2012 -- S 2323

=======

LC01296

=======

STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2012

____________

A N A C T

RELATING TO INSURANCE - HEARING AIDS

     Introduced By: Senators Gallo, Doyle, and Walaska

     Date Introduced: February 07, 2012

     Referred To: Senate Health & Human Services

It is enacted by the General Assembly as follows:

1-1

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

1-2

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

1-3

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

1-4

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

1-5

delivered, issued for delivery, or renewed in this state on or after January 1, 2006 July 1, 2012,

1-6

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

1-7

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

1-8

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

1-9

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

1-10

years and older.

1-11

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

1-12

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

1-13

or after January 1, 2006 July 1, 2012, shall provide, as an optional rider, additional hearing aid

1-14

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

1-15

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

1-16

      (b) For the purposes of this section:

1-17

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

1-18

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

1-19

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

1-20

systems.

2-1

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

2-2

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

2-3

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

2-4

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

2-5

care, medical necessity, or utilization review.

2-6

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

2-7

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

2-8

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

2-9

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

2-10

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

2-11

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

2-12

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

2-13

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

2-14

delivered, issued for delivery, or renewed in this state on or after January 1, 2006 July 1, 2012,

2-15

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

2-16

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

2-17

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

2-18

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

2-19

years and older.

2-20

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

2-21

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

2-22

or after January 1, 2006 July 1, 2012, shall provide, as an optional rider, additional hearing aid

2-23

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

2-24

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

2-25

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

2-26

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

2-27

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

2-28

including, but not limited to, FM systems.

2-29

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

2-30

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

2-31

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

2-32

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

2-33

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

3-34

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

3-35

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

3-36

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

3-37

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

3-38

delivered, issued for delivery, or renewed in this state on or after January 1, 2006 July 1, 2012,

3-39

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

3-40

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

3-41

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

3-42

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

3-43

years and older.

3-44

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

3-45

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

3-46

or after January 1, 2006 July 1, 2012, shall provide, as an optional rider, additional hearing aid

3-47

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

3-48

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

3-49

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

3-50

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

3-51

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

3-52

including, but not limited to, FM systems.

3-53

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

3-54

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

3-55

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

3-56

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

3-57

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

3-58

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

3-59

Maintenance Organizations" is hereby amended to read as follows:

3-60

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

3-61

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

3-62

delivered, issued for delivery, or renewed in this state on or after January 1, 2006 July 1, 2012,

3-63

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

3-64

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

3-65

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

3-66

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

3-67

years and older.

4-68

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

4-69

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

4-70

or after January 1, 2006 July 1, 2012, shall provide, as an optional rider, additional hearing aid

4-71

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

4-72

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

4-73

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

4-74

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

4-75

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

4-76

including, but not limited to FM systems.

4-77

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

4-78

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

4-79

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

4-80

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

4-81

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

4-82

     SECTION 5. This act shall take effect upon passage.

=======

LC01296

========

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO INSURANCE - HEARING AIDS

***

5-1

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

5-2

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

5-3

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

5-4

($1,500).

5-5

     This act would take effect upon passage.

=======

LC01296

=======