I 

118TH CONGRESS 

1ST SESSION H. R. 2439 

To amend title XXVII of the Public Health Service Act, the Employee 

Retirement Income Security Act of 1974, the Internal Revenue Code 

of 1986, and the Patient Protection and Affordable Care Act to require 

coverage of hearing devices and systems in certain private health insurance plans, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 30, 2023 

Mr. NEGUSE (for himself, Mr. FITZPATRICK, and Mr. THOMPSON of California) introduced the following bill; which was referred to the Committee 

on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such 

provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend title XXVII of the Public Health Service Act, 

the Employee Retirement Income Security Act of 1974, 

the Internal Revenue Code of 1986, and the Patient 

Protection and Affordable Care Act to require coverage 

of hearing devices and systems in certain private health 

insurance plans, and for other purposes. 

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 ‘‘Ally’s Act’’. 


kjohnson on DSK79L0C42PROD with BILLS
2 

•HR 2439 IH

1 SEC. 2. COVERAGE OF HEARING DEVICES AND SYSTEMS IN 

2 CERTAIN PRIVATE HEALTH INSURANCE 

3 PLANS. 

4 (a) PHSA.—Part D of the Public Health Service Act 

5 (42 U.S.C. 300gg–111 et seq.) is amended by adding at 

6 the end the following new section: 

7 ‘‘SEC. 2799A–11. COVERAGE OF HEARING DEVICES AND SYS8 TEMS. 

9 ‘‘(a) IN GENERAL.—A group health plan and a health 

10 insurance issuer offering group or individual health insur11 ance coverage shall at a minimum provide coverage for 

12 the following items and services furnished to a qualifying 

13 individual (as defined in subsection (d)): 

14 ‘‘(1) Auditory implant devices (including audi15 tory osseointegrated (bone conduction) implants and 

16 cochlear implants) and external sound processors. 

17 ‘‘(2) The maintenance of auditory implant de18 vices and external sound processors described in 

19 paragraph (1). 

20 ‘‘(3) Every 5 years, the upgrade (or replace21 ment if an upgrade is not available) of auditory im22 plant devices and external sound processors de23 scribed in paragraph (1). 

24 ‘‘(4) Adhesive adapters and softband head25 bands. 


kjohnson on DSK79L0C42PROD with BILLS
3 

•HR 2439 IH

1 ‘‘(5) The repair of auditory implant devices and 

2 external sound processors described in paragraph 

3 (1). 

4 ‘‘(6) A comprehensive hearing assessment. 

5 ‘‘(7) A preoperative medical assessment. 

6 ‘‘(8) Surgery relating to the furnishing of such 

7 devices and processors (as determined necessary by 

8 a physician or qualified audiologist (as such terms 

9 are defined for purposes of subsection (d)) treating 

10 such individual). 

11 ‘‘(9) Postoperative medical visits for purposes 

12 of ensuring appropriate recovery from such surgery. 

13 ‘‘(10) Postoperative audiological visits for acti14 vation and fitting of such devices and processors. 

15 ‘‘(11) Aural rehabilitation and treatment serv16 ices (as so determined necessary). 

17 ‘‘(b) COVERAGE REQUIREMENTS.—In the case of an 

18 item or service described in subsection (a) furnished to 

19 a qualifying individual under a group health plan or group 

20 or individual health insurance coverage, such plan or cov21 erage shall ensure that— 

22 ‘‘(1) the financial requirements (as defined in 

23 section 2726(a)(3)) applicable to such item or serv24 ice are no more restrictive than the predominant fi25 nancial requirements applied to substantially all 


kjohnson on DSK79L0C42PROD with BILLS
4 

•HR 2439 IH

1 medical and surgical benefits covered by the plan or 

2 coverage (as applicable), and that there are no sepa3 rate cost sharing requirements that are applicable 

4 only with respect to such item or service; and 

5 ‘‘(2) the treatment limitations (as defined in 

6 such section) applicable to such item or service are 

7 no more restrictive than the predominant treatment 

8 limitations applied to substantially all medical and 

9 surgical benefits covered by the plan or coverage (as 

10 applicable), and that there are no separate treat11 ment limitations that are applicable only with re12 spect to such item or service. 

13 ‘‘(c) PROHIBITION ON REVIEW OF MEDICAL NECES14 SITY.—A group health plan and a health insurance issuer 

15 offering group or individual health insurance coverage 

16 may not deny or otherwise limit coverage of any item or 

17 service described in subsection (a) furnished to a quali18 fying individual on the basis of a review of the medical 

19 necessity of such item or service by such plan or issuer. 

20 ‘‘(d) QUALIFYING INDIVIDUAL DEFINED.—For pur21 poses of this section, the term ‘qualifying individual’ 

22 means an individual that a physician (as defined in section 

23 1861(r) of the Social Security Act) or qualified audiologist 

24 (as defined in section 1861(ll)(4)(B) of such Act) deter25 mines meets an indication (including unilateral or bilateral 


kjohnson on DSK79L0C42PROD with BILLS
5 

•HR 2439 IH

1 hearing loss) for an auditory implant device and external 

2 sound processor described in subsection (a)(1).’’. 

3 (b) ERISA.— 

4 (1) IN GENERAL.—Subpart B of part 7 of sub5 title B of title I of the Employee Retirement Income 

6 Security Act of 1974 (29 U.S.C. 1185 et seq.) by 

7 adding at the end the following new section: 

8 ‘‘SEC. 726. COVERAGE OF HEARING DEVICES AND SYSTEMS. 

9 ‘‘(a) IN GENERAL.—A group health plan and a health 

10 insurance issuer offering group health insurance coverage 

11 shall at a minimum provide coverage for the following 

12 items and services furnished to a qualifying individual (as 

13 defined in subsection (d)): 

14 ‘‘(1) Auditory implant devices (including audi15 tory osseointegrated (bone conduction) implants and 

16 cochlear implants) and external sound processors. 

17 ‘‘(2) The maintenance of auditory implant de18 vices and external sound processors described in 

19 paragraph (1). 

20 ‘‘(3) Every 5 years, the upgrade (or replace21 ment if an upgrade is not available) of auditory im22 plant devices and external sound processors de23 scribed in paragraph (1). 

24 ‘‘(4) Adhesive adapters and softband head25 bands. 


kjohnson on DSK79L0C42PROD with BILLS
6 

•HR 2439 IH

1 ‘‘(5) The repair of auditory implant devices and 

2 external sound processors described in paragraph 

3 (1). 

4 ‘‘(6) A comprehensive hearing assessment. 

5 ‘‘(7) A preoperative medical assessment. 

6 ‘‘(8) Surgery relating to the furnishing of such 

7 devices and processors (as determined necessary by 

8 a physician or qualified audiologist (as such terms 

9 are defined for purposes of subsection (d)) treating 

10 such individual). 

11 ‘‘(9) Postoperative medical visits for purposes 

12 of ensuring appropriate recovery from such surgery. 

13 ‘‘(10) Postoperative audiological visits for acti14 vation and fitting of such devices and processors. 

15 ‘‘(11) Aural rehabilitation and treatment serv16 ices (as so determined necessary). 

17 ‘‘(b) COVERAGE REQUIREMENTS.—In the case of an 

18 item or service described in subsection (a) furnished to 

19 a qualifying individual under a group health plan or group 

20 health insurance coverage, such plan or coverage shall en21 sure that— 

22 ‘‘(1) the financial requirements (as defined in 

23 section 2726(a)(3) of the Public Health Service Act) 

24 applicable to such item or service are no more re25 strictive than the predominant financial requireVerDate Sep 11 2014 03:55 Apr 12, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2439.IH H2439

kjohnson on DSK79L0C42PROD with BILLS
7 

•HR 2439 IH

1 ments applied to substantially all medical and sur2 gical benefits covered by the plan or coverage (as ap3 plicable), and that there are no separate cost sharing 

4 requirements that are applicable only with respect to 

5 such item or service; and 

6 ‘‘(2) the treatment limitations (as defined in 

7 such section) applicable to such item or service are 

8 no more restrictive than the predominant treatment 

9 limitations applied to substantially all medical and 

10 surgical benefits covered by the plan or coverage (as 

11 applicable), and that there are no separate treat12 ment limitations that are applicable only with re13 spect to such item or service. 

14 ‘‘(c) PROHIBITION ON REVIEW OF MEDICAL NECES15 SITY.—A group health plan and a health insurance issuer 

16 offering group health insurance coverage may not deny or 

17 otherwise limit coverage of any item or service described 

18 in subsection (a) furnished to a qualifying individual on 

19 the basis of a review of the medical necessity of such item 

20 or service by such plan or issuer. 

21 ‘‘(d) QUALIFYING INDIVIDUAL DEFINED.—For pur22 poses of this section, the term ‘qualifying individual’ 

23 means an individual that a physician (as defined in section 

24 1861(r) of the Social Security Act) or qualified audiologist 

25 (as defined in section 1861(ll)(4)(B) of such Act) deterVerDate Sep 11 2014 03:55 Apr 12, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2439.IH H2439

kjohnson on DSK79L0C42PROD with BILLS
8 

•HR 2439 IH

1 mines meets an indication (including unilateral or bilateral 

2 hearing loss) for an auditory implant device and external 

3 sound processor described in subsection (a)(1).’’. 

4 (2) CLERICAL AMENDMENT.—The table of con5 tents in section 1 of the Employee Retirement In6 come Security Act of 1974 (29 U.S.C. 1001 et seq.) 

7 is amended by inserting after the item relating to 

8 section 725 the following new item: 

‘‘Sec. 726. Coverage of hearing devices and systems.’’. 

9 (c) IRC.— 

10 (1) IN GENERAL.—Subchapter B of chapter 

11 100 of the Internal Revenue Code of 1986 is amend12 ed by adding at the end the following new section: 

13 ‘‘SEC. 9826. COVERAGE OF HEARING DEVICES AND SYS14 TEMS. 

15 ‘‘(a) IN GENERAL.—A group health plan shall at a 

16 minimum provide coverage for the following items and 

17 services furnished to a qualifying individual (as defined 

18 in subsection (d)): 

19 ‘‘(1) Auditory implant devices (including audi20 tory osseointegrated (bone conduction) implants and 

21 cochlear implants) and external sound processors. 

22 ‘‘(2) The maintenance of auditory implant de23 vices and external sound processors described in 

24 paragraph (1). 


kjohnson on DSK79L0C42PROD with BILLS
9 

•HR 2439 IH

1 ‘‘(3) Every 5 years, the upgrade (or replace2 ment if an upgrade is not available) of auditory im3 plant devices and external sound processors de4 scribed in paragraph (1). 

5 ‘‘(4) Adhesive adapters and softband head6 bands. 

7 ‘‘(5) The repair of auditory implant devices and 

8 external sound processors described in paragraph 

9 (1). 

10 ‘‘(6) A comprehensive hearing assessment. 

11 ‘‘(7) A preoperative medical assessment. 

12 ‘‘(8) Surgery relating to the furnishing of such 

13 devices and processors (as determined necessary by 

14 a physician or qualified audiologist (as such terms 

15 are defined for purposes of subsection (d)) treating 

16 such individual). 

17 ‘‘(9) Postoperative medical visits for purposes 

18 of ensuring appropriate recovery from such surgery. 

19 ‘‘(10) Postoperative audiological visits for acti20 vation and fitting of such devices and processors. 

21 ‘‘(11) Aural rehabilitation and treatment serv22 ices (as so determined necessary). 

23 ‘‘(b) COVERAGE REQUIREMENTS.—In the case of an 

24 item or service described in subsection (a) furnished to 


kjohnson on DSK79L0C42PROD with BILLS
10 

•HR 2439 IH

1 a qualifying individual under a group health plan, such 

2 plan shall ensure that— 

3 ‘‘(1) the financial requirements (as defined in 

4 section 2726(a)(3) of the Public Health Service Act) 

5 applicable to such item or service are no more re6 strictive than the predominant financial require7 ments applied to substantially all medical and sur8 gical benefits covered by the plan, and that there are 

9 no separate cost sharing requirements that are ap10 plicable only with respect to such item or service; 

11 and 

12 ‘‘(2) the treatment limitations (as defined in 

13 such section) applicable to such item or service are 

14 no more restrictive than the predominant treatment 

15 limitations applied to substantially all medical and 

16 surgical benefits covered by the plan, and that there 

17 are no separate treatment limitations that are appli18 cable only with respect to such item or service. 

19 ‘‘(c) PROHIBITION ON REVIEW OF MEDICAL NECES20 SITY.—A group health plan may not deny or otherwise 

21 limit coverage of any item or service described in sub22 section (a) furnished to a qualifying individual on the basis 

23 of a review of the medical necessity of such item or service 

24 by such plan or issuer. 


kjohnson on DSK79L0C42PROD with BILLS
11 

•HR 2439 IH

1 ‘‘(d) QUALIFYING INDIVIDUAL DEFINED.—For pur2 poses of this section, the term ‘qualifying individual’ 

3 means an individual that a physician (as defined in section 

4 1861(r) of the Social Security Act) or qualified audiologist 

5 (as defined in section 1861(ll)(4)(B) of such Act) deter6 mines meets an indication (including unilateral or bilateral 

7 hearing loss) for an auditory implant device and external 

8 sound processor described in subsection (a)(1).’’. 

9 (2) CLERICAL AMENDMENT.—The table of sec10 tions for subchapter B of chapter 100 of the Inter11 nal Revenue Code of 1986 is amended by inserting 

12 after the item relating to section 9825 the following 

13 new item: 

‘‘Sec. 9286. Coverage of hearing devices and systems.’’. 

14 (d) APPLICATION TO GRANDFATHERED HEALTH

15 PLANS.—Section 1251(a)(4)(A) of the Patient Protection 

16 and Affordable Care Act (42 U.S.C. 18011(a)(4)(A)) is 

17 amended— 

18 (1) by striking ‘‘title’’ and inserting ‘‘title, or as 

19 added after the date of the enactment of this Act)’’; 

20 and 

21 (2) by adding at the end the following new 

22 clause: 

23 ‘‘(v) Section 2799A–11 (relating to 

24 hearing devices and systems).’’. 


kjohnson on DSK79L0C42PROD with BILLS
12 

•HR 2439 IH

1 (3) EFFECTIVE DATE.—The amendments made 

2 by this subsection shall apply with respect to plan 

3 years beginning on or after January 1, 2025. 

Æ 


kjohnson on DSK79L0C42PROD with BILLS