Bill Text: NY S03379 | 2011-2012 | General Assembly | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft
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: Partisan Bill (Republican 2-0)

Status: (Introduced - Dead) 2012-03-30 - PRINT NUMBER 3379A [S03379 Detail]

Download: New_York-2011-S03379-Amended.html
                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                        3379--A
                              2011-2012 Regular Sessions
                                   I N  S E N A T E
                                   February 17, 2011
                                      ___________
       Introduced  by  Sens. McDONALD, LANZA -- read twice and ordered printed,
         and when printed to be committed to  the  Committee  on  Insurance  --
         recommitted  to  the  Committee on Insurance in accordance with Senate
         Rule  6,  sec.  8  --  committee  discharged,  bill  amended,  ordered
         reprinted as amended and recommitted to said committee
       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 29 to read as follows:
    5    (29) (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,
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD06999-04-2
       S. 3379--A                          2
    1  BUT SHALL ONLY BE ALLOWED REIMBURSEMENT UP TO  THE  AMOUNT  PROVIDED  IN
    2  CLAUSE (I) OF THIS SUBPARAGRAPH.
    3    (B)(I) FOR THE PURPOSES OF THIS PARAGRAPH "HEARING AID" SHALL MEAN ANY
    4  WEARABLE  INSTRUMENT  OR  DEVICES  DESIGNED  FOR  HEARING AND ANY PARTS,
    5  ATTACHMENTS OR ACCESSORIES BUT EXCLUDING BATTERIES AND CORDS OR ACCESSO-
    6  RIES THERETO.
    7    (II) FOR THE PURPOSES OF THIS SECTION, SERVICES FOR RECASING, RESHELL-
    8  ING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE POLICIES.
    9    (C) COVERAGE PROVIDED PURSUANT TO THIS PARAGRAPH SHALL NOT BE  SUBJECT
   10  TO DEDUCTIBLES, COINSURANCE OR COPAYMENTS.
   11    S  3.  Section  3221  of  the insurance law is amended by adding a new
   12  subsection (s) to read as follows:
   13    (S) (1) (A) EVERY GROUP HEALTH INSURANCE POLICY ISSUED OR DELIVERED IN
   14  THIS STATE SHALL PROVIDE COVERAGE FOR  HEARING  AIDS  PURCHASED  FROM  A
   15  HEARING  AID  DISPENSER  REGISTERED  UNDER ARTICLE THIRTY-SEVEN-A OF THE
   16  GENERAL BUSINESS LAW  OR  AN  AUDIOLOGIST  LICENSED  UNDER  ARTICLE  ONE
   17  HUNDRED  FIFTY-NINE  OF  THE  EDUCATION LAW FOR AN INSURED PERSON WHO IS
   18  LESS THAN SIXTEEN YEARS OF AGE, SUCH INSURED PERSON SHALL BE ENTITLED TO
   19  REIMBURSEMENT OF UP TO ONE THOUSAND DOLLARS FOR EACH HEARING  AID  EVERY
   20  TWO  YEARS  FOR  EXPENSES  RELATED  TO THE PURCHASE OF UP TO TWO HEARING
   21  AIDS.  WHEN IT IS DEMONSTRATED THAT (I) THE INSURED CHILD'S HEARING  HAS
   22  CHANGED  SIGNIFICANTLY  WITHIN  A  TWO YEAR PERIOD AND (II) THE EXISTING
   23  HEARING AID WILL NO  LONGER  CORRECT  THE  CHILD'S  HEARING  LOSS,  SUCH
   24  INSURED PERSON SHALL BE ENTITLED TO REIMBURSEMENT FOR ADDITIONAL HEARING
   25  AID EXPENSES.
   26    (B)  FOR  THE PURPOSES OF THIS SUBSECTION, THE INSURED PERSON SHALL BE
   27  ENTITLED TO SPEND MORE THAN ONE THOUSAND DOLLARS ON  EACH  HEARING  AID,
   28  BUT  SHALL  ONLY  BE  ALLOWED REIMBURSEMENT UP TO THE AMOUNT PROVIDED IN
   29  SUBPARAGRAPH (A) OF THIS PARAGRAPH.
   30    (2)(A) FOR THE PURPOSES OF THIS SUBSECTION, "HEARING AID"  SHALL  MEAN
   31  ANY  WEARABLE  INSTRUMENT OR DEVICES DESIGNED FOR HEARING AND ANY PARTS,
   32  ATTACHMENTS OR ACCESSORIES BUT EXCLUDING BATTERIES AND CORDS OR ACCESSO-
   33  RIES THERETO.
   34    (B) FOR THE PURPOSES OF THIS SECTION, SERVICES FOR RECASING,  RESHELL-
   35  ING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE POLICIES.
   36    (3) COVERAGE PROVIDED PURSUANT TO THIS SUBSECTION SHALL NOT BE SUBJECT
   37  TO DEDUCTIBLES, COINSURANCE OR COPAYMENTS.
   38    S  4.  Section  4303  of  the insurance law is amended by adding a new
   39  subsection (ii) to read as follows:
   40    (II) (1) (A) EVERY CONTRACT ISSUED OR DELIVERED IN  THIS  STATE  BY  A
   41  HEALTH SERVICE CORPORATION OR HOSPITAL SERVICE CORPORATION SHALL PROVIDE
   42  COVERAGE  FOR HEARING AIDS PURCHASED FROM A HEARING AID DISPENSER REGIS-
   43  TERED UNDER ARTICLE THIRTY-SEVEN-A OF THE GENERAL  BUSINESS  LAW  OR  AN
   44  AUDIOLOGIST  LICENSED UNDER ARTICLE ONE HUNDRED FIFTY-NINE OF THE EDUCA-
   45  TION LAW FOR AN INSURED PERSON WHO IS LESS THAN SIXTEEN  YEARS  OF  AGE,
   46  SUCH  INSURED  PERSON  SHALL  BE  ENTITLED TO REIMBURSEMENT OF UP TO ONE
   47  THOUSAND DOLLARS FOR EACH HEARING  AID  EVERY  TWO  YEARS  FOR  EXPENSES
   48  RELATED  TO  THE  PURCHASE OF UP TO TWO HEARING AIDS.  WHEN IT IS DEMON-
   49  STRATED THAT (I) THE INSURED CHILD'S HEARING HAS  CHANGED  SIGNIFICANTLY
   50  WITHIN A TWO YEAR PERIOD AND (II) THE EXISTING HEARING AID WILL NO LONG-
   51  ER  CORRECT THE CHILD'S HEARING LOSS, SUCH INSURED PERSON SHALL BE ENTI-
   52  TLED TO REIMBURSEMENT FOR ADDITIONAL HEARING AID EXPENSES.
   53    (B) FOR THE PURPOSES OF THIS SUBSECTION, THE INSURED PERSON  SHALL  BE
   54  ENTITLED  TO  SPEND  MORE THAN ONE THOUSAND DOLLARS ON EACH HEARING AID,
   55  BUT SHALL ONLY BE ALLOWED REIMBURSEMENT UP TO  THE  AMOUNT  PROVIDED  IN
   56  SUBPARAGRAPH (A) OF THIS PARAGRAPH.
       S. 3379--A                          3
    1    (2)(A)  FOR  THE PURPOSES OF THIS SUBSECTION, "HEARING AID" SHALL MEAN
    2  ANY 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    (B)  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    (3) COVERAGE PROVIDED PURSUANT TO THIS SUBSECTION SHALL NOT BE SUBJECT
    8  TO DEDUCTIBLES, COINSURANCE OR COPAYMENTS.
    9    S 5. Subdivision 6 of section 2511 of the public health law is amended
   10  by adding a new paragraph (c-1) to read as follows:
   11    (C-1) STANDARDS REQUIRING COVERAGE  FOR  MEDICALLY  NECESSARY  HEARING
   12  AIDS  IN  ACCORDANCE  WITH  SUBSECTION (S) OF SECTION THREE THOUSAND TWO
   13  HUNDRED TWENTY-ONE OF THE INSURANCE LAW;
   14    S 6. Subdivision 2 of section 365-a of  the  social  services  law  is
   15  amended by adding a new paragraph (w) to read as follows:
   16    (W)  THE  PURCHASE  OF MEDICALLY NECESSARY HEARING AIDS FROM A HEARING
   17  AID DISPENSER REGISTERED UNDER ARTICLE  THIRTY-SEVEN-A  OF  THE  GENERAL
   18  BUSINESS  LAW  OR  AN  AUDIOLOGIST  LICENSED  UNDER  ARTICLE ONE HUNDRED
   19  FIFTY-NINE OF THE EDUCATION LAW FOR ANY CHILD WHO IS LESS  THAN  SIXTEEN
   20  YEARS  OF  AGE. SUCH ASSISTANCE SHALL BE LIMITED TO ONE THOUSAND DOLLARS
   21  FOR EACH HEARING AID EVERY TWO YEARS FOR UP TO TWO HEARING AIDS.
   22    S 7. This act shall take effect July 1, 2014 and sections  two,  three
   23  and  four  of  this  act shall apply to all policies issued, modified or
   24  renewed on and after such date.
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