Add SS3216, 3221 & 4303, Ins L; amd S2511, Pub Health L; amd S365-a, Soc Serv L
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.
STATE OF NEW YORK
________________________________________________________________________
3379--A
2011-2012 Regular Sessions
IN SENATE
February 17, 2011
___________
Introduced by Sens. McDONALD, LANZA -- read twice and ordered printed,
and when printed to be committed to the Committee on Insurance --
recommitted to the Committee on Insurance in accordance with Senate
Rule 6, sec. 8 -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee
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:
1 Section 1. Short title. This act shall be known and may be cited as
2 "Isabella's law".
3 § 2. Subsection (i) of section 3216 of the insurance law is amended by
4 adding a new paragraph 29 to read as follows:
5 (29) (A) (i) Every health insurance policy issued or delivered in this
6 state shall provide coverage for medically necessary hearing aids
7 purchased from a hearing aid dispenser registered under article thirty-
8 seven-A of the general business law or an audiologist licensed under
9 article one hundred fifty-nine of the education law for an insured
10 person who is less than sixteen years of age, such insured person shall
11 be entitled to reimbursement of up to one thousand dollars for each
12 hearing aid every two years for expenses related to the purchase of up
13 to two hearing aids. When it is demonstrated that (1) the insured
14 child's hearing has changed significantly within a two year period and
15 (2) the existing hearing aid will no longer correct the child's hearing
16 loss, such insured person shall be entitled to reimbursement for addi-
17 tional hearing aid expenses.
18 (ii) for the purposes of this paragraph, the insured person shall be
19 entitled to spend more than one thousand dollars on each hearing aid,
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD06999-04-2
S. 3379--A 2
1 but shall only be allowed reimbursement up to the amount provided in
2 clause (i) of this subparagraph.
3 (B)(i) For the purposes of this paragraph "hearing aid" shall mean any
4 wearable instrument or devices designed for hearing and any parts,
5 attachments or accessories but excluding batteries and cords or accesso-
6 ries thereto.
7 (ii) For the purposes of this section, services for recasing, reshell-
8 ing and acquiring new molds shall be included as part of the policies.
9 (C) Coverage provided pursuant to this paragraph shall not be subject
10 to deductibles, coinsurance or copayments.
11 § 3. Section 3221 of the insurance law is amended by adding a new
12 subsection (s) to read as follows:
13 (s) (1) (A) Every group health insurance policy issued or delivered in
14 this state shall provide coverage for hearing aids purchased from a
15 hearing aid dispenser registered under article thirty-seven-A of the
16 general business law or an audiologist licensed under article one
17 hundred fifty-nine of the education law for an insured person who is
18 less than sixteen years of age, such insured person shall be entitled to
19 reimbursement of up to one thousand dollars for each hearing aid every
20 two years for expenses related to the purchase of up to two hearing
21 aids. When it is demonstrated that (i) the insured child's hearing has
22 changed significantly within a two year period and (ii) the existing
23 hearing aid will no longer correct the child's hearing loss, such
24 insured person shall be entitled to reimbursement for additional hearing
25 aid expenses.
26 (B) For the purposes of this subsection, the insured person shall be
27 entitled to spend more than one thousand dollars on each hearing aid,
28 but shall only be allowed reimbursement up to the amount provided in
29 subparagraph (A) of this paragraph.
30 (2)(A) For the purposes of this subsection, "hearing aid" shall mean
31 any wearable instrument or devices designed for hearing and any parts,
32 attachments or accessories but excluding batteries and cords or accesso-
33 ries thereto.
34 (B) For the purposes of this section, services for recasing, reshell-
35 ing and acquiring new molds shall be included as part of the policies.
36 (3) Coverage provided pursuant to this subsection shall not be subject
37 to deductibles, coinsurance or copayments.
38 § 4. Section 4303 of the insurance law is amended by adding a new
39 subsection (ii) to read as follows:
40 (ii) (1) (A) Every contract issued or delivered in this state by a
41 health service corporation or hospital service corporation shall provide
42 coverage for hearing aids purchased from a hearing aid dispenser regis-
43 tered under article thirty-seven-A of the general business law or an
44 audiologist licensed under article one hundred fifty-nine of the educa-
45 tion law for an insured person who is less than sixteen years of age,
46 such insured person shall be entitled to reimbursement of up to one
47 thousand dollars for each hearing aid every two years for expenses
48 related to the purchase of up to two hearing aids. When it is demon-
49 strated that (i) the insured child's hearing has changed significantly
50 within a two year period and (ii) the existing hearing aid will no long-
51 er correct the child's hearing loss, such insured person shall be enti-
52 tled to reimbursement for additional hearing aid expenses.
53 (B) For the purposes of this subsection, the insured person shall be
54 entitled to spend more than one thousand dollars on each hearing aid,
55 but shall only be allowed reimbursement up to the amount provided in
56 subparagraph (A) of this paragraph.
S. 3379--A 3
1 (2)(A) For the purposes of this subsection, "hearing aid" shall mean
2 any wearable instrument or devices designed for hearing and any parts,
3 attachments or accessories but excluding batteries and cords or accesso-
4 ries thereto.
5 (B) For the purposes of this section, services for recasing, reshell-
6 ing and acquiring new molds shall be included as part of the policies.
7 (3) Coverage provided pursuant to this subsection shall not be subject
8 to deductibles, coinsurance or copayments.
9 § 5. Subdivision 6 of section 2511 of the public health law is amended
10 by adding a new paragraph (c-1) to read as follows:
11 (c-1) standards requiring coverage for medically necessary hearing
12 aids in accordance with subsection (s) of section three thousand two
13 hundred twenty-one of the insurance law;
14 § 6. Subdivision 2 of section 365-a of the social services law is
15 amended by adding a new paragraph (w) to read as follows:
16 (w) the purchase of medically necessary hearing aids from a hearing
17 aid dispenser registered under article thirty-seven-A of the general
18 business law or an audiologist licensed under article one hundred
19 fifty-nine of the education law for any child who is less than sixteen
20 years of age. Such assistance shall be limited to one thousand dollars
21 for each hearing aid every two years for up to two hearing aids.
22 § 7. This act shall take effect July 1, 2014 and sections two, three
23 and four of this act shall apply to all policies issued, modified or
24 renewed on and after such date.
