Amended in Assembly March 9, 2016

California Legislature—2015–16 Regular Session

Assembly BillNo. 2004


Introduced by Assembly Member Bloom

February 16, 2016


An act to add Section 1367.72 to the Health and Safety Code, and to add Section 10123.72 to the Insurance Code, relating to health care coverage.

LEGISLATIVE COUNSEL’S DIGEST

AB 2004, as amended, 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:

P2    1

SECTION 1.  

Section 1367.72 is added to the Health and Safety
2Code
, to read:

3

1367.72.  

(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,begin insert new ear molds,end insert new
9hearing aids if alterations to the existing hearing aids cannot meet
10the needs of the child, a new hearing aid if the existing one is no
11longer working, fittings, adjustments, auditory training, and
12maintenance of the hearing aids.

13(b) For purposes of this section, “hearing aid” means begin delete 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.end delete
begin insert an
17electronic device usually worn in or behind the ear of a deaf and
18hard of hearing person for the purpose of amplifying sound.end insert

19(c) This section shall not apply to Medicare supplement,
20dental-only, or vision-only health care service plan contracts.

21

SEC. 2.  

Section 10123.72 is added to the Insurance Code, to
22read:

23

10123.72.  

(a) (1) A health insurance policy issued, amended,
24or renewed on or after January 1, 2017, shall include coverage for
25hearing aids for all insureds under 18 years of age when medically
26necessary.

27(2) Coverage for hearing aids includes an initial assessment,
28new hearing aids at least every five years,begin insert new ear molds,end insert new
29hearing aids if alterations to the existing hearing aids cannot meet
30the needs of the child, a new hearing aid if the existing one is no
31longer working, fittings, adjustments, auditory training, and
32maintenance of the hearing aids.

33(b) For purposes of this section, “hearing aid” means begin delete any
34nonexperimental, wearable instrument or device designed for the
35ear and offered for the purpose of aiding or compensating for
P3    1impaired human hearing, but excluding batteries and cords.end delete
begin insert end insertbegin insertan
2electronic device usually worn in or behind the ear of a deaf and
3hard of hearing person for the purpose of amplifying sound.end insert

4(c) This section shall not apply to accident-only, specified
5disease, hospital indemnity, Medicare supplement, dental-only, or
6vision-only health insurance policies.

7

SEC. 3.  

No reimbursement is required by this act pursuant to
8Section 6 of Article XIII B of the California Constitution because
9the only costs that may be incurred by a local agency or school
10district will be incurred because this act creates a new crime or
11infraction, eliminates a crime or infraction, or changes the penalty
12for a crime or infraction, within the meaning of Section 17556 of
13the Government Code, or changes the definition of a crime within
14the meaning of Section 6 of Article XIII B of the California
15Constitution.



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