BILL NUMBER: S8265A
SPONSOR: SUTTON
 
TITLE OF BILL:
An act to amend the insurance law, in relation to ensuring continued
access to backup devices for patients with cochlear implants
 
PURPOSE OR GENERAL IDEA OF BILL:
To require insurance coverage for backup cochlear implant devices to
ensure uninterrupted access for patients during device upgrades or
replacements.
 
SUMMARY OF PROVISIONS:
This bill amends Sections 3221 and 4303 of the Insurance Law to mandate
that all large group health insurance policies providing medical or
major medical coverage must include:
1. Coverage for Cochlear Implants and Backup Devices: Insurance plans
must cover cochlear implants and provide a backup device when prescribed
by a licensed healthcare practitioner.
2. Provision of Backup Devices During Upgrades/Replacements: Patients
receiving an upgrade or replacement cochlear implant must be provided
with a corresponding backup device, ensuring continuous hearing capabil-
ity.
3. Definitions: Cochlear Implant: A surgically implanted medical device
that provides hearing to individuals with severe to profound sensorin-
eural hearing loss. Backup Cochlear Implant Device: An additional set
of external components of the cochlear implant, including a processor,
if the primary device fails or requires maintenance.
4. Severability: If any part of this act is deemed invalid, the remain-
ing sections will continue in effect.
5. Effective Date: This act shall take effect on January 1, 2027 and
will apply to all relevant insurance policies issued, renewed, or modi-
fied on or after that date.
 
JUSTIFICATION:
Cochlear implants are life-changing devices for individuals with severe
hearing loss, restoring the ability to hear and significantly improving
quality of life. However, current insurance practices often provide
backup devices only at the time of initial implantation, leaving
patients vulnerable during upgrades or replacements that typically occur
every 3-5 years.
Without a functioning device, patients-especially children-may experi-
ence periods of complete hearing loss, leading to developmental
setbacks, communication challenges, and safety concerns. This bill
addresses a critical gap in insurance coverage, ensuring patients have
access to backup devices throughout the lifespan of their cochlear
implant, thereby preventing interruptions in hearing. By guaranteeing
continuous access to these essential devices, this legislation promotes
better health outcomes, supports social integration, and protects the
rights and well-being of individuals relying on cochlear implants.
 
PRIOR LEGISLATIVE HISTORY:
None
 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
Minimal. While insurance providers may incur additional costs for cover-
ing backup devices, the overall impact is expected to be limited. The
potential long-term savings from avoiding complications related to
interrupted hearing may offset initial expenses.
 
EFFECTIVE DATE: This act shall take effect on January 1, 2027 and
will apply to all policies and contracts issued, renewed, modified,
altered, or amended on or after such date.

Statutes affected:
S8265: 3216 insurance law, 3216(i) insurance law, 3221 insurance law, 3221(k) insurance law, 4303 insurance law
S8265A: 3221 insurance law, 3221(k) insurance law, 4303 insurance law