other than small businesses, non-small businesses, the state, or local government entities, because the amendments merely conform this rule to statutory changes enacted by HB 374 (2026), update examination requirements, and reorganize, streamline, and update this rule to provide more utility to licensees and to comply with OAR drafting requirements and Division standards. The proposed rule amendments will not create new obligations for other persons or increase the costs associated with any existing obligations for other persons.

F. Compliance costs for affected persons:

As described in Box 5E for other persons, no compliance costs are expected for affected persons. 6. Regulatory Impact Summary Table Enter the cost or savings in the relevant cell. If there is no cost or savings, enter, "$0." If a cost or savings is inestimable, enter, "inestimable." Fiscal Cost FY2027 FY2028 FY2029 FY2030 FY2031 State Budget $0 $0 $0 $0 $0 Local Governments $0 $0 $0 $0 $0 Small Businesses $0 $0 $0 $0 $0 Non-Small Businesses $0 $0 $0 $0 $0 Other Persons $0 $0 $0 $0 $0 Total Fiscal Cost $0 $0 $0 $0 $0 Fiscal Benefits FY2027 FY2028 FY2029 FY2030 FY2031 State Budget $0 $0 $0 $0 $0 Local Governments $0 $0 $0 $0 $0 Small Businesses $0 $0 $0 $0 $0 Non-Small Businesses $0 $0 $0 $0 $0 Other Persons $0 $0 $0 $0 $0 Total Fiscal Benefits $0 $0 $0 $0 $0 Net Fiscal Benefits $0 $0 $0 $0 $0 7. Regulatory Impact Analysis Approval The Commissioner of the Department of Commerce, Margaret W. Busse, has reviewed and approved this regulatory impact analysis. 8. Family Impact Information

A. The agency has considered this rule's impact on family health, stability, and fo☒mation:

42 UTAH STATE BULLETIN, September 15, 2026, Vol. 2026, No. 18 NOTICES OF PROPOSED RULES 9. Citation Information Provide citations to the statutory authority for the rule. If there is also a federal requirement for the rule, provide a citation to that requirement: Subsection 58-1-106(1)(a) Subsection 58-1-202(1)(a) Section 58-46a-101 10. Incorporation by Reference Information Incorporation by Reference: A. This rule adds or updates the following title of material incorporated by reference (a copy of the material incorporated by reference must be submitted to the Office of Administrative Rules. If none, leave blank): Official Title of Materials Incorporated Code of Ethics (from title page) Publisher International Hearing Society Issue Date May 2023 11. Public Notice Information The public may submit written or oral comments to the agency identified in box 1.

A. Comments will be accepted until: 10/15/2026

B. A public hearing (optional) will be held (The public may request a hearing by submitting a written request to the agency, as outlined in Section 63G-3-302 and Rule R15-1.): Date: Time: Place (physical address or URL): 10/08/2026 10:00 AM Anchor Meeting Location: Heber M Wells Building Room 402 160 E 300 S Salt Lake City, UT Google Meet joining info: Video call link: https://meet.google.com/zyf-ewzt-ard Or dial: (US) +1 260-227-7072 PIN: 664 539 085# More phone numbers: https://tel.meet/zyf-ewzt-afd? Pin=6241205830378 12. Effective Date Information This rule change MAY become effective on: 10/22/2026 (NOTE: This is the date the agency anticipates making the filing effective. It is NOT the effective date) 13. Agency Authorization Information Agency head or Deborah Blackburn, Assistant Director Date: 08/31/2026 designee and title: R156. Commerce, Professional Licensing. R156-46a. Hearing Instrument Specialist LicensingAct Rule. R156-46a-101. Title -Authority - [Organization]Relationship to Rule R156-1. (1) This rule is known as the "Hearing Instrument Specialist LicensingAct Rule." (2) This rule is adopted by the Division under the authority of Subsection 58-1-106(1)(a) to enable the Division to administer Title 58, Chapter 46a, Hearing Instrument Specialist LicensingAct. (3) The organization of this rule and its relationship to Rule R156-1 is as described in Section R156-1-10[7]1. UTAH STATE BULLETIN, September 15, 2026, Vol. 2026, No. 18 43 NOTICES OF PROPOSED RULES R156-46a-102. Definitions. [In addition to the definitions]Terms used in this rule are defined in Title 58, Chapter 1, Division of Professional Licensing[,] and Title 58, Chapter 46a, Hearing Instrument Specialist Licensing Act[, under Subsection 58-1-203(1)(e) "unprofessional conduct" is further defined in Section R156-46a-502a]. In addition: (1) "IHS" means the International Hearing Society. (2) "ILE" means the International Licensing Examination for Hearing Healthcare Professionals administered by IHS. (3) "NBC-HIS" means the National Board for Certification in Hearing Instrument Sciences. (4) "NCE" means the National Competency ExamAdministered by NBC-HIS. (5) "Unprofessional conduct" is further defined in Section R156-46a-501. R156-46a-302. Qualifications for Licensure - Examination Requirements. (1) [Under Subsections 58-46a-302(1)(d) and 58-46a-302(2)(c), the minimum score required to pass the Utah Law and Rules Examination for hearing instrument specialists and hearing instrument interns is 75%.]Under Subsection 58-46a-302(1)(c), an applicant for licensure as a hearing instrument specialist shall pass one of the following exams: (a) the International Licensing Examination (ILE) administered by the International Hearing Society (IHS); or (b) the National Competency Exam (NCE) administered by the National Board for Certification in Hearing Instrument Sciences (NBC-HIS). (2) If an individual's license as a hearing instrument intern expires before the individual becomes licensed as a hearing instrument specialist, the individual shall retake and pass the Utah Hearing Instrument Specialists Law and Rule[s] Examination before the individual may reapply for licensure as a hearing instrument intern. R156-46a-302.5. Internship Supervision Requirements. (1) Under Subsection 58-46a-302(2)(d) and Section 58-46a-302.5, the supervision requirements for practice as a hearing instrument intern are established in this section. (2) Asupervising hearing instrument specialist or supervising audiologist shall: (a) begin supervising a hearing instrument intern only after: (i) the hearing instrument intern is licensed as a hearing instrument intern; and (ii) the supervisor is approved by the Division under Subsection 58-46a-102([6]7)(c) or (8)(c); (b) supervise no more than one hearing instrument intern on direct supervision; (c) supervise no more than two hearing instrument interns at one time; and (d) notify the Division within ten working days if an internship program is terminated. (3) To practice under indirect supervision as allowed by Subsection 58-46a-302.5(2), the hearing instrument intern shall: (a) under Subsection 58-46a-302.5(2)(a), have received a passing score on [each section of ]the [International Hearing Society (IHS)]IHS Practical Examination for Hearing Instrument Interns[, subject to the following: (i) if the hearing instrument intern receives a failing score on one or more exam sections, the intern may retake that section or those sections within 60 days; and (ii) if the hearing instrument intern does not pass each failed section within the 60-day period, the hearing instrument intern shall retake the entire exam]; and (b) under Subsection 58-46a-302.5(2)(b), have successfully completed the [International Hearing Society (IHS)]IHS [d]Distance Learning for Professionals in Hearing Health Sciences Course. R156-46a-303. Renewal Cycle - Procedures. (1) Under Subsection 58-1-308(1), the renewal date for the two-year renewal cycle for licensees underTitle 58, Chapter 46a, Hearing Instrument Specialist LicensingAct is established in Section R156-1-308a. (2) Renewal and reinstatement procedures shall be in accordance with Sections R156-1-308[c]b through R156-1- 308l. (3) Under Subsection 58-46a-303(1)(b), an applicant shall attest that the applicant has maintained competent and safe practices by meeting the requirements of Section R156-46a-304 for each two-year renewal cycle. (4) Under Subsection 58-1-308(3)(b)(vii), an applicant shall attest that the applicant has calibrated equipment as follows: (a) each audiometer used in the fitting of hearing instruments shall be calibrated when necessary, and at least annually; (b) the calibration shall be to ANSI standard calibration of frequency, accuracy, acoustic output, attenuator linearity, and harmonic distortion; and (c) calibration shall be accomplished by the manufacturer, or a properly trained person, or an institution of higher learning equipped with proper instruments for calibration of an audiometer. ([3]5) Under Subsection 58-46a-303(2)(b), a hearing instrument intern license may be renewed for a term of three years if the hearing instrument intern presents evidence satisfactory to the Division [and board ]that: (a) the licensee is on a course reasonably expected to lead to licensure, such as making reasonable progress toward passing the qualifying examination and completing required hours of supervision; and (b) a circumstance of hardship arose beyond the licensee's control to prevent the completion of the licensure process. R156-46a-304. Continuing Education - Maintaining Competence and Safe Practices. (1) Under Subsections [58-46a-304]58-1-308(3)(b) and 58-46a-303(1)(b), [a hearing instrument specialist shall complete continuing education requirements under this section for renewal of licensure]the continuing education requirements for renewal or reinstatement of 44 UTAH STATE BULLETIN, September 15, 2026, Vol. 2026, No. 18 NOTICES OF PROPOSED RULES licensure as a hearing instrument specialist under Title 58, Chapter 46a, Hearing Instrument Specialist Licensing Act are established in this section. (2) Ahearing instrument specialist shall complete at least 16 hours of continuing education during each two-year renewal cycle. (3) Continuing education courses shall be in one or more of the following topics: (a) acoustics; (b) nature of the ear such as normal ear, hearing process, disorders of hearing; (c) hearing measurement; (d) hearing [aid]instrument technology; (e) selection of hearing [aids]instruments; (f) marketing and customer relations; (g) client counseling; (h) ethical practice; (i) state laws and regulations regarding the dispensing of hearing [aids]instruments; and (j) other topics approved by the Division. (4) Continuing education courses shall be approved by: (a) theAmerican Speech-Language-HearingAssociation (ASHA); (b) theAmericanAcademy ofAudiology (AAA); or (c) the [International Hearing Society (]IHS[)]. (5) A licensee may fulfill continuing education requirements by maintaining current [National Board for Certification in Hearing Instrument Sciences (]NBC-HIS[)] board certification. (6) A licensee shall maintain documentation sufficient to prove [showing ]compliance with [the requirements of ]this section[, such as copies of transcripts or certificates of completion or of board certification,] for a period of two years [from]after the end of the renewal [period]cycle for which the continuing education is due. (7) If a licensee first becomes licensed during the two-year renewal cycle, the licensee's required number of continuing education hours shall be decreased proportionately according to the date of licensure. (8) The Division may defer or waive continuing education requirements as provided in Section R156-1-308d. R156-46a-50[2a]1. Unprofessional Conduct. Under Sections 58-1-501 and 58-46a-501, "[U]unprofessional conduct" includes: (1) violating a state or federal law applicable to persons practicing as a hearing instrument specialist or hearing instrument intern; (2) failing to perform the minimum components of an evaluation for a hearing [aid]instrument in Section R156-46a-502[b]; (3) dispensing a hearing [aid]instrument without[: (a) ] the patient having received a medical evaluation as required by Subsection [58-46-502(5)]58-41-305(2) within the six-month period before the [purchase]fitting or testing of the hearing [aid]instrument;[ or (b) a document signed by the purchaser being a fully informed adult waiving the medical evaluation in accordance with Food and Drug Administration (FDA) required disclosures in CFR Title 21, Section 801.422, except a person under the age of 18 years may not waive the medical evaluation;] (4) engaging in unprofessional conduct specified in Subsection 58-1-501(2)(a)(viii), including: (a) quoting prices of competitive hearing instruments or devices without disclosing that they are not the current prices; (b) showing, demonstrating, or representing competitive models as being current when they are not; or (c) using stalling tactics, excuses, arguing or attempting to dissuade the consumer, to prevent or delay the consumer from exercising the 30-day right to cancel a hearing [aid]instrument purchase pursuant to Subsection 58-46a-503(1); and (5) failing to conform to the generally accepted and recognized standards and ethics of the profession including those established in the Code of Ethics of the [International Hearing Society]IHS, [adopted March 2009]revised May 2023, which is incorporated by reference. R156-46a-502[b]. Minimum Components of an Evaluation for a Hearing [Aid]Instrument and Dispensing of a Hearing [Aid]Instrument. (1) Under Subsection 58-46a-102([5]4), the minimum components of a hearing [aid]instrument examination include: (a) air conduction tests at frequencies of 250, 500, 1,000, 2,000, and 4,000 hertz; (b) appropriate masking if the air conduction threshold at any one frequency differs from the bone conduction threshold of the contralateral or non-test ear by 40 decibels at the same frequency; (c) bone conduction tests at 500, 1,000, [and ]2,000, and 4,000 hertz, with proper masking; (d) speech audiometry by live voice or recorded voice, including [speech discrimination]word recognition testing, most comfortable loudness (MCL) measurements, and uncomfortable levels of loudness (UCL) measurements; and (e) recording and interpretation of audiograms and speech audiometry and other appropriate tests for the sole purpose of determining proper selection and adaptation of a hearing [aid]instrument. (2) [Only i]If the procedures in Subsection (1)(a) are clearly impractical, [may ]the licensee may select the best instrument to compensate for the loss by trial of one or more instruments. (3) Tests performed by a physician specializing in diseases of the ear, a clinical audiologist, or another licensed hearing instrument specialist [shall be accepted]may fulfill the evaluation requirement if they were performed within six months before the dispensing of the hearing [aid]instrument. UTAH STATE BULLETIN, September 15, 2026, Vol. 2026, No. 18 45 NOTICES OF PROPOSED RULES [R156-46a-502c. Calibration of Technical Instruments. The requirement in Subsection 58-46a-303(1)(b)(ii) for calibration of each appropriate technical instruments used in practice is defined as follows: (1) each audiometer used in the fitting of hearing aids shall be calibrated when necessary, but not less than annually; (2) the calibration shall include to ANSI standards calibration of frequency accuracy, acoustic output, attenuator linearity, and harmonic distortion; and (3) calibration shall be accomplished by the manufacturer, or a properly trained person, or an institution of higher learning equipped with proper instruments for calibration of an audiometer.] R156-46a-50[2d]3. Form of Written Informed Consent. Under Subsection 58-46a-502(4)(c), an agreement to provide hearing instrument specialist goods and services shall include the patient's informed consent in a form substantially [the following form]similar to the Hearing Instrument Specialist Acknowledgement of Informed Consent Form, available on the Division's website at https://commerce.utah.gov/dopl/hearing-instrument/resources. [TABLE ACKNOWLEDGEMENT OF INFORMED CONSENT As a consumer of hearing instrument specialist goods or services, you are required to be informed of certain information as provided in Utah Code Sections 58-46a-502 and 58-46a-503.

1. The list of goods and services to be provided to you

include the following: (add additional lines as required) Services: Charge: Goods (circle as applicable: new, used, reconditioned): Charge: These goods (circle as applicable: are, are not) covered by a warranty or guarantee. Additional information about any warranty or guarantee is attached.

2. The licensees providing these goods and services are:

(add additional lines as required) hearing instrument specialist: name: license number: hearing instrument intern name: license number:

4. If the goods to be provided include a hearing instrument:

(a) Additional information is attached about hearing instruments that work with assisted listening systems that are compliant with ADA Standards for Accessible Design adopted by the United States Department of Justice in accordance with the American with Disabilities Act, 42 U.S.C. Sec. 12101 et seq. (b) You have the right to receive a written receipt or written contract, which includes notice to you that you have a 30-day right to cancel the purchase and obtain a refund if you find the hearing aid does not function adequately for you. (i) The 30-day right to cancel shall start from either the date the hearing aid is originally delivered to you or the date the written receipt or contract is delivered to you, whichever is later. The 30-day period shall be tolled for any period during which the hearing aid seller, dealer, or fitter has possession or control of the hearing aid after its original delivery. (ii) Upon exercise of the 30-day right to cancel a hearing aid purchase, the seller of the hearing aid is entitled to a cancellation fee not to exceed 15% of all fees charged to the consumer, including testing, fitting, counseling, and the purchase price of the hearing aid. The exact amount of the cancellation fee shall be stated in the written receipt or contract provided to the consumer.

5. If the goods and services provided do not substantially

enhance your hearing as stated in the expected results, you are entitled to: (a) necessary intervention to produce satisfactory recovery results consistent with the representations made above at no additional cost; or (b) refund of the fees you paid for the hearing instrument within a reasonable period after finding that the hearing instrument does not substantially enhance your hearing. I hereby acknowledge being informed of the above and consent to receive the goods and services. Patient's Signature and Date] 46 UTAH STATE BULLETIN, September 15, 2026, Vol. 2026, No. 18 NOTICES OF PROPOSED RULES KEY: licensing, hearing [aids]instruments, hearing instrument specialist, hearing instrument intern Date of Last Change: [December 11, 2023]2026 Notice of Continuation: October 2, 2023 Authorizing, and Implemented or Interpreted Law: 58-1-106(1)(a); 58-1-202(1)(a); 58-46a-101; 58-46a-304 NOTICE OF SUBSTANTIVE CHANGE TYPE OF FILING: Amendment Filing ID: 58206