S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1042
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 13, 2023
                                ___________
 
 Introduced  by  M.  of A. PAULIN, SEAWRIGHT -- read once and referred to
   the Committee on Insurance
 
 AN ACT to amend the insurance law,  in  relation  to  requiring  certain
   group health insurance policies to provide coverage for hearing aids
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 3221 of the insurance law is amended  by  adding  a
 new subsection (u) to read as follows:
   (U) (1) EVERY GROUP HEALTH INSURANCE POLICY OFFERED IN THE LARGE GROUP
 MARKET  THAT  IS ISSUED, AMENDED, OR RENEWED 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 IN THE FOLLOWING MANNER:
   (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-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02166-01-3
 A. 1042                             2
              

 
 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 SECTION, SERVICES FOR RECASING, RESHELL-
 ING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE POLICIES.
   (3) THE INSURED PERSON MAY CHOOSE A HEARING AID EXCEEDING  THE  AMOUNT
 OF COVERAGE REQUIRED BY THIS SECTION AND SHALL BE LIABLE FOR THE DIFFER-
 ENCE  IN  COST. REIMBURSEMENT SHALL BE PROVIDED ACCORDING TO THE RESPEC-
 TIVE 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. Section 4305 of the insurance law is  amended  by  adding  a  new
 subsection (o) to read as follows:
   (O)  (1) A GROUP CONTRACT ISSUED, AMENDED, OR RENEWED PURSUANT TO THIS
 SECTION OFFERED IN THE LARGE GROUP MARKET  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:
   (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 SECTION, SERVICES FOR RECASING,  RESHELL-
 ING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE POLICIES.
   (3)  THE  INSURED PERSON MAY CHOOSE A HEARING AID EXCEEDING THE AMOUNT
 OF COVERAGE REQUIRED BY THIS SECTION AND SHALL BE LIABLE FOR THE DIFFER-
 ENCE IN COST. REIMBURSEMENT SHALL BE PROVIDED ACCORDING TO  THE  RESPEC-
 TIVE  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.  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.