Bill Text: IA HF2178 | 2017-2018 | 87th General Assembly | Introduced

Iowa House Bill 2178 (Prior Session Legislation)

Introduced

Bill Title: A bill for an act relating to health insurance coverage for hearing aids for covered persons age eighteen and younger and including applicability provisions.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2018-02-16 - Subcommittee recommends indefinite postponement. [HF2178 Detail]

Download: Iowa-2017-HF2178-Introduced.html


House File 2178 - Introduced




                                 HOUSE FILE       
                                 BY  MOMMSEN

                                      A BILL FOR

  1 An Act relating to health insurance coverage for hearing aids
  2    for covered persons age eighteen and younger and including
  3    applicability provisions.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN



  1  1    Section 1.  NEW SECTION.  514C.32  Hearing aid coverage for
  1  2 covered persons age eighteen and younger.
  1  3    1.  Definitions.  For the purposes of this section:
  1  4    a.  "Audiologist" means a person who engages in the practice
  1  5 of audiology and is licensed in this state pursuant to chapter
  1  6 154F.
  1  7    b.  "Cost sharing" means any coverage limit, copayment,
  1  8 coinsurance, deductible, or other out=of=pocket expense
  1  9 required by a health carrier.
  1 10    c.  "Health care professional" means the same as defined in
  1 11 section 514J.102.
  1 12    d.  "Health care services" means the same as defined in
  1 13 section 514J.102.
  1 14    e.  "Health carrier" means the same as defined in section
  1 15 514J.102.
  1 16    f.  "Hearing aid" means the same as defined in section
  1 17 154A.1.
  1 18    g.  "Hearing aid fitting" means the same as defined in
  1 19 section 154A.1.
  1 20    h.  "Hearing aid specialist" means the same as defined in
  1 21 section 154A.1.
  1 22    i.  "Practice of audiology" means the same as defined in
  1 23 section 154F.1.
  1 24    2.  Required coverage.
  1 25    a.  Notwithstanding the uniformity of treatment requirements
  1 26 of section 514C.6, a health carrier that offers individual,
  1 27 group, or small group contracts, policies, or plans in this
  1 28 state that provide for third=party payment or prepayment of
  1 29 health or medical expenses shall offer coverage for the cost
  1 30 of a hearing aid as recommended by a health care professional
  1 31 or audiologist for a covered person who is age eighteen or
  1 32 younger.
  1 33    b.  Coverage required under this section shall include all
  1 34 of the following:
  1 35    (1)  Hearing aid fitting and dispensing services conducted
  2  1 by a hearing aid specialist, audiologist, or health care
  2  2 professional.
  2  3    (2)  The provision of ear molds as necessary to maintain
  2  4 optimal fit of hearing aids.
  2  5    (3)  Any health care services related to a hearing
  2  6 aid, including audiological habilitation or audiological
  2  7 rehabilitation, as recommended by a health care professional
  2  8 or audiologist.
  2  9    c.  Coverage required under this section is limited to one
  2 10 hearing aid for each ear during a three=year period for a
  2 11 covered person who is age eighteen or younger.
  2 12    d.  Coverage required under this section shall not be less
  2 13 favorable than coverage a health carrier offers for general
  2 14 physical illness.
  2 15    e.  Cost sharing requirements imposed for coverage required
  2 16 under this section shall not be less favorable than cost
  2 17 sharing requirements imposed by a health carrier for general
  2 18 physical illness.
  2 19    3.  Rules.  The commissioner shall adopt rules pursuant to
  2 20 chapter 17A to administer this section.
  2 21    4.  Applicability.
  2 22    a.  This section shall apply to the following classes of
  2 23 third=party payment provider contracts, policies, or plans
  2 24 delivered, issued for delivery, continued, or renewed in this
  2 25 state on or after January 1, 2019:
  2 26    (1)  Individual or group accident and sickness insurance
  2 27 providing coverage on an expense=incurred basis.
  2 28    (2)  An individual or group hospital or medical service
  2 29 contract issued pursuant to chapter 509, 514, or 514A.
  2 30    (3)  An individual or group health maintenance organization
  2 31 contract regulated under chapter 514B.
  2 32    (4)  A plan established for public employees pursuant to
  2 33 chapter 509A.
  2 34    b.  This section shall not apply to accident=only,
  2 35 specified disease, short=term hospital or medical, hospital
  3  1 confinement indemnity, credit, dental, vision, Medicare
  3  2 supplement, long=term care, basic hospital and medical=surgical
  3  3 expense coverage as defined by the commissioner, disability
  3  4 income insurance coverage, coverage issued as a supplement
  3  5 to liability insurance, workers' compensation or similar
  3  6 insurance, or automobile medical payment insurance.
  3  7                           EXPLANATION
  3  8 The inclusion of this explanation does not constitute agreement with
  3  9 the explanation's substance by the members of the general assembly.
  3 10    This bill relates to health insurance coverage for hearing
  3 11 aids for covered persons age 18 and younger. The bill requires
  3 12 a health carrier that offers individual, group, or small group
  3 13 contracts, policies, or plans in this state that provide for
  3 14 third=party payment or prepayment of health or medical expenses
  3 15 to offer coverage for a hearing aid as recommended by a health
  3 16 care professional or audiologist.
  3 17    The bill requires the coverage to include hearing aid
  3 18 fitting and dispensing services conducted by a hearing aid
  3 19 specialist, audiologist, or health care professional. The
  3 20 coverage must include ear molds as necessary to maintain
  3 21 optimal hearing aid fit. The bill also requires coverage of
  3 22 any health care services related to a hearing aid, including
  3 23 audiological habilitation or audiological rehabilitation, as
  3 24 recommended by a health care professional or audiologist.
  3 25    The bill limits coverage to one hearing aid for each ear
  3 26 during a three=year period for a covered person age 18 or
  3 27 younger.
  3 28    The bill requires that coverage under this Code section
  3 29 shall not be less favorable than coverage a health carrier
  3 30 offers for general physical illness. Health carriers
  3 31 are prohibited from imposing less favorable cost sharing
  3 32 requirements than those imposed by the health carrier for
  3 33 general physical illnesses.
  3 34    The commissioner is required to adopt rules to administer
  3 35 the requirements of the bill.
  4  1 The bill applies to third=party payment provider contracts,
  4  2 policies, or plans delivered, issued for delivery, continued,
  4  3 or renewed in this state on or after January 1, 2019, by the
  4  4 third=party payment providers enumerated in the bill.
  4  5    The bill specifies the types of specialized health related
  4  6 insurance which are not subject to the coverage requirements
  4  7 of the bill.
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