,,ii  #aai? ,,congress  #a/ ,session    
,s4 #cdjj  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,decemb] #i1 #bjbe,mr4 
,curtis 7= himself1 ,ms4 ,w>r51 ,mrs4   
,capito1 ,mr4 ,hick5loop]1 & ,mr4       
,w>nock7 introduc$ ! foll[+ bill2 :i* 0 
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d title ,,xxvii ( !   
,public ,heal? ,s]vice ,act1 ! ,employee
 ,retirem5t ,income ,security ,act (    
#aigd1 ! ,int]nal ,rev5ue ,code ( #aihf1
 & ! ,pati5t ,protection & ,af=dable    
,c>e ,act to require cov]age ( he>+     
devices & sy/ems 9 c]ta9 private heal?  
insurance plans1 & = o!r purposes4  #a4 
,%ort title ,?is ,act may be cit$ z     
,ally's ,act4  #b4 ,cov]age ( he>+      
devices & sy/ems 9 c]ta9 private heal?  
insurance plans  7a7 ,,phsa ,"p ,d ( !  
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjj;gg-#aaa et seq47 is am5d$
 by add+ at ! end ! foll[+ new section3 
#bgii;,a-#aa4 ,cov]age ( he>+ devices & 
sy/ems  7a7 ,9 g5]al ,a gr\p heal? plan 

& a heal? insurance issu] (f]+ gr\p or  
individual heal? insurance cov]age %all 
at a m9imum provide cov]age = ! foll[+  
items & s]vices furni%$ to a qualify+   
individual3 7#a7 ,auditory implant      
devices 7includ+ auditory osseo9tegrat$ 
7bone conduction7 implants & co*le>     
implants7 & ext]nal s\nd processors4    
7#b7 ,! ma9t5ance ( auditory implant    
devices & ext]nal s\nd processors       
describ$ 9 p>agraph 7#a74  7#c7 ,e #e   
ye>s1 ! upgrade 7or replacem5t if an    
upgrade is n available7 ( auditory      
implant devices & ext]nal s\nd          
processors describ$ 9 p>agraph 7#a74    
7#d7 ,adhesive adapt]s & s(tb& headb&s4 
7#e7 ,! repair ( auditory implant       
devices & ext]nal s\nd processors       
describ$ 9 p>agraph 7#a74  7#f7 ,a      
compreh5sive he>+ assessm5t4  7#g7 ,a   
preop]ative m$ical assessm5t4  7#h7     
,surg]y relat+ to ! furni%+ ( su*       
devices & processors 7z det]m9$ necess>y
 by a physician or qualifi$ audiologi/  
7z su* t]ms are def9$ 9 subsection 7d77 

treat+ su* individual74  7#i7           
,po/op]ative m$ical visits = purposes ( 
ensur+ appropriate recov]y f su* surg]y4
  7#aj7 ,po/op]ative audiological visits
 = activation & fitt+ ( su* devices &   
processors4  7#aa7 ,aural rehabilitation
 & treatm5t s]vices 7z s det]m9$        
necess>y74  7b7 ,cov]age requirem5ts ,9 
! case ( an item or s]vice describ$ 9   
subsection 7a7 furni%$ to a qualify+    
individual "u a gr\p heal? plan or gr\p 
or individual heal? insurance cov]age1  
su* plan or cov]age %all ensure t-- 7#a7
 ! f9ancial requirem5ts 7z def9$ 9      
section #bgbf7;a77#c77 applicable to su*
 item or s]vice are no m re/rictive ?an 
! pr$om9ant f9ancial requirem5ts appli$ 
to sub/antially all m$ical & surgical   
b5efits cov]$ by ! plan or cov]age 7z   
applicable71 & t !re are no sep>ate co/ 
%>+ requirem5ts t are applicable only ) 
respect to su* item or s]vice2 &  7#b7 !
 treatm5t limitations 7z def9$ 9 su*    
section7 applicable to su* item or      
s]vice are no m re/rictive ?an !        

pr$om9ant treatm5t limitations appli$ to
 sub/antially all m$ical & surgical     
b5efits cov]$ by ! plan or cov]age 7z   
applicable71 & t !re are no sep>ate     
treatm5t limitations t are applicable   
only ) respect to su* item or s]vice4   
7c7 ,prohibition on review ( m$ical     
necessity ,a gr\p heal? plan & a heal?  
insurance issu] (f]+ gr\p or individual 
heal? insurance cov]age may n d5y or    
o!rwise limit cov]age ( any item or     
s]vice describ$ 9 subsection 7a7 :]e su*
 item or s]vice has be5 det]m9$ to be   
m$ically necess>y by a physician or     
qualifi$ audiologi/ 7z su* t]ms are     
def9$ 9 subsection 7d774  7d7 ,qualify+ 
individual def9$ ,= purposes ( ?is      
section1 ! t]m qualify+ individual means
 an individual t a physician 7z def9$ 9 
section #ahfa7r7 ( ! ,social ,security  
,act7 or qualifi$ audiologi/ 7z def9$ 9 
section #ahfa7ll77#d77;,b7 ( su* ,act7  
det]m9es meets an indication 7includ+   
unilat]al or bilat]al he>+ loss7 = an   
auditory implant device & ext]nal s\nd  

processor describ$ 9 subsection 7a77#a74
  4  7b7 ,,erisa  7#a7 ,9 g5]al ,subp>t 
,b ( "p #g ( subtitle ,b ( title ,i ( ! 
,employee ,retirem5t ,income ,security  
,act ( #aigd 7#bi ,u4,s4,c4 #aahe et    
seq47 by add+ at ! end ! foll[+ new     
section3  #gbf4 ,cov]age ( he>+ devices 
& sy/ems  7a7 ,9 g5]al ,a gr\p heal?    
plan & a heal? insurance issu] (f]+ gr\p
 heal? insurance cov]age %all at a      
m9imum provide cov]age = ! foll[+ items 
& s]vices furni%$ to a qualify+         
individual3 7#a7 ,auditory implant      
devices 7includ+ auditory osseo9tegrat$ 
7bone conduction7 implants & co*le>     
implants7 & ext]nal s\nd processors4    
7#b7 ,! ma9t5ance ( auditory implant    
devices & ext]nal s\nd processors       
describ$ 9 p>agraph 7#a74  7#c7 ,e #e   
ye>s1 ! upgrade 7or replacem5t if an    
upgrade is n available7 ( auditory      
implant devices & ext]nal s\nd          
processors describ$ 9 p>agraph 7#a74    
7#d7 ,adhesive adapt]s & s(tb& headb&s4 
7#e7 ,! repair ( auditory implant       

devices & ext]nal s\nd processors       
describ$ 9 p>agraph 7#a74  7#f7 ,a      
compreh5sive he>+ assessm5t4  7#g7 ,a   
preop]ative m$ical assessm5t4  7#h7     
,surg]y relat+ to ! furni%+ ( su*       
devices & processors 7z det]m9$ necess>y
 by a physician or qualifi$ audiologi/  
7z su* t]ms are def9$ 9 subsection 7d77 
treat+ su* individual74  7#i7           
,po/op]ative m$ical visits = purposes ( 
ensur+ appropriate recov]y f su* surg]y4
  7#aj7 ,po/op]ative audiological visits
 = activation & fitt+ ( su* devices &   
processors4  7#aa7 ,aural rehabilitation
 & treatm5t s]vices 7z s det]m9$        
necess>y74  7b7 ,cov]age requirem5ts ,9 
! case ( an item or s]vice describ$ 9   
subsection 7a7 furni%$ to a qualify+    
individual "u a gr\p heal? plan or gr\p 
heal? insurance cov]age1 su* plan or    
cov]age %all ensure t-- 7#a7 ! f9ancial 
requirem5ts 7z def9$ 9 section          
#gab7;a77#c77 applicable to su* item or 
s]vice are no m re/rictive ?an !        
pr$om9ant f9ancial requirem5ts appli$ to

 sub/antially all m$ical & surgical     
b5efits cov]$ by ! plan or cov]age 7z   
applicable71 & t !re are no sep>ate co/ 
%>+ requirem5ts t are applicable only ) 
respect to su* item or s]vice2 &  7#b7 !
 treatm5t limitations 7z def9$ 9 su*    
section7 applicable to su* item or      
s]vice are no m re/rictive ?an !        
pr$om9ant treatm5t limitations appli$ to
 sub/antially all m$ical & surgical     
b5efits cov]$ by ! plan or cov]age 7z   
applicable71 & t !re are no sep>ate     
treatm5t limitations t are applicable   
only ) respect to su* item or s]vice4   
7c7 ,prohibition on review ( m$ical     
necessity ,a gr\p heal? plan & a heal?  
insurance issu] (f]+ gr\p heal?         
insurance cov]age may n d5y or o!rwise  
limit cov]age ( any item or s]vice      
describ$ 9 subsection 7a7 :]e su* item  
or s]vice has be5 det]m9$ to be m$ically
 necess>y by a physician or qualifi$    
audiologi/ 7z su* t]ms are def9$ 9      
subsection 7d774  7d7 ,qualify+         
individual def9$ ,= purposes ( ?is      

section1 ! t]m qualify+ individual means
 an individual t a physician 7z def9$ 9 
section #ahfa7r7 ( ! ,social ,security  
,act 7#db ,u4,s4,c4 #aciex7r777 or      
qualifi$ audiologi/ 7z def9$ 9 section  
#ahfa7ll77#d77;,b7 ( su* ,act 7#db      
,u4,s4,c4 #aciex7ll77#d77;,b777 det]m9es
 meets an indication 7includ+ unilat]al 
or bilat]al he>+ loss7 = an auditory    
implant device & ext]nal s\nd processor 
describ$ 9 subsection 7a77#a74  4  7#b7 
,cl]ical am5dm5t ,! table ( cont5ts 9   
section #a ( ! ,employee ,retirem5t     
,income ,security ,act ( #aigd 7#bi     
,u4,s4,c4 #ajja et seq47 is am5d$ by    
ins]t+ aft] ! item relat+ to section    
#gbe ! foll[+ new item3  ,sec4 #gbf4    
,cov]age ( he>+ devices & sy/ems4  4    
7c7 ,,irc  7#a7 ,9 g5]al ,sub*apt] ,b ( 
*apt] #ajj ( ! ,int]nal ,rev5ue ,code ( 
#aihf is am5d$ by add+ at ! end ! foll[+
 new section3  #ihbf4 ,cov]age ( he>+   
devices & sy/ems  7a7 ,9 g5]al ,a gr\p  
heal? plan %all at a m9imum provide     
cov]age = ! foll[+ items & s]vices      

furni%$ to a qualify+ individual3 7#a7  
,auditory implant devices 7includ+      
auditory osseo9tegrat$ 7bone conduction7
 implants & co*le> implants7 & ext]nal  
s\nd processors4  7#b7 ,! ma9t5ance (   
auditory implant devices & ext]nal s\nd 
processors describ$ 9 p>agraph 7#a74    
7#c7 ,e #e ye>s1 ! upgrade 7or          
replacem5t if an upgrade is n available7
 ( auditory implant devices & ext]nal   
s\nd processors describ$ 9 p>agraph     
7#a74  7#d7 ,adhesive adapt]s & s(tb&   
headb&s4  7#e7 ,! repair ( auditory     
implant devices & ext]nal s\nd          
processors describ$ 9 p>agraph 7#a74    
7#f7 ,a compreh5sive he>+ assessm5t4    
7#g7 ,a preop]ative m$ical assessm5t4   
7#h7 ,surg]y relat+ to ! furni%+ ( su*  
devices & processors 7z det]m9$ necess>y
 by a physician or qualifi$ audiologi/  
7z su* t]ms are def9$ 9 subsection 7d77 
treat+ su* individual74  7#i7           
,po/op]ative m$ical visits = purposes ( 
ensur+ appropriate recov]y f su* surg]y4
  7#aj7 ,po/op]ative audiological visits

 = activation & fitt+ ( su* devices &   
processors4  7#aa7 ,aural rehabilitation
 & treatm5t s]vices 7z s det]m9$        
necess>y74  7b7 ,cov]age requirem5ts ,9 
! case ( an item or s]vice describ$ 9   
subsection 7a7 furni%$ to a qualify+    
individual "u a gr\p heal? plan1 su*    
plan %all ensure t-- 7#a7 ! f9ancial    
requirem5ts 7z def9$ 9 section          
#ihab7;a77#c77 applicable to su* item or
 s]vice are no m re/rictive ?an !       
pr$om9ant f9ancial requirem5ts appli$ to
 sub/antially all m$ical & surgical     
b5efits cov]$ by ! plan1 & t !re are no 
sep>ate co/ %>+ requirem5ts t are       
applicable only ) respect to su* item or
 s]vice2 &  7#b7 ! treatm5t limitations 
7z def9$ 9 su* section7 applicable to   
su* item or s]vice are no m re/rictive  
?an ! pr$om9ant treatm5t limitations    
appli$ to sub/antially all m$ical &     
surgical b5efits cov]$ by ! plan1 & t   
!re are no sep>ate treatm5t limitations 
t are applicable only ) respect to su*  
item or s]vice4  7c7 ,prohibition on    

review ( m$ical necessity ,a gr\p heal? 
plan may n d5y or o!rwise limit cov]age 
( any item or s]vice describ$ 9         
subsection 7a7 :]e su* item or s]vice   
has be5 det]m9$ to be m$ically necess>y 
by a physician or qualifi$ audiologi/ 7z
 su* t]ms are def9$ 9 subsection 7d774  
7d7 ,qualify+ individual def9$ ,=       
purposes ( ?is section1 ! t]m qualify+  
individual means an individual t a      
physician 7z def9$ 9 section #ahfa7r7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#aciex7r777 or qualifi$ audiologi/ 7z   
def9$ 9 section #ahfa7ll77#d77;,b7 ( su*
 ,act 7#db ,u4,s4,c4                    
#aciex7ll77#d77;,b777 det]m9es meets an 
indication 7includ+ unilat]al or        
bilat]al he>+ loss7 = an auditory       
implant device & ext]nal s\nd processor 
describ$ 9 subsection 7a77#a74  4  7#b7 
,cl]ical am5dm5t ,! table ( sections =  
sub*apt] ,b ( *apt] #ajj ( ! ,int]nal   
,rev5ue ,code ( #aihf is am5d$ by ins]t+
 aft] ! item relat+ to section #ihbe !  
foll[+ new item3  ,sec4 #ibhf4 ,cov]age 

( he>+ devices & sy/ems4  4  7d7        
,application to gr&fa!r$ heal? plans    
,section #abea7;a77#d77;,a7 ( ! ,pati5t 
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjaa7;a77#d77;,a77 is       
am5d$-- 7#a7 by /rik+ title & ins]t+    
title1 or z add$ aft] ! date ( !        
enactm5t ( ?is ,act2 &  7#b7 by add+ at 
! end ! foll[+ new clause3  7v7 ,section
 #bgii;,a-#aa 7relat+ to he>+ devices & 
sy/ems74  4  7e7 ,effective date ,!     
am5dm5ts made by ?is section %all apply 
) respect to plan ye>s beg9n+ on or aft]
 ,janu>y #a1 #bjbf4