HOUSE DOCKET, NO. 4214        FILED ON: 3/14/2023

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 3554

The Commonwealth of Massachusetts

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PRESENTED BY:

Kristin E. Kassner

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act relative to insurance coverage of hearing aids.

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PETITION OF:

HOUSE DOCKET, NO. 4214        FILED ON: 3/14/2023

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 3554

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Third General Court
(2023-2024)

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An Act relative to insurance coverage of hearing aids.

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. Section 23 of chapter 32A of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by striking out the second paragraph and inserting in place thereof the following paragraph:--

            The commission shall provide to any active or retired employee of the commonwealth and to any child, who is under 26 years of age or without regard to age if such child is incapable of self-sustaining employment due to disability, of any active or retired employee of the commonwealth and who is insured under the group insurance commission, coverage for hearing aids, as defined in section 196 of chapter 112. Coverage under this section shall include all related services prescribed by a health care professional or a licensed audiologist or hearing instrument specialist, as defined in said section 196 of said chapter 112, including the initial hearing aid examination or evaluation, fitting and adjustments and supplies, including ear molds. Alternatively, if the insured is 18 years of age or older, no examination, evaluation or prescription shall be required for coverage for hearing aids. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than other benefits provided by the insurer. Nothing in this section shall prohibit the commission from offering greater coverage for hearing aids than required by this section. This section shall also require coverage for such hearing aids under any non-group policy.

SECTION 2. Chapter 118E of the General Laws, as so appearing, is hereby amended by inserting after section 10Q the following section:-

Section 10R. The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third-party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall provide coverage for hearing aids, as defined in section 196 of chapter 112. Coverage under this section shall include all related services prescribed by a health care professional or a licensed audiologist or hearing instrument specialist, as defined in said section 196 of said chapter 112, including the initial hearing aid examination or evaluation, fitting and adjustments and supplies, including ear molds. Alternatively, if the insured is 18 years of age or older, no examination, evaluation or prescription shall be required for coverage for hearing aids.

SECTION 3. Section 47X of chapter 175 of the General Laws, as so appearing is hereby amended by striking out the second paragraph and inserting in place thereof the following paragraph:-

            Any policy of accident and sickness insurance as described in section 108 which provides hospital expense and surgical expense insurance and which is delivered, issued or subsequently renewed by agreement between the insurer and policyholder in the commonwealth; any blanket or general policy of insurance described in subdivision (A), (C) or (D) of section 110 that provides hospital expense and surgical expense insurance and that is delivered, issued or subsequently renewed by agreement between the insurer and the policyholder, within or without the commonwealth; or any employees' health and welfare fund that provides hospital expense and surgical expense benefits and that is delivered, issued or renewed to any person or group of people in the commonwealth, shall provide coverage for hearing aids, as defined in section 196 of chapter 112 to the insured and to any child of the insured who is under 26 years of age or without regard to age if such child is incapable of self-sustaining employment due to disability. Coverage under this section shall include all related services prescribed by a health care professional or a licensed audiologist or hearing instrument specialist, as defined in said section 196 of said chapter 112, including the initial hearing aid examination or evaluation, fitting and adjustments and supplies, including ear molds. Alternatively, if the insured is 18 years of age or older, no examination, evaluation or prescription shall be required for coverage for hearing aids. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefits provided by the insurer. Nothing in this section shall prohibit an insurer from offering greater coverage for hearing aids than required by this section. This section shall also require coverage for hearing aids under any non-group policy.

SECTION 4. Section 8Y of chapter 176A of the General Laws, as so appearing is hereby amended by striking out the second paragraph and inserting in place thereof the following paragraph:-

            Any contracts, except contracts providing supplemental coverage to Medicare or other governmental programs, between a subscriber and the corporation under an individual or group hospital service plan that is delivered, issued or renewed in the commonwealth shall provide coverage for hearing aids, as defined in section 196 of chapter 112 to all individual subscribers or members within the commonwealth and to all group members having a principal place of employment in the commonwealth and to any child of such person who is under 26 years of age or without regard to age if such child is incapable of self-sustaining employment due to disability. Coverage under this section shall include all related services prescribed by a health care professional or a licensed audiologist or hearing instrument specialist, as defined in said section 196 of said chapter 112, including the initial hearing aid examination or evaluation, fitting and adjustments and supplies, including ear molds. Alternatively, if the insured is 18 years of age or older, no examination, evaluation or prescription shall be required for coverage for hearing aids. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefits provided by the insurer. Nothing in this section shall prohibit an insurer from offering greater coverage for hearing aids than required by this section. This section shall also require coverage for hearing aids under any non-group policy.

SECTION 5. Chapter 176B of the General Laws, as so appearing is hereby amended by striking out section 4EE and inserting in place thereof the following section:-

Section 4EE. Any subscription certificate under an individual or group medical service agreement, except certificates which provide supplemental coverage to Medicare or other governmental programs, that shall be delivered, issued or renewed within the commonwealth shall provide coverage for hearing aids, as defined in section 196 of chapter 112 to all individual subscribers or members within the commonwealth and to all group members having a principal place of employment in the commonwealth and to any child of such person who is under 26 years of age or without regard to age if such child is incapable of self-sustaining employment due to disability. Coverage under this section shall include all related services prescribed by a health care professional or a licensed audiologist or hearing instrument specialist, as defined in said section 196 of said chapter 112, including the initial hearing aid examination or evaluation, fitting and adjustments and supplies, including ear molds. Alternatively, if the insured is 18 years of age or older, no examination, evaluation or prescription shall be required for coverage for hearing aids. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefits provided by the insurer. Nothing in this section shall prohibit an insurer from offering greater coverage for hearing aids than required by this section. This section shall also require coverage for hearing aids under any non-group policy.

SECTION 6. Section 4N of chapter 176G of the General Laws, as so appearing, is hereby amended by striking out the second paragraph and inserting in place thereof the following paragraph:-

An individual or group health maintenance contract, except contracts providing supplemental coverage to Medicare or other governmental programs, shall provide coverage for hearing aids, as defined in section 196 of chapter 112 to the insured and to any child of the insured who is under 26 years of age or without regard to age if such child is incapable of self-sustaining employment due to disability. Coverage under this section shall include all related services prescribed by a health care professional or a licensed audiologist or hearing instrument specialist, as defined in said section 196 of said chapter 112, including the initial hearing aid examination or evaluation, fitting and adjustments and supplies, including ear molds. Alternatively, if the insured is 18 years of age or older, no examination, evaluation or prescription shall be required for coverage for hearing aids. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefits provided by the insurer. Nothing in this section shall prohibit an insurer from offering greater coverage for hearing aids than required by this section. This section shall also require coverage for hearing aids under any non-group policy.