S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6247
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               March 4, 2019
                                ___________
 
 Introduced  by  M. of A. FALL -- 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".
   § 2. Subsection (i) of section 3216 of the insurance law is amended by
 adding a new paragraph 35 to read as follows:
   (35) (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.
   (B)(I) FOR THE PURPOSES OF THIS PARAGRAPH "HEARING AID" SHALL MEAN ANY
 WEARABLE INSTRUMENT OR DEVICES  DESIGNED  FOR  HEARING  AND  ANY  PARTS,
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD08200-01-9

 A. 6247                             2
 
 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.
   § 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 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.
   § 4. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (ss) to read as follows:
   (SS)  (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,
 ATTACHMENTS OR ACCESSORIES BUT EXCLUDING BATTERIES AND CORDS OR ACCESSO-
 RIES THERETO.

 A. 6247                             3
 
   (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.
   § 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;
   §  6.  Subdivision  2  of  section 365-a of the social services law is
 amended by adding a new paragraph (ff) to read as follows:
   (FF) 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.
   §  7.  This act shall take effect July 1, 2020 and sections two, three
 and four of this act shall apply to all  policies  issued,  modified  or
 renewed on and after such date.