PRINTER'S NO. 2385
No. 1921 Session of 1999
INTRODUCED BY McILHINNEY, ARGALL, BARRAR, BELARDI, BELFANTI,
BISHOP, CAPPABIANCA, CLYMER, CORRIGAN, COSTA, DeLUCA,
FAIRCHILD, GRUCELA, HARHAI, HENNESSEY, LAUGHLIN, LEDERER,
LEVDANSKY, MELIO, R. MILLER, MUNDY, RAMOS, SATHER, SCHULER,
SERAFINI, SEYFERT, SHANER, STABACK, STEELMAN, STEVENSON,
E. Z. TAYLOR, J. TAYLOR, TIGUE, TRAVAGLIO, TRELLO, WILLIAMS,
WOJNAROSKI AND YUDICHAK, OCTOBER 5, 1999
REFERRED TO COMMITTEE ON HEALTH AND HUMAN SERVICES,
OCTOBER 5, 1999
AN ACT
1 Establishing the Universal Newborn Hearing Screening Program.
2 The General Assembly of the Commonwealth of Pennsylvania
3 hereby enacts as follows:
4 Section 1. Short title.
5 This act shall be known and may be cited as the Universal
6 Newborn Hearing Screening Act.
7 Section 2. Legislative findings and purpose.
8 (a) Findings.--The General Assembly finds as follows:
9 (1) Deafness in newborn children is a serious concern
10 because the first few months of a child's life are a crucial
11 period in the development of speech and language skills which
12 depend heavily on hearing acuity. A delay in these skills may
13 adversely affect the child's social, emotional, cognitive and
14 academic skills development. Advancements in hearing aid
1 technology have made it possible to provide hearing
2 amplification devices to children as young as two months.
3 These technological advancements, coupled with early
4 intervention, can result in improved language development,
5 increased academic success and ultimately in improved
6 lifetime earnings.
7 (2) Many hospitals have developed hearing testing
8 programs for newborn children who meet certain high-risk
9 criteria. However, this type of high-risk-only testing misses
10 between one half and three quarters of all newborn children
11 with a hearing loss. The average age at which a hearing loss
12 is identified in the United States is between two and two and
13 one-half years of age and can be as high as five and three-
14 tenths years for children of low-income families.
15 (b) Purpose.--The purpose of this act is to provide for the
16 early detection of hearing loss in newborn children, to enable
17 these children and their families to obtain needed treatment and
18 intervention services at the earliest opportunity and to prevent
19 or mitigate the developmental delays associated with late
20 identification of hearing loss.
21 Section 3. Definitions.
22 The following words and phrases when used in this act shall
23 have the meanings given to them in this section unless the
24 context clearly indicates otherwise:
25 "Department." The Department of Health of the Commonwealth.
26 "Health care provider." A health care facility or health
27 care practitioner as defined by regulations of the Department of
28 Health.
29 "Health insurance policy." Except for specified disease
30 policies, the term shall mean any group health insurance policy,
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1 contract or plan or any individual policy, contract or plan with
2 dependent coverage for children, which provides medical coverage
3 on an expense-incurred service or prepaid basis. The term
4 includes the following:
5 (1) A health insurance policy or contract issued by a
6 nonprofit corporation subject to 40 Pa.C.S. Chs. 61 (relating
7 to hospital plan corporations) and 63 (relating to
8 professional health services plan corporations) and the act
9 of December 14, 1992 (P.L.835, No.134), known as the
10 Fraternal Benefit Societies Code.
11 (2) A health service plan operating under the act of
12 December 29, 1972 (P.L.1701, No.364), known as the Health
13 Maintenance Organization Act.
14 (3) An employee welfare benefit plan as defined in
15 section 3 of the Employee Retirement Income Security Act of
16 1974 (Public Law 93-406, 88 Stat. 829).
17 "Parent." A natural parent, stepparent, adoptive parent,
18 guardian or custodian of a child.
19 "Program." The Universal Newborn Hearing Screening Program
20 administered by the Department of Health.
21 "Secretary." The Secretary of Health of the Commonwealth.
22 Section 4. Universal Newborn Hearing Screening Program.
23 (a) General rule.--In order to assist parents and health
24 care providers in determining whether a newborn child has a
25 hearing loss requiring treatment, the department shall establish
26 the Universal Newborn Hearing Screening Program.
27 (b) The program shall consist of, at least, the following:
28 (1) A hearing screening test that every newborn child
29 shall undergo for identification of newborn hearing loss. The
30 hearing screening test may be performed by any person
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1 properly trained to do so.
2 (2) The test shall include the use of at least one of
3 the following technologies: auditory brain stem response
4 (ABR), automated ABR, otoacoustic emissions (OAE) or other
5 appropriate technology.
6 (3) A health care provider may provide the newborn
7 hearing screening test on site, contract for the test with
8 another provider or enter into other arrangements for the
9 test upon approval by the department.
10 (4) The test shall be completed, when possible, before
11 discharge from the hospital newborn nursery unit. The test
12 results are to be conveyed to the custodial parents, and are
13 to be included as part of the child's health care record.
14 (5) If the test is not done before discharge from the
15 hospital newborn nursery unit, it should be conducted within
16 90 days of birth and the hospital shall be required to notify
17 the parents of the need to have the newborn child tested
18 within 90 days of birth.
19 (6) The notice in paragraph (5) shall be developed by
20 the department and shall notify the parents of all of the
21 following:
22 (i) The department encourages the testing of newborn
23 children within 90 days of birth.
24 (ii) If the test is conducted within 90 days of
25 birth, the parents' health insurance policy or medical
26 assistance may cover the fee for the test.
27 (iii) The department can recommend health care
28 providers who can provide the test for the newborn child.
29 (c) Refusal of test on religious grounds.--No test is to be
30 performed if a newborn child's parent dissents on the ground
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1 that the test conflicts with a personal religious belief or
2 practice.
3 Section 5. Hearing testing insurance coverage.
4 (a) Insurance coverage for testing.--Except as provided in
5 subsection (d), any health insurance policy which is delivered,
6 issued for delivery, renewed, extended or modified in this
7 Commonwealth by any health care insurer shall provide that the
8 health insurance benefits applicable under the policy shall
9 include coverage for initial testing and for any necessary
10 follow-up testing.
11 (b) Delivery of policy.--Except as provided in subsection
12 (d), if a health insurance policy provides coverage or benefits
13 to a resident of this Commonwealth, it shall be deemed to be
14 delivered in this Commonwealth within the meaning of this act
15 regardless of whether the health care insurer issuing or
16 delivering the policy is located within or outside this
17 Commonwealth.
18 (c) Cost-sharing provision.--Benefits for the newborn
19 hearing screening test shall be subject to copayment and
20 coinsurance provisions of a health insurance policy to the
21 extent that other medical services covered by the policy are
22 subject to those provisions, except that benefits for the
23 newborn child hearing screening test shall be exempt from
24 deductible or dollar limit provisions in a health insurance
25 policy. This exemption must be explicitly provided for in the
26 policy.
27 (d) Exemption.--
28 (1) Notwithstanding subsections (a) and (b), this
29 section shall not be construed to require a health insurance
30 policy to include coverage for the newborn hearing screening
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1 test for an individual who is a resident of this Commonwealth
2 if the individual is employed outside this Commonwealth and
3 the individual's employer maintains a health insurance policy
4 for the individual as an employment benefit.
5 (2) Nothing in this act shall apply to accident only,
6 specified disease, hospital indemnity, Medicare supplement,
7 long-term care, or other limited benefit health insurance
8 policies.
9 (e) Applicability.--This act shall apply to all insurance
10 policies, subscriber contracts and group insurance certificates
11 issued under any group master policy, delivered or issued for
12 delivery on or after the effective date of this act. This act
13 shall also apply to all renewals of contracts on any renewal
14 date which is on or after the effective date of this act.
15 Section 6. Coverage under medical assistance.
16 The Department of Public Welfare shall pay for the newborn
17 hearing screening test if the child is eligible for medical
18 assistance under Article IV of the act of June 13, 1967 (P.L.31,
19 No.21), known as the Public Welfare Code.
20 Section 7. Regulations.
21 (a) Secretary of Health.--The Secretary of Health shall
22 promulgate regulations as may be necessary to implement the
23 provisions under section 4.
24 (b) Insurance Commissioner.--The Insurance Commissioner
25 shall promulgate regulations necessary to implement the
26 provisions under section 5.
27 Section 8. Effective date.
28 This act shall take effect in 90 days.
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