Bill Text: NY A03403 | 2015-2016 | General Assembly | Introduced
Bill Title: 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.
Spectrum: Moderate Partisan Bill (Democrat 10-2)
Status: (Introduced - Dead) 2016-01-06 - referred to insurance [A03403 Detail]
Download: New_York-2015-A03403-Introduced.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 3403 2015-2016 Regular Sessions I N A S S E M B L Y January 22, 2015 ___________ Introduced by M. of A. TITONE, TENNEY -- Multi-Sponsored by -- M. of A. ABBATE, ENGLEBRIGHT, GALEF, GOTTFRIED, HIKIND, HOOPER, MONTESANO, SCHIMEL -- 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 S 2. Subsection (i) of section 3216 of the insurance law is amended by 4 adding a new paragraph 32 to read as follows: 5 (32) (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. LBD03836-02-5 A. 3403 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 S 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 S 4. Section 4303 of the insurance law is amended by adding a new 37 subsection (pp) to read as follows: 38 (PP) (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. 3403 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 S 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 S 6. Subdivision 2 of section 365-a of the social services law is 13 amended by adding a new paragraph (cc) to read as follows: 14 (CC) 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 S 7. This act shall take effect July 1, 2016 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.