HB 561-FN – AS INTRODUCED
2009 SESSION
01/04
HOUSE BILL 561-FN
AN ACT relative to insurance coverage for persons having deafness and hearing loss.
SPONSORS: Rep. Emerson, Ches 7; Rep. Pilliod, Belk 5; Rep. Kopka, Hills 26; Sen. Cilley, Dist 6
COMMITTEE: Commerce and Consumer Affairs
This bill requires insurance for hearing evaluations, hearing aids, and the dispensing and fitting of hearing aids.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
09-0042
01/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Nine
AN ACT relative to insurance coverage for persons having deafness and hearing loss.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Coverage for Hearing Aids. Amend RSA 415 by inserting after section 6-o the following new section:
415:6-p Coverage for Hearing Aids. Each insurer that issues or renews any individual policy or certificate for delivery in this state, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide coverage for the professional services associated with the practice of fitting, dispensing, servicing, or sale of hearing instruments or hearing aids. The benefits included in this section shall not be subject to any greater deductible or coinsurance or copay than any other benefits provided by the insurer. Insurers are required to cover the cost of a hearing aid for each ear, as needed, as well as related services necessary to assess, select, and fit the hearing aid with a maximum of no less than $1,500 per hearing aid every 36 months. The insured may choose a higher price hearing aid and pay the difference in cost. The hearing aid shall be prescribed and dispensed by a licensed audiologist or hearing instrument specialist. The payment maximum in this section shall apply to the cost of the equipment only and not to the cost of professional services. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall apply to the medical assistance program, pursuant to RSA 161 and RSA 167. In this section:
I. “Hearing care professional” means a person who is a licensed audiologist, a licensed hearing instrument dispenser, or a licensed physician.
II. “Hearing instrument” or “hearing aid” means any instrument or device designed, intended, or offered for the purpose of improving a person’s hearing and any parts, attachments, or accessories, including earmolds. Batteries, cords, and individual or group auditory training devices and any instrument or device used by a public utility in providing telephone or other communication services are excluded.
III. “Hearing instrument dispenser” means a person who is a hearing care professional that engages in the selling, practice of fitting, selecting, recommending, dispensing, or servicing of hearing instruments or the testing for means of hearing instrument selection or who advertises or displays a sign or represents himself or herself as a person who practices the testing, fitting, selecting, servicing, dispensing, or selling of hearing instruments.
IV. “Practice of fitting, dispensing, servicing, or sale of hearing instruments” means the measurement of human hearing with an audiometer, calibrated to the current American National Standard Institute standards, for the purpose of making selections, recommendations, adoptions, services, or sales of hearing instruments including the making of earmolds as a part of the hearing instrument.
2 New Section; Coverage for Hearing Aids. Amend RSA 415 by inserting after section 18-t the following new section:
415:18-u Coverage for Hearing Aids. Each insurer that issues or renews any policy or certificate for delivery in this state of group or blanket accident or health insurance providing benefits for medical or hospital expenses, shall provide coverage for the professional services associated with the practice of fitting, dispensing, servicing, or sale of hearing instruments or hearing aids by a hearing instrument dispenser or other hearing care professional. The benefits included in this section shall not be subject to any greater deductible or coinsurance or copay than any other benefits provided by the insurer. Insurers are required to cover the cost of a hearing aid for each ear, as needed, as well as related services necessary to assess, select, and fit the hearing aid with a maximum of no less than $1,500 per hearing aid every 36 months. The insured may choose a higher price hearing aid and pay the difference in cost. The hearing aid shall be prescribed and dispensed by a licensed audiologist or hearing instrument specialist. The payment maximum in this section shall apply to the cost of the equipment only and not to the cost of professional services. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall apply to the medical assistance program, pursuant to RSA 161 and RSA 167. In this section:
I. “Hearing care professional” means a person who is a licensed audiologist, a licensed hearing instrument dispenser, or a licensed physician.
II. “Hearing instrument” or “hearing aid” means any instrument or device designed, intended, or offered for the purpose of improving a person’s hearing and any parts, attachments, or accessories, including earmolds. Batteries, cords, and individual or group auditory training devices and any instrument or device used by a public utility in providing telephone or other communication services are excluded.
III. “Hearing instrument dispenser” means a person who is a hearing care professional that engages in the selling, practice of fitting, selecting, recommending, dispensing, or servicing of hearing instruments or the testing for means of hearing instrument selection or who advertises or displays a sign or represents himself or herself as a person who practices the testing, fitting, selecting, servicing, dispensing, or selling of hearing instruments.
IV. “Practice of fitting, dispensing, servicing, or sale of hearing instruments” means the measurement of human hearing with an audiometer, calibrated to the current American National Standard Institute standards, for the purpose of making selections, recommendations, adoptions, services, or sales of hearing instruments including the making of earmolds as a part of the hearing instrument.
3 Coverage for Hearing Aids. Amend RSA 420-A:2 to read as follows:
420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:18, V, RSA 415:18, VII(g), RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-u, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.
4 Coverage for Hearing Aids. Amend RSA 420-B:20, III to read as follows:
III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:18, VII(g), RSA 415:18, VII-a, RSA 415:18-j, RSA 415:18-u, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.
5 Effective Date. This act shall take effect 60 days after its passage.
LBAO
09-0042
01/21/09
HB 461-FN - FISCAL NOTE
AN ACT relative to insurance coverage for persons having deafness and hearing loss.
FISCAL IMPACT:
The Insurance Department, Department of Administrative Services, New Hampshire Association of Counties, and New Hampshire Municipal Association states this bill may increase state revenue by $44,000 in FY 2009, $177,000 in FY 2010, $179,000 in FY 2011, $182,000 in FY 2012, and $185,000 in FY 2013, and increase state, county, and local expenditures by an indeterminable amount in FY 2009 and each year thereafter. This bill will have no fiscal impact on county and local revenue.
METHODOLOGY:
The Insurance Department states this bill mandates health insurance coverage of hearing aids and certain associated expenses. The Department also maintains that the state would not be subject to this mandate, as it is self-insured. The Department states to the extent health insurance premiums increase as a result of this bill, premium tax revenue will increase. Specifically, the Department’s actuary estimated that the bill’s impact on health insurance premiums would be around 0.6%. The Department collected approximately $88 million in premium tax in FY 2008, of which approximately 32.5% was attributable to health insurance premiums. Assuming an annual growth rate of 1.5%, the Department estimated an increase in premium tax revenue of approximately $44,000 prorated for the last quarter of FY 2009. Using these same assumptions, the Department estimated that the full year effect of the bill would be approximately $177,000 in FY 2010, $179,000 in FY 2011, $182,000 in FY 2012, and $185,000 in FY 2013.
While the state’s self-insurance plan would not be subject to the bill’s requirements, the Department of Administrative Services estimated the potential cost to the state if the plan did adopt the bill’s provisions. In conjunction with the plan’s current program medical administrator, the Department estimated the bill would add approximately 0.4% to current medical costs. Using this incremental rate, setting the base at the FY 2008 actual medical claim costs of $155,707,498, and assuming an annual growth rate of 10%, the Department estimated that the bill could increase state expenditures by $685,113 in FY 2009, $753,624 in FY 2010, $828,987 in FY 2011, $911,885 in FY 1012, and $1,003,074 in FY 2013.
The New Hampshire Association of Counties and the New Hampshire Municipal Association state to the extent that county and local health insurance providers do not currently cover the costs outlined in the bill, this bill may increase county and local expenditures in the form of higher health insurance premiums. The New Hampshire Municipal Association states this bill does not apply to pooled risk organizations; therefore it would not have a fiscal impact on those municipalities participating in a pooled risk organization. The exact fiscal impact cannot be determined at this time.