An Act To Require All Health Insurers To Cover the Costs of Hearing Aids LR 0989(02)
Maine Legislature, Session 121, LD 1087
Committee Amendment CA_A_S358 (Senate)
Amends: 24-A MRSA §2761, 24-A MRSA §2847-L, 24-A MRSA §4252

COMMITTEE AMENDMENT "A" to S.P. 359, L.D. 1087, Bill, "An 
Act To Require All Health Insurers To Cover the Costs of Hearing 
Aids" 
Amend the bill by striking out everything after the enacting 
clause and before the summary and inserting in its place the 
following: 
'Sec. I. 24 MRS A §2317-B, sub-§12-B is enacted to read: 
12-B. 
Title 24-A, sections 2761, 2847-L and 4252. 
Coverage 
for hearing aids. Title 24-A. sections 2761. 2847-L and 4252; 
Sec. 2. 24-A MRSA §2761 is enacted to read: 
§2761. 
Coverage for hearing aids 
1. 
Reqy.ired coverage. 
All individual health policies and 
contracts must provide coverage for the purchase of a hearing aid 
for each ear from an audiologist licensed pursuant to Title 32. 
chapter 77 or a hearing aid dealer licensed pursuant to Title 32, 
chapter 23-A for a person 21 years of age or under whose hearing 
loss has been documented by a physician or licensed audiologist. 
'For 
purposes 
of 
this 
section. 
"hearing 
aid" 
means 
any 
nonexperimental, wearable instrument or device designed for the 
ear and offered for the purpose of aiding or compensating for 
impaired human hearing. excluding batteries and cords and other 
assistive listening devices. 
including. 
but not 
limited to. 
freguency modulation systems. 
Page l-LR0989(2) 
COMMITTEE AMENDMENT 
~,,~. 
COMMITTEE AMENDMENT "f.l" to S. P. 359, L. D. 1087 
2. 
Limits: 
coinsurance: 
deductibles. 
Any 
policy 
or 
contract that provides coverage for services under this section 
may contain provisions for maximum benefits and coinsurance and 
reasonable limitations, deductibles and excl us ions to the extent 
that these provisions are not inconsistent with the reguirements 
of this section. 
Sec. 3. 24-A MRSA §2847-L is enacted to read: 
§2847-L. 
Coverage for hearing aids 
1. 
Regyired 
coverage. 
All 
group 
insurance 
policies, 
contracts and certificates must provide coverage for the purchase 
of 
a 
hearing aid for each ear from 
an audiologist licensed 
pursuant to Title 32, chapter 77 or a hearing aid dealer licensed 
pursuant to Title 32, chapter 23-A for a person 21 years of age 
or under whose hearing loss has been dOCumented by a physician or 
licensed audiologist. 
For purposes of this section. "hearing 
aid" means 
any nonexperimentaL 
wearable instrument or device 
designed for the ear and offered for the purpose of aiding or 
compensating for impaired human hearing, excluding batteries and 
cords and other assistive listening devices, including. but not 
limited to, frequency modulation systems. 
2. 
Limits; coinsurance: deductibles. 
Any policy, contract 
or certificate that provides coverage for services under this 
section 
may 
contain 
pronSJ.ons 
for 
maximum 
benefits 
and 
coinsurance 
and 
reasonable 
limitations, 
deductibles 
and 
exclusions 
to 
the 
extent 
that 
these 
provJ.sJ.ons 
are 
not 
inconsistent with the requirements of this section. 
Sec. 4. 24-A MRSA §4252 is enacted to read: 
§4252. 
Coverage for hearing aids 
1. 
Required coverage. 
All health maintenance organization 
individual and group health policies, contracts and certificates 
must provide coverage for the purchase of a hearing aid for each 
ear from an audiologist licensed pursuant to Title 32, chapter 77 
or a hearing aid dealer licensed pursuant to Title 32, chapter 
'23-A for a person 21 years of age or under whose hearing loss has 
been documented by a 
physician or licensed audiologist. 
For 
purposes 
of 
this 
section, 
"hearing 
aid" 
means 
any 
nonexperimentaL wearable instrument or device designed for the 
ear and offered for the purpose of aiding or compensating for 
impaired human hearing, excluding batteries and cords and other 
assistive 
listening devices, 
including, 
but not limited to, 
freguency modulation systems. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT .. A 
.. to S.P. 359, L.D. 1087 
2. 
Limits; coinsurance: deductibles. 
Any policy, contract 
or certificate that provides coverage for services under this 
section 
may 
contain 
provisions 
for 
maximum 
benefits 
and 
coinsurance 
and 
reasonable 
limitations, 
deductibles 
and 
exclusions 
to 
the 
extent 
that 
these 
provisions 
are 
not 
inconsistent with the requirements of this section. 
Sec. 
5. 
Expenditures in excess of allocations. 
Expenditures 
required by this Act of funds from other than the General Fund, 
Highway Fund and Fund for 
a Heal thy Maine are authorized to 
exceed 
legislative allocations 
during 
the 
2004-2005 
biennium 
ending June 
30, 
2005. 
Appropriate adjustments to basic work 
programs facilitating these expenditures in excess of allocations 
must be recommended by the State Budget Officer and approved by 
the Governor. 
Sec. 
6. 
Appropriations 
and 
allocations. 
appropriations and allocations are made. 
ADMINISTRATIVE AND FINANCIAL 
SERVICES, DEPARTMENT OF 
Salary Plan 
The 
following 
Ini tiative: 
Appropriates and allocates funds for the additional 
costs 
of 
health insurance 
to 
the State 
resulting 
from 
the 
requirement to provide coverage for hearing aids for persons 21 
years of age and under. 
General Fund 
2003-04 
2004-05 
Personal Services 
$0 
$57,168 
General Fund Total 
$0 
$57,168 
Highway Fund 
2003-04 
2004-05 
Personal Services 
$0 
$22,508 
Highway Fund Total 
$0 
$22,508 
Fund for a Healthy Maine 
2003-04 
2004-05 
Personal Services 
$0 
$177 
Fund for a Healthy Maine Total 
$0 
$177 
COMMITTEE AMENDMENT 
t\~t\ 'b. 
COMMITTEE AMENDMENT .. A .. to S.P. 359, L.D. 1087 
ADMINISTRATIVE AND FINANCIAL SERVICES 
DEPARTMENT'l'OTALS 
General Fund 
Biqhway Fund 
Fund For a Healthy Maine 
DEPARTMENT 'l'OTAL -
ALL FUNDS 
2003-04 
$0 
o 
o 
$0 
2004-05 
$57,168 
22,508 
$79,853 
Sec. 7. Application. 
The requirements of this Act apply to 
all policies, contracts and certificates executed, 
delivered, 
issued for delivery, continued or renewed in this State on or 
after January 1, 2005. 
For purposes of this Act, all contracts 
are 
deemed 
to 
be 
renewed 
no 
later 
than 
the 
next 
yearly 
anniversary of the contract date.' 
SUMMARY 
This amendment is the minority report and replaces the bill. 
It requires health insurance policies, contracts and certificates 
to provide coverage for hearing aids for persons 21 years of age 
and under. The provisions apply to all policies, contracts and 
certificates issued or renewed on or after January 1, 2005. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Net Cost (Savings) 
General Fund 
Highway Fund 
Fund for a Healthy Maine 
Appropriations/Allocations 
General Fund 
Highway Fund 
Fund for a Healthy Maine 
Fiscal Detail and Notes 
Approved: 01106/04 ~aC!. 
Office of Fiscal and Program Review 
LD 1087 
An Act To Require All Health Insurers To Cover the Costs of Hearing 
Aids 
LR 0989(02) 
Fiscal Note for Bill as Amended by Committee Amendment (1"S 3 5<is· 
Committee: Insurance and Financial Services 
Fiscal Note Required: Yes 
Minority Report 
Fiscal Note 
Projections 
Projections 
2003-04 
2004-05 
2005-06 
2006-07 
$0 
$57,168 
$256,113 
$286,847 
$0 
$22,508 
$100,835 
$112,935 
$0 
$177 
$794 
$889 
$0 
$57,168 
$256,113 
$286,847 
$0 
$22,508 
$100,835 
$112,935 
$0 
$177 
$794 
$889 
These estimates assume that adding hearing aid coverage to persons age 21 and under will increase premium costs by' 
0.4% for the state employee health plan effective with the contract beginning April 1, 2005. The additional employer 
costs across all funds to the state employee health insurance program will be $124,839 in fiscal year 2004-05, 
$559,281 in fiscal year 2005-06 and $626,395 in fiscal year 2006-07. 
General Fund appropriations of $57,168, Highway Fund allocations of $22,508 and Fund for a Healthy Maine 
allocations of $177 in fiscal year 2004-05 are required to be set aside in the salary plan reserve accounts to fund the 
increases for General Fund, Highway Fund and Fund for a Healthy Maine employees. The costs for employees paid 
by other funds, estimated to be $44,986, may require increased allotments to meet these additional personal services 
expenditures. 
Any additional costs to the Department of Professional and Financial Regulation in implementing this legislation can 
be absorbed by the Department within existing resources. This fiscal note does not reflect the additional costs to the 
private insurance market as a result of this legislation. 
LR0989(2) - Fiscal Note - Page 1 of 1