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FIRST REGULAR
SESSION
SENATE BILL NO. 274
92ND GENERAL ASSEMBLY
INTRODUCED BY SENATOR CASKEY.
AN ACT
To amend chapter 376, RSMo, by adding thereto one new section
relating to health insurance coverage for children's hearing aids.
Be it enacted by the General Assembly of the State
of Missouri, as follows:
Section A. Chapter 376, RSMo, is amended by adding thereto one new
section, to be known as section 376.1221, to read as follows:
376.1221.1.Every health insurer and health benefit plan, as defined
in section 376.1350, offering health benefit plans that are
delivered, issued for delivery, continued, or renewed after January
1, 2004, shall provide coverage for hearing aids and associated
hearing evaluations and consumable supplies that are prescribed and
dispensed by appropriately licensed professionals to dependent
children through age nineteen under a policy, contract, or plan.
2.The hearing aids covered pursuant to this section
shall:
(1)Be an electronic, wearable device designed for the purpose of
aiding or compensating for human hearing loss and any parts,
attachments, or accessories, including earmolds;
(2)Be of a design and circuitry to optimize audibility and listening
skills in the environment commonly experienced by children; and
(3)Have multiple-band wide dynamic range compression and direct
audio input compatibility.
3.The coverage provided by this section shall
include coverage for replacement hearing aids for the child at least
once every three years.
4.A health insurer or health benefit plan subject to
this section shall not cap the benefit payable for hearing aids to
less than one thousand two hundred fifty dollars per hearing aid for
each ear with a hearing loss. An insured or enrollee may choose a
hearing aid that costs more than the benefit payable and may pay the
difference between the cost of the hearing aid and the benefit
payable without financial or contractual penalty to the provider of
the hearing aid.
5.Nothing in this section shall prohibit a health
insurer or health benefit plan from providing coverage that is
greater than or more favorable to enrollees than the coverage
provided by this section.
6.The health care service required by this section
shall not be subject to a deductible or co-payment that exceeds
twenty percent of the actual covered service costs. No health
insurer or health benefit plan subject to this section shall request
or require hearing acuity information from or about persons applying
for coverage.
7.This section shall not apply to a supplemental
insurance policy, including a life care contract, accident-only
policy, specified disease policy, hospital policy providing a fixed
daily benefit only, Medicare supplement policy, long-term care
policy, short-term major medical policies of six months or less
duration, or any other supplemental policy as determined by the
director of the department of insurance.
8.The director of the department of insurance may
promulgate rules to implement the provisions of this section. Any
rule or portion of a rule, as that term is defined in section
536.010, RSMo, that is created under the authority delegated in this
section shall become effective only if it complies with and is
subject to all of the provisions of chapter 536, RSMo, and, if
applicable, section 536.028, RSMo. This section and chapter 536,
RSMo, are nonseverable and if any of the powers vested with the
general assembly pursuant to chapter 536, RSMo, to review, to delay
the effective date or to disapprove and annul a rule are
subsequently held unconstitutional, then the grant of rulemaking
authority and any rule proposed or adopted after August 28, 2003,
shall be invalid and void. |
