House File 2178 - Introduced HOUSE FILE 2178 BY MOMMSEN A BILL FOR An Act relating to health insurance coverage for hearing aids 1 for covered persons age eighteen and younger and including 2 applicability provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 5441YH (4) 87 ko/rj

H.F. 2178 Section 1. NEW SECTION . 514C.32 Hearing aid coverage for 1 covered persons age eighteen and younger. 2 1. Definitions. For the purposes of this section: 3 a. “Audiologist” means a person who engages in the practice 4 of audiology and is licensed in this state pursuant to chapter 5 154F. 6 b. “Cost sharing” means any coverage limit, copayment, 7 coinsurance, deductible, or other out-of-pocket expense 8 required by a health carrier. 9 c. “Health care professional” means the same as defined in 10 section 514J.102. 11 d. “Health care services” means the same as defined in 12 section 514J.102. 13 e. “Health carrier” means the same as defined in section 14 514J.102. 15 f. “Hearing aid” means the same as defined in section 16 154A.1. 17 g. “Hearing aid fitting” means the same as defined in 18 section 154A.1. 19 h. “Hearing aid specialist” means the same as defined in 20 section 154A.1. 21 i. “Practice of audiology” means the same as defined in 22 section 154F.1. 23 2. Required coverage. 24 a. Notwithstanding the uniformity of treatment requirements 25 of section 514C.6, a health carrier that offers individual, 26 group, or small group contracts, policies, or plans in this 27 state that provide for third-party payment or prepayment of 28 health or medical expenses shall offer coverage for the cost 29 of a hearing aid as recommended by a health care professional 30 or audiologist for a covered person who is age eighteen or 31 younger. 32 b. Coverage required under this section shall include all 33 of the following: 34 (1) Hearing aid fitting and dispensing services conducted 35 -1- LSB 5441YH (4) 87 ko/rj 1/ 4

H.F. 2178 by a hearing aid specialist, audiologist, or health care 1 professional. 2 (2) The provision of ear molds as necessary to maintain 3 optimal fit of hearing aids. 4 (3) Any health care services related to a hearing 5 aid, including audiological habilitation or audiological 6 rehabilitation, as recommended by a health care professional 7 or audiologist. 8 c. Coverage required under this section is limited to one 9 hearing aid for each ear during a three-year period for a 10 covered person who is age eighteen or younger. 11 d. Coverage required under this section shall not be less 12 favorable than coverage a health carrier offers for general 13 physical illness. 14 e. Cost sharing requirements imposed for coverage required 15 under this section shall not be less favorable than cost 16 sharing requirements imposed by a health carrier for general 17 physical illness. 18 3. Rules. The commissioner shall adopt rules pursuant to 19 chapter 17A to administer this section. 20 4. Applicability. 21 a. This section shall apply to the following classes of 22 third-party payment provider contracts, policies, or plans 23 delivered, issued for delivery, continued, or renewed in this 24 state on or after January 1, 2019: 25 (1) Individual or group accident and sickness insurance 26 providing coverage on an expense-incurred basis. 27 (2) An individual or group hospital or medical service 28 contract issued pursuant to chapter 509, 514, or 514A. 29 (3) An individual or group health maintenance organization 30 contract regulated under chapter 514B. 31 (4) A plan established for public employees pursuant to 32 chapter 509A. 33 b. This section shall not apply to accident-only, 34 specified disease, short-term hospital or medical, hospital 35 -2- LSB 5441YH (4) 87 ko/rj 2/ 4

H.F. 2178 confinement indemnity, credit, dental, vision, Medicare 1 supplement, long-term care, basic hospital and medical-surgical 2 expense coverage as defined by the commissioner, disability 3 income insurance coverage, coverage issued as a supplement 4 to liability insurance, workers’ compensation or similar 5 insurance, or automobile medical payment insurance. 6 EXPLANATION 7 The inclusion of this explanation does not constitute agreement with 8 the explanation’s substance by the members of the general assembly. 9 This bill relates to health insurance coverage for hearing 10 aids for covered persons age 18 and younger. The bill requires 11 a health carrier that offers individual, group, or small group 12 contracts, policies, or plans in this state that provide for 13 third-party payment or prepayment of health or medical expenses 14 to offer coverage for a hearing aid as recommended by a health 15 care professional or audiologist. 16 The bill requires the coverage to include hearing aid 17 fitting and dispensing services conducted by a hearing aid 18 specialist, audiologist, or health care professional. The 19 coverage must include ear molds as necessary to maintain 20 optimal hearing aid fit. The bill also requires coverage of 21 any health care services related to a hearing aid, including 22 audiological habilitation or audiological rehabilitation, as 23 recommended by a health care professional or audiologist. 24 The bill limits coverage to one hearing aid for each ear 25 during a three-year period for a covered person age 18 or 26 younger. 27 The bill requires that coverage under this Code section 28 shall not be less favorable than coverage a health carrier 29 offers for general physical illness. Health carriers 30 are prohibited from imposing less favorable cost sharing 31 requirements than those imposed by the health carrier for 32 general physical illnesses. 33 The commissioner is required to adopt rules to administer 34 the requirements of the bill. 35 -3- LSB 5441YH (4) 87 ko/rj 3/ 4

H.F. 2178 The bill applies to third-party payment provider contracts, 1 policies, or plans delivered, issued for delivery, continued, 2 or renewed in this state on or after January 1, 2019, by the 3 third-party payment providers enumerated in the bill. 4 The bill specifies the types of specialized health related 5 insurance which are not subject to the coverage requirements 6 of the bill. 7 -4- LSB 5441YH (4) 87 ko/rj 4/ 4