PRIOR PRINTER'S NO. 1019 PRINTER'S NO. 1952
No. 938 Session of 1997
INTRODUCED BY LEMMOND, BELAN, WHITE, WILLIAMS, HELFRICK, COSTA, AFFLERBACH, KUKOVICH, TOMLINSON, HECKLER, O'PAKE, MELLOW, THOMPSON, GERLACH, SCHWARTZ, STOUT, MUSTO, WENGER, TARTAGLIONE, KASUNIC, ULIANA AND MURPHY, APRIL 24, 1997
SENATOR MOWERY, PUBLIC HEALTH AND WELFARE, AS AMENDED, APRIL 28, 1998
AN ACT 1 Establishing the Universal Newborn Child Hearing Screening Test <-- 2 and Follow-up Program; and establishing the Newborn Child <-- 3 Hearing Advisory Committee. 4 The General Assembly of the Commonwealth of Pennsylvania 5 hereby enacts as follows: 6 Section 1. Short title. 7 This act shall be known and may be cited as the Universal 8 Newborn Child Hearing Screening Test Act. <-- 9 Section 2. Legislative findings and purpose. 10 (a) Findings.--The General Assembly finds as follows: 11 (1) Deafness in newborn children is a serious concern 12 because the first few months of a child's life are a crucial 13 period in the development of speech and language skills which 14 depend heavily on hearing acuity. A delay in these skills may 15 adversely affect the child's social, emotional, cognitive and 16 academic skills development. Advancements in hearing aid 17 technology have made it possible to provide hearing
1 amplification devices to children as young as two months. 2 These technological advancements, coupled with early 3 intervention, can result in improved language development, 4 increased academic success and ultimately in improved 5 lifetime earnings. 6 (2) Many hospitals have developed hearing testing 7 programs for newborn children who meet certain high-risk 8 criteria. However, this type of high-risk-only testing misses 9 between one half and three quarters of all newborn children 10 with a hearing loss. The average age at which a hearing loss 11 is identified in the United States is between two and two and 12 one-half years of age and can be as high as five and three- 13 tenths years for children of low-income families. 14 (b) Purpose.--The purpose of this act is to provide for the 15 early detection of hearing loss in newborn children, to enable 16 these children and their families to obtain needed treatment and 17 intervention services at the earliest opportunity and to prevent 18 or mitigate the developmental delays associated with late 19 identification of hearing loss. 20 Section 3. Definitions. 21 The following words and phrases when used in this act shall 22 have the meanings given to them in this section unless the 23 context clearly indicates otherwise: 24 "Advisory committee." The Newborn Infant Hearing Advisory <-- 25 Committee established in this act. 26 "Department." The Department of Health of the Commonwealth. 27 "Health care provider." A health care facility or health 28 care practitioner as defined by regulations of the Department of 29 Health. 30 "Health insurance policy." Except for specified disease 19970S0938B1952 - 2 -
1 policies, the term shall mean any group health insurance policy, 2 contract or plan or any individual policy, contract or plan with 3 dependent coverage for children, which provides medical coverage 4 on an expense-incurred service or prepaid basis. The term 5 includes the following: 6 (1) A health insurance policy or contract issued by a 7 nonprofit corporation subject to 40 Pa.C.S. Chs. 61 (relating 8 to hospital plan corporations) and 63 (relating to 9 professional health services plan corporations) and the act 10 of December 14, 1992 (P.L.835, No.134), known as the 11 Fraternal Benefit Societies Code. 12 (2) A health service plan operating under the act of 13 December 29, 1972 (P.L.1701, No.364), known as the Health 14 Maintenance Organization Act. 15 (3) An employee welfare benefit plan as defined in 16 section 3 of the Employee Retirement Income Security Act of 17 1974 (Public Law 93-406, 88 Stat. 829). 18 "Newborn child." A child less than 28 days of age. <-- 19 "Parent." A natural parent, stepparent, adoptive parent, 20 guardian or custodian of a child. 21 "Program." The UNIVERSAL Newborn Child Hearing Screening <-- 22 Test and Follow-up Program administered by the Department of <-- 23 Health. 24 "Secretary." The Secretary of Health of the Commonwealth. 25 Section 4. Universal Newborn Child Hearing Screening Test and <-- 26 Follow-up Program. 27 (a) General rule.--In order to assist parents and health 28 care providers in determining whether a newborn child has a 29 hearing loss requiring audiologic treatment, the department <-- 30 shall establish the Universal Newborn Child Hearing Screening <-- 19970S0938B1952 - 3 -
1 Test and Follow-up Program which shall provide for: <-- 2 PROGRAM. <-- 3 (B) THE PROGRAM SHALL CONSIST OF, AT LEAST, THE FOLLOWING: 4 (1) A hearing screening test that every newborn child 5 shall undergo for identification of newborn child hearing <-- 6 loss. The hearing screening test may be performed by a <-- 7 volunteer, a nurse, a technician or any person properly 8 trained and supervised by a Pennsylvania-licensed <-- 9 audiologist. The hearing screening test should be completed 10 before discharge from a newborn nursery unit but no later 11 than three months after a newborn child's birth and shall 12 TRAINED TO DO SO. <-- 13 (2) THE TEST SHALL include the use of at least one of 14 the following technologies: auditory brain stem response 15 (ABR), automated ABR, otoacoustic emissions (OAE) or other 16 appropriate technology that has been preapproved by the <-- 17 boards of the Pennsylvania Academy of Audiology and of the 18 Pennsylvania Speech-Language-Hearing Association. 19 (2) Follow-up services relating to the confirmation of 20 hearing loss, assessment and diagnosis of newborn children 21 with abnormal or inconclusive screening test results. These 22 follow-up services are to be performed by an audiologist 23 licensed by the Commonwealth. 24 (3) Basic guidelines for the newborn child hearing 25 screening test and follow-up program. 26 (b) Powers of health care provider.--A health care provider 27 TECHNOLOGY. <-- 28 (3) A HEALTH CARE PROVIDER may provide the newborn child <-- 29 hearing screening test on site, contract for the test with 30 another provider or enter into other arrangements for the 19970S0938B1952 - 4 -
1 test upon approval by the department.
2 (4) THE TEST SHALL BE COMPLETED, WHEN POSSIBLE, BEFORE <--
3 DISCHARGE FROM THE HOSPITAL NEWBORN NURSERY UNIT. THE TEST
4 RESULTS ARE TO BE CONVEYED TO THE CUSTODIAL PARENTS, AND ARE
5 TO BE INCLUDED AS PART OF THE CHILD'S HEALTH CARE RECORD.
6 (5) IF THE TEST IS NOT DONE BEFORE DISCHARGE FROM THE
7 HOSPITAL NEWBORN NURSERY UNIT, IT SHOULD BE CONDUCTED WITHIN
8 90 DAYS OF BIRTH AND THE HOSPITAL SHALL BE REQUIRED TO NOTIFY
9 THE PARENTS OF THE NEED TO HAVE THE NEWBORN CHILD TESTED
10 WITHIN 90 DAYS OF BIRTH.
11 (6) THE NOTICE IN PARAGRAPH (5) SHALL BE DEVELOPED BY
12 THE DEPARTMENT AND SHALL NOTIFY THE PARENTS OF ALL OF THE
13 FOLLOWING:
14 (I) THE DEPARTMENT ENCOURAGES THE TESTING OF NEWBORN
15 CHILDREN WITHIN 90 DAYS OF BIRTH.
16 (II) IF THE TEST IS CONDUCTED WITHIN 90 DAYS OF
17 BIRTH, THE PARENTS' HEALTH INSURANCE POLICY OR MEDICAL
18 ASSISTANCE MAY COVER THE FEE FOR THE TEST.
19 (III) THE DEPARTMENT CAN RECOMMEND HEALTH CARE
20 PROVIDERS WHO CAN PROVIDE THE TEST FOR THE NEWBORN CHILD.
21 (c) Refusal of test on religious grounds.--No test is to be
22 performed if a newborn child's parent dissents on the ground
23 that the test conflicts with a personal religious belief or
24 practice.
25 Section 5. Hearing testing insurance coverage.
26 (a) Hearing screening tests.--INSURANCE COVERAGE FOR <--
27 TESTING.--Except as provided in subsection (d), any health
28 insurance policy which is delivered, issued for delivery,
29 renewed, extended or modified in this Commonwealth by any health
30 care insurer shall provide that the health insurance benefits
19970S0938B1952 - 5 -
1 applicable under the policy shall include coverage for initial 2 testing and for any necessary follow-up for the newborn child <-- 3 hearing screening test TESTING. <-- 4 (b) Delivery of policy.--Except as provided in subsection 5 (d), if a health insurance policy provides coverage or benefits 6 to a resident of this Commonwealth, it shall be deemed to be 7 delivered in this Commonwealth within the meaning of this act 8 regardless of whether the health care insurer issuing or 9 delivering the policy is located within or outside this 10 Commonwealth. 11 (c) Cost-sharing provision.--Benefits for the newborn child <-- 12 hearing screening test shall be subject to copayment and 13 coinsurance provisions of a health insurance policy to the 14 extent that other medical services covered by the policy are 15 subject to those provisions, except that benefits for the 16 newborn child hearing screening test shall be exempt from 17 deductible or dollar limit provisions in a health insurance 18 policy. This exemption must be explicitly provided for in the 19 policy. 20 (d) Exemption.-- 21 (1) Notwithstanding subsections (a) and (b), this <-- 22 section shall not be construed to require a health insurance 23 policy to include coverage for the newborn child hearing <-- 24 screening test for an individual who is a resident of this 25 Commonwealth if the individual is employed outside this 26 Commonwealth and the individual's employer maintains a health 27 insurance policy for the individual as an employment benefit. 28 (2) NOTHING IN THIS ACT SHALL APPLY TO ACCIDENT ONLY, <-- 29 SPECIFIED DISEASE, HOSPITAL INDEMNITY, MEDICARE SUPPLEMENT, 30 LONG-TERM CARE, OR OTHER LIMITED BENEFIT HEALTH INSURANCE 19970S0938B1952 - 6 -
1 POLICIES. 2 (e) Applicability.--This act shall apply to all insurance 3 policies, subscriber contracts and group insurance certificates 4 issued under any group master policy, delivered or issued for 5 delivery on or after the effective date of this act. This act 6 shall also apply to all renewals of contracts on any renewal 7 date which is on or after the effective date of this act. 8 Section 6. Coverage under medical assistance. 9 The Department of Public Welfare shall pay for the newborn 10 child hearing screening test if the child is eligible for <-- 11 medical assistance under Article IV of the act of June 13, 1967 12 (P.L.31, No.21), known as the Public Welfare Code. 13 Section 7. Newborn Child Hearing Advisory Committee. <-- 14 There is established the Newborn Child Hearing Advisory 15 Committee under the jurisdiction of the department. The 16 committee shall advise the secretary on issues relating to the 17 newborn child hearing screening test, diagnostic hearing 18 testing, intervention, treatment and follow-up of newborn 19 children. The committee shall meet at least two times per year 20 and shall be chaired by an individual elected by the committee 21 members. The department shall provide support services required 22 by the committee. The members of the committee shall receive no 23 compensation for their services as members but may receive 24 reimbursement for travel expenses incurred as a result of their 25 duties as members of the committee. The committee shall be 26 composed of ten members appointed by the secretary from the 27 following professions or organizations: 28 (1) A representative of the health insurance industry. 29 (2) A representative of hospital neonatal nurseries. 30 (3) The Secretary of Health, or a designee. 19970S0938B1952 - 7 -
1 (4) The Secretary of Public Welfare, or a designee. 2 (5) A representative of early intervention services 3 within the Department of Education. 4 (6) An audiologist, designated by the Pennsylvania 5 Academy of Audiology. 6 (7) The parent of a child with hearing loss. 7 (8) An audiologist designated by the Pennsylvania 8 Chapter of the American Speech-Language-Hearing Association. 9 (9) A neonatologist designated by the Pennsylvania 10 Chapter of the American Academy of Pediatrics. 11 (10) An otolaryngologist specializing in pediatrics 12 designated by the Pennsylvania Academy of Otolaryngology/Head 13 and Neck Surgery. 14 Section 8. Expiration. 15 The Newborn Child Hearing Advisory Committee shall expire 24 16 months after the effective date of this act unless the General 17 Assembly shall extend the date of expiration. 18 Section 9 7. Regulations. <-- 19 (a) Secretary of Health.--The Secretary of Health shall 20 promulgate regulations as may be necessary to implement the 21 provisions under section 4. 22 (b) Insurance Commissioner.--The Insurance Commissioner 23 shall promulgate regulations necessary to implement the 24 provisions under section 5. 25 Section 10 8. Effective date. <-- 26 This act shall take effect in 90 days. D2L35JS/19970S0938B1952 - 8 -