NY State Senate Bill 2025-S8265

Current 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
May 28, 2025	referred to insurance

co-Sponsors

2025-S8265 (ACTIVE) - Details

See Assembly Version of this Bill:: A6314
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L

2025-S8265 (ACTIVE) - Summary

Requires insurance coverage for cochlear implants and backup devices during the initial implantation and for replacements and upgrades.

2025-S8265 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S8265

SPONSOR: SUTTON
 
TITLE OF BILL:

An act to amend the insurance law, in relation to ensuring continued
access to backup devices for patients with cochlear implants

 
PURPOSE OR GENERAL IDEA OF BILL:

To require insurance coverage for backup cochlear implant devices to
ensure uninterrupted access for patients during device upgrades or
replacements.

 
SUMMARY OF PROVISIONS:

This bill amends Sections 3216, 3221, and 4303 of the Insurance Law to
mandate that all health insurance policies providing medical or major
medical coverage must include:

1. Coverage for Cochlear Implants and Backup Devices:

*Insurance plans must cover cochlear implants and provide a backup
device when prescribed by a licensed healthcare practitioner.

2. Provision of Backup Devices During Upgrades/Replacements:

*Patients receiving an upgrade or replacement cochlear implant must be
provided with a corresponding backup device, ensuring continuous hearing
capability.

3. No Additional Costs to Patients:

*Coverage for backup devices will not be subject to annual deductibles
or coinsurance..

4. Definitions:

*Cochlear Implant: A surgically implanted medical device that provides
hething to individuals with severe to profound sensorineural hearing
loss.

*Backup Cochlear Implant Device: An additional set of components
supporting the functioning of the cochlear implant if the primary device
fails or requires maintenance.

5. Severability:

*If any part of this act is deemed invalid, the remaining sections will
continue in effect.

6. Effective Date:

* This act shall take effect 180 days after becoming law and will apply
to all relevant insurance policies issued, renewed, or modified on or
after that date.

 
JUSTIFICATION:

Cochlear implants are life-changing devices for individuals with severe
hearing loss, restoring the ability to hear and significantly improving
quality of life. However, current insurance practices often provide
backup devices only at the time of initial implantation, leaving
patients vulnerable during upgrades or replacements that typically occur
every 3-5 years.

Without a functioning device, patients-especially children-may experi-
ence periods of complete hearing loss, leading to developmental
setbacks, communication challenges, and safety concerns. This bill
addresses a critical gap in insurance coverage, ensuring patients have
access to backup devices throughout the lifespan of their cochlear
implant, thereby preventing interruptions in hearing.

By guaranteeing continuous access to these essential devices, this
legislation promotes better health outcomes, supports social inte-
gration, and protects the rights and well-being of individuals relying
on cochlear implants.

 
PRIOR LEGISLATIVE HISTORY:

None

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

Minimal. While insurance providers may incur additional costs for cover-
ing backup devices, the overall impact is, expected to be limited. The
potential long-term savings from avoiding complications related to
interrupted hearing may offset initial expenses.

 
EFFECTIVE DATE:
This act shall take effect 180 days after becoming law and will apply to
all policies and contracts issued, renewed, modified, altered, or
amended on or after such date.

2025-S8265 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8265
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                               May 28, 2025
                                ___________
 
 Introduced  by  Sen.  SUTTON -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance law, in  relation  to  ensuring  continued
   access to backup devices for patients with cochlear implants
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Legislative intent. The  legislature  finds  that  cochlear
 implants  are  critical  for  patients with hearing loss to maintain the
 ability to hear. These devices, which  are  often  life-changing,  allow
 individuals to improve their quality of life, integrate fully into their
 communities, and perform daily activities. It is essential that individ-
 uals  who rely on cochlear implants have continuous access to the neces-
 sary backup equipment to  ensure  uninterrupted  use,  including  during
 device upgrades and replacements. Currently, backup devices are provided
 only  with  the  initial  implantation,  but  are  not made available to
 patients upon the upgrade or replacement of the implant after 3-5 years.
 This bill seeks to address this gap in  coverage  and  ensure  that  all
 patients  requiring  cochlear  implants  have  a backup device available
 throughout the duration of their treatment.
   § 2. Subsection (i) of section 3216 of the insurance law is amended by
 adding a new paragraph 41 to read as follows:
   (41) (A) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR  SIMI-
 LAR  COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE THE COVERAGE FOR COCHLEAR
 IMPLANTS AND FOR A BACKUP COCHLEAR IMPLANT DEVICE WHEN PRESCRIBED  BY  A
 HEALTH  CARE PRACTITIONER LICENSED, CERTIFIED, OR AUTHORIZED UNDER TITLE
 EIGHT OF THE EDUCATION LAW, AND ACTING  WITHIN  THEIR  LAWFUL  SCOPE  OF
 PRACTICE AND FOR A BACKUP DEVICE.
   (B)  A  PATIENT  RECEIVING  AN  UPGRADE  OR  REPLACEMENT OF A COCHLEAR
 IMPLANT DEVICE SHALL BE PROVIDED WITH A BACKUP DEVICE  CORRESPONDING  TO
 THE  REPLACEMENT  OR UPGRADE DEVICE. THE BACKUP DEVICE SHALL BE PROVIDED
 AS LONG AS THE PATIENT IS ACTIVELY USING THE COCHLEAR IMPLANT,  AND  FOR
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD10291-01-5

 S. 8265                             2
 
 THE  DURATION OF THE PATIENT'S NEED FOR THE DEVICE, INCLUDING ANY NECES-
 SARY UPGRADES.
   (C)  THE  COVERAGE  REQUIRED  PURSUANT  TO THIS PARAGRAPH SHALL NOT BE
 SUBJECT TO ANNUAL DEDUCTIBLES OR COINSURANCE.
   (D) AS USED IN THIS PARAGRAPH, THE  FOLLOWING  TERMS  SHALL  HAVE  THE
 FOLLOWING MEANINGS:
   (I)  "COCHLEAR IMPLANT" MEANS A MEDICAL DEVICE SURGICALLY IMPLANTED TO
 PROVIDE HEARING TO INDIVIDUALS WITH  SEVERE  TO  PROFOUND  SENSORINEURAL
 HEARING LOSS; AND
   (II)  BACKUP  COCHLEAR  IMPLANT  DEVICE REFERS TO AN ADDITIONAL SET OF
 COMPONENTS THAT SUPPORTS THE FUNCTIONING OF THE COCHLEAR IMPLANT IN  THE
 EVENT THAT THE PRIMARY DEVICE FAILS OR REQUIRES MAINTENANCE.
   § 3. Subsection (k) of section 3221 of the insurance law is amended by
 adding a new paragraph 24 to read as follows:
   (24)  (A) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMI-
 LAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE THE COVERAGE FOR  COCHLEAR
 IMPLANTS  AND  FOR A BACKUP COCHLEAR IMPLANT DEVICE WHEN PRESCRIBED BY A
 HEALTH CARE PRACTITIONER LICENSED, CERTIFIED, OR AUTHORIZED UNDER  TITLE
 EIGHT  OF  THE  EDUCATION  LAW,  AND ACTING WITHIN THEIR LAWFUL SCOPE OF
 PRACTICE AND FOR A BACKUP DEVICE.
   (B) A PATIENT RECEIVING  AN  UPGRADE  OR  REPLACEMENT  OF  A  COCHLEAR
 IMPLANT  DEVICE  SHALL BE PROVIDED WITH A BACKUP DEVICE CORRESPONDING TO
 THE REPLACEMENT OR UPGRADE DEVICE. THE BACKUP DEVICE SHALL  BE  PROVIDED
 AS  LONG  AS THE PATIENT IS ACTIVELY USING THE COCHLEAR IMPLANT, AND FOR
 THE DURATION OF THE PATIENT'S NEED FOR THE DEVICE, INCLUDING ANY  NECES-
 SARY UPGRADES.
   (C)  THE  COVERAGE  REQUIRED  PURSUANT  TO THIS PARAGRAPH SHALL NOT BE
 SUBJECT TO ANNUAL DEDUCTIBLES OR COINSURANCE.
   (D) AS USED IN THIS PARAGRAPH, THE  FOLLOWING  TERMS  SHALL  HAVE  THE
 FOLLOWING MEANINGS:
   (I)  "COCHLEAR IMPLANT" MEANS A MEDICAL DEVICE SURGICALLY IMPLANTED TO
 PROVIDE HEARING TO INDIVIDUALS WITH  SEVERE  TO  PROFOUND  SENSORINEURAL
 HEARING LOSS; AND
   (II)  BACKUP  COCHLEAR  IMPLANT  DEVICE REFERS TO AN ADDITIONAL SET OF
 COMPONENTS THAT SUPPORTS THE FUNCTIONING OF THE COCHLEAR IMPLANT IN  THE
 EVENT THAT THE PRIMARY DEVICE FAILS OR REQUIRES MAINTENANCE.
   §  4.  Section  4303  of  the insurance law is amended by adding a new
 subsection (ww) to read as follows:
   (WW) (1) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR  SIMI-
 LAR  COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE THE COVERAGE FOR COCHLEAR
 IMPLANTS AND FOR A BACKUP COCHLEAR IMPLANT DEVICE WHEN PRESCRIBED  BY  A
 HEALTH  CARE PRACTITIONER LICENSED, CERTIFIED, OR AUTHORIZED UNDER TITLE
 EIGHT OF THE EDUCATION LAW, AND ACTING  WITHIN  THEIR  LAWFUL  SCOPE  OF
 PRACTICE AND FOR A BACKUP DEVICE.
   (2)  A  PATIENT  RECEIVING  AN  UPGRADE  OR  REPLACEMENT OF A COCHLEAR
 IMPLANT DEVICE SHALL BE PROVIDED WITH A BACKUP DEVICE  CORRESPONDING  TO
 THE  REPLACEMENT  OR UPGRADE DEVICE. THE BACKUP DEVICE SHALL BE PROVIDED
 AS LONG AS THE PATIENT IS ACTIVELY USING THE COCHLEAR IMPLANT,  AND  FOR
 THE  DURATION OF THE PATIENT'S NEED FOR THE DEVICE, INCLUDING ANY NECES-
 SARY UPGRADES.
   (3) THE COVERAGE REQUIRED PURSUANT TO  THIS  PARAGRAPH  SHALL  NOT  BE
 SUBJECT TO ANNUAL DEDUCTIBLES OR COINSURANCE.
   (4)  AS  USED  IN  THIS  PARAGRAPH, THE FOLLOWING TERMS SHALL HAVE THE
 FOLLOWING MEANINGS:
 S. 8265                             3
 
   (A) "COCHLEAR IMPLANT" MEANS A MEDICAL DEVICE SURGICALLY IMPLANTED  TO
 PROVIDE  HEARING  TO  INDIVIDUALS  WITH SEVERE TO PROFOUND SENSORINEURAL
 HEARING LOSS; AND
   (B)  BACKUP  COCHLEAR  IMPLANT  DEVICE  REFERS TO AN ADDITIONAL SET OF
 COMPONENTS THAT SUPPORTS THE FUNCTIONING OF THE COCHLEAR IMPLANT IN  THE
 EVENT THAT THE PRIMARY DEVICE FAILS OR REQUIRES MAINTENANCE.
   §  5.  Severability.  If any clause, sentence, paragraph, subdivision,
 section or part of this act shall be adjudged by any court of  competent
 jurisdiction  to  be invalid, such judgment shall not affect, impair, or
 invalidate the remainder thereof, but shall be confined in its operation
 to the clause, sentence, paragraph, subdivision, section or part thereof
 directly involved in the controversy in which such judgment  shall  have
 been rendered. It is hereby declared to be the intent of the legislature
 that  this  act  would have been enacted even if such invalid provisions
 had not been included herein.
   § 6. This act shall take effect on the one hundred eightieth day after
 it shall have become a law and shall apply to all policies and contracts
 issued, renewed, modified, altered or amended on  or  after  such  date.
 Effective immediately, the addition, amendment and/or repeal of any rule
 or regulation necessary for the implementation of this act on its effec-
 tive  date  are  authorized  to  be made and completed on or before such
 effective date.

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Senate Bill S8265

Sponsored By

Current Bill Status - In Senate Committee Insurance Committee

co-Sponsors

2025-S8265 (ACTIVE) - Details

2025-S8265 (ACTIVE) - Summary

2025-S8265 (ACTIVE) - Sponsor Memo

2025-S8265 (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S8265

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Sponsored By

Sam Sutton

Current Bill Status - In Senate Committee Insurance Committee

co-Sponsors

Andrew Gounardes

Zellnor Myrie

Bill Weber

2025-S8265 (ACTIVE) - Details

2025-S8265 (ACTIVE) - Summary

2025-S8265 (ACTIVE) - Sponsor Memo

2025-S8265 (ACTIVE) - Bill Text download pdf

Comments