S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  10300

                          I N  A S S E M B L Y

                              May 20, 2016
                               ___________

Introduced by M. of A. PAULIN -- read once and referred to the Committee
  on Insurance

AN  ACT  to  amend  the  insurance law, in relation to requiring certain
  group health insurance policies to provide coverage for hearing aids

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  Section  3221 of the insurance law is amended by adding a
new subsection (t) to read as follows:
  (T) (1) EVERY GROUP HEALTH INSURANCE POLICY OFFERED IN THE LARGE GROUP
MARKET THAT IS ISSUED, AMENDED, OR RENEWED IN THIS STATE  SHALL  PROVIDE
COVERAGE  FOR  MEDICALLY NECESSARY HEARING AIDS PURCHASED FROM A HEARING
AID DISPENSER REGISTERED UNDER ARTICLE  THIRTY-SEVEN-A  OF  THE  GENERAL
BUSINESS  LAW  OR  AN  AUDIOLOGIST  LICENSED  UNDER  ARTICLE ONE HUNDRED
FIFTY-NINE OF THE EDUCATION LAW IN THE FOLLOWING MANNER:
  (A) FOR AN INSURED PERSON SIXTEEN YEARS OF AGE OR OLDER, SUCH  INSURED
PERSON  SHALL  BE  ENTITLED  TO  REIMBURSEMENT  OF  UP TO THREE THOUSAND
DOLLARS EVERY THIRTY-SIX MONTHS FOR EXPENSES RELATED TO THE PURCHASE  OF
UP TO TWO HEARING AIDS.
  (B)  FOR AN INSURED PERSON WHO IS LESS THAN SIXTEEN YEARS OF AGE, SUCH
INSURED PERSON SHALL BE ENTITLED TO REIMBURSEMENT OF UP TO TWO  THOUSAND
DOLLARS EVERY TWENTY-FOUR MONTHS FOR EXPENSES RELATED TO THE PURCHASE OF
UP TO TWO HEARING AIDS, WHEN IT IS MEDICALLY DEMONSTRATED THAT:
  (I)  THE  HEARING  OF  THE INSURED PERSON UNDER THE AGE OF SIXTEEN HAS
CHANGED SIGNIFICANTLY WITHIN A TWO-YEAR PERIOD; AND
  (II) THE EXISTING HEARING AID WILL NO LONGER CORRECT  THE  HEARING  OF
THE  INSURED PERSON UNDER THE AGE OF SIXTEEN; SUCH PERSON SHALL BE ENTI-
TLED TO REIMBURSEMENT FOR ADDITIONAL HEARING AID EXPENSES.
  (2)(A) FOR THE PURPOSES OF THIS SUBSECTION, "HEARING AID"  SHALL  MEAN
ANY  WEARABLE  INSTRUMENT  OR DEVICE DESIGNED FOR HEARING AND ANY PARTS,
ATTACHMENTS OR ACCESSORIES BUT EXCLUDING BATTERIES AND CORDS OR ACCESSO-
RIES THERETO. A REGISTERED HEARING AID DISPENSER OR LICENSED AUDIOLOGIST
SHALL DETERMINE THE TYPE OF DEVICE NEEDED TO CORRECT THE HEARING LOSS.
  (B) FOR THE PURPOSES OF THIS SECTION, SERVICES FOR RECASING,  RESHELL-
ING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE POLICIES.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
              

                                                           LBD15482-02-6

A. 10300                            2

  (3)  THE  INSURED PERSON MAY CHOOSE A HEARING AID EXCEEDING THE AMOUNT
OF COVERAGE REQUIRED BY THIS SECTION AND SHALL BE LIABLE FOR THE DIFFER-
ENCE IN COST. REIMBURSEMENT SHALL BE PROVIDED ACCORDING TO  THE  RESPEC-
TIVE  PRINCIPLES  AND  POLICIES  OF  THE  HEALTH  INSURANCE PLAN AND MAY
INCLUDE  SUCH  POLICY  PROVISIONS AS DEDUCTIBLES, COINSURANCE, ALLOWABLE
CHARGE LIMITATIONS, AND COORDINATION OF BENEFITS.
  S 2. Section 4305 of the insurance law is  amended  by  adding  a  new
subsection (n) to read as follows:
  (N)  (1) A GROUP CONTRACT ISSUED, AMENDED, OR RENEWED PURSUANT TO THIS
SECTION OFFERED IN THE LARGE GROUP MARKET  SHALL  PROVIDE  COVERAGE  FOR
MEDICALLY  NECESSARY HEARING AIDS PURCHASED FROM A HEARING AID DISPENSER
REGISTERED UNDER ARTICLE THIRTY-SEVEN-A OF THE GENERAL BUSINESS  LAW  OR
AN  AUDIOLOGIST  LICENSED  UNDER  ARTICLE  ONE HUNDRED FIFTY-NINE OF THE
EDUCATION LAW IN THE FOLLOWING MANNER:
  (A) FOR AN INSURED PERSON SIXTEEN YEARS OF AGE OR OLDER, SUCH  INSURED
PERSON  SHALL  BE  ENTITLED  TO  REIMBURSEMENT  OF  UP TO THREE THOUSAND
DOLLARS EVERY THIRTY-SIX MONTHS FOR EXPENSES RELATED TO THE PURCHASE  OF
UP TO TWO HEARING AIDS.
  (B)  FOR AN INSURED PERSON WHO IS LESS THAN SIXTEEN YEARS OF AGE, SUCH
INSURED PERSON SHALL BE ENTITLED TO REIMBURSEMENT OF UP TO TWO  THOUSAND
DOLLARS EVERY TWENTY-FOUR MONTHS FOR EXPENSES RELATED TO THE PURCHASE OF
UP TO TWO HEARING AIDS, WHEN IT IS MEDICALLY DEMONSTRATED THAT:
  (I)  THE  HEARING  OF  THE INSURED PERSON UNDER THE AGE OF SIXTEEN HAS
CHANGED SIGNIFICANTLY WITHIN A TWO-YEAR PERIOD; AND
  (II) THE EXISTING HEARING AID WILL NO LONGER CORRECT  THE  HEARING  OF
THE  INSURED PERSON UNDER THE AGE OF SIXTEEN; SUCH PERSON SHALL BE ENTI-
TLED TO REIMBURSEMENT FOR ADDITIONAL HEARING AID EXPENSES.
  (2)(A) FOR THE PURPOSES OF THIS SUBSECTION, "HEARING AID"  SHALL  MEAN
ANY  WEARABLE  INSTRUMENT  OR DEVICE DESIGNED FOR HEARING AND ANY PARTS,
ATTACHMENTS OR ACCESSORIES BUT EXCLUDING BATTERIES AND CORDS OR ACCESSO-
RIES THERETO. A REGISTERED HEARING AID DISPENSER OR LICENSED AUDIOLOGIST
SHALL DETERMINE THE TYPE OF DEVICE NEEDED TO CORRECT THE HEARING LOSS.
  (B) FOR THE PURPOSES OF THIS SECTION, SERVICES FOR RECASING,  RESHELL-
ING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE POLICIES.
  (3)  THE  INSURED PERSON MAY CHOOSE A HEARING AID EXCEEDING THE AMOUNT
OF COVERAGE REQUIRED BY THIS SECTION AND SHALL BE LIABLE FOR THE DIFFER-
ENCE IN COST. REIMBURSEMENT SHALL BE PROVIDED ACCORDING TO  THE  RESPEC-
TIVE  PRINCIPLES  AND  POLICIES  OF  THE  HEALTH  INSURANCE PLAN AND MAY
INCLUDE SUCH POLICY PROVISIONS AS  DEDUCTIBLES,  COINSURANCE,  ALLOWABLE
CHARGE LIMITATIONS, AND COORDINATION OF BENEFITS.
  S  3.  This  act shall take effect on the ninetieth day after it shall
have become a law and shall apply according to its terms  to  all  poli-
cies,  contracts  and certificates issued, renewed, modified, altered or
amended on or after such date.