Bill Text: IA HF2178 | 2017-2018 | 87th General Assembly | 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: TLSB 5441YH (4) 87 ko/rj 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. LSB 5441YH (4) 87 ko/rj
