- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
| Assembly Actions - Lowercase Senate Actions - UPPERCASE | |
|---|---|
| May 25, 2022 | print number 9572a |
| May 25, 2022 | amend and recommit to insurance |
| Mar 16, 2022 | referred to insurance |
Bill Amendments
Original A (Active)2021-A9572 - Details
See Senate Version of this Bill: S8684 Current Committee: Assembly Insurance Law Section: Insurance Law Laws Affected: Amd §§3216, 3221 & 4303, Ins L Versions Introduced in 2023-2024 Legislative Session: A142, S1474
2021-A9572 - Summary
Requires 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 Association following medical clearance by a physician licensed to practice medicine and an audiological evaluation.
2021-A9572 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 9572 I N A S S E M B L Y March 16, 2022 ___________ 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. 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. (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, PROVIDED: (I) AN ENTITY SUBJECT TO THIS PARAGRAPH MAY LIMIT THE BENEFIT PAYABLE UNDER THIS PARAGRAPH TO FIVE 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. EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
LBD15037-01-2 A. 9572 2 (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. (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, PROVIDED: (A) AN ENTITY SUBJECT TO THIS SUBSECTION MAY LIMIT THE BENEFIT PAYABLE UNDER THIS SUBSECTION TO FIVE 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- A. 9572 3 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. (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, PROVIDED: (A) AN ENTITY SUBJECT TO THIS SUBSECTION MAY LIMIT THE BENEFIT PAYABLE UNDER THIS SUBSECTION TO FIVE 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 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. A. 9572 4 (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.
2021-A9572A (ACTIVE) - Details
See Senate Version of this Bill: S8684 Current Committee: Assembly Insurance Law Section: Insurance Law Laws Affected: Amd §§3216, 3221 & 4303, Ins L Versions Introduced in 2023-2024 Legislative Session: A142, S1474
2021-A9572A (ACTIVE) - Summary
Requires 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 Association following medical clearance by a physician licensed to practice medicine and an audiological evaluation.
2021-A9572A (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 9572--A I N A S S E M B L Y March 16, 2022 ___________ 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 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. (B) EVERY POLICY WHICH PROVIDES HOSPITAL, MEDICAL OR SURGICAL COVERAGE SHALL PROVIDE COVERAGE FOR HEARING AIDS FOR PATIENTS 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 EVALU- ATION, PROVIDED AN ENTITY SUBJECT TO THIS PARAGRAPH MAY LIMIT THE BENE- FIT PAYABLE UNDER THIS PARAGRAPH TO FIVE 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. § 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. (2) EVERY POLICY WHICH PROVIDES HOSPITAL, MEDICAL OR SURGICAL COVERAGE SHALL PROVIDE COVERAGE FOR HEARING AIDS FOR PATIENTS IF SUCH HEARING AIDS ARE FITTED AND DISPENSED BY A LICENSED AUDIOLOGIST CERTIFIED BY THE AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION, FOLLOWING MEDICAL CLEAR- ANCE BY A PHYSICIAN LICENSED TO PRACTICE MEDICINE, AND AN AUDIOLOGICAL EVALUATION, PROVIDED AN ENTITY SUBJECT TO THIS SUBSECTION MAY LIMIT THE EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
LBD15037-02-2 A. 9572--A 2 BENEFIT PAYABLE UNDER THIS SUBSECTION TO FIVE THOUSAND DOLLARS PER HEAR- ING AID FOR EACH HEARING-IMPAIRED 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. (2) EVERY POLICY WHICH PROVIDES HOSPITAL, MEDICAL OR SURGICAL COVERAGE SHALL PROVIDE COVERAGE FOR HEARING AIDS FOR PATIENTS IF SUCH HEARING AIDS ARE FITTED AND DISPENSED BY A LICENSED AUDIOLOGIST CERTIFIED BY THE AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION, FOLLOWING MEDICAL CLEAR- ANCE BY A PHYSICIAN LICENSED TO PRACTICE MEDICINE, AND AN AUDIOLOGICAL EVALUATION, PROVIDED AN ENTITY SUBJECT TO THIS SUBSECTION MAY LIMIT THE BENEFIT PAYABLE UNDER THIS SUBSECTION TO FIVE THOUSAND DOLLARS PER HEAR- ING AID FOR EACH HEARING-IMPAIRED 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.
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