MISSISSIPPI LEGISLATURE
2012 Regular Session
To: Insurance; Public Health and Human Services
By: Representative Hines
AN ACT TO REQUIRE CERTAIN INSURERS, NONPROFIT HEALTH SERVICE PLANS AND MANAGED CARE ORGANIZATIONS TO PROVIDE COVERAGE FOR HEARING AIDS FOR DEPENDENT CHILDREN; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. (1) The following words and phrases shall have the meanings ascribed in this section unless the context clearly indicates otherwise:
(a) "Hearing aid" means a nondisposable electronic device that is designed to optimize a person's auditory capability.
(b) "Dependent" means a dependent child of an insured or enrolled individual less than twenty-one (21) years of age. However, if the insured or enrolled individual's insurance plan defines the term to include children older than twenty-one (21) years of age, the term "dependent" includes dependent children of the insured or enrolled individual that are the prescribed maximum age or younger.
(2) The section shall apply to the following entities:
(a) Insurers and nonprofit health service plans that provide hospital, medical or surgical benefits to individuals or groups on an expense-incurred basis under health insurance policies or contracts that are issued or delivered in this state.
(b) Managed care organizations as defined in Section 83-47-3 that provide hospital, medical or surgical benefits to individuals or groups under contracts that are issued or delivered in this state.
(3) (a) An entity described under subsection (2) of this section must provide coverage for hearing aids and medical testing necessary for the evaluation and/or fitting of a hearing aid for a dependent who is covered under a policy or contract of insurance, if the hearing aids are fitted and dispensed by a licensed professional following medical clearance from a physician licensed to practice medicine.
(b) An entity described under subsection (2) of this section may limit the benefit payable under paragraph (a) of this subsection (3) to One Thousand Five Hundred Dollars ($1,500.00) per hearing aid for each hearing-impaired ear within a thirty-six (36) month period.
(c) An entity described under subsection (2) of this section must provide coverage for up to four (4) additional ear molds per year for a dependent two (2) years of age or younger.
(d) A dependent may choose a hearing aid that is priced higher than the benefit payable under this subsection and may pay the difference between the price of the hearing aid and the benefit payable under this subsection without financial or contractual penalty to the provider of the hearing aid.
(e) In the case of a health insurer or managed care organization that administers benefits according to contracts with health care providers, hearing aids covered by this section must be obtained from health care providers contracted with the health insurer or managed care organization. These providers shall be subject to the same contracting requirements that apply to other contracted health care providers.
(4) This section does not prohibit an entity described under subsection (2) of this section from providing coverage that is greater or more favorable to an insured or enrolled individual than the coverage required under this section.
(5) The provisions of this section shall take effect and be in force from and after July 1, 2012, and shall apply to any new policy, contract, program or plan issued by an entity subject to the provisions of this section on or after July 1, 2012. Any such policy, contract, program or plan in effect prior to July 1, 2012, shall convert to the provisions of this section on or before the renewal date thereof, but in no event later than January 1, 2014. Any policy affected by the provisions of this section shall apply to an insured or participant under such policy, contract, program or plan whether or not the hearing impairment is a preexisting condition of the insured or participant.
SECTION 2. This act shall take effect and be in force from and after July 1, 2012.