2013 -- H 5419

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LC00558

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2013

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A N A C T

RELATING TO INSURANCE - HEARING AIDS

     Introduced By: Representatives Jacquard, Naughton, and Handy

     Date Introduced: February 13, 2013

     Referred To: House Health, Education & Welfare

It is enacted by the General Assembly as follows:

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     SECTION 1. Section 27-18-60 of the General Laws in Chapter 27-18 entitled "Accident

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and Sickness Insurance Policies" is hereby amended to read as follows:

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     27-18-60. Hearing aids. -- (a) (1) Every individual or group health insurance contract, or

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every individual or group hospital or medical expense insurance policy, plan, or group policy

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delivered, issued for delivery, or renewed in this state on or after January 1, 2006 July 1, 2013,

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shall provide coverage for one thousand five hundred dollars ($1,500) per one individual hearing

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aid, per ear, every three (3) years for anyone under the age of nineteen (19) years, and shall

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provide coverage for seven hundred dollars ($700) one thousand five hundred dollars ($1,500)

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per individual hearing aid, per ear, every three (3) years for anyone of the age of nineteen (19)

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years and older.

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      (2) Every group health insurance contract or group hospital or medical expense

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insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on

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or after January 1, 2006 July 1, 2013, shall provide, as an optional rider, additional hearing aid

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coverage. Provided, the provisions of this paragraph shall not apply to contracts, plans, or group

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policies subject to the small employer health insurance availability act, chapter 50 of this title.

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      (b) For the purposes of this section:

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      (1) "Hearing aid" means any nonexperimental, wearable instrument or device designed

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for the ear and offered for the purpose of aiding or compensating for impaired human hearing, but

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excluding batteries, cords, and other assistive listening devices, including, but not limited to FM

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systems.

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      (c) It shall remain within the sole discretion of the accident and sickness insurer as to the

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provider of hearing aids with which they choose to contract. Reimbursement shall be provided

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according to the respective principles and policies of the accident and sickness insurer. Nothing

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contained in this section precludes the accident and sickness insurer from conducting managed

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care, medical necessity, or utilization review.

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      (d) This section does not apply to insurance coverage providing benefits for: (1) hospital

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confinement indemnity; (2) disability income; (3) accident only; (4) long term care; (5) Medicare

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supplement; (6) limited benefit health; (7) specified diseased indemnity; (8) sickness of bodily

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injury or death by accident or both; (9) and other limited benefit policies.

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     SECTION 2. Section 27-19-51 of the General Laws in Chapter 27-19 entitled "Nonprofit

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Hospital Service Corporations" is hereby amended to read as follows:

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     27-19-51. Hearing aids. -- (a) (1) Every individual or group health insurance contract, or

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every individual or group hospital or medical expense insurance policy, plan, or group policy

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delivered, issued for delivery, or renewed in this state on or after January 1, 2006 July 1, 2013,

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shall provide coverage for one thousand five hundred dollars ($1,500) per one individual hearing

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aid, per ear, every three (3) years for anyone under the age of nineteen (19) years, and shall

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provide coverage for seven hundred dollars ($700) one thousand five hundred dollars ($1,500)

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per individual hearing aid per ear, every three (3) years for anyone of the age of nineteen (19)

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years and older.

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      (2) Every group health insurance contract or group hospital or medical expense

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insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on

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or after January 1, 2006 July 1, 2013, shall provide, as an optional rider, additional hearing aid

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coverage. Provided, the provisions of this paragraph shall not apply to contracts, plans, or group

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policies subject to the small employer health insurance availability act, chapter 50 of this title.

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      (b) For the purposes of this section, "hearing aid" means any nonexperimental, wearable

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instrument or device designed for the ear and offered for the purpose of aiding or compensating

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for impaired human hearing, but excluding batteries, cords, and other assistive listening devices,

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including, but not limited to, FM systems.

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      (c) It shall remain within the sole discretion of the nonprofit hospital service corporation

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as to the provider of hearing aids with which they choose to contract. Reimbursement shall be

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provided according to the respective principles and policies of the nonprofit hospital service

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corporation. Nothing contained in this section precludes the nonprofit hospital service corporation

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from conducting managed care, medical necessity, or utilization review.

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     SECTION 3. Section 27-20-46 of the General Laws in Chapter 27-20 entitled "Nonprofit

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Medical Service Corporations" is hereby amended to read as follows:

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     27-20-46. Hearing aids. -- (a) (1) Every individual or group health insurance contract, or

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every individual or group hospital or medical expense insurance policy, plan, or group policy

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delivered, issued for delivery, or renewed in this state on or after January 1, 2006 July 1, 2013,

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shall provide coverage for one thousand five hundred dollars ($1,500) per one individual hearing

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aid, per ear, every three (3) years for anyone under the age of nineteen (19) years, and shall

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provide coverage for seven hundred dollars ($700) one thousand five hundred dollars ($1,500)

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per individual hearing aid per ear, every three (3) years for anyone of the age of nineteen (19)

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years and older.

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      (2) Every group health insurance contract or group hospital or medical expense

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insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on

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or after January 1, 2006 July 1, 2013, shall provide, as an optional rider, additional hearing aid

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coverage. Provided, the provisions of this paragraph shall not apply to contracts, plans, or group

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policies subject to the small employer health insurance availability act, chapter 50 of this title.

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      (b) For the purposes of this section, "hearing aid" means any nonexperimental, wearable

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instrument or device designed for the ear and offered for the purpose of aiding or compensating

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for impaired human hearing, but excluding batteries, cords, and other assistive listening devices,

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including, but not limited to, FM systems.

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      (c) It shall remain within the sole discretion of the nonprofit medical service corporation

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as to the provider of hearing aids with which they choose to contract. Reimbursement shall be

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provided according to the respective principles and policies of the nonprofit medical service

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corporation. Nothing contained in this section precludes the nonprofit medical service corporation

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from conducting managed care, medical necessity, or utilization review.

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     SECTION 4. Section 27-41-63 of the General Laws in Chapter 27-41 entitled "Health

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Maintenance Organizations" is hereby amended to read as follows:

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     27-41-63. Hearing aids. -- (a) (1) Every individual or group health insurance contract, or

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every individual or group hospital or medical expense insurance policy, plan, or group policy

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delivered, issued for delivery, or renewed in this state on or after January 1, 2006 July 1, 2013,

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shall provide coverage for one thousand five hundred dollars ($1,500) per one individual hearing

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aid, per ear, every three (3) years for anyone under the age of nineteen (19) years, and shall

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provide coverage for seven hundred dollars ($700) one thousand five hundred dollars ($1,500)

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per individual hearing aid per ear, every three (3) years for anyone of the age of nineteen (19)

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years and older.

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      (2) Every group health insurance contract or group hospital or medical expense

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insurance policy, plan, or group policy delivered, issued for delivery, or renewed in this state on

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or after January 1, 2006 July 1, 2013, shall provide, as an optional rider, additional hearing aid

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coverage. Provided, the provisions of this paragraph shall not apply to contracts, plans, or group

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policies subject to the small employer health insurance availability act, chapter 50 of this title.

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      (b) For the purposes of this section, "hearing aid" means any nonexperimental, wearable

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instrument or device designed for the ear and offered for the purpose of aiding or compensating

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for impaired human hearing, but excluding batteries, cords, and other assistive listening devices,

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including, but not limited to FM systems.

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      (c) It shall remain within the sole discretion of the health maintenance organizations as

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to the provider of hearing aids with which they choose to contract. Reimbursement shall be

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provided according to the respective principles and policies of the health maintenance

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organizations. Nothing contained in this section precludes the health maintenance organizations

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from conducting managed care, medical necessity, or utilization review.

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     SECTION 5. This act shall take effect upon passage.

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LC00558

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO INSURANCE - HEARING AIDS

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     This act would increase hearing aid insurance coverage for those under the age of

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nineteen (19) from one thousand five hundred dollars ($1,500) to full cost, and for those age

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nineteen (19) and older from seven hundred dollars ($700) to one thousand five hundred dollars

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($1,500).

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     This act would take effect upon passage.

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LC00558

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