American Speech-Language-Hearing Association

Model Bill: Mandated Offering of Health Benefits for Audiology and Speech-Language Pathology Services

Insurers, nonprofit hospital and medical service plan corporations, health benefit plans provided to state government employees, and managed care organizations transacting health insurance or providing other health coverage in this state shall offer and make available coverage for medically necessary audiology and speech-language pathology services subject to the same durational limits, deductibles and coinsurance factors as other covered services in such policies or contracts. Such services shall be provided by an audiologist or speech-language pathologist licensed by the state and certified by the American Speech-Language-Hearing Association acting within the scope of their license and certification. An entity subject to this section is not required to provide reimbursement for services delivered through early intervention or school services provided under federally funded programs for children with disabilities.

Nothing in this section shall prohibit the insurance company or not-for-profit health service corporation from including any coverage for audiology or speech-language pathology services as standard coverage in their policies or contracts, but same shall not contain terms contrary to this section.

Note: Insurance laws vary considerably from state to state in the format and detail required. This model bill may need to be modified significantly to meet individual state practices.

 

 

 

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