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| | 102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB5514 Introduced 1/31/2022, by Rep. Natalie A. Manley SYNOPSIS AS INTRODUCED:
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| 215 ILCS 5/356z.30 | | 215 ILCS 5/356z.30a rep. | |
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Amends the Illinois Insurance Code. Provides that an individual or group policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed after the effective date of the amendatory Act must provide coverage for medically necessary hearing instruments and related services for all individuals (rather than all individuals under the age of 18) when a hearing care professional prescribes a hearing instrument to augment communication. Makes conforming changes, including repealing provisions concerning optional coverage or optional reimbursement for hearing instruments and related services. Effective January 1, 2024.
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| | A BILL FOR |
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| | HB5514 | | LRB102 25341 BMS 34618 b |
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| 1 | | AN ACT concerning regulation.
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| 2 | | Be it enacted by the People of the State of Illinois,
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| 3 | | represented in the General Assembly:
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| 4 | | Section 5. The Illinois Insurance Code is amended by |
| 5 | | changing Section 356z.30 as follows:
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| 6 | | (215 ILCS 5/356z.30) |
| 7 | | Sec. 356z.30. Coverage for hearing aids for individuals |
| 8 | | under the age of 18. |
| 9 | | (a) As used in this Section: |
| 10 | | "Hearing care professional" means a person who is a
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| 11 | | licensed hearing instrument dispenser, licensed audiologist, |
| 12 | | or licensed physician. |
| 13 | | "Hearing instrument" or "hearing aid" means any wearable
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| 14 | | non-disposable, non-experimental instrument or device designed |
| 15 | | to aid or
compensate for impaired human hearing and any parts, |
| 16 | | attachments, or accessories for the instrument or device, |
| 17 | | including
an ear mold but excluding batteries and cords. |
| 18 | | (b) An individual or group policy of accident and health
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| 19 | | insurance or managed care plan that is amended, delivered,
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| 20 | | issued, or renewed after the effective date of this amendatory |
| 21 | | Act of the 102nd General Assembly August 22, 2018 (the |
| 22 | | effective date of Public Act 100-1026) must provide coverage |
| 23 | | for
medically necessary hearing instruments and related |
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| | HB5514 | - 2 - | LRB102 25341 BMS 34618 b |
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| 1 | | services for all individuals under the age of 18
when a hearing |
| 2 | | care professional prescribes a hearing instrument to augment |
| 3 | | communication. |
| 4 | | (c) An insurer shall provide coverage, subject to all |
| 5 | | applicable co-payments, co-insurance, deductibles, and |
| 6 | | out-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 |
| 16 | | this amendatory Act of the 102nd General Assembly August 22, |
| 17 | | 2018 (the effective date of Public Act 100-1026), the |
| 18 | | Secretary of the United States Department of Health and Human |
| 19 | | Services, or its successor agency, promulgates rules or |
| 20 | | regulations to be published in the Federal Register, publishes |
| 21 | | a comment in the Federal Register, or issues an opinion, |
| 22 | | guidance, or other action that would require the State, |
| 23 | | pursuant to any provision of the Patient Protection and |
| 24 | | Affordable Care Act (Pub. L. 111–148), including, but not |
| 25 | | limited to, 42 U.S.C. 18031(d)(3)(B) or any successor |
| 26 | | provision, to defray the cost of coverage for medically |
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| | HB5514 | - 3 - | LRB102 25341 BMS 34618 b |
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| 1 | | necessary hearing instruments and related services for any |
| 2 | | individual individuals under the age of 18, then this Section |
| 3 | | is inoperative with respect to all such coverage other than |
| 4 | | that authorized under Section 1902 of the Social Security Act, |
| 5 | | 42 U.S.C. 1396a, and the State shall not assume any obligation |
| 6 | | for the cost of coverage for medically necessary hearing |
| 7 | | instruments and related services for any individual subject to |
| 8 | | federally defrayed cost of coverage individuals under the age |
| 9 | | of 18.
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| 10 | | (Source: P.A. 100-1026, eff. 8-22-18; 101-81, eff. 7-12-19.)
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| 11 | | (215 ILCS 5/356z.30a rep.) |
| 12 | | Section 10. The Illinois Insurance Code is amended by |
| 13 | | repealing Section 356z.30a.
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| 14 | | Section 99. Effective date. This Act takes effect January |
| 15 | | 1, 2024.
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