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Model Bill: Mandated Coverage of 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 provide standard coverage for audiology and speech-language pathology services that are determined by a physician to be medically necessary. Such services shall be rendered to the individual 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.

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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