S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6586
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                              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:

   Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
 amended by adding a new paragraph 35 to read as follows:
   (35) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL OR
 MEDICAL CARE 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  IN  THE  FOLLOWING
 MANNER:
   (I)  FOR AN INSURED PERSON SIXTEEN YEARS OF AGE OR OLDER, SUCH INSURED
 PERSON SHALL BE ENTITLED  TO  REIMBURSEMENT  OF  UP  TO  THREE  THOUSAND
 DOLLARS  EVERY THIRTY-SIX MONTHS FOR EXPENSES RELATED TO THE PURCHASE OF
 UP TO TWO HEARING AIDS.
   (II) FOR AN INSURED PERSON WHO IS LESS THAN SIXTEEN YEARS OF AGE, SUCH
 INSURED PERSON SHALL BE ENTITLED TO REIMBURSEMENT OF UP TO TWO  THOUSAND
 DOLLARS EVERY TWENTY-FOUR MONTHS FOR EXPENSES RELATED TO THE PURCHASE OF
 UP TO TWO HEARING AIDS, WHEN IT IS MEDICALLY DEMONSTRATED THAT:
   (1)  THE  HEARING  OF  THE INSURED PERSON UNDER THE AGE OF SIXTEEN HAS
 CHANGED SIGNIFICANTLY WITHIN A TWO-YEAR PERIOD; AND
   (2) THE EXISTING HEARING AID WILL NO LONGER CORRECT THE HEARING OF THE
 INSURED PERSON UNDER THE AGE OF SIXTEEN; SUCH PERSON SHALL  BE  ENTITLED
 TO REIMBURSEMENT FOR ADDITIONAL HEARING AID EXPENSES.
   (B)(I)  FOR  THE  PURPOSES OF THIS PARAGRAPH, "HEARING AID" SHALL MEAN
 ANY WEARABLE INSTRUMENT OR DEVICE DESIGNED FOR HEARING  AND  ANY  PARTS,
 ATTACHMENTS OR ACCESSORIES BUT EXCLUDING BATTERIES AND CORDS OR ACCESSO-
 RIES THERETO. A REGISTERED HEARING AID DISPENSER OR LICENSED AUDIOLOGIST
 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
 
   (II)  FOR  THE  PURPOSES  OF  THIS  PARAGRAPH,  SERVICES FOR RECASING,
 RESHELLING AND ACQUIRING NEW MOLDS SHALL BE  INCLUDED  AS  PART  OF  THE
 POLICIES.
   (C)  THE  INSURED PERSON MAY CHOOSE A HEARING AID EXCEEDING THE AMOUNT
 OF COVERAGE REQUIRED BY THIS PARAGRAPH  AND  SHALL  BE  LIABLE  FOR  THE
 DIFFERENCE  IN  COST.  REIMBURSEMENT  SHALL BE PROVIDED ACCORDING TO THE
 RESPECTIVE PRINCIPLES AND POLICIES OF THE HEALTH INSURANCE PLAN AND  MAY
 INCLUDE  SUCH  POLICY  PROVISIONS AS DEDUCTIBLES, COINSURANCE, ALLOWABLE
 CHARGE LIMITATIONS, AND COORDINATION OF BENEFITS.
   § 2. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 21 to read as follows:
   (21) (A) EVERY SMALL GROUP POLICY THAT PROVIDES COVERAGE FOR HOSPITAL,
 SURGICAL OR MEDICAL CARE 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 IN
 THE FOLLOWING MANNER:
   (I) FOR AN INSURED PERSON SIXTEEN YEARS OF AGE OR OLDER, SUCH  INSURED
 PERSON  SHALL  BE  ENTITLED  TO  REIMBURSEMENT  OF  UP TO THREE THOUSAND
 DOLLARS EVERY THIRTY-SIX MONTHS FOR EXPENSES RELATED TO THE PURCHASE  OF
 UP TO TWO HEARING AIDS.
   (II) FOR AN INSURED PERSON WHO IS LESS THAN SIXTEEN YEARS OF AGE, SUCH
 INSURED  PERSON SHALL BE ENTITLED TO REIMBURSEMENT OF UP TO TWO THOUSAND
 DOLLARS EVERY TWENTY-FOUR MONTHS FOR EXPENSES RELATED TO THE PURCHASE OF
 UP TO TWO HEARING AIDS, WHEN IT IS MEDICALLY DEMONSTRATED THAT:
   (1) THE HEARING OF THE INSURED PERSON UNDER THE  AGE  OF  SIXTEEN  HAS
 CHANGED SIGNIFICANTLY WITHIN A TWO-YEAR PERIOD; AND
   (2) THE EXISTING HEARING AID WILL NO LONGER CORRECT THE HEARING OF THE
 INSURED  PERSON  UNDER THE AGE OF SIXTEEN; SUCH PERSON SHALL BE ENTITLED
 TO REIMBURSEMENT FOR ADDITIONAL HEARING AID EXPENSES.
   (B)(I) FOR THE PURPOSES OF THIS PARAGRAPH, "HEARING  AID"  SHALL  MEAN
 ANY  WEARABLE  INSTRUMENT  OR DEVICE DESIGNED FOR HEARING AND ANY PARTS,
 ATTACHMENTS OR ACCESSORIES BUT EXCLUDING BATTERIES AND CORDS OR ACCESSO-
 RIES THERETO. A REGISTERED HEARING AID DISPENSER OR LICENSED AUDIOLOGIST
 SHALL DETERMINE THE TYPE OF DEVICE NEEDED TO CORRECT THE HEARING LOSS.
   (II) FOR THE  PURPOSES  OF  THIS  PARAGRAPH,  SERVICES  FOR  RECASING,
 RESHELLING  AND  ACQUIRING  NEW  MOLDS  SHALL BE INCLUDED AS PART OF THE
 POLICIES.
   (III) FOR PURPOSES OF THIS PARAGRAPH, "SMALL GROUP" SHALL MEAN A GROUP
 OF ONE HUNDRED OR FEWER EMPLOYEES OR MEMBERS EXCLUSIVE  OF  SPOUSES  AND
 DEPENDENTS.
   (C)  THE  INSURED PERSON MAY CHOOSE A HEARING AID EXCEEDING THE AMOUNT
 OF COVERAGE REQUIRED BY THIS PARAGRAPH  AND  SHALL  BE  LIABLE  FOR  THE
 DIFFERENCE  IN  COST.  REIMBURSEMENT  SHALL BE PROVIDED ACCORDING TO THE
 RESPECTIVE PRINCIPLES AND POLICIES OF THE HEALTH INSURANCE PLAN AND  MAY
 INCLUDE  SUCH  POLICY  PROVISIONS AS DEDUCTIBLES, COINSURANCE, ALLOWABLE
 CHARGE LIMITATIONS, AND COORDINATION OF BENEFITS.
   § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (ss) to read as follows:
   (SS)  (1)  EVERY  INDIVIDUAL  AND  SMALL  GROUP CONTRACT THAT PROVIDES
 COVERAGE FOR HOSPITAL, SURGICAL OR MEDICAL CARE SHALL  PROVIDE  COVERAGE
 FOR  MEDICALLY  NECESSARY  HEARING  AIDS  PURCHASED  FROM  A HEARING AID
 DISPENSER REGISTERED UNDER ARTICLE THIRTY-SEVEN-A OF THE  GENERAL  BUSI-
 NESS LAW OR AN AUDIOLOGIST LICENSED UNDER ARTICLE ONE HUNDRED FIFTY-NINE
 OF THE EDUCATION LAW IN THE FOLLOWING MANNER:

 A. 6586                             3
 
   (A)  FOR AN INSURED PERSON SIXTEEN YEARS OF AGE OR OLDER, SUCH INSURED
 PERSON SHALL BE ENTITLED  TO  REIMBURSEMENT  OF  UP  TO  THREE  THOUSAND
 DOLLARS  EVERY THIRTY-SIX MONTHS FOR EXPENSES RELATED TO THE PURCHASE OF
 UP TO TWO HEARING AIDS.
   (B)  FOR AN INSURED PERSON WHO IS LESS THAN SIXTEEN YEARS OF AGE, SUCH
 INSURED PERSON SHALL BE ENTITLED TO REIMBURSEMENT OF UP TO TWO  THOUSAND
 DOLLARS EVERY TWENTY-FOUR MONTHS FOR EXPENSES RELATED TO THE PURCHASE OF
 UP TO TWO HEARING AIDS, WHEN IT IS MEDICALLY DEMONSTRATED THAT:
   (I)  THE  HEARING  OF  THE INSURED PERSON UNDER THE AGE OF SIXTEEN HAS
 CHANGED SIGNIFICANTLY WITHIN A TWO-YEAR PERIOD; AND
   (II) THE EXISTING HEARING AID WILL NO LONGER CORRECT  THE  HEARING  OF
 THE  INSURED PERSON UNDER THE AGE OF SIXTEEN; SUCH PERSON SHALL BE ENTI-
 TLED TO REIMBURSEMENT FOR ADDITIONAL HEARING AID EXPENSES.
   (2)(A) FOR THE PURPOSES OF THIS SUBSECTION, "HEARING AID"  SHALL  MEAN
 ANY  WEARABLE  INSTRUMENT  OR DEVICE DESIGNED FOR HEARING AND ANY PARTS,
 ATTACHMENTS OR ACCESSORIES BUT EXCLUDING BATTERIES AND CORDS OR ACCESSO-
 RIES THERETO. A REGISTERED HEARING AID DISPENSER OR LICENSED AUDIOLOGIST
 SHALL DETERMINE THE TYPE OF DEVICE NEEDED TO CORRECT THE HEARING LOSS.
   (B) FOR THE  PURPOSES  OF  THIS  SUBSECTION,  SERVICES  FOR  RECASING,
 RESHELLING  AND  ACQUIRING  NEW  MOLDS  SHALL BE INCLUDED AS PART OF THE
 POLICIES.
   (C) FOR PURPOSES OF THIS SUBSECTION, "SMALL GROUP" SHALL MEAN A  GROUP
 OF  ONE  HUNDRED  OR FEWER EMPLOYEES OR MEMBERS EXCLUSIVE OF SPOUSES AND
 DEPENDENTS.
   (D) THE INSURED PERSON MAY CHOOSE A HEARING AID EXCEEDING  THE  AMOUNT
 OF  COVERAGE  REQUIRED  BY  THIS  SUBSECTION AND SHALL BE LIABLE FOR THE
 DIFFERENCE IN COST. REIMBURSEMENT SHALL BE  PROVIDED  ACCORDING  TO  THE
 RESPECTIVE  PRINCIPLES AND POLICIES OF THE HEALTH INSURANCE PLAN AND MAY
 INCLUDE SUCH POLICY PROVISIONS AS  DEDUCTIBLES,  COINSURANCE,  ALLOWABLE
 CHARGE LIMITATIONS, AND COORDINATION OF BENEFITS.
   §  4.  This  act shall take effect on the ninetieth day after it shall
 have become a law and shall apply according to its terms  to  all  poli-
 cies,  contracts  and certificates issued, renewed, modified, altered or
 amended on or after such date.