2019 -- H 5121

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LC000524

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO INSURANCE - HEARING AIDS

     

     Introduced By: Representatives Vella-Wilkinson, Morin, Solomon, Bennett, and Millea

     Date Introduced: January 11, 2019

     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.

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     (a)(1) Every individual or group health insurance contract, or every individual or group

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hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

6

or renewed in this state on or after January 1, 2006 July 1, 2019, shall provide coverage for one

7

thousand five hundred dollars ($1,500) two thousand dollars ($2,000) per individual hearing aid,

8

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

9

coverage for seven hundred dollars ($700) per individual hearing aid, per ear, every three (3)

10

years for anyone of the age of nineteen (19) years and older.

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

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

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January 1, 2006 July 1, 2019, shall provide, as an optional rider, additional hearing aid coverage.

14

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

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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.

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     (a)(1) Every individual or group health insurance contract, or every individual or group

15

hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

16

or renewed in this state on or after January 1, 2006 July 1, 2019, shall provide coverage for one

17

thousand five hundred dollars ($1,500) two thousand dollars ($2,000) per individual hearing aid,

18

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

19

coverage for seven hundred dollars ($700) per individual hearing aid per ear, every three (3) years

20

for anyone of the age of nineteen (19) years and older.

21

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

22

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

23

January 1, 2006 July 1, 2019, shall provide, as an optional rider, additional hearing aid coverage.

24

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

25

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

26

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

27

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

28

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

29

including, but not limited to, FM systems.

30

     (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.

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     (a)(1) Every individual or group health insurance contract, or every individual or group

5

hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

6

or renewed in this state on or after January 1, 2006 July 1, 2019, shall provide coverage for one

7

thousand five hundred dollars ($1,500) two thousand dollars ($2,000) per individual hearing aid,

8

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

9

coverage for seven hundred dollars ($700) per individual hearing aid per ear, every three (3) years

10

for anyone of the age of nineteen (19) years and older.

11

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

12

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

13

January 1, 2006 July 1, 2019, shall provide, as an optional rider, additional hearing aid coverage.

14

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

15

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

16

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

17

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

18

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

19

including, but not limited to, FM systems.

20

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

21

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

22

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

23

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.

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     (a)(1) Every individual or group health insurance contract, or every individual or group

29

hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery,

30

or renewed in this state on or after January 1, 2006 July 1, 2019, shall provide coverage for one

31

thousand five hundred dollars ($1,500) two thousand dollars ($2,000) per individual hearing aid,

32

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

33

coverage for seven hundred dollars ($700) per individual hearing aid per ear, every three (3) years

34

for anyone of the age of nineteen (19) years and older.

 

LC000524 - Page 3 of 5

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

2

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

3

January 1, 2006 July 1, 2019, shall provide, as an optional rider, additional hearing aid coverage.

4

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

5

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

6

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

7

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

8

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

9

including, but not limited to FM systems.

10

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

11

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

12

according to the respective principles and policies of the health maintenance organizations.

13

Nothing contained in this section precludes the health maintenance organizations from

14

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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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE - HEARING AIDS

***

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     This act would increase insurance coverage for hearing aids from one thousand five

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hundred dollars ($1,500) to two thousand dollars ($2,000), per ear, every three (3) years. In

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addition, the amount of insurance coverage would no longer be based on the age of the recipient.

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     This act would take effect upon passage.

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