Louisiana Speech-Language-Hearing Association

The following bills were passed during the 2003 legislative session: 

Implementation of Act 816 Underway

Beginning January 1, 2004, as new health insurance contracts are written as well as when already-existing health plans are renewed, a provision for coverage of children's hearing aids is being included in policies issued in the state of Louisiana.  Act 816 (SB 408) of the 2003 Regular Session of the Louisiana Legislature sponsored by Senators Gautreaux and Hines and Representatives Faucheux, Murray, and Peychaud, provides for hearing aids for children in the amount of $1400 per ear every thirty-six months.  The hearing aid must be fitted and dispensed by a licensed audiologist or licensed hearing aid specialist following the medical clearance of a physician and an audiological evaluation medically appropriate to the age of the child.   

While implementation has been largely successful, there are two exceptions to coverage that should be noted.  If a resident of Louisiana is an employee of an out-of-state company where the group health insurance is issued out-of-state, the insurance mandate specified in Act 816 does not apply.  When a single health insurance contract is issued, it must comply with the mandates required for that state.  If an employer is domiciled in Alabama, for example, that Alabama business does not have to adhere to a Louisiana-mandated insurance code. 

Although there are few of these in Louisiana, another exception has to do with self-funded health plans.  A self-funded health plan is one in which the employer pays claims out of company funds, rather than an insurance company funding claims based on premiums.  State departments of insurance and state insurance commissioners do not have legal authority to regulate self-funded ERISA (Employee Retirement and Income Security Act) plans.  Therefore, if a Louisiana employer/company chooses to implement a self-funded health plan, the 20+ insurance mandates in the state of Louisiana would not be required as a component of the health plan because ERISA plans are exempt.

Louisiana became the sixth state in the country to enact legislation requiring insurance coverage for children's hearing aids, and due in large part to the implementation language included in the bill, Act 816 is being viewed as model legislation.  Theresa Rodgers, 2003 Legislation Chair, and Glenn Waguespack, Chair of LSHA’s Ad Hoc Committee on Hearing Aid Legislation, have been asked to present Louisiana's success story at the upcoming American Academy of Audiology (AAA) convention in Salt Lake City.  "Providing a Sound Start for Infants Needing Amplification" will also include presenters from Kentucky, Oklahoma, and Maryland.  Karen Ditty, network audiologist for the National Center for Hearing Assessment and Management (NCHAM) and formerly the audiologist at Woman's Hospital in Baton Rouge, is coordinating the presentation as well as a similar session at the third annual national early hearing detection and intervention (EHDI) conference in Washington D.C. this month. 

Because of this important legislation, service delivery in audiology is being expanded to include additional coverage for children under eighteen.  LSHA appreciates the efforts of those who worked so diligently to pass this legislation, paving the way for successful implementation.

Contact US: LSHA; 8550 United Plaza Blvd.; Suite 1001; Baton Rouge, LA 70809; (225) 922-4512; Fax: (225) 922-4611; Email: lsha@pncpa.com