Amd §§3216, 3221 & 4303, Ins L; amd §2511, Pub Health L; amd §365-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
________________________________________________________________________
6626
2017-2018 Regular Sessions
IN ASSEMBLY
March 10, 2017
___________
Introduced by M. of A. TITONE, SKOUFIS -- Multi-Sponsored by -- M. of A.
ABBATE, COOK, ENGLEBRIGHT, GALEF, GOTTFRIED, HIKIND, HOOPER, MONTESANO
-- read once and referred to the Committee on Insurance
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 34 to read as follows:
5 (34) (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,
20 but shall only be allowed reimbursement up to the amount provided in
21 clause (i) of this subparagraph.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD09218-01-7
A. 6626 2
1 (B)(i) For the purposes of this paragraph "hearing aid" shall mean any
2 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 (ii) 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 (C) Coverage provided pursuant to this paragraph shall not be subject
8 to deductibles, coinsurance or copayments.
9 § 3. Section 3221 of the insurance law is amended by adding a new
10 subsection (t) to read as follows:
11 (t) (1) (A) Every group health insurance policy issued or delivered in
12 this state shall provide coverage for hearing aids purchased from a
13 hearing aid dispenser registered under article thirty-seven-A of the
14 general business law or an audiologist licensed under article one
15 hundred fifty-nine of the education law for an insured person who is
16 less than sixteen years of age, such insured person shall be entitled to
17 reimbursement of up to one thousand dollars for each hearing aid every
18 two years for expenses related to the purchase of up to two hearing
19 aids. When it is demonstrated that (i) the insured child's hearing has
20 changed significantly within a two year period and (ii) the existing
21 hearing aid will no longer correct the child's hearing loss, such
22 insured person shall be entitled to reimbursement for additional hearing
23 aid expenses.
24 (B) For the purposes of this subsection, the insured person shall be
25 entitled to spend more than one thousand dollars on each hearing aid,
26 but shall only be allowed reimbursement up to the amount provided in
27 subparagraph (A) of this paragraph.
28 (2)(A) For the purposes of this subsection, "hearing aid" shall mean
29 any wearable instrument or devices designed for hearing and any parts,
30 attachments or accessories but excluding batteries and cords or accesso-
31 ries thereto.
32 (B) For the purposes of this section, services for recasing, reshell-
33 ing and acquiring new molds shall be included as part of the policies.
34 (3) Coverage provided pursuant to this subsection shall not be subject
35 to deductibles, coinsurance or copayments.
36 § 4. Section 4303 of the insurance law is amended by adding a new
37 subsection (rr) to read as follows:
38 (rr) (1) (A) Every contract issued or delivered in this state by a
39 health service corporation or hospital service corporation shall provide
40 coverage for hearing aids purchased from a hearing aid dispenser regis-
41 tered under article thirty-seven-A of the general business law or an
42 audiologist licensed under article one hundred fifty-nine of the educa-
43 tion law for an insured person who is less than sixteen years of age,
44 such insured person shall be entitled to reimbursement of up to one
45 thousand dollars for each hearing aid every two years for expenses
46 related to the purchase of up to two hearing aids. When it is demon-
47 strated that (i) the insured child's hearing has changed significantly
48 within a two year period and (ii) the existing hearing aid will no long-
49 er correct the child's hearing loss, such insured person shall be enti-
50 tled to reimbursement for additional hearing aid expenses.
51 (B) For the purposes of this subsection, the insured person shall be
52 entitled to spend more than one thousand dollars on each hearing aid,
53 but shall only be allowed reimbursement up to the amount provided in
54 subparagraph (A) of this paragraph.
55 (2)(A) For the purposes of this subsection, "hearing aid" shall mean
56 any wearable instrument or devices designed for hearing and any parts,
A. 6626 3
1 attachments or accessories but excluding batteries and cords or accesso-
2 ries thereto.
3 (B) For the purposes of this section, services for recasing, reshell-
4 ing and acquiring new molds shall be included as part of the policies.
5 (3) Coverage provided pursuant to this subsection shall not be subject
6 to deductibles, coinsurance or copayments.
7 § 5. Subdivision 6 of section 2511 of the public health law is amended
8 by adding a new paragraph (c-1) to read as follows:
9 (c-1) standards requiring coverage for medically necessary hearing
10 aids in accordance with subsection (t) of section three thousand two
11 hundred twenty-one of the insurance law;
12 § 6. Subdivision 2 of section 365-a of the social services law is
13 amended by adding a new paragraph (dd) to read as follows:
14 (dd) the purchase of medically necessary hearing aids from a hearing
15 aid dispenser registered under article thirty-seven-A of the general
16 business law or an audiologist licensed under article one hundred
17 fifty-nine of the education law for any child who is less than sixteen
18 years of age. Such assistance shall be limited to one thousand dollars
19 for each hearing aid every two years for up to two hearing aids.
20 § 7. This act shall take effect July 1, 2018 and sections two, three
21 and four of this act shall apply to all policies issued, modified or
22 renewed on and after such date.
