BILL REQ. #:  H-2186.1 

READ FIRST TIME 02/28/05.   

     AN ACT Relating to coverage for hearing aids; adding a new section to chapter 41.05 RCW; adding a new section to chapter 48.20 RCW; adding a new section to chapter 48.21 RCW; adding a new section to chapter 48.44 RCW; adding a new section to chapter 48.46 RCW; creating a new section; and providing an effective date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   The legislature finds that the inability to purchase hearing aids adversely affects hearing-impaired people of all ages and impacts the employment and educational opportunities of hearing-impaired children and adults in Washington state by limiting communication options. To provide these individuals with equal opportunity and protect the well-being of the population, the legislature intends to establish insurance coverage provisions for hearing aids.

NEW SECTION.  Sec. 2   A new section is added to chapter 41.05 RCW to read as follows:
     All state-purchased health care that provides coverage for prostheses shall include coverage for hearing aids. Covered hearing instruments and related services shall be recommended by the patient's physician or advanced registered nurse practitioner as authorized by the nursing care quality assurance commission under chapter 18.79 RCW or physician assistant under chapter 18.71A or 18.57A RCW.
     This section shall not be construed to prevent the application of standard health plan provisions applicable to prosthesis benefits, such as deductibles, copayments, medical necessity, quantity limitations, or preauthorizations. This section does not limit the authority of the state health care authority to negotiate rates and contract with specific providers for the delivery of prostheses. The replacement of hearing aids shall be limited as follows: Every four years for an adult; every two years for children between the ages of two and eighteen; and no more than three times a year for infants and toddlers up to two years of age. This section does not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.

NEW SECTION.  Sec. 3   A new section is added to chapter 48.20 RCW to read as follows:
     An insurer that offers to any individual a health benefit plan that provides coverage for prostheses shall include coverage for hearing aids. Covered hearing instruments and related services shall be recommended by the patient's physician or advanced registered nurse practitioner as authorized by the nursing care quality assurance commission under chapter 18.79 RCW or physician assistant under chapter 18.71A or 18.57A RCW.
     This section shall not be construed to prevent the application of standard health plan provisions applicable to prosthesis benefits, such as deductibles, copayments, medical necessity, quantity limitations, or preauthorizations. This section does not limit the authority of a carrier to negotiate rates and contract with specific providers for the delivery of prostheses. The replacement of hearing aids shall be limited as follows: Every four years for an adult; every two years for children between the ages of two and eighteen; and no more than three times a year for infants and toddlers up to two years of age. This section does not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.

NEW SECTION.  Sec. 4   A new section is added to chapter 48.21 RCW to read as follows:
     A group insurance contract or blanket disability insurance contract that provides coverage for prostheses shall include coverage for hearing aids. Covered hearing instruments and related services shall be recommended by the patient's physician or advanced registered nurse practitioner as authorized by the nursing care quality assurance commission under chapter 18.79 RCW or physician assistant under chapter 18.71A or 18.57A RCW.
     This section shall not be construed to prevent the application of standard health plan provisions applicable to prosthesis benefits, such as deductibles, copayments, medical necessity, quantity limitations, or preauthorizations. This section does not limit the authority of a carrier to negotiate rates and contract with specific providers for the delivery of prostheses. The replacement of hearing aids shall be limited as follows: Every four years for an adult; every two years for children between the ages of two and eighteen; and no more than three times a year for infants and toddlers up to two years of age. This section does not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.

NEW SECTION.  Sec. 5   A new section is added to chapter 48.44 RCW to read as follows:
     A health service contractor that provides coverage for prostheses shall include coverage for hearing aids. Covered hearing instruments and related services shall be recommended by the patient's physician or advanced registered nurse practitioner as authorized by the nursing care quality assurance commission under chapter 18.79 RCW or physician assistant under chapter 18.71A or 18.57A RCW.
     This section shall not be construed to prevent the application of standard health plan provisions applicable to prosthesis benefits, such as deductibles, copayments, medical necessity, quantity limitations, or preauthorizations. This section does not limit the authority of the carrier to negotiate rates and contract with specific providers for the delivery of prostheses. The replacement of hearing aids shall be limited as follows: Every four years for an adult; every two years for children between the ages of two and eighteen; and no more than three times a year for infants and toddlers up to two years of age. This section does not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.

NEW SECTION.  Sec. 6   A new section is added to chapter 48.46 RCW to read as follows:
     A health maintenance organization that provides coverage for prostheses shall include coverage for hearing aids. Covered hearing instruments and related services shall be recommended by the patient's physician or advanced registered nurse practitioner as authorized by the nursing care quality assurance commission under chapter 18.79 RCW or physician assistant under chapter 18.71A or 18.57A RCW.
     This section shall not be construed to prevent the application of standard health plan provisions applicable to prosthesis benefits, such as deductibles, copayments, medical necessity, quantity limitations, or preauthorizations. This section does not limit the authority of the carrier to negotiate rates and contract with specific providers for the delivery of prostheses. The replacement of hearing aids shall be limited as follows: Every four years for an adult; every two years for children between the ages of two and eighteen; and no more than three times a year for infants and toddlers up to two years of age. This section does not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.

NEW SECTION.  Sec. 7   This act takes effect January 1, 2006.