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HOUSE DOCKET, NO. 780 FILED ON: 1/19/2011 HOUSE . . . . . . . . . . . . . . . No. 324
The Commonwealth of Massachusetts _________________ PRESENTED BY: John W. Scibak _______________ To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General The undersigned legislators and/or citizens respectfully petition for the passage of the accompanying: An Act to provide hearing aid coverage for persons with profound hearing loss . _______________ PETITION OF:
HOUSE DOCKET, NO. 780 FILED ON: 1/19/2011 HOUSE . . . . . . . . . . . . . . . No. 324
An Act to provide hearing aid coverage for persons with profound hearing loss . Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows: SECTION 1: Chapter 118E of the General Laws, as appearing in the 2004 Official Edition, is hereby amended by inserting after section 9C the following section:- Section 9D. (a) Definitions. As used in the section: (i) “Hearing Aid” shall mean any wearable, non-disposable instrument or device designed to aid or compensate for impaired or diminished human hearing; and any part, attachments, or accessories including earmolds but excluding batteries. In the event that any part of this definition conflicts with the definition of a hearing aid in section 196 of chapter 112 of the General Laws, this definition will take precedent for the purposes of this section. (ii) “Profound Hearing Loss” shall mean a pure tone average of 91 decibels (dB) or greater at 500Hz, 1000 Hz, and 2000 Hz. (iii) “Related Services” shall mean those services necessary to assess, select, and appropriately adjust or fit the hearing aid to ensure optimal performance.
(b) A health benefit plan shall provide 80 percent coverage, subject to all applicable co-payments, coinsurance, deductibles, and out-of-pocket limits, in the cost of one hearing aid and all related services per hearing impaired ear, every 24 months for insured individuals with bilateral profound hearing loss, which shall be prescribed by an audiologist or a hearing instrument specialist as defined in section 196 of chapter 12 of the General Laws, and dispensed by an audiologist or a hearing instrument specialist as defined in said section. (d) A health benefit plan shall not be required to pay a claim filed by its insured for payment of the cost of a hearing aid under the coverage required by subsection (2) of this section if less than 2 years prior to the date of the claim its insured filed a claim for payment of cost of a hearing aid under the required coverage and the claim was paid by any health benefit plan. |