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A10595 Summary:

BILL NOA10595
 
SAME ASNo Same As
 
SPONSORWieder
 
COSPNSR
 
MLTSPNSR
 
Amd §§3216, 3221 & 4303, Ins L
 
Requires insurance coverage for cochlear implants and backup devices during the initial implantaton and for replacements and upgrades.
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A10595 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          10595
 
                   IN ASSEMBLY
 
                                     March 13, 2026
                                       ___________
 
        Introduced by M. of A. WIEDER -- read once and referred 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:

     1    Section  1.  Legislative  intent.  The legislature finds that cochlear
     2  implants are critical for patients with hearing  loss  to  maintain  the
     3  ability  to  hear.  These  devices, which are often life-changing, allow
     4  individuals to improve their quality of life, integrate fully into their
     5  communities, and perform daily activities. It is essential that individ-
     6  uals who rely on cochlear implants have continuous access to the  neces-
     7  sary  backup  equipment  to  ensure  uninterrupted use, including during
     8  device upgrades and replacements. Currently, backup devices are provided
     9  only with the initial  implantation,  but  are  not  made  available  to
    10  patients upon the upgrade or replacement of the implant after 3-5 years.
    11  This  bill  seeks  to  address  this gap in coverage and ensure that all
    12  patients requiring cochlear implants  have  a  backup  device  available
    13  throughout the duration of their treatment.
    14    § 2. Subsection (i) of section 3216 of the insurance law is amended by
    15  adding a new paragraph 41 to read as follows:
    16    (41)  (A) Every policy which provides medical, major medical, or simi-
    17  lar comprehensive-type coverage shall provide the coverage for  cochlear
    18  implants  and  for a backup cochlear implant device when prescribed by a
    19  health care practitioner licensed, certified, or authorized under  title
    20  eight  of  the  education  law,  and acting within their lawful scope of
    21  practice and for a backup device.
    22    (B) A patient receiving  an  upgrade  or  replacement  of  a  cochlear
    23  implant  device  shall be provided with a backup device corresponding to
    24  the replacement or upgrade device. The backup device shall  be  provided
    25  as  long  as the patient is actively using the cochlear implant, and for
    26  the duration of the patient's need for the device, including any  neces-
    27  sary upgrades.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10291-01-5

        A. 10595                            2
 
     1    (C)  The  coverage  required  pursuant  to this paragraph shall not be
     2  subject to annual deductibles or coinsurance.
     3    (D)  As  used  in  this  paragraph, the following terms shall have the
     4  following meanings:
     5    (i) "cochlear implant" means a medical device surgically implanted  to
     6  provide  hearing  to  individuals  with severe to profound sensorineural
     7  hearing loss; and
     8    (ii) backup cochlear implant device refers to  an  additional  set  of
     9  components  that supports the functioning of the cochlear implant in the
    10  event that the primary device fails or requires maintenance.
    11    § 3. Subsection (k) of section 3221 of the insurance law is amended by
    12  adding a new paragraph 24 to read as follows:
    13    (24) (A) Every policy which provides medical, major medical, or  simi-
    14  lar  comprehensive-type coverage shall provide the coverage for cochlear
    15  implants and for a backup cochlear implant device when prescribed  by  a
    16  health  care practitioner licensed, certified, or authorized under title
    17  eight of the education law, and acting  within  their  lawful  scope  of
    18  practice and for a backup device.
    19    (B)  A  patient  receiving  an  upgrade  or  replacement of a cochlear
    20  implant device shall be provided with a backup device  corresponding  to
    21  the  replacement  or upgrade device. The backup device shall be provided
    22  as long as the patient is actively using the cochlear implant,  and  for
    23  the  duration of the patient's need for the device, including any neces-
    24  sary upgrades.
    25    (C) The coverage required pursuant to  this  paragraph  shall  not  be
    26  subject to annual deductibles or coinsurance.
    27    (D)  As  used  in  this  paragraph, the following terms shall have the
    28  following meanings:
    29    (i) "cochlear implant" means a medical device surgically implanted  to
    30  provide  hearing  to  individuals  with severe to profound sensorineural
    31  hearing loss; and
    32    (ii) backup cochlear implant device refers to  an  additional  set  of
    33  components  that supports the functioning of the cochlear implant in the
    34  event that the primary device fails or requires maintenance.
    35    § 4. Section 4303 of the insurance law is  amended  by  adding  a  new
    36  subsection (ww) to read as follows:
    37    (ww)  (1) Every policy which provides medical, major medical, or simi-
    38  lar comprehensive-type coverage shall provide the coverage for  cochlear
    39  implants  and  for a backup cochlear implant device when prescribed by a
    40  health care practitioner licensed, certified, or authorized under  title
    41  eight  of  the  education  law,  and acting within their lawful scope of
    42  practice and for a backup device.
    43    (2) A patient receiving  an  upgrade  or  replacement  of  a  cochlear
    44  implant  device  shall be provided with a backup device corresponding to
    45  the replacement or upgrade device. The backup device shall  be  provided
    46  as  long  as the patient is actively using the cochlear implant, and for
    47  the duration of the patient's need for the device, including any  neces-
    48  sary upgrades.
    49    (3)  The  coverage  required  pursuant  to this paragraph shall not be
    50  subject to annual deductibles or coinsurance.
    51    (4) As used in this paragraph, the  following  terms  shall  have  the
    52  following meanings:
    53    (A)  "cochlear implant" means a medical device surgically implanted to
    54  provide hearing to individuals with  severe  to  profound  sensorineural
    55  hearing loss; and

        A. 10595                            3
 
     1    (B)  backup  cochlear  implant  device  refers to an additional set of
     2  components that supports the functioning of the cochlear implant in  the
     3  event that the primary device fails or requires maintenance.
     4    §  5.  Severability.  If any clause, sentence, paragraph, subdivision,
     5  section or part of this act shall be adjudged by any court of  competent
     6  jurisdiction  to  be invalid, such judgment shall not affect, impair, or
     7  invalidate the remainder thereof, but shall be confined in its operation
     8  to the clause, sentence, paragraph, subdivision, section or part thereof
     9  directly involved in the controversy in which such judgment  shall  have
    10  been rendered. It is hereby declared to be the intent of the legislature
    11  that  this  act  would have been enacted even if such invalid provisions
    12  had not been included herein.
    13    § 6. This act shall take effect on the one hundred eightieth day after
    14  it shall have become a law and shall apply to all policies and contracts
    15  issued, renewed, modified, altered or amended on  or  after  such  date.
    16  Effective immediately, the addition, amendment and/or repeal of any rule
    17  or regulation necessary for the implementation of this act on its effec-
    18  tive  date  are  authorized  to  be made and completed on or before such
    19  effective date.
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