SEATTLE, WASHINGTON — According to a report in the Yakima Herald, a Seattle law firm has filed suit against two health insurance companies due to the companies not covering treatment for hearing loss. The suit alleges that the exclusion of hearing loss treatment constitutes illegal discrimination under federal law.
The outcome of the case could set a precedent for insurers across the country.
The class action lawsuit was filed last week against Regence BlueShield and Kaiser Foundation Health Plan of Washington by law firm Sirianni Youtz Spoonemore Hamburger on behalf of three named plaintiffs, who represent thousands of Washington patients possibly effected by the case outcome.
According to comments from attorney Ele Hamburger to the Yakima Herald, she said the lawsuit is the first of its kind nationwide:
“The question that we’re raising in this litigation is… Can insurance companies, under the new anti-discrimination part of the Affordable Care Act, exclude an entire group of people for health coverage to treat their disability?”
The law firm filing the class action suit successfully argued last year that Washington state’s Medicaid program could not refuse coverage for a hepatitis C cure for people whose liver disease hadn’t yet advanced to cirrhosis. Now, because of that case, all patients with Hepatitis C with Medicaid can be considered for the drug.
Hearing Aid Insurance Coverage Denial: Illegal Discrimination?
While some states mandate insurance coverage for hearing aids, the vast majority do not. Typically insurers will cover the audiological examination, but not treatment.
According to the lawsuit:
“By categorically excluding insureds with Hearing Loss of all medical treatment related to their disability (except for cochlear implants), Regence/Kaiser engages in illegal disability discrimination. The Affordable Care Act prohibits discrimination on the basis of disability by covered entities, including health insurers”
In Washington, the state’s Medicaid covers hearing aids for children until age 21, but the hearing aid benefit for adults was cut several years ago due to budget constraints. Insurers in the state are required by state law to cover hearing screening tests, as well as cochlear implants, as part of the “essential health benefits” that are mandated by the ACA.
According to Hamburger, the exclusion of hearing loss coverage relates to “an old-fashioned interpretation of health insurance”, as something that only covers accidents, injuries and illnesses of an immediate nature, while leaving out conditions that people are born with or may struggle with throughout their lives.