Chapter
395
2005 -- H 5742 SUBSTITUTE A
Enacted 07/19/05
A N A C T
RELATING TO HEALTH
INSURANCE COVERAGE -- MANDATED HEARING AID
COVERAGE
Introduced By: Representatives Jacquard, Lewiss, and Schadone
Date Introduced: February
17, 2005
It is enacted
by the General Assembly as follows:
SECTION
1. Section 27-18-60 of the General Laws in Chapter 27-18 entitled
"Accident
and
Sickness Insurance Policies" is hereby amended to read as follows:
27-18-60.
Hearing aids. -- (a) (1) Every individual or group health
insurance contract, or
every
individual or group hospital or medical expense insurance policy, plan, or
group policy
delivered,
issued for delivery, or renewed in this state on or after January 1, 2005
2006, shall
provide coverage
for one thousand dollars ($1,000) four hundred dollars ($400) per
individual
hearing
aid, per ear, every three (3) years, for children under the age of eighteen
(18) years of age,
covered
as a dependent by the policy holder and shall also provide, as an optional
rider, coverage
for
hearing aids.
(2)
Every group health insurance contract or group hospital or medical expense
insurance
policy,
plan, or group policy delivered, issued for delivery, or renewed in this state
on or after
January
1, 2006, shall provide, as an optional rider, additional hearing aid coverage.
Provided, the
provisions
of this paragraph shall not apply to contracts, plans, or group policies
subject to the
small
employer health insurance availability act, chapter 50 of this title.
(b) For the purposes of this section:
(1) "Hearing aid" means any nonexperimental, wearable instrument or
device designed
for the
ear and offered for the purpose of aiding or compensating for impaired human
hearing, but
excluding
batteries, cords, and other assistive listening devices, including, but not
limited to FM
systems.
(c) It shall remain within the sole discretion of the accident and sickness
insurer as to the
provider
of hearing aids with which they choose to contract. Reimbursement shall be
provided
according
to the respective principles and policies of the accident and sickness insurer.
Nothing
contained
in this section precludes the accident and sickness insurer from conducting
managed
care,
medical necessity, or utilization review.
(d) This section does not apply to insurance coverage providing benefits for:
(1) hospital
confinement
indemnity; (2) disability income; (3) accident only; (4) long term care; (5)
Medicare
supplement;
(6) limited benefit health; (7) specified diseased indemnity; (8) sickness of
bodily
injury
or death by accident or both; (9) and other limited benefit policies;
and (10) contracts,
plans
or group policies subject to the Small Employer Health Insurance Availability
Act, chapter
50 of
this title.
SECTION
2. Section 27-19-51 of the General Laws in Chapter 27-19 entitled
"Nonprofit
Hospital
Service Corporations" is hereby amended to read as follows:
27-19-51.
Hearing aids. -- (a) (1) Every individual or group health
insurance contract, or
every
individual or group hospital or medical expense insurance policy, plan, or
group policy
delivered,
issued for delivery, or renewed in this state on or after January 1, 2005
2006, shall
provide
coverage for one thousand dollars ($1,000) four hundred dollars
($400) per individual
hearing
aid, per ear, every three (3) years, for children under the age of eighteen
(18) years of age,
covered
as a dependent by the policy holder and shall also provide, as an optional
rider, coverage
for
hearing aids.
(2)
Every group health insurance contract or group hospital or medical expense
insurance
policy,
plan, or group policy delivered, issued for delivery, or renewed in this state
on or after
January
1, 2006, shall provide, as an optional rider, additional hearing aid coverage.
Provided, the
provisions
of this paragraph shall not apply to contracts, plans, or group policies
subject to the
small
employer health insurance availability act, chapter 50 of this title.
(b) For the purposes of this section, "hearing aid" means any
nonexperimental, wearable
instrument
or device designed for the ear and offered for the purpose of aiding or
compensating
for
impaired human hearing, but excluding batteries, cords, and other assistive
listening devices,
including,
but not limited to, FM systems.
(c) It shall remain within the sole discretion of the nonprofit hospital
service corporation
as to
the provider of hearing aids with which they choose to contract. Reimbursement
shall be
provided
according to the respective principles and policies of the nonprofit hospital
service
corporation.
Nothing contained in this section precludes the nonprofit hospital service
corporation
from
conducting managed care, medical necessity, or utilization review.
(d) This section does not apply to contract plans or group policies subject
to the Small
Employer
Health Insurance Availability Act, chapter 50 of this title.
SECTION
3. Section 27-20-46 of the General Laws in Chapter 27-20 entitled
"Nonprofit
Medical
Service Corporations" is hereby amended to read as follows:
27-20-46.
Hearing aids. -- (a) (1) Every individual or group health
insurance contract, or
every individual
or group hospital or medical expense insurance policy, plan, or group policy
delivered,
issued for delivery, or renewed in this state on or after January 1, 2005
2006, shall
provide
coverage for one thousand dollars ($1,000) four hundred dollars
($400) per individual
hearing
aid, per ear, every three (3) years, for children under the age of eighteen
(18) years of age,
covered
as a dependent by the policy holder, as an optional rider, coverage for hearing
aids.
(2)
Every group health insurance contract or group hospital or medical expense
insurance
policy,
plan, or group policy delivered, issued for delivery, or renewed in this state
on or after
January
1, 2006, shall provide, as an optional rider, additional hearing aid coverage.
Provided, the
provisions
of this paragraph shall not apply to contracts, plans, or group policies
subject to the
small
employer health insurance availability act, chapter 50 of this title.
(b) For the purposes of this section, "hearing aid" means any
nonexperimental, wearable
instrument
or device designed for the ear and offered for the purpose of aiding or
compensating
for
impaired human hearing, but excluding batteries, cords, and other assistive
listening devices,
including,
but not limited to, FM systems.
(c) It shall remain within the sole discretion of the nonprofit medical service
corporation
as to
the provider of hearing aids with which they choose to contract. Reimbursement
shall be
provided
according to the respective principles and policies of the nonprofit medical
service
corporation.
Nothing contained in this section precludes the nonprofit medical service
corporation
from
conducting managed care, medical necessity, or utilization review.
(d) This section does not apply to contract plans or group policies subject
to the Small
Employer
Health Insurance Availability Act, chapter 50 of this title.
SECTION
4. Section 27-41-63 of the General Laws in Chapter 27-41 entitled "Health
Maintenance
Organizations" is hereby amended to read as follows:
27-41-63.
Hearing aids. -- (a) (1) Every individual or group health
insurance contract, or
every
individual or group hospital or medical expense insurance policy, plan, or
group policy
delivered,
issued for delivery, or renewed in this state on or after January 1, 2005
2006, shall
provide
coverage for one thousand dollars ($1,000) four hundred dollars
($400) per individual
hearing
aid, per ear, every three (3) years, for children under the age of eighteen
(18) years of age,
covered
as a dependent by the policy holder, as an optional rider, coverage for hearing
aids.
(2)
Every group health insurance contract or group hospital or medical expense
insurance
policy,
plan, or group policy delivered, issued for delivery, or renewed in this state
on or after
January
1, 2006, shall provide, as an optional rider, additional hearing aid coverage.
Provided, the
provisions
of this paragraph shall not apply to contracts, plans, or group policies
subject to the
small
employer health insurance availability act, chapter 50 of this title.
(b) For the purposes of this section, "hearing aid" means any
nonexperimental, wearable
instrument
or device designed for the ear and offered for the purpose of aiding or
compensating
for
impaired human hearing, but excluding batteries, cords, and other assistive
listening devices,
including,
but not limited to FM systems.
(c) It shall remain within the sole discretion of the health maintenance
organizations as
to the
provider of hearing aids with which they choose to contract. Reimbursement
shall be
provided
according to the respective principles and policies of the health maintenance
organizations.
Nothing contained in this section precludes the health maintenance
organizations
from
conducting managed care, medical necessity, or utilization review.
(d) Provided, that this section does not apply to contracts, plans or group
policies subject
to
the Small Employer Health Insurance Availability Act, chapter 50 of this title.
SECTION 5. This act shall
take effect January 1, 2006.
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LC00628/SUB A
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