Comparing SB 2268 → SB 6291 — Requiring coverage for hearing instruments for children a...

Struck = only in SB 2268 · added = only in SB 6291.

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SB2268 (As Introduced) - 2020 Regular Session MISSISSIPPI LEGISLATURE Regular Session To:
S-5340.1SENATE BILL 6291State of Washington66th Legislature2020 Regular SessionBySenators Van De Wege, Rolfes, Walsh, Hasegawa, Hunt, Keiser, Randall, Stanford, and Wilson, C.Read first time 01/15/20.Referred to Committee on Health & Long Term Care.AN ACT Relating to requiring coverage for hearing instruments for children and adolescents;
Insurance By:
amending RCW 48.43.0128;
Senator(s) Chism Senate Bill 2268 AN ACT TO REQUIRE THAT CERTAIN INSURANCE POLICIES AND CONTRACTS SHALL PROVIDE COVERAGE FOR HEARING AIDS AND SERVICES FOR DEAF AND HEARING IMPAIRED CHILDREN UNDER 21 YEARS OF AGE;
and adding a new section to chapter 48.43 RCW.BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:NEW SECTION.  Sec.
AND FOR RELATED PURPOSES.
1.
     BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
A new section is added to chapter 48.43 RCW to read as follows:(1) A health carrier offering a health plan issued or renewed on or after January 1, 2021, must include coverage for hearing instruments, including bone conduction hearing devices, for persons who are eighteen years of age or younger.(2) Coverage must include the hearing instrument, the initial assessment, fitting, adjustment, auditory training, and ear molds as necessary to maintain optimal fit.(3) The maximum benefit amount required by this section is two thousand five hundred dollars per hearing impaired ear every thirty-six months.
     SECTION 1.  (1)  All individual and group health insurance policies providing coverage on an expense-incurred basis, individual and group service or indemnity type contracts issued by a nonprofit corporation, individual and group service contracts issued by a health maintenance organization, all self-insured group arrangements to the extent not preempted by federal law and all managed health care delivery entities of any type or description that are delivered, issued for delivery, continued or renewed on or after July 1, 2020, and providing coverage to any resident of this state shall provide benefits or coverage for hearing aids and services for deaf and hearing impaired for dependent children under twenty-one (21) years of age who are covered under a policy or contract of insurance.  Coverage or benefits shall be provided when the prescribing physician has issued a written order stating that the dependent child is deaf or hearing impaired and that the treatment is medically cleared.
This benefit is not subject to the covered individual's deductible.(4) A covered individual may choose a higher priced hearing instrument and pay the difference between the price of the hearing instrument and the benefit required under this section, without financial or contractual penalty to the covered individual or to the provider of the hearing instrument.(5) The hearing instrument must be recommended by a licensed audiologist, hearing aid specialist, or a licensed physician or osteopathic physician who specializes in otolaryngology and dispensed by a licensed audiologist, hearing aid specialist, or a licensed physician or osteopathic physician who specializes in otolaryngology.(6) For the purposes of this section, "hearing instrument" and "hearing aid specialist" have the same meaning as defined in RCW 18.35.010.Sec.
Coverage or benefits shall be provided for all the hearing examinations and tests that are administered.  The coverage required under this section shall meet the requirements set forth in subsection (2) of this section.
2.
     (2)  A dependent child under twenty-one (21) years of age shall not be required to pay an additional deductible or coinsurance for testing that is greater than an annual deductible or coinsurance established for similar benefits.  If the program or contract does not cover a similar benefit, a deductible or coinsurance may not be set at a level that materially diminishes the value of the deaf or hearing impaired treatment required.  Reimbursement to health care providers for deaf or hearing impaired treatment provided under this section shall be equal to or greater than reimbursement to health care providers provided under the Medicaid program.
RCW 48.43.0128 and 2019 c 33 s 15 are each amended to read as follows:(1) A health carrier offering a nongrandfathered health plan in the individual or small group market may not:(a) In its benefit design or implementation of its benefit design, discriminate against individuals because of their age, expected length of life, present or predicted disability, degree of medical dependency, quality of life, or other health conditions;
     (3)  A group health plan or health insurance issuer is not required under this section to provide for a referral to a nonparticipating health care provider unless the plan or issuer does not have an appropriate health care provider that is available and accessible to administer the screening exam and that is a participating health care provider with respect to that treatment.
and(b) With respect to the health plan, discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, or sexual orientation.(2) Nothing in this section may be construed to prevent an issuer from appropriately utilizing reasonable medical management techniques.(3) Unless preempted by federal law, the commissioner shall adopt any rules necessary to implement this section, consistent with federal rules and guidance in effect on January 1, 2017, implementing the patient protection and affordable care act.(4) This section does not apply when a health carrier is complying with the mandate in section 1 of this act to provide benefits for hearing instruments for children.--- END ---
     (4)  If a plan or issuer refers a dependent child under twenty-one (21) years of age to a nonparticipating health care provider in accordance with this section, services provided according to the approved screening exam and resulting treatment, if any, shall be provided at no additional cost to the dependent child beyond what the dependent child would otherwise pay for services received by a participating health care provider.
     SECTION 2.  This act shall take effect and be in force from and after July 1, 2020.