AB 2004, as introduced, Bloom. Hearing aids: minors.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law requires health care service plan contracts and health insurance policies to provide coverage for specified benefits.
This bill would require a health care service plan contract or a health insurance policy issued, amended, or renewed on or after January 1, 2017, to include coverage for hearing aids for an enrollee or insured under 18 years of age, as specified. Because a willful violation of these requirements by a health care service plan would be a crime, this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.
The people of the State of California do enact as follows:
Section 1367.72 is added to the Health and Safety
2Code, to read:
(a) (1) A health care service plan contract issued,
4amended, or renewed on or after January 1, 2017, shall include
5coverage for hearing aids for all enrollees under 18 years of age
6when medically necessary.
7(2) Coverage for hearing aids includes an initial assessment,
8new hearing aids at least every five years, new hearing aids if
9alterations to the existing hearing aids cannot meet the needs of
10the child, a new hearing aid if the existing one is no longer
11working, fittings, adjustments, auditory training, and maintenance
12of the hearing aids.
13(b) For purposes of this section, “hearing aid” means any
14nonexperimental, wearable instrument or device designed for
the
15ear and offered for the purpose of aiding or compensating for
16impaired human hearing, but excluding batteries and cords.
17(c) This section shall not apply to Medicare supplement,
18dental-only, or vision-only health care service plan contracts.
Section 10123.72 is added to the Insurance Code, to
20read:
(a) (1) A health insurance policy issued, amended,
22or renewed on or after January 1, 2017, shall include coverage for
23hearing aids for all insureds under 18 years of age when medically
24necessary.
25(2) Coverage for hearing aids includes an initial assessment,
26new hearing aids at least every five years, new hearing aids if
27alterations to the existing hearing aids cannot meet the needs of
28the child, a new hearing aid if the existing one is no longer
29working, fittings, adjustments, auditory training, and maintenance
30of the hearing aids.
31(b) For purposes of this section, “hearing aid” means any
32nonexperimental, wearable instrument or device designed for the
33ear
and offered for the purpose of aiding or compensating for
34impaired human hearing, but excluding batteries and cords.
P3 1(c) This section shall not apply to accident-only, specified
2disease, hospital indemnity, Medicare supplement, dental-only, or
3vision-only health insurance policies.
No reimbursement is required by this act pursuant to
5Section 6 of Article XIII B of the California Constitution because
6the only costs that may be incurred by a local agency or school
7district will be incurred because this act creates a new crime or
8infraction, eliminates a crime or infraction, or changes the penalty
9for a crime or infraction, within the meaning of Section 17556 of
10the Government Code, or changes the definition of a crime within
11the meaning of Section 6 of Article XIII B of the California
12Constitution.
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