Bill S6423-2013

Relates to insurance coverage of up to one thousand five hundred dollars for hearing aids for people under age sixteen

Requires insurance coverage of up to one thousand five hundred dollars for hearing aids for people under age sixteen.

Details

Actions

  • Jan 22, 2014: REFERRED TO INSURANCE

Memo

BILL NUMBER:S6423

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 (1) of section 3216 of the insurance law is amended by adding a new paragraph 30 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 $1,500 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 $1,500 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, reshelling 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 (1) of section 3216 of the insurance law.

Section 4303 of the insurance law is amended by adding a new subsection (jj) (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 $1,500 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 $1,500 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 (c-1), 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 (aa), 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 $1,500 for each hearing aid every 2 years for up to 2 hearing aids.

JUSTIFICATION:

Isabella Pager is a 9-year-old girl from Dutchess County, New York with a severe hearing impairment. Currently, her parents are forced to pay for her hearing aids out of pocket. Isabella's parents and other parents throughout New York State cannot afford the thousands of dollars needed to purchase hearing aids for their children. Isabella and every other child in New York State deserves the chance to learn how to speak and to hear their parents tell them that they are loved. Children out-grow hearing aids frequently and children with progressive hearing loss require stronger hearing aids as they grow. This becomes more and more costly to parents as time goes on. We owe all of our children a chance to live fuller lives by giving them the gift of hearing.

The state of New Jersey passed a similar measure in 2005.

LEGISLATIVE HISTORY:

This is a new bill.

FISCAL IMPLICATIONS:

Unknown

EFFECTIVE DATE:

This act shall take effect July 1, 2015 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 ________________________________________________________________________ 6423 IN SENATE January 22, 2014 ___________
Introduced by Sen. GIPSON -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance 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 30 to read as follows: (30) (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 FIVE HUNDRED 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 ADDITIONAL HEARING AID EXPENSES. (II) FOR THE PURPOSES OF THIS PARAGRAPH, THE INSURED PERSON SHALL BE ENTITLED TO SPEND MORE THAN ONE THOUSAND FIVE HUNDRED 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 (t) to read as follows: (T) (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 FIVE HUNDRED DOLLARS FOR EACH HEAR- ING 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 FIVE HUNDRED 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 (oo) to read as follows: (OO) (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 FIVE HUNDRED 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 SIGNIF- ICANTLY 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 FIVE HUNDRED 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 (T) 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 (bb) to read as follows: (BB) 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 FIVE HUNDRED DOLLARS FOR EACH HEARING AID EVERY TWO YEARS FOR UP TO TWO HEAR- ING AIDS. S 7. This act shall take effect July 1, 2015 and sections two, three and four of this act shall apply to all policies issued, modified or renewed on and after such date.

Comments

Open Legislation comments facilitate discussion of New York State legislation. All comments are subject to moderation. Comments deemed off-topic, commercial, campaign-related, self-promotional; or that contain profanity or hate speech; or that link to sites outside of the nysenate.gov domain are not permitted, and will not be published. Comment moderation is generally performed Monday through Friday.

By contributing or voting you agree to the Terms of Participation and verify you are over 13.

Discuss!

blog comments powered by Disqus