HEAR Act of 2021

I 117TH CONGRESS 1ST SESSION H. R. 1106 To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of hearing aids and related hearing services. IN THE HOUSE OF REPRESENTATIVES FEBRUARY 18, 2021 Mr. CARTWRIGHT (for himself, Mr. KATKO, Ms. CLARKE of New York, Mr. GRIJALVA, Mr. HASTINGS, Ms. JACKSON LEE, Ms. MCCOLLUM, Mr. MCKINLEY, Mr. NADLER, and Mr. THOMPSON of California) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend title XVIII of the Social Security Act to provide for coverage under the Medicare program of hearing aids and related hearing services. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Help Extend Auditory 4 Relief Act of 2021’’ or the ‘‘HEAR Act of 2021’’. 5 VerDate Sep 11 2014 20:54 Mar 12, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1106.IH H1106 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 1106 IH SEC. 2. MEDICARE COVERAGE OF HEARING REHABILITA- 1 TION. 2 (a) COVERAGE OF AURAL REHABILITATION SERV- 3 ICES.—Section 1861(s)(2) of the Social Security Act (42 4 U.S.C. 1395x(s)(2)) is amended— 5 (1) in subparagraph (GG), by striking ‘‘and’’ at 6 the end; 7 (2) in subparagraph (HH) by inserting ‘‘and’’ 8 at the end; and 9 (3) by adding at the end the following new sub- 10 paragraph: 11 ‘‘(II) aural rehabilitation services (as described 12 in subsection (lll)(1)(A));’’. 13 (b) COVERAGE OF HEARING AIDS AS DURABLE MED- 14 ICAL EQUIPMENT.—Section 1861(s)(8) of the Social Secu- 15 rity Act (42 U.S.C. 1395x(s)(8)) is amended by inserting 16 ‘‘and hearing aids (as defined in subsection (lll)(3))’’ be- 17 fore the period. 18 (c) HEARING REHABILITATION AND HEARING AID 19 DEFINED.—Section 1861 of the Social Security Act (42 20 U.S.C. 1395x) is amended by adding at the end the fol- 21 lowing new subsection: 22 ‘‘Hearing Rehabilitation 23 ‘‘(kkk)(1) The term ‘hearing rehabilitation’ means— 24 ‘‘(A) aural rehabilitation services (described in 25 paragraph (2)) which meet such requirements as the 26 VerDate Sep 11 2014 20:54 Mar 12, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1106.IH H1106 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 1106 IH Secretary prescribes and which are furnished by a 1 physician or qualified audiologist, who is legally au- 2 thorized to furnish such services under the State law 3 (or the State regulatory mechanism provided by 4 State law) of the State in which the services are fur- 5 nished; and 6 ‘‘(B) hearing aids (as defined in paragraph 7 (3)). 8 ‘‘(2) The services described in this subparagraph in- 9 clude— 10 ‘‘(A) aural rehabilitation services; 11 ‘‘(B) in the case of an individual who has a 12 hearing loss (as defined by the Secretary), a com- 13 prehensive audiologic assessment to determine if a 14 hearing aid is appropriate and to determine the need 15 for other diagnostic medical or audiologic testing; 16 and 17 ‘‘(C) a threshold test to determine audio acuity. 18 ‘‘(3)(A) The term ‘hearing aid’ means a hearing aid 19 described in subparagraph (B), including the services de- 20 scribed in subparagraph (C) furnished by a physician or 21 qualified audiologist, who is legally authorized to supply 22 such hearing aid under the State law (or State regulatory 23 mechanism provided by State law) of the State in which 24 VerDate Sep 11 2014 20:54 Mar 12, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1106.IH H1106 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 1106 IH the hearing aid is supplied, to an individual described in 1 subparagraph (D). 2 ‘‘(B) A hearing aid described in this subparagraph 3 is any wearable instrument or device for, offered for the 4 purpose of, or represented as aiding individuals with, or 5 compensating for, hearing loss that meets requirements of 6 the Food and Drug Administration for marketing. 7 ‘‘(C) The services described in this subparagraph in- 8 clude— 9 ‘‘(i) audiology services (as defined in subsection 10 (ll)(2)); 11 ‘‘(ii) a hearing aid assessment to determine the 12 appropriate hearing aid for the individual; 13 ‘‘(iii) procurement of an appropriate hearing 14 aid; 15 ‘‘(iv) initial fitting and adjustment of the hear- 16 ing aid; 17 ‘‘(v) appropriate instruction on the use of the 18 hearing aid; 19 ‘‘(vi) periodic refittings and adjustments; and 20 ‘‘(vii) rehabilitation, including counseling on 21 hearing loss, speech reading, and auditory training. 22 ‘‘(D) The individuals described in this subpara- 23 graph— 24 VerDate Sep 11 2014 20:54 Mar 12, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1106.IH H1106 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 1106 IH ‘‘(i) have been determined (as a result of a com- 1 prehensive audiologic assessment) to have a hearing 2 loss which can be appropriately treated with a hear- 3 ing aid; 4 ‘‘(ii) have not been supplied with one monaural 5 hearing aid or two binaural hearing aids during the 6 preceding 3 years; and 7 ‘‘(iii) have had a comprehensive audiologic as- 8 sessment which indicates that the hearing of such 9 individual has deteriorated since such individual was 10 last supplied with a hearing aid such that a hearing 11 aid of a different type is appropriate for such indi- 12 vidual.’’. 13 (d) INCLUSION OF AUDIOLOGY REHABILITATION 14 SERVICES.—Section 1861(ll)(2) of the Social Security Act 15 (42 U.S.C. 1395x(ll)(2)) is amended by inserting ‘‘and re- 16 habilitation’’ after ‘‘balance assessment’’. 17 (e) EXCEPTION TO EXCLUSIONS FROM COVERAGE.— 18 Section 1862(a) of the Social Security Act (42 U.S.C. 19 1395y(a)) is amended— 20 (1) in paragraph (1)— 21 (A) in subparagraph (O), by striking 22 ‘‘and’’ at the end; 23 (B) in subparagraph (P); by striking the 24 semicolon at the end and inserting ‘‘, and’’; and 25 VerDate Sep 11 2014 20:54 Mar 12, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1106.IH H1106 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 1106 IH (C) by adding at the end the following new 1 subparagraph: 2 ‘‘(Q) in the case of hearing rehabilitation, which 3 is furnished or supplied more frequently than is pro- 4 vided under section 1861(lll)(3)(D)(ii).’’; and 5 (2) in paragraph (7) by striking ‘‘hearing aids 6 or examinations therefor’’. 7 (f) EFFECTIVE DATE.—The amendments made by 8 this section shall take effect on the date of the enactment 9 of this Act, and shall apply to items and services furnished 10 on or after a date specified by the Secretary of Health 11 and Human Services that is not sooner than January 1 12 of the first year beginning after such date of enactment 13 and not later than January 1 of the third year beginning 14 after such date of enactment. 15 Æ VerDate Sep 11 2014 20:54 Mar 12, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\H1106.IH H1106 pamtmann on DSKBC07HB2PROD with BILLS