Bill S3379A-2011

Requires all insurance policies and medical assistance to provide coverage for medically necessary hearing aids for children under 16 years of age

Enacts "Isabella's law" to require all health insurance policies and medical assistance to provide insurance coverage for the cost of medically necessary hearing aids for children under the age of 16.

Details

Actions

  • Mar 30, 2012: PRINT NUMBER 3379A
  • Mar 30, 2012: AMEND AND RECOMMIT TO INSURANCE
  • Jan 4, 2012: REFERRED TO INSURANCE
  • Feb 17, 2011: REFERRED TO INSURANCE

Memo

BILL NUMBER:S3379A

TITLE OF BILL: An act to amend the insurance law, the public health law and the social services law, in relation to requiring coverage for the purchase of medically necessary hearing aids for children under the age of sixteen years

PURPOSE: "Isabella's Law" requires all insurance policies and medical assistance to provide coverage for medically necessary hearing aids for children under 16 years of age.

SUMMARY OF PROVISIONS: Section 1. This Act shall be known and may be cited as "Isabella's law".

Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 29 (A) (i) Every health insurance policy issued or delivered in this state shall provide coverage for medically necessary hearing aids purchased from a hearing aid dispenser registered under article 37A of the general business law or an audiologist licensed under article 159 of the education law for an insured person who is less than 16 years of age, such insured person shall be entitled to reimbursement of up to $1,000 for each hearing aid every 2 years for expenses related to the purchase of up to 2 hearing aids. When it is demonstrated that (1) the insured child's hearing has changed significantly within a 2-year period and (2) the existing hearing aid will no longer correct the child's hearing loss, such insured person shall be entitled to reimbursement for additional hearing aid expenses. (ii) the insured personal shall be entitled to spend more than $1,000 on each hearing aid, but shall only be allowed reimbursement up to the amount provided in clause (i) of this subparagraph. 28 (B) (i) For the purpose of this paragraph "hearing aid" shall mean any wearable instrument or devices designed for hearing and any parts, attachments or accessories but excluding batteries and cords or accessories thereto. (ii) For the purpose of this section, services for recasing, resheiling and acquiring new molds shall be included as part of the policies. (C) Coverage provided pursuant to this paragraph shall not be subject to deductibles, coinsurance or co-payments.

Section 3221 of the insurance law is amended by adding a new subsection (s) (I) (A), (B), (2A), (B) and (3) that reads exactly as the new (A) (i) to Subsection (i) of section 3216 of the insurance law.

Section 4303 of the insurance law is amended by adding a new subsection (hh) (1) (A) which reads, every contract issued or delivered in this state by a health service corporation or hospital

service corporation shall provide coverage for hearing aids purchased from a hearing aid dispenser registered under article 37-A of the general business law or an audiologist licensed under article 159 of the education law for an insured person who is less than 16 years of age, such insured person shall be entitled to reimbursement of up to $1,000 for each hearing aid every 2 years for expenses related to the purchase of up to 2 hearing aids. When it is demonstrated that (i) the insured child's hearing has changed significantly within a 2-year period and (ii) the existing hearing aid will no longer correct the child's hearing loss, such insured person shall be entitled to reimbursement for additional hearing aid expenses. (B) the insured person shall be entitled to spend more than $1,000 on each hearing aid, but shall only be allowed reimbursement up to the amount provided in subparagraph (A) of this paragraph. (2) (A), For the purpose of this paragraph "hearing aid" shall mean any wearable instrument or devices designed for hearing and any parts, attachments or accessories but excluding batteries and cords or accessories thereto. (B) For the purpose of this section, services for recasing, reshelling and acquiring new molds shall be included as part of the policies. (3) Coverage provided pursuant to this paragraph shall not be subject to deductibles, coinsurance or co-payments.

Subdivision 6 of section 2511 of the public health law is amended by adding a new paragraph (C1), standards requiring coverage for medically necessary hearing aids in accordance with subsection (s) of section 3221 of the insurance law.

Section 5, Subdivision 2 of section 365-a of the social services law is amended by adding a new paragraph (w), the purchase of medically necessary hearing aids from a hearing aid dispenser registered under article 37-A of the general business law or an audiologist licensed under article 159 of the education law for any child who is less than 16 years of age. Such assistance shall be limited to $1,000 for each hearing aid every 2 years for up to 2 hearing aids.

JUSTIFICATION: Isabella Fager is a 6-year-old little girl from New York with a severe hearing impairment and currently her parents are forced to pay for her hearing aids out of their own pockets. In the event that Isabella's parents and other parents in their position could not afford the thousands of dollars needed to purchase hearing aids Isabella may have never had the chance to learn how to speak or be able to hear her morn and dad tell her that they love her. This bill is especially important because children out-grow hearing aids frequently and in cases of children with progressive hearing loss, they will require stronger hearing aids as time goes on, making replacement hearing aids necessary and costly to the parents.

The state of New Jersey passed a similar measure in 2008.

LEGISLATIVE HISTORY: None.

FISCAL IMPLICATIONS: Unknown.

EFFECTIVE DATE: This act shall take effect July 1, 2014 and sections one, two and three of this act shall apply to all policies issued, modified or renewed on and after such date.


Text

STATE OF NEW YORK ________________________________________________________________________ 3379--A 2011-2012 Regular Sessions IN SENATE February 17, 2011 ___________
Introduced by Sens. McDONALD, LANZA -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- recommitted to the Committee on Insurance in accordance with Senate Rule 6, sec. 8 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the insurance law, the public health law and the social services law, in relation to requiring coverage for the purchase of medically necessary hearing aids for children under the age of sixteen years THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Short title. This act shall be known and may be cited as "Isabella's law". S 2. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 29 to read as follows: (29) (A) (I) EVERY HEALTH INSURANCE POLICY ISSUED OR DELIVERED IN THIS STATE SHALL PROVIDE COVERAGE FOR MEDICALLY NECESSARY HEARING AIDS PURCHASED FROM A HEARING AID DISPENSER REGISTERED UNDER ARTICLE THIRTY- SEVEN-A OF THE GENERAL BUSINESS LAW OR AN AUDIOLOGIST LICENSED UNDER ARTICLE ONE HUNDRED FIFTY-NINE OF THE EDUCATION LAW FOR AN INSURED PERSON WHO IS LESS THAN SIXTEEN YEARS OF AGE, SUCH INSURED PERSON SHALL BE ENTITLED TO REIMBURSEMENT OF UP TO ONE THOUSAND DOLLARS FOR EACH HEARING AID EVERY TWO YEARS FOR EXPENSES RELATED TO THE PURCHASE OF UP TO TWO HEARING AIDS. WHEN IT IS DEMONSTRATED THAT (1) THE INSURED CHILD'S HEARING HAS CHANGED SIGNIFICANTLY WITHIN A TWO YEAR PERIOD AND (2) THE EXISTING HEARING AID WILL NO LONGER CORRECT THE CHILD'S HEARING LOSS, SUCH INSURED PERSON SHALL BE ENTITLED TO REIMBURSEMENT FOR ADDI- TIONAL HEARING AID EXPENSES. (II) FOR THE PURPOSES OF THIS PARAGRAPH, THE INSURED PERSON SHALL BE ENTITLED TO SPEND MORE THAN ONE THOUSAND DOLLARS ON EACH HEARING AID,
BUT SHALL ONLY BE ALLOWED REIMBURSEMENT UP TO THE AMOUNT PROVIDED IN CLAUSE (I) OF THIS SUBPARAGRAPH. (B)(I) FOR THE PURPOSES OF THIS PARAGRAPH "HEARING AID" SHALL MEAN ANY WEARABLE INSTRUMENT OR DEVICES DESIGNED FOR HEARING AND ANY PARTS, ATTACHMENTS OR ACCESSORIES BUT EXCLUDING BATTERIES AND CORDS OR ACCESSO- RIES THERETO. (II) FOR THE PURPOSES OF THIS SECTION, SERVICES FOR RECASING, RESHELL- ING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE POLICIES. (C) COVERAGE PROVIDED PURSUANT TO THIS PARAGRAPH SHALL NOT BE SUBJECT TO DEDUCTIBLES, COINSURANCE OR COPAYMENTS. S 3. Section 3221 of the insurance law is amended by adding a new subsection (s) to read as follows: (S) (1) (A) EVERY GROUP HEALTH INSURANCE POLICY ISSUED OR DELIVERED IN THIS STATE SHALL PROVIDE COVERAGE FOR HEARING AIDS PURCHASED FROM A HEARING AID DISPENSER REGISTERED UNDER ARTICLE THIRTY-SEVEN-A OF THE GENERAL BUSINESS LAW OR AN AUDIOLOGIST LICENSED UNDER ARTICLE ONE HUNDRED FIFTY-NINE OF THE EDUCATION LAW FOR AN INSURED PERSON WHO IS LESS THAN SIXTEEN YEARS OF AGE, SUCH INSURED PERSON SHALL BE ENTITLED TO REIMBURSEMENT OF UP TO ONE THOUSAND DOLLARS FOR EACH HEARING AID EVERY TWO YEARS FOR EXPENSES RELATED TO THE PURCHASE OF UP TO TWO HEARING AIDS. WHEN IT IS DEMONSTRATED THAT (I) THE INSURED CHILD'S HEARING HAS CHANGED SIGNIFICANTLY WITHIN A TWO YEAR PERIOD AND (II) THE EXISTING HEARING AID WILL NO LONGER CORRECT THE CHILD'S HEARING LOSS, SUCH INSURED PERSON SHALL BE ENTITLED TO REIMBURSEMENT FOR ADDITIONAL HEARING AID EXPENSES. (B) FOR THE PURPOSES OF THIS SUBSECTION, THE INSURED PERSON SHALL BE ENTITLED TO SPEND MORE THAN ONE THOUSAND DOLLARS ON EACH HEARING AID, BUT SHALL ONLY BE ALLOWED REIMBURSEMENT UP TO THE AMOUNT PROVIDED IN SUBPARAGRAPH (A) OF THIS PARAGRAPH. (2)(A) FOR THE PURPOSES OF THIS SUBSECTION, "HEARING AID" SHALL MEAN ANY WEARABLE INSTRUMENT OR DEVICES DESIGNED FOR HEARING AND ANY PARTS, ATTACHMENTS OR ACCESSORIES BUT EXCLUDING BATTERIES AND CORDS OR ACCESSO- RIES THERETO. (B) FOR THE PURPOSES OF THIS SECTION, SERVICES FOR RECASING, RESHELL- ING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE POLICIES. (3) COVERAGE PROVIDED PURSUANT TO THIS SUBSECTION SHALL NOT BE SUBJECT TO DEDUCTIBLES, COINSURANCE OR COPAYMENTS. S 4. Section 4303 of the insurance law is amended by adding a new subsection (ii) to read as follows: (II) (1) (A) EVERY CONTRACT ISSUED OR DELIVERED IN THIS STATE BY A HEALTH SERVICE CORPORATION OR HOSPITAL SERVICE CORPORATION SHALL PROVIDE COVERAGE FOR HEARING AIDS PURCHASED FROM A HEARING AID DISPENSER REGIS- TERED UNDER ARTICLE THIRTY-SEVEN-A OF THE GENERAL BUSINESS LAW OR AN AUDIOLOGIST LICENSED UNDER ARTICLE ONE HUNDRED FIFTY-NINE OF THE EDUCA- TION LAW FOR AN INSURED PERSON WHO IS LESS THAN SIXTEEN YEARS OF AGE, SUCH INSURED PERSON SHALL BE ENTITLED TO REIMBURSEMENT OF UP TO ONE THOUSAND DOLLARS FOR EACH HEARING AID EVERY TWO YEARS FOR EXPENSES RELATED TO THE PURCHASE OF UP TO TWO HEARING AIDS. WHEN IT IS DEMON- STRATED THAT (I) THE INSURED CHILD'S HEARING HAS CHANGED SIGNIFICANTLY WITHIN A TWO YEAR PERIOD AND (II) THE EXISTING HEARING AID WILL NO LONG- ER CORRECT THE CHILD'S HEARING LOSS, SUCH INSURED PERSON SHALL BE ENTI- TLED TO REIMBURSEMENT FOR ADDITIONAL HEARING AID EXPENSES. (B) FOR THE PURPOSES OF THIS SUBSECTION, THE INSURED PERSON SHALL BE ENTITLED TO SPEND MORE THAN ONE THOUSAND DOLLARS ON EACH HEARING AID, BUT SHALL ONLY BE ALLOWED REIMBURSEMENT UP TO THE AMOUNT PROVIDED IN SUBPARAGRAPH (A) OF THIS PARAGRAPH.
(2)(A) FOR THE PURPOSES OF THIS SUBSECTION, "HEARING AID" SHALL MEAN ANY WEARABLE INSTRUMENT OR DEVICES DESIGNED FOR HEARING AND ANY PARTS, ATTACHMENTS OR ACCESSORIES BUT EXCLUDING BATTERIES AND CORDS OR ACCESSO- RIES THERETO. (B) FOR THE PURPOSES OF THIS SECTION, SERVICES FOR RECASING, RESHELL- ING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE POLICIES. (3) COVERAGE PROVIDED PURSUANT TO THIS SUBSECTION SHALL NOT BE SUBJECT TO DEDUCTIBLES, COINSURANCE OR COPAYMENTS. S 5. Subdivision 6 of section 2511 of the public health law is amended by adding a new paragraph (c-1) to read as follows: (C-1) STANDARDS REQUIRING COVERAGE FOR MEDICALLY NECESSARY HEARING AIDS IN ACCORDANCE WITH SUBSECTION (S) OF SECTION THREE THOUSAND TWO HUNDRED TWENTY-ONE OF THE INSURANCE LAW; S 6. Subdivision 2 of section 365-a of the social services law is amended by adding a new paragraph (w) to read as follows: (W) THE PURCHASE OF MEDICALLY NECESSARY HEARING AIDS FROM A HEARING AID DISPENSER REGISTERED UNDER ARTICLE THIRTY-SEVEN-A OF THE GENERAL BUSINESS LAW OR AN AUDIOLOGIST LICENSED UNDER ARTICLE ONE HUNDRED FIFTY-NINE OF THE EDUCATION LAW FOR ANY CHILD WHO IS LESS THAN SIXTEEN YEARS OF AGE. SUCH ASSISTANCE SHALL BE LIMITED TO ONE THOUSAND DOLLARS FOR EACH HEARING AID EVERY TWO YEARS FOR UP TO TWO HEARING AIDS. S 7. This act shall take effect July 1, 2014 and sections two, three and four of this act shall apply to all policies issued, modified or renewed on and after such date.

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