HB2443 EnrolledLRB103 30349 BMS 56779 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by
5changing Section 356z.30 as follows:
 
6    (215 ILCS 5/356z.30)
7    Sec. 356z.30. Coverage for hearing aids for individuals
8under the age of 18.
9    (a) As used in this Section:
10    "Hearing care professional" means a person who is a
11licensed hearing instrument dispenser, licensed audiologist,
12or licensed physician.
13    "Hearing instrument" or "hearing aid" means any wearable
14non-disposable, non-experimental instrument or device designed
15to aid or compensate for impaired human hearing and any parts,
16attachments, or accessories for the instrument or device,
17including an ear mold but excluding batteries and cords.
18    (b) An individual or group policy of accident and health
19insurance or managed care plan that is amended, delivered,
20issued, or renewed after the effective date of this amendatory
21Act of the 103rd General Assembly August 22, 2018 (the
22effective date of Public Act 100-1026) must provide coverage
23for medically necessary hearing instruments and related

 

 

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1services for all individuals under the age of 18 when a hearing
2care professional prescribes a hearing instrument to augment
3communication.
4    (c) An insurer shall provide coverage, subject to all
5applicable co-payments, co-insurance, deductibles, and
6out-of-pocket limits, subject to the following restrictions:
7        (1) one hearing instrument shall be covered for each
8    ear every 36 months;
9        (2) related services, such as audiological exams and
10    selection, fitting, and adjustment of ear molds to
11    maintain optimal fit shall be covered when deemed
12    medically necessary by a hearing care professional; and
13        (3) hearing instrument repairs may be covered when
14    deemed medically necessary.
15    (d) If, at any time before or after the effective date of
16this amendatory Act of the 103rd General Assembly August 22,
172018 (the effective date of Public Act 100-1026), the
18Secretary of the United States Department of Health and Human
19Services, or its successor agency, promulgates rules or
20regulations to be published in the Federal Register, publishes
21a comment in the Federal Register, or issues an opinion,
22guidance, or other action that would require the State,
23pursuant to any provision of the Patient Protection and
24Affordable Care Act (Pub. L. 111–148), including, but not
25limited to, 42 U.S.C. 18031(d)(3)(B) or any successor
26provision, to defray the cost of coverage for medically

 

 

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1necessary hearing instruments and related services for any
2individual individuals under the age of 18, then this Section
3is inoperative with respect to all such coverage other than
4that authorized under Section 1902 of the Social Security Act,
542 U.S.C. 1396a, and the State shall not assume any obligation
6for the cost of coverage for medically necessary hearing
7instruments and related services for any individual subject to
8federally defrayed cost of coverage individuals under the age
9of 18.
10(Source: P.A. 100-1026, eff. 8-22-18; 101-81, eff. 7-12-19.)
 
11    Section 99. Effective date. This Act takes effect January
121, 2025.