Washington State House of Representatives Office of Program Research | BILL ANALYSIS |
Health Care & Wellness Committee |
HB 1264
This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent. |
Brief Description: Specifying medical assistance coverage for hearing devices for adults.
Sponsors: Representatives McBride, Harris, Blake, Appleton, Goodman, Kloba, Tarleton, Jinkins, Kilduff, Fey, Doglio, Ryu, Pollet and Dolan.
Brief Summary of Bill |
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Hearing Date: 1/25/17
Staff: Chris Blake (786-7392).
Background:
The Health Care Authority administers the Medicaid program which is a state-federal program that pays for health care for low-income state residents who meet certain eligibility criteria. Benefits under the program vary according to a person's eligibility category which is determined by several factors, including income, age, health condition, and disability status.
Hearing aid coverage is currently available for Medicaid clients who are twenty years old and younger once they have completed a hearing evaluation and received a referral for a hearing aid. In addition, adults who are enrolled for coverage through the Developmental Disability Administration at the Department of Social and Health Services may receive hearing aids. Coverage includes new monaural or binaural hearing aids, as well as ear molds, replacement parts, and repairs. Hearing aid coverage had been available for adults enrolled in Medicaid until the 2011-13 operating budget eliminated the benefit.
Summary of Bill:
By January 1, 2018, the Health Care Authority must provide coverage for hearing aids and related equipment and services to Medicaid enrollees who are 21 years old and over. The amount of coverage depends on the extent of hearing loss.
For persons with an average decibel loss of 45 or more in his or her better ear, coverage consists of the purchase of one new monaural hearing aid every five years, including ear molds and connecting wires, and a prefitting evaluation and follow up appointments. For hearing aids that are lost, damaged, or need maintenance, coverage also includes replacement, repair, reprogramming, and rental.
For persons with an average decibel loss of 56 or more in each ear, coverage consists of the purchase of two new hearing aids every five years, including ear molds and connecting wires, and a prefitting evaluation and follow up appointments. For hearing aids that are lost, damaged, or need maintenance, coverage also includes replacement, repair, reprogramming, and rental.
Persons with an average decibel loss of 45 or more in each ear who have tried to adapt with one hearing aid for at least six months may receive a second hearing aid. To receive the second hearing aid, the person must either be legally blind or have demonstrated that the inability to hear has resulted in difficulty with job performance or school.
Appropriation: None.
Fiscal Note: Requested on January 18, 2017.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.