NY State Senate Bill 2021-S533B

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 20, 2022	print number 533b
May 20, 2022	amend and recommit to insurance
Mar 18, 2022	print number 533a
Mar 18, 2022	amend and recommit to insurance
Jan 05, 2022	referred to insurance
Jan 06, 2021	referred to insurance

co-Sponsors

2021-S533 - Details

See Assembly Version of this Bill:: A5035
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2017-2018: A8628
2019-2020: S5495, A2325
2023-2024: S1475, A149

2021-S533 - Summary

Provides for coverage of hearing aids for child 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 Association following medical clearance by a physician licensed to practice medicine and an audiological evaluation medically appropriate to the age of the child.

2021-S533 - Sponsor Memo

                                
 
BILL NUMBER: S533

SPONSOR: PERSAUD
 
TITLE OF BILL:

An act to amend the insurance law, in relation to the mandatory coverage
of hearing aids by insurers and other organizations

 
PURPOSE:

To require all managed care organizations that provide hospital,
medical, or surgical benefits to individuals or groups under contracts
that are issued in this state to provide coverage for hearing aids for
children under the age of eighteen.

 
SUMMARY OF PROVISIONS:

Section 1. Subdivision (i) of section 3216 of the insurance law is
amended by adding a new paragraph 34 to read as follows:

(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 children.

(B) This paragraph shall apply to the following entities: (i) Insurers
and nonprofit health service plans, including the office of group bene-
fits, that provide hospital, medical, or surgical benefits to individ-
uals or groups on an expense-incurred basis under health insurance poli-
cies 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 hear-
ing 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.

(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 favor-
able to an insured or enrolled individual than the coverage required
under this paragraph.

 
EXISTING LAW:

Currently insurance is not required to cover hearing aids for children.

 
JUSTIFICATION:

This legislation seeks to offer insurance coverage for hearing aids by
all insurers, non-profit health plans, and managed care organizations to
provide funding for the purchase of hearing aids and hearing aid related
services for all patients 18 years and younger.

A 2017 survey by the Hearing Health Foundation, a group that funds
research and advocates for treatments and cures for hearing loss, found
that 40 percent of the people they asked had no hearing aid coverage
through health insurance. Currently, 13 states, including Colorado,
Delaware, Georgia, Kentucky, Louisiana, Maine, Maryland, Massachusetts,
Minnesota, Missouri, New Jersey, New Mexico, North Carolina, Oklahoma,
Oregon, Tennessee, and Texas require that health benefits plans in their
state pay for hearing aids for children.

Arkansas, Connecticut, Illinois, New Hampshire and Rhode Island also
require health plans to pay for hearing aids, regardless of age. 19
states in total mandate the coverage of hearing aids in some form.
Studies provided by the Center for Hearing and Communication elucidate
that hearing loss occurs in 5 out of every 1,000 newborns. Children ages
18 and under are subject to the greatest physical growth of their whole
life. Constant growth through puberty can leave them with outstanding
balances from purchasing hearing aids when they suffer from hearing
loss. Not only can the potential outstanding balances affect the chil-
dren in our community, but also can affect their studies and future
success. The Center for Hearing and Communication also state that a mild
hearing loss can cause a child to miss as much as 50% of classroom
discussion. It is imperative to ensure insurance coverage for our young-
est community.

Additionally, providing hearing aids to children stands to save the
state money over the long run. According to the 2017 Annual Report on
the Children's Hearing Aid Program, published by the Utah Department of
Health: "The provision of hearing aids in eligible young children
reduces the need for long term services. Research has shown that the
earlier a child can be fit with appropriate amplification, the greater
the potential for typical speech and language development, social
skills, academic achievement, and future vocational skills.

Early amplification and appropriate Early Intervention services save
significant costs associated with special education services and the
potential need for long term services, thereby reducing financial burden
on the public."

 
LEGISLATIVE HISTORY:

2020: Referred to Insurance

 
FISCAL IMPLICATIONS:

Undetermined.

 
EFFECTIVE DATE:
90th Day

2021-S533 - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    533
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by Sens. PERSAUD, SKOUFIS -- read twice and ordered printed,
   and when printed to be committed to the Committee 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.  Subsection  (i)  of  section 3216 of the insurance law is
 amended by adding a new paragraph 36 to read as follows:
   (36) (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.
                                                            LBD02919-01-1

 S. 533                              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  TWENTY-THREE.
 ANY  SUCH  POLICY,  CONTRACT, PROGRAM OR PLAN IN EFFECT PRIOR TO JANUARY
 FIRST, TWO THOUSAND TWENTY-THREE 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 TWENTY-THREE. ANY POLICY AFFECTED BY
 THE PROVISIONS OF THIS PARAGRAPH SHALL APPLY TO AN  INSURED  OR  PARTIC-
 IPANT  UNDER  SUCH POLICY, CONTRACT, PROGRAM, OR PLAN WHETHER OR NOT THE
 HEARING IMPAIRMENT IS A PRE-EXISTING CONDITION OF THE INSURED OR PARTIC-
 IPANT.
   § 2. Section 3221 of the insurance law is  amended  by  adding  a  new
 subsection (u) to read as follows:
   (U)  (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.

 S. 533                              3
 
   (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
 PAYABLE  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 TWENTY-THREE.
 ANY SUCH POLICY, CONTRACT, PROGRAM OR PLAN IN EFFECT  PRIOR  TO  JANUARY
 FIRST, TWO THOUSAND TWENTY-THREE 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 TWENTY-THREE. ANY  POLICY  AFFECTED  BY
 THE  PROVISIONS  OF THIS SUBSECTION SHALL APPLY TO AN INSURED OR PARTIC-
 IPANT UNDER SUCH POLICY, CONTRACT, PROGRAM, OR PLAN WHETHER OR  NOT  THE
 HEARING IMPAIRMENT IS A PRE-EXISTING CONDITION OF THE INSURED OR PARTIC-
 IPANT.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (ss) to read as follows:
   (SS)(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 THIS SUBSECTION AND MAY
 PAY THE DIFFERENCE BETWEEN THE PRICE OF THE HEARING AID AND THE  BENEFIT

 S. 533                              4
 
 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
 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 TWENTY-THREE.
 ANY SUCH POLICY, CONTRACT, PROGRAM OR PLAN IN EFFECT  PRIOR  TO  JANUARY
 FIRST, TWO THOUSAND TWENTY-THREE 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 TWENTY-THREE. ANY  POLICY  AFFECTED  BY
 THE  PROVISIONS  OF THIS SUBSECTION SHALL APPLY TO AN INSURED OR PARTIC-
 IPANT UNDER SUCH POLICY, CONTRACT, PROGRAM, OR PLAN WHETHER OR  NOT  THE
 HEARING IMPAIRMENT IS A PRE-EXISTING CONDITION OF THE INSURED OR PARTIC-
 IPANT.
   §  4.  This  act shall take effect on the ninetieth day after it shall
 have become a law. Effective immediately, the addition, amendment and/or
 repeal of any rule or regulation necessary  for  the  implementation  of
 this  act  on its effective date are authorized to be made and completed
 on or before such date.

co-Sponsors

View additional co-sponsors

2021-S533A - Details

See Assembly Version of this Bill:: A5035
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2017-2018: A8628
2019-2020: S5495, A2325
2023-2024: S1475, A149

2021-S533A - Summary

Provides for coverage of hearing aids for child 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 Association following medical clearance by a physician licensed to practice medicine and an audiological evaluation medically appropriate to the age of the child.

2021-S533A - Sponsor Memo

                                 
BILL NUMBER: S533A

SPONSOR: PERSAUD
 
TITLE OF BILL:

An act to amend the insurance law, in relation to the mandatory coverage
of hearing aids by insurers and other organizations

 
PURPOSE:

To require all managed care organizations that provide hospital,
medical, or surgical benefits to individuals or groups under contracts
that are issued in this state to provide coverage for hearing aids for
children under the age of eighteen.

 
SUMMARY OF PROVISIONS:

Section 1. Subdivision (i) of section 3216 of the insurance law is
amended by adding a new paragraph 34 to read as follows:

(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 children.

(B) This paragraph shall apply to the following entities: (i) Insurers
and nonprofit health service plans, including the office of group bene-
fits, that provide hospital, medical, or surgical benefits to individ-
uals or groups on an expense-incurred basis under health insurance poli-
cies 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 hear-
ing 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.

(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 favor-
able to an insured or enrolled individual than the coverage required
under this paragraph.

 
EXISTING LAW:

Currently insurance is not required to cover hearing aids for children.

 
JUSTIFICATION:

This legislation seeks to offer insurance coverage for hearing aids by
all insurers, non-profit health plans, and managed care organizations to
provide funding for the purchase of hearing aids and hearing aid related
services for all patients 18 years and younger.

A 2017 survey by the Hearing Health Foundation, a group that funds
research and advocates for treatments and cures for hearing loss, found
that 40 percent of the people they asked had no hearing aid coverage
through health insurance. Currently, 13 states, including Colorado,
Delaware, Georgia, Kentucky, Louisiana, Maine, Maryland, Massachusetts,
Minnesota, Missouri, New Jersey, New Mexico, North Carolina, Oklahoma,
Oregon, Tennessee, and Texas require that health benefits plans in their
state pay for hearing aids for children.

Arkansas, Connecticut, Illinois, New Hampshire and Rhode Island also
require health plans to pay for hearing aids, regardless of age. 19
states in total mandate the coverage of hearing aids in some form.
Studies provided by the Center for Hearing and Communication elucidate
that hearing loss occurs in 5 out of every 1,000 newborns. Children ages
18 and under are subject to the greatest physical growth of their whole
life. Constant growth through puberty can leave them with outstanding
balances from purchasing hearing aids when they suffer from hearing
loss. Not only can the potential outstanding balances affect the chil-
dren in our community, but also can affect their studies and future
success. The Center for Hearing and Communication also state that a mild
hearing loss can cause a child to miss as much as 50% of classroom
discussion. It is imperative to ensure insurance coverage for our young-
est community.

Additionally, providing hearing aids to children stands to save the
state money over the long run. According to the 2017 Annual Report on
the Children's Hearing Aid Program, published by the Utah Department of
Health: "The provision of hearing aids in eligible young children
reduces the need for long term services. Research has shown that the
earlier a child can be fit with appropriate amplification, the greater
the potential for typical speech and language development, social
skills, academic achievement, and future vocational skills.

Early amplification and appropriate Early Intervention services save
significant costs associated with special education services and the
potential need for long term services, thereby reducing financial burden
on the public."

 
LEGISLATIVE HISTORY:

2020: Referred to Insurance

 
FISCAL IMPLICATIONS:

Undetermined.

 
EFFECTIVE DATE:
90th Day

2021-S533A - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  533--A
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by  Sens. PERSAUD, SKOUFIS, GOUNARDES, MANNION -- read twice
   and ordered printed, and when printed to be committed to the Committee
   on Insurance -- recommitted to the Committee on Insurance  in  accord-
   ance 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, 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 36 to read as follows:
   (36)  (A)  AS USED IN THIS PARAGRAPH, "HEARING AID" SHALL MEAN A MEDI-
 CALLY-PRESCRIBED, NON-DISPOSABLE DEVICE THAT IS OF A DESIGN AND  CIRCUI-
 TRY TO OPTIMIZE AUDITION AND LISTENING SKILLS IN THE ENVIRONMENT COMMON-
 LY EXPERIENCED BY CHILDREN.
   (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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02919-03-2

 S. 533--A                           2
 
 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 FOUR 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  TWENTY-THREE.
 ANY  SUCH  POLICY,  CONTRACT, PROGRAM OR PLAN IN EFFECT PRIOR TO JANUARY
 FIRST, TWO THOUSAND TWENTY-THREE 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 TWENTY-THREE. ANY POLICY AFFECTED BY
 THE PROVISIONS OF THIS PARAGRAPH SHALL APPLY TO AN  INSURED  OR  PARTIC-
 IPANT  UNDER  SUCH POLICY, CONTRACT, PROGRAM, OR PLAN WHETHER OR NOT THE
 HEARING IMPAIRMENT IS A PRE-EXISTING CONDITION OF THE INSURED OR PARTIC-
 IPANT.
   § 2. Section 3221 of the insurance law is  amended  by  adding  a  new
 subsection (u) to read as follows:
   (U)  (1)  AS USED IN THIS SUBSECTION, "HEARING AID" SHALL MEAN A MEDI-
 CALLY-PRESCRIBED, NON-DISPOSABLE DEVICE THAT IS OF A DESIGN AND  CIRCUI-
 TRY TO OPTIMIZE AUDITION AND LISTENING SKILLS IN THE ENVIRONMENT COMMON-
 LY EXPERIENCED BY CHILDREN.
   (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:
 S. 533--A                           3
 
   (A) AN ENTITY SUBJECT TO THIS SUBSECTION MAY LIMIT THE BENEFIT PAYABLE
 UNDER THIS SUBSECTION TO FOUR 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
 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 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 TWENTY-THREE.
 ANY SUCH POLICY, CONTRACT, PROGRAM OR PLAN IN EFFECT  PRIOR  TO  JANUARY
 FIRST, TWO THOUSAND TWENTY-THREE 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 TWENTY-THREE. ANY  POLICY  AFFECTED  BY
 THE  PROVISIONS  OF THIS SUBSECTION SHALL APPLY TO AN INSURED OR PARTIC-
 IPANT UNDER SUCH POLICY, CONTRACT, PROGRAM, OR PLAN WHETHER OR  NOT  THE
 HEARING IMPAIRMENT IS A PRE-EXISTING CONDITION OF THE INSURED OR PARTIC-
 IPANT.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (ss) to read as follows:
   (SS)(1) AS USED IN THIS SUBSECTION, "HEARING AID" SHALL MEAN  A  MEDI-
 CALLY-PRESCRIBED,  NON-DISPOSABLE DEVICE THAT IS OF A DESIGN AND CIRCUI-
 TRY TO OPTIMIZE AUDITION AND LISTENING SKILLS IN THE ENVIRONMENT COMMON-
 LY EXPERIENCED BY CHILDREN.
   (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 FOUR THOUSAND DOLLARS PER HEARING AID FOR EACH
 HEARING-IMPAIRED EAR EVERY TWENTY-FOUR MONTHS.
 S. 533--A                           4
 
   (B) AN INSURED OR ENROLLED INDIVIDUAL MAY CHOOSE A HEARING AID THAT IS
 PRICED  HIGHER THEN THE BENEFIT PAYABLE UNDER THIS  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
 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 TWENTY-THREE.
 ANY SUCH POLICY, CONTRACT, PROGRAM OR PLAN IN EFFECT  PRIOR  TO  JANUARY
 FIRST, TWO THOUSAND TWENTY-THREE 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 TWENTY-THREE. ANY  POLICY  AFFECTED  BY
 THE  PROVISIONS  OF THIS SUBSECTION SHALL APPLY TO AN INSURED OR PARTIC-
 IPANT UNDER SUCH POLICY, CONTRACT, PROGRAM, OR PLAN WHETHER OR  NOT  THE
 HEARING IMPAIRMENT IS A PRE-EXISTING CONDITION OF THE INSURED OR PARTIC-
 IPANT.
   §  4.  This  act shall take effect on the ninetieth day after it shall
 have become a law. Effective immediately, the addition, amendment and/or
 repeal of any rule or regulation necessary  for  the  implementation  of
 this  act  on its effective date are authorized to be made and completed
 on or before such date.

co-Sponsors

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2021-S533B (ACTIVE) - Details

See Assembly Version of this Bill:: A5035
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2017-2018: A8628
2019-2020: S5495, A2325
2023-2024: S1475, A149

2021-S533B (ACTIVE) - Summary

Provides for coverage of hearing aids for child 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 Association following medical clearance by a physician licensed to practice medicine and an audiological evaluation medically appropriate to the age of the child.

2021-S533B (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S533B

SPONSOR: PERSAUD
 
TITLE OF BILL:

An act to amend the insurance law, in relation to the mandatory coverage
of hearing aids by insurers and other organizations

 
PURPOSE:

To require all managed care organizations that provide hospital,
medical, or surgical benefits to individuals or groups under contracts
that are issued in this state to provide coverage for hearing aids for
children under the age of eighteen.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1, 2 and 3 provides for the definition of hearing aid, and the
parties that shall provide hearing aid coverage.

Section 4 provides for the effective date

 
JUSTIFICATION:

This legislation seeks to offer insurance coverage for hearing aids by
all insurers, non-profit health plans, and managed care organizations to
provide funding for the purchase of hearing aids and hearing aid related
services for all patients 18 years and younger.

A 2017 survey by the Hearing Health Foundation, a group that funds
research and advocates for treatments and cures for hearing loss, found
that 40 percent of the people they asked had no hearing aid coverage
through health insurance. Currently, 13 states, including Colorado,
Delaware, Georgia, Kentucky, Louisiana, Maine, Maryland, Massachusetts,
Minnesota, Missouri, New Jersey, New Mexico, North Carolina, Oklahoma,
Oregon, Tennessee, and Texas require that health benefits plans in their
state pay for hearing aids for children.

Arkansas, Connecticut, Illinois, New Hampshire and Rhode Island also
require health plans to pay for hearing aids, regardless of age. 19
states in total mandate the coverage of hearing aids in some form.
Studies provided by the Center for Hearing and Communication elucidate
that hearing loss occurs in 5 out of every 1,000 newborns.  Children
ages 18 and under are subject to the greatest physical growth of their
whole life. Constant growth through puberty can leave them with
outstanding balances from purchasing hearing aids when they suffer from
hearing loss. Not only can the potential outstanding balances affect the
children in our community, but also can affect their studies and future
success. The Center for Hearing and Communication also state that a mild
hearing loss can cause a child to miss as much as 50% of classroom
discussion. It is imperative to.ensure insurance coverage for our young-
est community.

Additionally, providing hearing aids to children stands to save the
state money over the long run. According to the 2017 Annual Report on
the Children's Hearing Aid Program, published by the Utah Department of
Health: "The provision of hearing aids in eligible young children
reduces the need for long term services. Research has shown that the
earlier a child can be fit with appropriate amplification, the greater
the potential for typical speech and language development, social
skills, academic achievement, and future vocational skills.

Early amplification and appropriate Early Intervention services save
significant costs associated with special education services and the
potential need for long term services, thereby reducing financial burden
on the public."

 
LEGISLATIVE HISTORY:

2020: Referred to Insurance

 
FISCAL IMPLICATIONS:

Undetermined.

 
EFFECTIVE DATE:
This act shall take effect on the first of January next succeeding the
date on which it shall have become a law and shall apply to all policies
and contracts issued, renewed, modified, altered, or amended on or after
such date. Effective immediately, the addition, amendment and/or repeal
of any rule or regulation necessary for the implementation of this act
on its effective date are authorized to be made and completed on or
before such date.

2021-S533B (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  533--B
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by  Sens. PERSAUD, SKOUFIS, ADDABBO, BIAGGI, BROOKS, COMRIE,
   GAUGHRAN, GOUNARDES, HINCHEY, KENNEDY, MANNION, MYRIE, SALAZAR -- 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  commit-
   tee  --  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 37 to read as follows:
   (37) (A) AS USED IN THIS PARAGRAPH, "HEARING AID" SHALL MEAN  A  MEDI-
 CALLY-PRESCRIBED,  NON-DISPOSABLE DEVICE THAT IS OF A DESIGN AND CIRCUI-
 TRY TO OPTIMIZE AUDITION AND LISTENING SKILLS IN THE ENVIRONMENT COMMON-
 LY EXPERIENCED BY CHILDREN.
   (B) EVERY POLICY WHICH PROVIDES HOSPITAL, MEDICAL OR SURGICAL COVERAGE
 SHALL PROVIDE COVERAGE FOR HEARING AIDS IF SUCH 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  AN  ENTITY
 SUBJECT TO THIS PARAGRAPH MAY LIMIT THE BENEFIT PAYABLE UNDER THIS PARA-
 GRAPH TO FOUR THOUSAND DOLLARS PER HEARING AID FOR EACH HEARING-IMPAIRED
 EAR EVERY TWENTY-FOUR MONTHS.
   (C)  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.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD02919-04-2
 S. 533--B                           2
 
   §  2.  Section  3221  of  the insurance law is amended by adding a new
 subsection (u) to read as follows:
   (U)  (1)  AS USED IN THIS SUBSECTION, "HEARING AID" SHALL MEAN A MEDI-
 CALLY-PRESCRIBED, NON-DISPOSABLE DEVICE THAT IS OF A DESIGN AND  CIRCUI-
 TRY TO OPTIMIZE AUDITION AND LISTENING SKILLS IN THE ENVIRONMENT COMMON-
 LY EXPERIENCED BY CHILDREN.
   (2) EVERY POLICY WHICH PROVIDES HOSPITAL, MEDICAL OR SURGICAL COVERAGE
 SHALL  PROVIDE COVERAGE FOR HEARING AIDS IF SUCH 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 AN ENTITY
 SUBJECT TO THIS SUBSECTION MAY LIMIT  THE  BENEFIT  PAYABLE  UNDER  THIS
 SUBSECTION TO FOUR THOUSAND DOLLARS PER HEARING AID FOR EACH HEARING-IM-
 PAIRED EAR EVERY TWENTY-FOUR MONTHS.
   (3)  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.
   § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (tt) to read as follows:
   (TT)(1)  AS  USED IN THIS SUBSECTION, "HEARING AID" SHALL MEAN A MEDI-
 CALLY-PRESCRIBED, NON-DISPOSABLE DEVICE THAT IS OF A DESIGN AND  CIRCUI-
 TRY TO OPTIMIZE AUDITION AND LISTENING SKILLS IN THE ENVIRONMENT COMMON-
 LY EXPERIENCED BY CHILDREN.
   (2) EVERY POLICY WHICH PROVIDES HOSPITAL, MEDICAL OR SURGICAL COVERAGE
 SHALL  PROVIDE COVERAGE FOR HEARING AIDS IF SUCH 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 AN ENTITY
 SUBJECT TO THIS SUBSECTION MAY LIMIT  THE  BENEFIT  PAYABLE  UNDER  THIS
 SUBSECTION TO FOUR THOUSAND DOLLARS PER HEARING AID FOR EACH HEARING-IM-
 PAIRED EAR EVERY TWENTY-FOUR MONTHS.
   (3)  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.
   § 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 and contracts issued, renewed, modified, altered, or amended on
 or after such date.   Effective  immediately,  the  addition,  amendment
 and/or repeal of any rule or regulation necessary for the implementation
 of  this  act  on  its  effective  date  are  authorized  to be made and
 completed on or before such date.

Senate Bill S533B

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Archive: Last Bill Status - In Senate Committee Insurance Committee

Bill Amendments

co-Sponsors

2021-S533 - Details

2021-S533 - Summary

2021-S533 - Sponsor Memo

2021-S533 - Bill Text download pdf

co-Sponsors

2021-S533A - Details

2021-S533A - Summary

2021-S533A - Sponsor Memo

2021-S533A - Bill Text download pdf

co-Sponsors

2021-S533B (ACTIVE) - Details

2021-S533B (ACTIVE) - Summary

2021-S533B (ACTIVE) - Sponsor Memo

2021-S533B (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S533B

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Sponsored By

Archive: Last Bill Status - In Senate Committee Insurance Committee

Bill Amendments

co-Sponsors

2021-S533 - Details

2021-S533 - Summary

2021-S533 - Sponsor Memo

2021-S533 - Bill Text download pdf

co-Sponsors

2021-S533A - Details

2021-S533A - Summary

2021-S533A - Sponsor Memo

2021-S533A - Bill Text download pdf

co-Sponsors

2021-S533B (ACTIVE) - Details

2021-S533B (ACTIVE) - Summary

2021-S533B (ACTIVE) - Sponsor Memo

2021-S533B (ACTIVE) - Bill Text download pdf

Comments