I 

117TH CONGRESS 

1ST SESSION H. R. 1106 

To amend title XVIII of the Social Security Act to provide for coverage 

under the Medicare program of hearing aids and related hearing services. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 18, 2021 

Mr. CARTWRIGHT (for himself, Mr. KATKO, Ms. CLARKE of New York, Mr. 

GRIJALVA, Mr. HASTINGS, Ms. JACKSON LEE, Ms. MCCOLLUM, Mr. 

MCKINLEY, Mr. NADLER, and Mr. THOMPSON of California) introduced 

the following bill; which was referred to the Committee on Energy and 

Commerce 

A BILL 

To amend title XVIII of the Social Security Act to provide 

for coverage under the Medicare program of hearing 

aids and related hearing services. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Help Extend Auditory 

5 Relief Act of 2021’’ or the ‘‘HEAR Act of 2021’’. 


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1 SEC. 2. MEDICARE COVERAGE OF HEARING REHABILITA2 TION. 

3 (a) COVERAGE OF AURAL REHABILITATION SERV4 ICES.—Section 1861(s)(2) of the Social Security Act (42 

5 U.S.C. 1395x(s)(2)) is amended— 

6 (1) in subparagraph (GG), by striking ‘‘and’’ at 

7 the end; 

8 (2) in subparagraph (HH) by inserting ‘‘and’’ 

9 at the end; and 

10 (3) by adding at the end the following new sub11 paragraph: 

12 ‘‘(II) aural rehabilitation services (as described 

13 in subsection (lll)(1)(A));’’. 

14 (b) COVERAGE OF HEARING AIDS AS DURABLE MED15 ICAL EQUIPMENT.—Section 1861(s)(8) of the Social Secu16 rity Act (42 U.S.C. 1395x(s)(8)) is amended by inserting 

17 ‘‘and hearing aids (as defined in subsection (lll)(3))’’ be18 fore the period. 

19 (c) HEARING REHABILITATION AND HEARING AID

20 DEFINED.—Section 1861 of the Social Security Act (42 

21 U.S.C. 1395x) is amended by adding at the end the fol22 lowing new subsection: 

23 ‘‘Hearing Rehabilitation 

24 ‘‘(kkk)(1) The term ‘hearing rehabilitation’ means— 

25 ‘‘(A) aural rehabilitation services (described in 

26 paragraph (2)) which meet such requirements as the 


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1 Secretary prescribes and which are furnished by a 

2 physician or qualified audiologist, who is legally au3 thorized to furnish such services under the State law 

4 (or the State regulatory mechanism provided by 

5 State law) of the State in which the services are fur6 nished; and 

7 ‘‘(B) hearing aids (as defined in paragraph 

8 (3)). 

9 ‘‘(2) The services described in this subparagraph in10 clude— 

11 ‘‘(A) aural rehabilitation services; 

12 ‘‘(B) in the case of an individual who has a 

13 hearing loss (as defined by the Secretary), a com14 prehensive audiologic assessment to determine if a 

15 hearing aid is appropriate and to determine the need 

16 for other diagnostic medical or audiologic testing; 

17 and 

18 ‘‘(C) a threshold test to determine audio acuity. 

19 ‘‘(3)(A) The term ‘hearing aid’ means a hearing aid 

20 described in subparagraph (B), including the services de21 scribed in subparagraph (C) furnished by a physician or 

22 qualified audiologist, who is legally authorized to supply 

23 such hearing aid under the State law (or State regulatory 

24 mechanism provided by State law) of the State in which 


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1 the hearing aid is supplied, to an individual described in 

2 subparagraph (D). 

3 ‘‘(B) A hearing aid described in this subparagraph 

4 is any wearable instrument or device for, offered for the 

5 purpose of, or represented as aiding individuals with, or 

6 compensating for, hearing loss that meets requirements of 

7 the Food and Drug Administration for marketing. 

8 ‘‘(C) The services described in this subparagraph in9 clude— 

10 ‘‘(i) audiology services (as defined in subsection 

11 (ll)(2)); 

12 ‘‘(ii) a hearing aid assessment to determine the 

13 appropriate hearing aid for the individual; 

14 ‘‘(iii) procurement of an appropriate hearing 

15 aid; 

16 ‘‘(iv) initial fitting and adjustment of the hear17 ing aid; 

18 ‘‘(v) appropriate instruction on the use of the 

19 hearing aid; 

20 ‘‘(vi) periodic refittings and adjustments; and 

21 ‘‘(vii) rehabilitation, including counseling on 

22 hearing loss, speech reading, and auditory training. 

23 ‘‘(D) The individuals described in this subpara24 graph— 


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1 ‘‘(i) have been determined (as a result of a com2 prehensive audiologic assessment) to have a hearing 

3 loss which can be appropriately treated with a hear4 ing aid; 

5 ‘‘(ii) have not been supplied with one monaural 

6 hearing aid or two binaural hearing aids during the 

7 preceding 3 years; and 

8 ‘‘(iii) have had a comprehensive audiologic as9 sessment which indicates that the hearing of such 

10 individual has deteriorated since such individual was 

11 last supplied with a hearing aid such that a hearing 

12 aid of a different type is appropriate for such indi13 vidual.’’. 

14 (d) INCLUSION OF AUDIOLOGY REHABILITATION

15 SERVICES.—Section 1861(ll)(2) of the Social Security Act 

16 (42 U.S.C. 1395x(ll)(2)) is amended by inserting ‘‘and re17 habilitation’’ after ‘‘balance assessment’’. 

18 (e) EXCEPTION TO EXCLUSIONS FROM COVERAGE.— 

19 Section 1862(a) of the Social Security Act (42 U.S.C. 

20 1395y(a)) is amended— 

21 (1) in paragraph (1)— 

22 (A) in subparagraph (O), by striking 

23 ‘‘and’’ at the end; 

24 (B) in subparagraph (P); by striking the 

25 semicolon at the end and inserting ‘‘, and’’; and 


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1 (C) by adding at the end the following new 

2 subparagraph: 

3 ‘‘(Q) in the case of hearing rehabilitation, which 

4 is furnished or supplied more frequently than is pro5 vided under section 1861(lll)(3)(D)(ii).’’; and 

6 (2) in paragraph (7) by striking ‘‘hearing aids 

7 or examinations therefor’’. 

8 (f) EFFECTIVE DATE.—The amendments made by 

9 this section shall take effect on the date of the enactment 

10 of this Act, and shall apply to items and services furnished 

11 on or after a date specified by the Secretary of Health 

12 and Human Services that is not sooner than January 1 

13 of the first year beginning after such date of enactment 

14 and not later than January 1 of the third year beginning 

15 after such date of enactment. 

Æ 


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