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.