S T A T E   O F   N E W   Y O R K
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                                  5207

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                            February 21, 2013
                               ___________

Introduced  by M. of A. TITONE -- Multi-Sponsored by -- M. of A. ABBATE,
  ENGLEBRIGHT, GALEF,  GIBSON,  GOTTFRIED,  HIKIND,  HOOPER,  MONTESANO,
  SCHIMEL -- read once and referred 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.
                                                           LBD02941-02-3

              

A. 5207                             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,

A. 5207                             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, 2014 and sections  two,  three
and  four  of  this  act shall apply to all policies issued, modified or
renewed on and after such date.