S. 3400 — Ally’s Act

This section amends the Public Health Service Act and ERISA to require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage—subject to no more restrictive financial requirements or treatment limitations than those applied to substantially all medical and surgical benefits, and with no separate cost-sharing or treatment limits—for the following items and services furnished to a qualifying individual: (1) auditory implant devices (including auditory osseointegrated (bone conduction) implants and cochlear implants) and external sound processors; (2) maintenance of such devices and processors; (3) upgrades (or replacements if unavailable) of such devices and processors every five years; (4) adhesive adapters and softband headbands; (5) repairs of such devices and processors; (6) comprehensive hearing assessments; (7) preoperative medical assessments; (8) related surgery; (9) postoperative medical visits; (10) postoperative audiological visits for activation and fitting; and (11) aural rehabilitation and treatment services (as determined necessary by the treating physician or qualified audiologist). Plans and issuers may not deny or limit any such coverage determined medically necessary by a physician or qualified audiologist. (A qualifying individual is one determined by such a provider to meet an indication, including unilateral or bilateral hearing loss, for an auditory implant device and external sound processor.)