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H 3946

Contractor licensure exemptions

2025-2026 Regular Session Introduced by Lucas Atkinson and 7 co-sponsors

Requires Massachusetts health plans to cover hearing aids as durable medical equipment, with one aid per ear every 36 months and a copay not to exceed $200.

Referred to Committee on Labor, Commerce and Industry
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Bill Summary · H 3946

Summary — H.3946 (House Docket No. 3015)

Title(s): An Act relative to health insurance coverage for hearing aids
Primary Sponsors: Rep. Sean Garballey and Rep. Jessica Ann Giannino (with multiple co-petitioners)
Classification: Bill (state-level)
Note on source materials: The provided file also contains text from an unrelated South Carolina contractor‑licensing amendment and a mismatched title (“Contractor licensure exemptions”). The body of H.3946 in the Massachusetts House docket is a hearing‑aid insurance coverage bill. Readers should confirm final text and status with the official legislative clerk for authoritative records.

Main purpose

Require state-regulated group and individual health coverage to pay for hearing aids and related services, treating hearing aids as durable medical equipment (DME) and ensuring parity with other DME benefits.

Key provisions

  • Amends:
    • Chapter 32A, §23 (Group Insurance Commission coverage)
    • Chapter 175, §47X (Accident & sickness insurance policies)
    • Chapter 176A, §8Y (Hospital service plan corporation contracts)
  • Coverage mandate:
    • Insurers/contractors must cover the cost of one hearing aid per hearing‑impaired ear every 36 months.
    • If a treating physician provides a written statement that a patient’s hearing capability changed so the current device is insufficient, a new hearing aid must be covered before the 36‑month interval expires.
  • Scope of covered items/services:
    • The hearing aid “deemed best for the patient” by the audiologist or hearing‑aid dispenser and the patient, regardless of brand.
    • Coverage treated as DME and subject to the same terms/conditions as other DME.
    • Includes related services prescribed by a licensed audiologist or hearing instrument specialist: initial evaluation, fitting, adjustments, supplies (ear molds, batteries, accessories), and repair or replacement when failure is not the user’s fault.
  • Cost sharing limits:
    • Benefits for hearing aids shall not be subject to greater deductibles, coinsurance, copayments, or out‑of‑pocket limits than other DME benefits.
    • A copayment for a hearing aid under this section shall not exceed $200.
  • Applicability:
    • Applies to group insurance (including Group Insurance Commission), non‑group (individual) policies, and certain funds and service plans (excludes supplemental Medicare/governmental program contracts per the text structure).

Who is affected

  • Individuals insured under:
    • The Group Insurance Commission (state employee plans),
    • Commercial accident and sickness insurance policies,
    • Individual and group hospital service plans issued by HMO/Care organizations in Massachusetts,
    • Employee health and welfare funds providing hospital/surgical benefits.
  • Licensed audiologists and hearing instrument specialists providing evaluations/fittings.
  • Insurers and health‑plan administrators in Massachusetts (must adjust DME benefit design, prior authorization procedures, and provider networks as applicable).

Procedural / timeline notes (from provided record)

  • Filed in House: 01/16/2025 (House docket No. 3015). Another entry shows introduced/read first time 02/11/2025.
  • 02/11/2025: Referred to Committee on Labor, Commerce and Industry (per record).
  • 03/31/2025: Referred to the Committee on Financial Services (record shows both committee referrals — verify current referral).
  • 04/03/2025: Senate concurred (per record) — this date may reflect action on a related or amended version; confirm with official journal.
  • 09/17/2025: Hearing scheduled (listed 09/09/2025 notice for a 09/17/2025 hearing, Gardner Auditorium).

Potential impacts and considerations

  • Increased access to hearing aids and associated services for insured Massachusetts residents, with a cap on copayment ($200) and parity with other DME.
  • Potential insurer cost exposure and premium or rate impacts depending on utilization; fiscal effect not specified in text.
  • Administrative changes for insurers to classify hearing aids as DME and to incorporate providers and supplies into covered benefits.
  • Interplay with federal programs (Medicare/Medicaid) and existing state mandates should be reviewed for duplication/exemption rules.

For final legal text and current status, consult the Massachusetts Legislature’s official website or the Clerk’s Office.

Compiled from official sources — confirm details with the bill’s official record.

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