Senate Bill S1580

2013-2014 Legislative Session

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

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Archive: Last Bill Status - Stricken

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 13, 2014	recommit, enacting clause stricken
Jan 08, 2014	referred to insurance
Jan 09, 2013	referred to insurance

co-Sponsors

2013-S1580 (ACTIVE) - Details

Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L; amd §2511, Pub Health L; amd §365-a, Soc Serv L
Versions Introduced in 2011-2012 Legislative Session:: S3379

2013-S1580 (ACTIVE) - Summary

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.

2013-S1580 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S1580

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 fox 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 $1,000 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, 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 (i) 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 $1,000 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 (c-1), standards requiring coverage fox
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 $1,000 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 2005.

LEGISLATIVE HISTORY:
2011-12: S.3379 - Referred to Insurance

FISCAL IMPLICATIONS: Unknown.

EFFECTIVE DATE:
This act shall take effect July 1, 2016 and sections one, two and
three of this act shall apply to all policies issued, modified or
renewed on and after such date.

2013-S1580 (ACTIVE) - Bill Text download pdf

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

                                  1580

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 9, 2013
                               ___________

Introduced  by  Sen.  PARKER -- 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 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.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02941-01-3

S. 1580                             2

  (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 (jj) to read as follows:
  (JJ)  (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,

S. 1580                             3

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 (aa) to read as follows:
  (AA)  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, 2016 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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Senate Bill S1580

Sponsored By

Archive: Last Bill Status - Stricken

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co-Sponsors

2013-S1580 (ACTIVE) - Details

2013-S1580 (ACTIVE) - Summary

2013-S1580 (ACTIVE) - Sponsor Memo

2013-S1580 (ACTIVE) - Bill Text download pdf

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Sponsored By

Kevin S. Parker

Archive: Last Bill Status - Stricken

Actions

co-Sponsors

John L. Sampson

2013-S1580 (ACTIVE) - Details

2013-S1580 (ACTIVE) - Summary

2013-S1580 (ACTIVE) - Sponsor Memo

2013-S1580 (ACTIVE) - Bill Text download pdf

Comments