ASHA-IIE-REFERRALS — ASHA Issues in Ethics: Referrals, Medical Orders, and Prescriptions (2025)
What does ASHA-IIE-REFERRALS say?
SLPs and audiologists must exercise independent professional judgment even when receiving referrals, medical orders, or prescriptions. Key guidance: (1) Practitioners must use independent judgment in recommending and providing services — a referral or prescription does not override clinical judgment. (2) If a referral source requests services that conflict with the practitioner's professional judgment, the practitioner should work collaboratively to resolve the conflict while maintaining client welfare as paramount. (3) Practitioners should not feel pressured to provide services they believe are not in the client's best interest, even when an order exists. (4) Ethical billing requires services to be clinically necessary — providing unnecessary services because they were ordered violates ethical standards. (5) Referral relationships must be transparent — kickback arrangements or hidden financial incentives for referrals are unethical and illegal. (6) When disagreeing with a referral or order, the practitioner should communicate concerns to the referring provider and document the interaction. (7) In interdisciplinary teams, practitioners must advocate for their professional opinions while respecting collaborative decision-making. Relevant Code sections: Principle I Rules B, L (competent services, independent judgment); Principle IV Rule B (independent professional judgment); Principle I Rule Q (accurate billing).
Official source: read the full text in the ASHA Code of Ethics (2023) (official document).