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AB-1914 Hearing aids.(2001-2002)



Current Version: 09/19/02 - Chaptered

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AB1914:v94#DOCUMENT

Assembly Bill No. 1914
CHAPTER 704

An act to add Section 14133.16 to the Welfare and Institutions Code, relating to hearing.

[ Filed with Secretary of State  September 19, 2002. Approved by Governor  September 19, 2002. ]

LEGISLATIVE COUNSEL'S DIGEST


AB 1914, Kehoe. Hearing aids.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Services, pursuant to which medical benefits are provided to public assistance recipients and certain other low-income persons. Existing law provides for hearing aids as a covered benefit, subject to utilization controls.
This bill would provide that hearing aids are a covered Medi-Cal benefit only after specified examinations and evaluations are completed by certain individuals.
This bill would make one hearing aid assessment in a 12-month period a covered benefit under Medi-Cal. In the event a beneficiary receives more than one hearing aid assessment within a 12-month period, Medi-Cal would reimburse the first valid claim for only one hearing aid assessment unless additional assessments are deemed to be medically necessary.

The people of the State of California do enact as follows:


SECTION 1.

 Section 14133.16 is added to the Welfare and Institutions Code, to read:

14133.16.
 (a) Notwithstanding subdivision (l) of Section 14132, hearing aids are covered when supplied by a hearing aid dispenser on prescription of an otolaryngologist, or the attending physician where there is no otolaryngologist available in the community, plus an audiological evaluation, which shall be performed by or under the supervision of the attending physician or by a licensed audiologist.
(b) Prior to prescribing a hearing aid, a physician or otolaryngologist shall perform a complete ear, nose, and throat examination.
(c) Prior to coverage, a hearing aid assessment shall be performed by the dispensing practitioner, either a physician, a licensed audiologist, or a licensed hearing aid dispenser acting within the scope of practice as described in Section 3306 of the Business and Professions Code.
(d) Coverage shall be based on the results of the examination, evaluation, and assessment required by this section.
(e) One hearing aid assessment within a 12-month period is a covered benefit. In the event the beneficiary receives more than one hearing aid assessment within a 12-month period, Medi-Cal shall reimburse the first valid claim received by the program for only one hearing aid assessment unless additional assessments are deemed to be medically necessary.