senate Bill S6423

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

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Sponsor

Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 22 / Jan / 2014
    • REFERRED TO INSURANCE

Summary

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

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Bill Details

Versions:
S6423
Legislative Cycle:
2013-2014
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L; amd §2511, Pub Health L; amd §365-a, Soc Serv L

Sponsor 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.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  6423

                            I N  S E N A T E

                            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.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11708-02-4

S. 6423                             2

  (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.

S. 6423                             3

  (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.

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