Audiology

1 Bulletin 14-04 To: Health Insurance Issuers From: Merle Scheiber, Director Date: July 1, 2014 Re: Audiology Senate Bill 122 passed during the 2014 Legislative Session states any qualified health plan issued on or after January 1, 2015, that offers coverage for professional audiology services shall include coverage for medically necessary physician services appropriate for the treatment of hearing impairment to a person under the age of 19. This shall include professional services rendered by an audiologist licensed pursuant to chapter 36-24. The benefits provided are subject to the same dollar limits, deductibles, coinsurance, and other limitations provided for other covered benefits in the policy. However, there is no mandate for payment by the health plan for hearing aids, devices, or equipment to correct hearing impairment or loss in SDCL 58-17-153, 58-18-95, 58-18B-60, and 58- 41-127. SDCL 58-17-153, 58-18-95, 58-18B-60, and 58-41-127 (SB 122) does not mandate coverage for all insurance companies, but rather provides permissible language for those carriers who choose to offer this audiology coverage starting January 1, 2015. Carriers providing audiology coverage for treatment due to illness or injury prior to July 1, 2014 are not required to expand coverage to meet the requirements under SDCL 58- 17-153, 58-18-95, 58-18B-60, and 58-41-127. 124 S. Euclid Avenue, 2nd Floor  Pierre, SD 57501 Division of Insurance Tel: 605.773.3563 Fax: 605.773.5369 www.state.sd.us/insurance