NY State Assembly Bill 2017-A8628A

Archive: Last Bill Status - In Assembly Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 03, 2018	referred to insurance
Sep 25, 2017	print number 8628a
Sep 25, 2017	amend and recommit to insurance
Sep 01, 2017	referred to insurance

Bill Amendments

Original

A (Active)

2017-A8628 - Details

See Senate Version of this Bill:: S6894
Current Committee:: Assembly Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2019-2020: A2325
2021-2022: A5035
2023-2024: A149

2017-A8628 - Summary

Relates to the mandatory coverage of hearing aids by insurers and other organizations.

2017-A8628 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8628
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             September 1, 2017
                                ___________
 
 Introduced  by M. of A. SOLAGES -- read once and referred to the Commit-
   tee on Insurance
 
 AN ACT to amend the insurance law, in relation to the mandatory coverage
   of hearing aids by insurers and other organizations
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section  1.  Subdivision  (i)  of section 3216 of the insurance law is
 amended by adding a new paragraph 34 to read as follows:
   (34) (A) AS USED IN THIS PARAGRAPH, "HEARING AID" SHALL  MEAN  A  NON-
 DISPOSABLE DEVICE THAT IS OF A DESIGN AND CIRCUITRY TO OPTIMIZE AUDITION
 AND  LISTENING  SKILLS  IN THE ENVIRONMENT COMMONLY EXPERIENCED BY CHIL-
 DREN.
   (B) THIS PARAGRAPH SHALL APPLY TO THE FOLLOWING ENTITIES:
   (I) INSURERS AND NONPROFIT HEALTH SERVICE PLANS, INCLUDING THE  OFFICE
 OF  GROUP BENEFITS, THAT PROVIDE HOSPITAL, MEDICAL, OR SURGICAL BENEFITS
 TO INDIVIDUALS OR GROUPS  ON  AN  EXPENSE-INCURRED  BASIS  UNDER  HEALTH
 INSURANCE  POLICIES  OR  CONTRACTS  THAT ARE ISSUED OR DELIVERED IN THIS
 STATE.
   (II) MANAGED CARE ORGANIZATIONS AS DEFINED AND LICENSED BY  STATE  LAW
 THAT  PROVIDE  HOSPITAL,  MEDICAL OR SURGICAL BENEFITS TO INDIVIDUALS OR
 GROUPS UNDER CONTRACTS THAT ARE ISSUED OR DELIVERED IN THIS STATE.
   (C) AN ENTITY SUBJECT TO THIS PARAGRAPH  SHALL  PROVIDE  COVERAGE  FOR
 HEARING  AIDS FOR A CHILD UNDER THE AGE OF EIGHTEEN WHO IS COVERED UNDER
 A POLICY OR CONTRACT OF INSURANCE IF THE HEARING  AIDS  ARE  FITTED  AND
 DISPENSED  BY  A  LICENSED AUDIOLOGIST CERTIFIED BY THE AMERICAN SPEECH-
 LANGUAGE-HEARING ASSOCIATION FOLLOWING MEDICAL CLEARANCE BY A  PHYSICIAN
 LICENSED  TO  PRACTICE MEDICINE AND AN AUDIOLOGICAL EVALUATION MEDICALLY
 APPROPRIATE TO THE AGE OF THE CHILD, PROVIDED:
   (I) AN ENTITY SUBJECT TO THIS PARAGRAPH MAY LIMIT THE BENEFIT  PAYABLE
 UNDER  THIS PARAGRAPH TO ONE THOUSAND AND FIVE HUNDRED DOLLARS PER HEAR-
 ING AID FOR EACH HEARING-IMPAIRED EAR EVERY THIRTY-SIX MONTHS.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD13317-01-7

 A. 8628                             2
 
   (II) AN INSURED OR ENROLLED INDIVIDUAL MAY CHOOSE A HEARING  AID  THAT
 IS  PRICED  HIGHER THAN THE BENEFIT PAYABLE UNDER THIS PARAGRAPH AND MAY
 PAY THE DIFFERENCE BETWEEN THE PRICE OF THE HEARING AID AND THE  BENEFIT
 PAYABLE UNDER THIS PARAGRAPH WITHOUT FINANCIAL OR CONTRACTUAL PENALTY TO
 THE PROVIDER OF THE HEARING AID.
   (III)  IN  THE  CASE  OF A HEALTH INSURER OR MANAGED CARE ORGANIZATION
 THAT ADMINISTERS  BENEFITS  ACCORDING  TO  CONTRACTS  WITH  HEALTH  CARE
 PROVIDERS,  HEARING  AIDS  COVERED  PURSUANT  TO THIS PARAGRAPH SHALL BE
 OBTAINED FROM HEALTH CARE PROVIDERS CONTRACTED WITH THE  HEALTH  INSURER
 OR  MANAGED  CARE  ORGANIZATION.  SUCH PROVIDERS SHALL BE SUBJECT TO THE
 SAME CONTRACTING AND CREDENTIALING  REQUIREMENTS  THAT  APPLY  TO  OTHER
 CONTRACTED HEALTH CARE PROVIDERS.
   (D)  THIS  PARAGRAPH  DOES  NOT  PROHIBIT  AN  ENTITY  SUBJECT  TO THE
 PROVISIONS OF THIS PARAGRAPH FROM PROVIDING COVERAGE THAT IS GREATER  OR
 MORE  FAVORABLE  TO  AN INSURED OR ENROLLED INDIVIDUAL THAN THE COVERAGE
 REQUIRED UNDER THIS PARAGRAPH.
   (E) THE PROVISIONS OF THIS PARAGRAPH SHALL APPLY TO  ANY  NEW  POLICY,
 CONTRACT, PROGRAM, OR PLAN ISSUED BY AN ENTITY SUBJECT TO THE PROVISIONS
 OF  THIS PARAGRAPH ON OR AFTER JANUARY FIRST, TWO THOUSAND NINETEEN. ANY
 SUCH POLICY, CONTRACT, PROGRAM OR PLAN IN EFFECT PRIOR TO JANUARY FIRST,
 TWO THOUSAND NINETEEN SHALL CONVERT TO THE PROVISIONS OF THIS  PARAGRAPH
 ON OR BEFORE THE RENEWAL DATE THEREOF BUT IN NO EVENT LATER THAN JANUARY
 FIRST,  TWO  THOUSAND NINETEEN. ANY POLICY AFFECTED BY THE PROVISIONS OF
 THIS PARAGRAPH SHALL APPLY TO AN INSURED OR PARTICIPANT UNDER SUCH POLI-
 CY, CONTRACT, PROGRAM, OR PLAN WHETHER OR NOT THE HEARING IMPAIRMENT  IS
 A PRE-EXISTING CONDITION OF THE INSURED OR PARTICIPANT.
   §  2.  Section  3221  of  the insurance law is amended by adding a new
 subsection (t) to read as follows:
   (T) (1) AS USED IN THIS SUBSECTION, "HEARING AID" SHALL  MEAN  A  NON-
 DISPOSABLE DEVICE THAT IS OF A DESIGN AND CIRCUITRY TO OPTIMIZE AUDITION
 AND  LISTENING  SKILLS  IN THE ENVIRONMENT COMMONLY EXPERIENCED BY CHIL-
 DREN.
   (2) THIS SUBSECTION SHALL APPLY TO THE FOLLOWING ENTITIES:
   (A) INSURERS AND NONPROFIT HEALTH SERVICE PLANS, INCLUDING THE  OFFICE
 OF  GROUP BENEFITS, THAT PROVIDE HOSPITAL, MEDICAL, OR SURGICAL BENEFITS
 TO INDIVIDUALS OR GROUPS  ON  AN  EXPENSE-INCURRED  BASIS  UNDER  HEALTH
 INSURANCE  POLICIES  OR  CONTRACTS  THAT ARE ISSUED OR DELIVERED IN THIS
 STATE.
   (B) MANAGED CARE ORGANIZATIONS AS DEFINED AND LICENSED  BY  STATE  LAW
 THAT  PROVIDE  HOSPITAL,  MEDICAL OR SURGICAL BENEFITS TO INDIVIDUALS OR
 GROUPS UNDER CONTRACTS THAT ARE ISSUED OR DELIVERED IN THIS STATE.
   (3) AN ENTITY SUBJECT TO THIS SUBSECTION SHALL  PROVIDE  COVERAGE  FOR
 HEARING  AIDS FOR A CHILD UNDER THE AGE OF EIGHTEEN WHO IS COVERED UNDER
 A POLICY OR CONTRACT OF INSURANCE IF THE HEARING  AIDS  ARE  FITTED  AND
 DISPENSED  BY  A  LICENSED AUDIOLOGIST CERTIFIED BY THE AMERICAN SPEECH-
 LANGUAGE-HEARING ASSOCIATION FOLLOWING MEDICAL CLEARANCE BY A  PHYSICIAN
 LICENSED  TO  PRACTICE MEDICINE AND AN AUDIOLOGICAL EVALUATION MEDICALLY
 APPROPRIATE TO THE AGE OF THE CHILD, PROVIDED:
   (A) AN ENTITY SUBJECT TO THIS SUBSECTION MAY LIMIT THE BENEFIT PAYABLE
 UNDER THIS SUBSECTION TO ONE THOUSAND AND FIVE HUNDRED DOLLARS PER HEAR-
 ING AID FOR EACH HEARING-IMPAIRED EAR EVERY THIRTY-SIX MONTHS.
   (B) AN INSURED OR ENROLLED INDIVIDUAL MAY CHOOSE A HEARING AID THAT IS
 PRICED HIGHER THAN THE BENEFIT PAYABLE UNDER THIS SUBSECTION AND MAY PAY
 THE DIFFERENCE BETWEEN THE PRICE OF THE  HEARING  AID  AND  THE  BENEFIT
 PAYABLY  UNDER  THIS SUBSECTION WITHOUT FINANCIAL OR CONTRACTUAL PENALTY
 TO THE PROVIDER OF THE HEARING AID.

 A. 8628                             3
 
   (C) IN THE CASE OF A HEALTH INSURER OR MANAGED CARE ORGANIZATION  THAT
 ADMINISTERS  BENEFITS ACCORDING TO CONTRACTS WITH HEALTH CARE PROVIDERS,
 HEARING AIDS COVERED PURSUANT TO THIS SUBSECTION SHALL BE OBTAINED  FROM
 HEALTH  CARE  PROVIDERS  CONTRACTED WITH   THE HEALTH INSURER OR MANAGED
 CARE ORGANIZATION. SUCH PROVIDERS SHALL BE SUBJECT TO THE SAME CONTRACT-
 ING AND CREDENTIALING REQUIREMENTS THAT APPLY TO OTHER CONTRACTED HEALTH
 CARE PROVIDERS.
   (4)  THIS  SUBSECTION  DOES  NOT  PROHIBIT  AN  ENTITY  SUBJECT TO THE
 PROVISIONS OF THIS SUBSECTION FROM PROVIDING COVERAGE THAT IS GREATER OR
 MORE FAVORABLE TO AN INSURED OR ENROLLED INDIVIDUAL  THAN  THE  COVERAGE
 REQUIRED UNDER THIS SUBSECTION.
   (5)  THE  PROVISIONS OF THIS SUBSECTION SHALL APPLY TO ANY NEW POLICY,
 CONTRACT, PROGRAM, OR PLAN ISSUED BY AN ENTITY SUBJECT TO THE PROVISIONS
 OF THIS SUBSECTION ON OR AFTER JANUARY FIRST, TWO THOUSAND NINETEEN. ANY
 SUCH POLICY, CONTRACT, PROGRAM OR PLAN IN EFFECT PRIOR TO JANUARY FIRST,
 TWO THOUSAND NINETEEN SHALL CONVERT TO THE PROVISIONS OF THIS SUBSECTION
 ON OR BEFORE THE RENEWAL DATE THEREOF BUT IN NO EVENT LATER THAN JANUARY
 FIRST, TWO THOUSAND NINETEEN. ANY POLICY AFFECTED BY THE  PROVISIONS  OF
 THIS  SUBSECTION  SHALL  APPLY  TO  AN INSURED OR PARTICIPANT UNDER SUCH
 POLICY, CONTRACT, PROGRAM, OR PLAN WHETHER OR NOT THE HEARING IMPAIRMENT
 IS A PRE-EXISTING CONDITION OF THE INSURED OR PARTICIPANT.
   § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (rr) to read as follows:
   (RR)(1)  AS  USED  IN THIS SUBSECTION, "HEARING AID" SHALL MEAN A NON-
 DISPOSABLE DEVICE THAT IS OF A DESIGN AND CIRCUITRY TO OPTIMIZE AUDITION
 AND LISTENING SKILLS IN THE ENVIRONMENT COMMONLY  EXPERIENCED  BY  CHIL-
 DREN.
   (2) THIS SUBSECTION SHALL APPLY TO THE FOLLOWING ENTITIES:
   (A)  INSURERS AND NONPROFIT HEALTH SERVICE PLANS, INCLUDING THE OFFICE
 OF GROUP BENEFITS, THAT PROVIDE HOSPITAL, MEDICAL, OR SURGICAL  BENEFITS
 TO  INDIVIDUALS  OR  GROUPS  ON  AN  EXPENSE-INCURRED BASIS UNDER HEALTH
 INSURANCE POLICIES OR CONTRACTS THAT ARE ISSUED  OR  DELIVERED  IN  THIS
 STATE.
   (B)  MANAGED  CARE  ORGANIZATIONS AS DEFINED AND LICENSED BY STATE LAW
 THAT PROVIDE HOSPITAL, MEDICAL OR SURGICAL BENEFITS  TO  INDIVIDUALS  OR
 GROUPS UNDER CONTRACTS THAT ARE ISSUED OR DELIVERED IN THIS STATE.
   (3)  AN  ENTITY  SUBJECT TO THIS SUBSECTION SHALL PROVIDE COVERAGE FOR
 HEARING AIDS FOR A CHILD UNDER THE AGE OF EIGHTEEN WHO IS COVERED  UNDER
 A  POLICY  OR  CONTRACT  OF INSURANCE IF THE HEARING AIDS ARE FITTED AND
 DISPENSED BY A LICENSES AUDIOLOGIST CERTIFIED BY  THE  AMERICAN  SPEECH-
 LANGUAGE-HEARING  ASSOCIATION FOLLOWING MEDICAL CLEARANCE BY A PHYSICIAN
 LICENSED TO PRACTICE MEDICINE AND AN AUDIOLOGICAL  EVALUATION  MEDICALLY
 APPROPRIATE TO THE AGE OF THE CHILD, PROVIDED:
   (A) AN ENTITY SUBJECT TO THIS SUBSECTION MAY LIMIT THE BENEFIT PAYABLE
 UNDER THIS SUBSECTION TO ONE THOUSAND AND FIVE HUNDRED DOLLARS PER HEAR-
 ING AID FOR EACH HEARING-IMPAIRED EAR EVERY THIRTY-SIX MONTHS.
   (B) AN INSURED OR ENROLLED INDIVIDUAL MAY CHOOSE A HEARING AID THAT IS
 PRICED  HIGHER THEN THE BENEFIT PAYABLE UNDER HIS SUBSECTION AND MAY PAY
 THE  DIFFERENCE  BETWEEN  THE  PRICE  OF THE HEARING AID AND THE BENEFIT
 PAYABLE UNDER THIS SUBSECTION WITHOUT FINANCIAL OR  CONTRACTUAL  PENALTY
 TO THE PROVIDER OF THE HEARING AID.
   (C)  IN  THE  CASE  OF THE HEALTH INSURER OR MANAGED CARE ORGANIZATION
 THAT ADMINISTERS  BENEFITS  ACCORDING  TO  CONTRACTS  WITH  HEALTH  CARE
 PROVIDERS,  HEARING  AIDS  COVERED  PURSUANT TO THIS SUBSECTION SHALL BE
 OBTAINED FROM HEALTH CARE PROVIDERS CONTRACTED WITH THE  HEALTH  INSURER
 OR  MANAGED  CARE  ORGANIZATION.  SUCH PROVIDERS SHALL BE SUBJECT TO THE

 A. 8628                             4

 SAME CONTRACTING AND CREDENTIALING  REQUIREMENTS  THAT  APPLY  TO  OTHER
 CONTRACTED HEALTH CARE PROVIDERS.
   (4)  THIS  SUBSECTION  DOES  NOT  PROHIBIT  AN  ENTITY  SUBJECT TO THE
 PROVISIONS OF THIS SUBSECTION FROM PROVIDING COVERAGE THAT IS GREATER OR
 MORE FAVORABLE TO AN INSURED OR ENROLLED INDIVIDUAL  THAN  THE  COVERAGE
 REQUIRED UNDER THIS SUBSECTION.
   (5)  THE  PROVISIONS OF THIS SUBSECTION SHALL APPLY TO ANY NEW POLICY,
 CONTRACT, PROGRAM, OR PLAN ISSUED BY AN ENTITY SUBJECT TO THE PROVISIONS
 OF THIS SUBSECTION ON OR AFTER JANUARY FIRST, TWO THOUSAND NINETEEN. ANY
 SUCH POLICY, CONTRACT, PROGRAM OR PLAN IN EFFECT PRIOR TO JANUARY FIRST,
 TWO THOUSAND NINETEEN SHALL CONVERT TO THE PROVISIONS OF THIS SUBSECTION
 ON OR BEFORE THE RENEWAL DATE THEREOF BUT IN NO EVENT LATER THAN JANUARY
 FIRST, TWO THOUSAND NINETEEN. ANY POLICY AFFECTED BY THE  PROVISIONS  OF
 THIS  SUBSECTION  SHALL  APPLY  TO  AN INSURED OR PARTICIPANT UNDER SUCH
 POLICY, CONTRACT, PROGRAM, OR PLAN WHETHER OR NOT THE HEARING IMPAIRMENT
 IS A PRE-EXISTING CONDITION OF THE INSURED OR PARTICIPANT.
   § 4. This act shall take effect on the ninetieth day  after  it  shall
 have become a law.

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2017-A8628A (ACTIVE) - Details

See Senate Version of this Bill:: S6894
Current Committee:: Assembly Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2019-2020: A2325
2021-2022: A5035
2023-2024: A149

2017-A8628A (ACTIVE) - Summary

Relates to the mandatory coverage of hearing aids by insurers and other organizations.

2017-A8628A (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  8628--A
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             September 1, 2017
                                ___________
 
 Introduced  by M. of A. SOLAGES -- read once and referred to the Commit-
   tee on  Insurance  --  committee  discharged,  bill  amended,  ordered
   reprinted as amended and recommitted to said committee
 
 AN ACT to amend the insurance law, in relation to the mandatory coverage
   of hearing aids by insurers and other organizations

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
 amended by adding a new paragraph 34 to read as follows:
   (34)  (A)  AS  USED IN THIS PARAGRAPH, "HEARING AID" SHALL MEAN A NON-
 DISPOSABLE DEVICE THAT IS OF A DESIGN AND CIRCUITRY TO OPTIMIZE AUDITION
 AND LISTENING SKILLS IN THE ENVIRONMENT COMMONLY  EXPERIENCED  BY  CHIL-
 DREN.
   (B) THIS PARAGRAPH SHALL APPLY TO THE FOLLOWING ENTITIES:
   (I)  INSURERS AND NONPROFIT HEALTH SERVICE PLANS, INCLUDING THE OFFICE
 OF GROUP BENEFITS, THAT PROVIDE HOSPITAL, MEDICAL, OR SURGICAL  BENEFITS
 TO  INDIVIDUALS  OR  GROUPS  ON  AN  EXPENSE-INCURRED BASIS UNDER HEALTH
 INSURANCE POLICIES OR CONTRACTS THAT ARE ISSUED  OR  DELIVERED  IN  THIS
 STATE.
   (II)  MANAGED  CARE ORGANIZATIONS AS DEFINED AND LICENSED BY STATE LAW
 THAT PROVIDE HOSPITAL, MEDICAL OR SURGICAL BENEFITS  TO  INDIVIDUALS  OR
 GROUPS UNDER CONTRACTS THAT ARE ISSUED OR DELIVERED IN THIS STATE.
   (C)  AN  ENTITY  SUBJECT  TO THIS PARAGRAPH SHALL PROVIDE COVERAGE FOR
 HEARING AIDS FOR PATIENTS WHO ARE COVERED UNDER A POLICY OR CONTRACT  OF
 INSURANCE  IF  THE  HEARING  AIDS ARE FITTED AND DISPENSED BY A LICENSED
 AUDIOLOGIST CERTIFIED BY THE  AMERICAN  SPEECH-LANGUAGE-HEARING  ASSOCI-
 ATION  FOLLOWING  MEDICAL  CLEARANCE BY A PHYSICIAN LICENSED TO PRACTICE
 MEDICINE AND AN AUDIOLOGICAL EVALUATION MEDICALLY APPROPRIATE TO THE AGE
 OF THE CHILD, PROVIDED:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD13317-02-7

 A. 8628--A                          2
 
   (I) AN ENTITY SUBJECT TO THIS PARAGRAPH MAY LIMIT THE BENEFIT  PAYABLE
 UNDER  THIS PARAGRAPH TO THREE THOUSAND DOLLARS PER HEARING AID FOR EACH
 HEARING-IMPAIRED EAR EVERY TWENTY-FOUR MONTHS.
   (II)  AN  INSURED OR ENROLLED INDIVIDUAL MAY CHOOSE A HEARING AID THAT
 IS PRICED HIGHER THAN THE BENEFIT PAYABLE UNDER THIS PARAGRAPH  AND  MAY
 PAY  THE DIFFERENCE BETWEEN THE PRICE OF THE HEARING AID AND THE BENEFIT
 PAYABLE UNDER THIS PARAGRAPH WITHOUT FINANCIAL OR CONTRACTUAL PENALTY TO
 THE PROVIDER OF THE HEARING AID.
   (III) IN THE CASE OF A HEALTH INSURER  OR  MANAGED  CARE  ORGANIZATION
 THAT  ADMINISTERS  BENEFITS  ACCORDING  TO  CONTRACTS  WITH  HEALTH CARE
 PROVIDERS, HEARING AIDS COVERED PURSUANT  TO  THIS  PARAGRAPH  SHALL  BE
 OBTAINED  FROM  HEALTH CARE PROVIDERS CONTRACTED WITH THE HEALTH INSURER
 OR MANAGED CARE ORGANIZATION. SUCH PROVIDERS SHALL  BE  SUBJECT  TO  THE
 SAME  CONTRACTING  AND  CREDENTIALING  REQUIREMENTS  THAT APPLY TO OTHER
 CONTRACTED HEALTH CARE PROVIDERS.
   (D) THIS  PARAGRAPH  DOES  NOT  PROHIBIT  AN  ENTITY  SUBJECT  TO  THE
 PROVISIONS  OF THIS PARAGRAPH FROM PROVIDING COVERAGE THAT IS GREATER OR
 MORE FAVORABLE TO AN INSURED OR ENROLLED INDIVIDUAL  THAN  THE  COVERAGE
 REQUIRED UNDER THIS PARAGRAPH.
   (E)  THE  PROVISIONS  OF THIS PARAGRAPH SHALL APPLY TO ANY NEW POLICY,
 CONTRACT, PROGRAM, OR PLAN ISSUED BY AN ENTITY SUBJECT TO THE PROVISIONS
 OF THIS PARAGRAPH ON OR AFTER JANUARY FIRST, TWO THOUSAND NINETEEN.  ANY
 SUCH POLICY, CONTRACT, PROGRAM OR PLAN IN EFFECT PRIOR TO JANUARY FIRST,
 TWO  THOUSAND NINETEEN SHALL CONVERT TO THE PROVISIONS OF THIS PARAGRAPH
 ON OR BEFORE THE RENEWAL DATE THEREOF BUT IN NO EVENT LATER THAN JANUARY
 FIRST, TWO THOUSAND NINETEEN. ANY POLICY AFFECTED BY THE  PROVISIONS  OF
 THIS PARAGRAPH SHALL APPLY TO AN INSURED OR PARTICIPANT UNDER SUCH POLI-
 CY,  CONTRACT, PROGRAM, OR PLAN WHETHER OR NOT THE HEARING IMPAIRMENT IS
 A PRE-EXISTING CONDITION OF THE INSURED OR PARTICIPANT.
   § 2. Section 3221 of the insurance law is  amended  by  adding  a  new
 subsection (t) to read as follows:
   (T)  (1)  AS  USED IN THIS SUBSECTION, "HEARING AID" SHALL MEAN A NON-
 DISPOSABLE DEVICE THAT IS OF A DESIGN AND CIRCUITRY TO OPTIMIZE AUDITION
 AND LISTENING SKILLS IN THE ENVIRONMENT COMMONLY  EXPERIENCED  BY  CHIL-
 DREN.
   (2) THIS SUBSECTION SHALL APPLY TO THE FOLLOWING ENTITIES:
   (A)  INSURERS AND NONPROFIT HEALTH SERVICE PLANS, INCLUDING THE OFFICE
 OF GROUP BENEFITS, THAT PROVIDE HOSPITAL, MEDICAL, OR SURGICAL  BENEFITS
 TO  INDIVIDUALS  OR  GROUPS  ON  AN  EXPENSE-INCURRED BASIS UNDER HEALTH
 INSURANCE POLICIES OR CONTRACTS THAT ARE ISSUED  OR  DELIVERED  IN  THIS
 STATE.
   (B)  MANAGED  CARE  ORGANIZATIONS AS DEFINED AND LICENSED BY STATE LAW
 THAT PROVIDE HOSPITAL, MEDICAL OR SURGICAL BENEFITS  TO  INDIVIDUALS  OR
 GROUPS UNDER CONTRACTS THAT ARE ISSUED OR DELIVERED IN THIS STATE.
   (3)  AN  ENTITY  SUBJECT TO THIS SUBSECTION SHALL PROVIDE COVERAGE FOR
 HEARING AIDS FOR PATIENTS WHO ARE COVERED UNDER A POLICY OR CONTRACT  OF
 INSURANCE  IF  THE  HEARING  AIDS ARE FITTED AND DISPENSED BY A LICENSED
 AUDIOLOGIST CERTIFIED BY THE  AMERICAN  SPEECH-LANGUAGE-HEARING  ASSOCI-
 ATION  FOLLOWING  MEDICAL  CLEARANCE BY A PHYSICIAN LICENSED TO PRACTICE
 MEDICINE AND AN AUDIOLOGICAL EVALUATION MEDICALLY APPROPRIATE TO THE AGE
 OF THE CHILD, PROVIDED:
   (A) AN ENTITY SUBJECT TO THIS SUBSECTION MAY LIMIT THE BENEFIT PAYABLE
 UNDER THIS SUBSECTION TO THREE THOUSAND DOLLARS PER HEARING AID FOR EACH
 HEARING-IMPAIRED EAR EVERY TWENTY-FOUR MONTHS.
   (B) AN INSURED OR ENROLLED INDIVIDUAL MAY CHOOSE A HEARING AID THAT IS
 PRICED HIGHER THAN THE BENEFIT PAYABLE UNDER THIS SUBSECTION AND MAY PAY

 A. 8628--A                          3
 
 THE DIFFERENCE BETWEEN THE PRICE OF THE  HEARING  AID  AND  THE  BENEFIT
 PAYABLY  UNDER  THIS SUBSECTION WITHOUT FINANCIAL OR CONTRACTUAL PENALTY
 TO THE PROVIDER OF THE HEARING AID.
   (C)  IN THE CASE OF A HEALTH INSURER OR MANAGED CARE ORGANIZATION THAT
 ADMINISTERS BENEFITS ACCORDING TO CONTRACTS WITH HEALTH CARE  PROVIDERS,
 HEARING  AIDS COVERED PURSUANT TO THIS SUBSECTION SHALL BE OBTAINED FROM
 HEALTH CARE PROVIDERS CONTRACTED WITH   THE HEALTH  INSURER  OR  MANAGED
 CARE ORGANIZATION. SUCH PROVIDERS SHALL BE SUBJECT TO THE SAME CONTRACT-
 ING AND CREDENTIALING REQUIREMENTS THAT APPLY TO OTHER CONTRACTED HEALTH
 CARE PROVIDERS.
   (4)  THIS  SUBSECTION  DOES  NOT  PROHIBIT  AN  ENTITY  SUBJECT TO THE
 PROVISIONS OF THIS SUBSECTION FROM PROVIDING COVERAGE THAT IS GREATER OR
 MORE FAVORABLE TO AN INSURED OR ENROLLED INDIVIDUAL  THAN  THE  COVERAGE
 REQUIRED UNDER THIS SUBSECTION.
   (5)  THE  PROVISIONS OF THIS SUBSECTION SHALL APPLY TO ANY NEW POLICY,
 CONTRACT, PROGRAM, OR PLAN ISSUED BY AN ENTITY SUBJECT TO THE PROVISIONS
 OF THIS SUBSECTION ON OR AFTER JANUARY FIRST, TWO THOUSAND NINETEEN. ANY
 SUCH POLICY, CONTRACT, PROGRAM OR PLAN IN EFFECT PRIOR TO JANUARY FIRST,
 TWO THOUSAND NINETEEN SHALL CONVERT TO THE PROVISIONS OF THIS SUBSECTION
 ON OR BEFORE THE RENEWAL DATE THEREOF BUT IN NO EVENT LATER THAN JANUARY
 FIRST, TWO THOUSAND NINETEEN. ANY POLICY AFFECTED BY THE  PROVISIONS  OF
 THIS  SUBSECTION  SHALL  APPLY  TO  AN INSURED OR PARTICIPANT UNDER SUCH
 POLICY, CONTRACT, PROGRAM, OR PLAN WHETHER OR NOT THE HEARING IMPAIRMENT
 IS A PRE-EXISTING CONDITION OF THE INSURED OR PARTICIPANT.
   § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (rr) to read as follows:
   (RR)(1)  AS  USED  IN THIS SUBSECTION, "HEARING AID" SHALL MEAN A NON-
 DISPOSABLE DEVICE THAT IS OF A DESIGN AND CIRCUITRY TO OPTIMIZE AUDITION
 AND LISTENING SKILLS IN THE ENVIRONMENT COMMONLY  EXPERIENCED  BY  CHIL-
 DREN.
   (2) THIS SUBSECTION SHALL APPLY TO THE FOLLOWING ENTITIES:
   (A)  INSURERS AND NONPROFIT HEALTH SERVICE PLANS, INCLUDING THE OFFICE
 OF GROUP BENEFITS, THAT PROVIDE HOSPITAL, MEDICAL, OR SURGICAL  BENEFITS
 TO  INDIVIDUALS  OR  GROUPS  ON  AN  EXPENSE-INCURRED BASIS UNDER HEALTH
 INSURANCE POLICIES OR CONTRACTS THAT ARE ISSUED  OR  DELIVERED  IN  THIS
 STATE.
   (B)  MANAGED  CARE  ORGANIZATIONS AS DEFINED AND LICENSED BY STATE LAW
 THAT PROVIDE HOSPITAL, MEDICAL OR SURGICAL BENEFITS  TO  INDIVIDUALS  OR
 GROUPS UNDER CONTRACTS THAT ARE ISSUED OR DELIVERED IN THIS STATE.
   (3)  AN  ENTITY  SUBJECT TO THIS SUBSECTION SHALL PROVIDE COVERAGE FOR
 HEARING AIDS FOR PATIENTS WHO ARE COVERED UNDER A POLICY OR CONTRACT  OF
 INSURANCE  IF  THE  HEARING  AIDS ARE FITTED AND DISPENSED BY A LICENSED
 AUDIOLOGIST CERTIFIED BY THE  AMERICAN  SPEECH-LANGUAGE-HEARING  ASSOCI-
 ATION  FOLLOWING  MEDICAL  CLEARANCE BY A PHYSICIAN LICENSED TO PRACTICE
 MEDICINE AND AN AUDIOLOGICAL EVALUATION MEDICALLY APPROPRIATE TO THE AGE
 OF THE CHILD, PROVIDED:
   (A) AN ENTITY SUBJECT TO THIS SUBSECTION MAY LIMIT THE BENEFIT PAYABLE
 UNDER THIS SUBSECTION TO THREE THOUSAND DOLLARS PER HEARING AID FOR EACH
 HEARING-IMPAIRED EAR EVERY TWENTY-FOUR MONTHS.
   (B) AN INSURED OR ENROLLED INDIVIDUAL MAY CHOOSE A HEARING AID THAT IS
 PRICED  HIGHER THEN THE BENEFIT PAYABLE UNDER HIS SUBSECTION AND MAY PAY
 THE DIFFERENCE BETWEEN THE PRICE OF THE  HEARING  AID  AND  THE  BENEFIT
 PAYABLE  UNDER  THIS SUBSECTION WITHOUT FINANCIAL OR CONTRACTUAL PENALTY
 TO THE PROVIDER OF THE HEARING AID.
   (C) IN THE CASE OF THE HEALTH INSURER  OR  MANAGED  CARE  ORGANIZATION
 THAT  ADMINISTERS  BENEFITS  ACCORDING  TO  CONTRACTS  WITH  HEALTH CARE

 A. 8628--A                          4
 
 PROVIDERS, HEARING AIDS COVERED PURSUANT TO  THIS  SUBSECTION  SHALL  BE
 OBTAINED  FROM  HEALTH CARE PROVIDERS CONTRACTED WITH THE HEALTH INSURER
 OR MANAGED CARE ORGANIZATION. SUCH PROVIDERS SHALL  BE  SUBJECT  TO  THE
 SAME  CONTRACTING  AND  CREDENTIALING  REQUIREMENTS  THAT APPLY TO OTHER
 CONTRACTED HEALTH CARE PROVIDERS.
   (4) THIS SUBSECTION  DOES  NOT  PROHIBIT  AN  ENTITY  SUBJECT  TO  THE
 PROVISIONS OF THIS SUBSECTION FROM PROVIDING COVERAGE THAT IS GREATER OR
 MORE  FAVORABLE  TO  AN INSURED OR ENROLLED INDIVIDUAL THAN THE COVERAGE
 REQUIRED UNDER THIS SUBSECTION.
   (5) THE PROVISIONS OF THIS SUBSECTION SHALL APPLY TO ANY  NEW  POLICY,
 CONTRACT, PROGRAM, OR PLAN ISSUED BY AN ENTITY SUBJECT TO THE PROVISIONS
 OF THIS SUBSECTION ON OR AFTER JANUARY FIRST, TWO THOUSAND NINETEEN. ANY
 SUCH POLICY, CONTRACT, PROGRAM OR PLAN IN EFFECT PRIOR TO JANUARY FIRST,
 TWO THOUSAND NINETEEN SHALL CONVERT TO THE PROVISIONS OF THIS SUBSECTION
 ON OR BEFORE THE RENEWAL DATE THEREOF BUT IN NO EVENT LATER THAN JANUARY
 FIRST,  TWO  THOUSAND NINETEEN. ANY POLICY AFFECTED BY THE PROVISIONS OF
 THIS SUBSECTION SHALL APPLY TO AN  INSURED  OR  PARTICIPANT  UNDER  SUCH
 POLICY, CONTRACT, PROGRAM, OR PLAN WHETHER OR NOT THE HEARING IMPAIRMENT
 IS A PRE-EXISTING CONDITION OF THE INSURED OR PARTICIPANT.
   §  4.  This  act shall take effect on the ninetieth day after it shall
 have become a law.

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Assembly Bill A8628A

Sponsored By

Archive: Last Bill Status - In Assembly Committee

Bill Amendments

2017-A8628 - Details

2017-A8628 - Summary

2017-A8628 - Bill Text download pdf

co-Sponsors

multi-Sponsors

2017-A8628A (ACTIVE) - Details

2017-A8628A (ACTIVE) - Summary

2017-A8628A (ACTIVE) - Bill Text download pdf

Comments

Assembly Bill A8628A

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Sponsored By

SOLAGES

Archive: Last Bill Status - In Assembly Committee

Bill Amendments

2017-A8628 - Details

2017-A8628 - Summary

2017-A8628 - Bill Text download pdf

co-Sponsors

Anthony D'Urso

Edward Ra

multi-Sponsors

Dean Murray

2017-A8628A (ACTIVE) - Details

2017-A8628A (ACTIVE) - Summary

2017-A8628A (ACTIVE) - Bill Text download pdf

Comments