NY State Senate Bill 2021-S432

Senate Bill S432

2021-2022 Legislative Session

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

download bill text pdf

Archive: Last Bill Status - In Senate Committee Insurance Committee

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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 05, 2022	referred to insurance
Jan 06, 2021	referred to insurance

2021-S432 (ACTIVE) - Details

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
Versions Introduced in Other Legislative Sessions:: 2019-2020: S7099
2023-2024: S2561

2021-S432 (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.

2021-S432 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S432

SPONSOR: HOYLMAN
 
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 OR GENERAL IDEA OF BILL:

"Isabella's Law" requires all insurance policies and medical assistance
to provide coverage for medically necessary hearing aids for children
less than 16 years of age.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1. This Act shall be known and may be cited as "Isabella's Law".
Subsection (i) of section 3216 of the insurance law is amended by adding
a new paragraph (35) (A) (1) 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 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 (1) the insured child's hearing has changed signif-
icantly 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. (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 accessor ies
but excluding batteries and cords or accessories thereto. (ii) For the
purpose of this section, services for recasting, resheiling and acquir-
ing 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
(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 on hundred
fifty-nine or the education law for an insured person who is less than
sixteen years of age.

Section 4303 of the insurance law is amended by adding a new subsection
(ss) (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 hear-
ing 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 recasting, respelling and
acquiring now 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.

Section 5; Subdivision 6 of section 2511 of the public health law is
amended by adding a new paragraph (cl), standards requiring coverage for
medically necessary hearing aids in accordance with subsection

(t) of section 3221 of the insurance law.

Section 6, Subdivision 2 of section 365-a of the social services Law is
amended by adding a new paragraph (ff), the purchase of medically neces-
sary hearing aids from a hearing aid dispenser registered under article
37-A of the general business law or an audiologist licensed under arti-
cle 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 was a 6-year-old little girl from New York with a severe
hearing impairment and her parents were forced to pay for her hearing
aids out of pocket. 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 mom and dad tell her that
they love her. This bill is especially important because children
outgrow hearing aids frequently and in cases of children with progres-
sive 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 2008.

 
PRIOR LEGISLATIVE HISTORY:

S.7099 of 2020 (Hoylman): Died in Insurance

 
FISCAL IMPLICATIONS:

Yet to be determined

 
EFFECTIVE DATE:
This act shall take effect July 1, 2020 and sections one, two and three
of this act shall apply to all policies issued, modified or renewed on
and after such date.

2021-S432 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    432
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by  Sen. HOYLMAN -- 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".
   § 2. Subsection (i) of section 3216 of the insurance law is amended by
 adding a new paragraph 36 to read as follows:
   (36) (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.

                                                            LBD02534-01-1

 S. 432                              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.
   § 3. Section 3221 of the insurance law is  amended  by  adding  a  new
 subsection (u) to read as follows:
   (U) (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,

 S. 432                              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.
   § 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 (U) 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 (gg) to read as follows:
   (GG)  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, 2021 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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