Bill Text: NY A06586 | 2019-2020 | General Assembly | Introduced


Bill Title: Requires coverage of hearing aids in the individual and small group markets.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2020-01-08 - referred to insurance [A06586 Detail]

Download: New_York-2019-A06586-Introduced.html


                STATE OF NEW YORK
        ________________________________________________________________________
                                          6586
                               2019-2020 Regular Sessions
                   IN ASSEMBLY
                                     March 12, 2019
                                       ___________
        Introduced  by  M.  of  A.  SEAWRIGHT  --  read once and referred to the
          Committee on Insurance
        AN ACT to amend the insurance law, in relation to hearing aids
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
     2  amended by adding a new paragraph 35 to read as follows:
     3    (35) (A) Every policy that provides coverage for hospital, surgical or
     4  medical care shall provide coverage for medically necessary hearing aids
     5  purchased from a hearing aid dispenser registered under article  thirty-
     6  seven-A  of  the  general  business law or an audiologist licensed under
     7  article one hundred fifty-nine of the education  law  in  the  following
     8  manner:
     9    (i)  For an insured person sixteen years of age or older, such insured
    10  person shall be entitled  to  reimbursement  of  up  to  three  thousand
    11  dollars  every thirty-six months for expenses related to the purchase of
    12  up to two hearing aids.
    13    (ii) For an insured person who is less than sixteen years of age, such
    14  insured person shall be entitled to reimbursement of up to two  thousand
    15  dollars every twenty-four months for expenses related to the purchase of
    16  up to two hearing aids, when it is medically demonstrated that:
    17    (1)  the  hearing  of  the insured person under the age of sixteen has
    18  changed significantly within a two-year period; and
    19    (2) the existing hearing aid will no longer correct the hearing of the
    20  insured person under the age of sixteen; such person shall  be  entitled
    21  to reimbursement for additional hearing aid expenses.
    22    (B)(i)  For  the  purposes of this paragraph, "hearing aid" shall mean
    23  any wearable instrument or device designed for hearing  and  any  parts,
    24  attachments or accessories but excluding batteries and cords or accesso-
    25  ries thereto. A registered hearing aid dispenser or licensed audiologist
    26  shall determine the type of device needed to correct the hearing loss.
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10275-01-9

        A. 6586                             2
     1    (ii)  For  the  purposes  of  this  paragraph,  services for recasing,
     2  reshelling and acquiring new molds shall be  included  as  part  of  the
     3  policies.
     4    (C)  The  insured person may choose a hearing aid exceeding the amount
     5  of coverage required by this paragraph  and  shall  be  liable  for  the
     6  difference  in  cost.  Reimbursement  shall be provided according to the
     7  respective principles and policies of the health insurance plan and  may
     8  include  such  policy  provisions as deductibles, coinsurance, allowable
     9  charge limitations, and coordination of benefits.
    10    § 2. Subsection (l) of section 3221 of the insurance law is amended by
    11  adding a new paragraph 21 to read as follows:
    12    (21) (A) Every small group policy that provides coverage for hospital,
    13  surgical or medical care shall provide coverage for medically  necessary
    14  hearing  aids  purchased  from  a hearing aid dispenser registered under
    15  article thirty-seven-A of the general business  law  or  an  audiologist
    16  licensed  under  article  one hundred fifty-nine of the education law in
    17  the following manner:
    18    (i) For an insured person sixteen years of age or older, such  insured
    19  person  shall  be  entitled  to  reimbursement  of  up to three thousand
    20  dollars every thirty-six months for expenses related to the purchase  of
    21  up to two hearing aids.
    22    (ii) For an insured person who is less than sixteen years of age, such
    23  insured  person shall be entitled to reimbursement of up to two thousand
    24  dollars every twenty-four months for expenses related to the purchase of
    25  up to two hearing aids, when it is medically demonstrated that:
    26    (1) the hearing of the insured person under the  age  of  sixteen  has
    27  changed significantly within a two-year period; and
    28    (2) the existing hearing aid will no longer correct the hearing of the
    29  insured  person  under the age of sixteen; such person shall be entitled
    30  to reimbursement for additional hearing aid expenses.
    31    (B)(i) For the purposes of this paragraph, "hearing  aid"  shall  mean
    32  any  wearable  instrument  or device designed for hearing and any parts,
    33  attachments or accessories but excluding batteries and cords or accesso-
    34  ries thereto. A registered hearing aid dispenser or licensed audiologist
    35  shall determine the type of device needed to correct the hearing loss.
    36    (ii) For the  purposes  of  this  paragraph,  services  for  recasing,
    37  reshelling  and  acquiring  new  molds  shall be included as part of the
    38  policies.
    39    (iii) For purposes of this paragraph, "small group" shall mean a group
    40  of one hundred or fewer employees or members exclusive  of  spouses  and
    41  dependents.
    42    (C)  The  insured person may choose a hearing aid exceeding the amount
    43  of coverage required by this paragraph  and  shall  be  liable  for  the
    44  difference  in  cost.  Reimbursement  shall be provided according to the
    45  respective principles and policies of the health insurance plan and  may
    46  include  such  policy  provisions as deductibles, coinsurance, allowable
    47  charge limitations, and coordination of benefits.
    48    § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
    49  subsection (ss) to read as follows:
    50    (ss)  (1)  Every  individual  and  small  group contract that provides
    51  coverage for hospital, surgical or medical care shall  provide  coverage
    52  for  medically  necessary  hearing  aids  purchased  from  a hearing aid
    53  dispenser registered under article thirty-seven-A of the  general  busi-
    54  ness law or an audiologist licensed under article one hundred fifty-nine
    55  of the education law in the following manner:

        A. 6586                             3
     1    (A)  For an insured person sixteen years of age or older, such insured
     2  person shall be entitled  to  reimbursement  of  up  to  three  thousand
     3  dollars  every thirty-six months for expenses related to the purchase of
     4  up to two hearing aids.
     5    (B)  For an insured person who is less than sixteen years of age, such
     6  insured person shall be entitled to reimbursement of up to two  thousand
     7  dollars every twenty-four months for expenses related to the purchase of
     8  up to two hearing aids, when it is medically demonstrated that:
     9    (i)  the  hearing  of  the insured person under the age of sixteen has
    10  changed significantly within a two-year period; and
    11    (ii) the existing hearing aid will no longer correct  the  hearing  of
    12  the  insured person under the age of sixteen; such person shall be enti-
    13  tled to reimbursement for additional hearing aid expenses.
    14    (2)(A) For the purposes of this subsection, "hearing aid"  shall  mean
    15  any  wearable  instrument  or device designed for hearing and any parts,
    16  attachments or accessories but excluding batteries and cords or accesso-
    17  ries thereto. A registered hearing aid dispenser or licensed audiologist
    18  shall determine the type of device needed to correct the hearing loss.
    19    (B) For the  purposes  of  this  subsection,  services  for  recasing,
    20  reshelling  and  acquiring  new  molds  shall be included as part of the
    21  policies.
    22    (C) For purposes of this subsection, "small group" shall mean a  group
    23  of  one  hundred  or fewer employees or members exclusive of spouses and
    24  dependents.
    25    (D) The insured person may choose a hearing aid exceeding  the  amount
    26  of  coverage  required  by  this  subsection and shall be liable for the
    27  difference in cost. Reimbursement shall be  provided  according  to  the
    28  respective  principles and policies of the health insurance plan and may
    29  include such policy provisions as  deductibles,  coinsurance,  allowable
    30  charge limitations, and coordination of benefits.
    31    §  4.  This  act shall take effect on the ninetieth day after it shall
    32  have become a law and shall apply according to its terms  to  all  poli-
    33  cies,  contracts  and certificates issued, renewed, modified, altered or
    34  amended on or after such date.
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