S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7861
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               May 28, 2021
                                ___________
 
 Introduced  by  M.  of  A.  ZEBROWSKI  --  read once and referred to the
   Committee on Insurance
 
 AN ACT to amend the insurance law, in relation  to  requiring  insurance
   policies  to  provide  coverage  for  medically necessary hearing aids
   purchased from hearing aid dispensers

   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 36 to read as follows:
   (36) (A) EVERY HEALTH INSURANCE POLICY THAT  PROVIDES  MEDICAL,  MAJOR
 MEDICAL,  OR  SIMILAR COMPREHENSIVE TYPE COVERAGE ISSUED OR DELIVERED IN
 THIS STATE SHALL PROVIDE COVERAGE FOR MEDICALLY NECESSARY  HEARING  AIDS
 PURCHASED   FROM   HEARING   AID  DISPENSERS  REGISTERED  UNDER  ARTICLE
 THIRTY-SEVEN-A OF THE GENERAL  BUSINESS  LAW  OR  AUDIOLOGISTS  LICENSED
 UNDER ARTICLE ONE HUNDRED FIFTY-NINE OF THE EDUCATION LAW FOR AN INSURED
 PERSON  WHO  IS LESS THAN EIGHTEEN YEARS OF AGE. COVERAGE MAY BE LIMITED
 TO ONE HEARING AID  PER  EACH  HEARING-IMPAIRED  EAR  EVERY  TWENTY-FOUR
 MONTHS  UNLESS  IT IS DEMONSTRATED THAT: (I) THE INSURED CHILD'S HEARING
 HAS CHANGED SIGNIFICANTLY WITHIN A TWO-YEAR PERIOD; AND (II) THE  EXIST-
 ING HEARING AID WILL NO LONGER CORRECT THE CHILD'S HEARING LOSS.
   (B)(I)  FOR  THE  PURPOSES OF THIS PARAGRAPH, "HEARING AID" SHALL MEAN
 ANY WEARABLE INSTRUMENT OR DEVICES 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.
   (II) FOR THE PURPOSES OF THIS SECTION, SERVICES FOR RECASING, RESHELL-
 ING AND ACQUIRING NEW MOLDS SHALL BE INCLUDED AS PART OF THE POLICIES.
   (C)  COVERAGE  PROVIDED  PURSUANT  TO THIS PARAGRAPH MAY BE SUBJECT TO
 DEDUCTIBLES, COINSURANCE, OR COPAYMENTS.
   § 2. Section 3221 of the insurance law is  amended  by  adding  a  new
 subsection (u) to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD11534-01-1

 A. 7861                             2
 
   (U)  (1)  EVERY  GROUP  HEALTH INSURANCE POLICY THAT PROVIDES MEDICAL,
 MAJOR MEDICAL, OR SIMILAR COMPREHENSIVE TYPE COVERAGE ISSUED  OR  DELIV-
 ERED  IN  THIS  STATE  SHALL PROVIDE COVERAGE FOR HEARING AIDS PURCHASED
 FROM HEARING AID DISPENSERS REGISTERED UNDER ARTICLE  THIRTY-SEVEN-A  OF
 THE  GENERAL  BUSINESS  LAW  OR  AUDIOLOGISTS LICENSED UNDER ARTICLE ONE
 HUNDRED FIFTY-NINE OF THE EDUCATION LAW FOR AN  INSURED  PERSON  WHO  IS
 LESS  THAN EIGHTEEN YEARS OF AGE. COVERAGE MAY BE LIMITED TO ONE HEARING
 AID PER EACH HEARING-IMPAIRED EAR EVERY TWENTY-FOUR MONTHS UNLESS IT  IS
 DEMONSTRATED  THAT:  (I) THE INSURED CHILD'S HEARING HAS CHANGED SIGNIF-
 ICANTLY WITHIN A TWO-YEAR PERIOD; AND (II) THE EXISTING HEARING AID WILL
 NO LONGER CORRECT THE CHILD'S HEARING LOSS, SUCH INSURED PERSON SHALL BE
 ENTITLED TO REIMBURSEMENT FOR ADDITIONAL HEARING AID EXPENSES.
   (2)(A) FOR THE PURPOSES OF THIS SUBSECTION, "HEARING AID"  SHALL  MEAN
 ANY  WEARABLE  INSTRUMENT OR DEVICES 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)  COVERAGE  PROVIDED  PURSUANT TO THIS SUBSECTION MAY BE SUBJECT TO
 DEDUCTIBLES, COINSURANCE, OR COPAYMENTS.
   § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (ss) to read as follows:
   (SS) (1) EVERY CONTRACT THAT PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMI-
 LAR  COMPREHENSIVE  TYPE COVERAGE ISSUED OR DELIVERED IN THIS STATE BY A
 HEALTH SERVICE CORPORATION OR HOSPITAL SERVICE CORPORATION SHALL PROVIDE
 COVERAGE FOR HEARING AIDS PURCHASED FROM HEARING AID  DISPENSERS  REGIS-
 TERED  UNDER  ARTICLE  THIRTY-SEVEN-A  OF  THE  GENERAL  BUSINESS LAW OR
 AUDIOLOGISTS LICENSED UNDER ARTICLE ONE HUNDRED FIFTY-NINE OF THE EDUCA-
 TION LAW FOR AN INSURED PERSON WHO IS LESS THAN EIGHTEEN YEARS  OF  AGE.
 COVERAGE MAY BE LIMITED TO ONE HEARING AID PER EACH HEARING-IMPAIRED EAR
 EVERY TWENTY-FOUR MONTHS UNLESS IT IS DEMONSTRATED THAT: (I) THE INSURED
 CHILD'S  HEARING HAS CHANGED SIGNIFICANTLY WITHIN A TWO-YEAR PERIOD; AND
 (II) THE EXISTING HEARING AID WILL NO LONGER CORRECT THE CHILD'S HEARING
 LOSS, SUCH INSURED PERSON SHALL BE ENTITLED TO REIMBURSEMENT  FOR  ADDI-
 TIONAL HEARING AID EXPENSES.
   (2)(A)  FOR  THE PURPOSES OF THIS SUBSECTION, "HEARING AID" SHALL MEAN
 ANY WEARABLE INSTRUMENT OR DEVICES 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) COVERAGE PROVIDED PURSUANT TO THIS SUBSECTION MAY  BE  SUBJECT  TO
 DEDUCTIBLES, COINSURANCE, OR COPAYMENTS.
   §  4. This act shall take effect on the first of January next succeed-
 ing the date on which it shall have become a law and shall apply to  all
 policies issued, modified or renewed on and after such date.