US Newborn Hearing Screening Resources: State Laws in United States
US Newborn Hearing Screening Resources: State Laws
A number of states have created task forces or advisory committees on newborn hearing screening. Thirty states, Guam,Puerto Rico, and the District of Columbia provide for the establishment of mandatory early hearing screening programs, including: Arkansas, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Montana, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Utah, Virginia, West Virginia and Wyoming.
Seventeen states, Guam, Puerto Rico, and the District of Columbia require specified or all insurers to cover the screening, including: Alaska, Delaware, Florida, Indiana, Maine, Maryland, Massachusetts, Mississippi, Missouri, Nebraska, New Jersey, New York, Rhode Island, Tennessee, Texas, Virginia and West Virginia.
At least three states–Massachussetts, Ohio, and West Virginia–have laws that specify who will pay for the screening if the facility is not reimbursed by a third-party payer and parents are unable to pay.
| State |
Summary of Statutes |
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| Alabama | |||
| Alaska | Alaska Stat. § 47.20.300 et seq. (2006) establishes a screening, tracking, and intervention program for newborn hearing screening. Also provides parental notification for child’s potential hearing impairment. (H.B.109)Alaska Stat. § 21.42.349 (2006) requires health care insurers to provide coverage for newborn and infant hearing screening within 30 days after birth. Insurers must also provide coverage for a follow up confirmatory hearing diagnostic evaluation if the initial screening determines that the child may have a hearing impairment. (H.B.109) |
| American Samoa |
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| Arizona | Ariz. Rev. Stat. Ann. § 36-694 (2005, 2008) provides for tests and follow up on newborns for certain congenital disorders; includes hearing test. This law was amended in 2008 to include guidelines for reporting results of hearing screening tests to the department of health services and a new fee schedule for first and second hearing tests. The amendment also establishes a central database for test results, and designates the state laboratory as the only testing facility for the newborn hearing screening program. (H.B.2802) | ||
| Arkansas | Ark. Stat. Ann. § 20-15-1101 et seq. establishes the Newborn Infant Hearing Screening Program, which is to be coordinated through the Division of Health of the Department of Health and Human Services and the Department of Education. Hospitals, birthing centers, and lay midwives shall complete hearing impairment at-risk questionaires, but parents may submit a written refusal for hearing screening. These facilities are to send newborn hearing test results to the Division of Health, and facilities are to provide parents or guardians with hearing impaired newborns with information on locations where they may seek follow-up.Ark. Stat. Ann. § 20-15-1501 et seq. (1999) creates the Universal Newborn Hearing Screening, Tracking, and Intervention Advisory Board. The act also requires birthing hospitals with more than 50 births per year to provide or arrange for a bilateral hearing screening on each birth. Test costs are reimbursable under Medicaid and the results will be forwarded to the Department of Health each month. Birthing hospitals are to provide information to the parents or guardians of the newborns on how follow-up care and screening can be obtained. | ||
| California | Cal. Health and Safety Code § 123975 (2006) requires a hearing screening be offered to every newborn upon birth through licensed prenatal services. Hospitals that are not approved by the Children’s Services program must contract for service. (A.B.2651)Cal. SCR 105 (1998) encourages the Department of Health to seek the advice of the task force with regard to approaches for a system to screen all newborns and infants for hearing loss and allows the task force to monitor implementation of the program. | ||
| Cal. Health and Safety Code § 124115 et seq. (1998) establishes the Newborn and Infant Hearing Screening, Tracking, and Intervention Act, and requires the State Department of Health Services to administer a system to screen infants at high risk for deafness and a system to provide follow-up and assessment service, when necessary. It requires all acute care hospitals that are approved for California Children’s Services funding to offer a hearing screening test to all infants. | |||
| Colorado | Colo. Rev. Stat. § 25-4-1004 (1997) creates an advisory committee on hearing in newborn infants for the purpose of collecting data to report to the legislature and provides recommendations to hospitals, and other health care institutions. Newborn hearing screening is to be conducted on 85 percent of the infants born in hospitals using procedures recommended by the advisory committee. | ||
| Connecticut | Conn. Gen. State. § 19a-59 (1997) requires certain health care institutions to include universal newborn hearing screening as part of its standard of care and establishes a mechanism for compliance review. | ||
| Delaware | Del. Code Ann. tit. 16, § 801A et seq. (2005) relates to hospitals and universal newborn and infant hearing screening. Provides that each hospital shall establish a Universal Newborn Hearing Screening program; provides for parental notice prior to discharge. (H.B.205)Del. Code Ann. tit. 18, § 3352, § 3568 require individual health insurance policies to provide coverage for hearing loss screening tests of newborns and infants before discharge from the hospital. | ||
| District of Columbia | D.C. Code Ann. § 7-851 et seq. (2001) requires that every hospital and maternity center establish a newborn hearing screening program to screen all newborns before they are discharged from the hospital. All health benefit plans are required to provide reimbursement for these hearing screenings. | ||
| Florida | Fla. Stat. § 409. 816 (2000) provides definitions; provides requirements for screening newborns for hearing impairment; provides for certain insurance & managed care coverage; provides for referral for ongoing services. (HB 399)Fla. Stat. § 383.145 (2002) requires licensed hospitals and birthing facilities that provide maternity and newborn care services to provide screening for the detection of hearing loss if the parents or legal guardians do not object to the screening. All screenings are to be conducted by a licensed audiologist, physician or specifically trained and supervised individual in newborn hearing screening. Hospitals and birthing centers conducting screenings are responsible for providing appropriate staff training, screening program supervision, monitoring the scoring and interpretation of screening results, rendering appropriate recommendations and coordinating the appropriate follow-up services. Provisions are included to inform parents of the importance of hearing screening for infants not delivered in a hospital or birthing center. In addition, the law mandates insurance coverage, including Medicaid, of the initial screening and any medically necessary follow-up re-evaluations leading to diagnosis. | ||
| Georgia | Ga. Code § 31-1-3.2 (1999) establishes an advisory committee on newborn hearing screening to study and collect information for the purpose of providing recommendations to health care facilities and providers. The act requires hearing screening to be conducted on no fewer than 95 percent of all newborn infants born in hospitals and requires hospitals and physicians to educate parents of the importance of screening and follow-up care. | ||
| Guam | 10 G.C.A. § 4101 et seq. (2004) establishes the Universal Newborn Hearing Screening and Intervention Act, which includes definitions, programs, insurance coverage, and reimbursement. | ||
| Hawaii | Hawaii Rev. Stat. § 321-361 et seq.(2001) provides for a statewide comprehensive and coordinated interdisciplinary program of early hearing impairment screening identification, and follow-up for children from birth to thirty-six months of age and their families. The law also requires all newborn infants born in a birthing facility to be screened for hearing impairment unless the infant’s parents or guardian objects in writing on religious grounds. It is the duty of the birthing facility to report the screening results to the department of health (SB 1138). Universal Newborn Hearing Screening first established 1990; qualified and amended in 2001. | ||
| Idaho | |||
| Illinois | Ill. Rev. Stat. ch. 410 § 213 (1999) requires all hospitals performing deliveries to conduct hearing screening on all newborns, effective December 31, 2002, unless parents object on religious grounds. The Department of Public Health is required to maintain a registry of children with positive screening results and organize an advisory committee. | ||
| Indiana | Ind. Code § 16-41-17-2, § 27-8-4-24 (1999) adds hearing examinations to the tests required under the newborn screening program unless the infant’s parents object to the screening on religious grounds. The law also requires every insurance policy or group contract that provides maternity benefits to cover hearing examinations. A newborn hearing screening and intervention advisory board is established to provide the state department of health, governmental agencies and private organizations that serve children with advice on issues involving hearing impairment. | ||
| Ind. Code § 12-15-15-1 (2001) specifies that infant hearing examinations are to be covered by Medicaid. | |||
| Iowa | Iowa Code § 135.131 (2003) requires that all infants born in the state of Iowa be screened for hearing loss and that the results collected be reported to the Iowa Department of Public Health for follow-up purposes. Confidential sharing of this information is allowed for persons and/or agencies involved with newborn hearing screening, follow-up, and intervention services. Parents who do not want their infant tested have the right to request a waiver. (Effective January 1, 2004; HB 454) | ||
| Kansas | Kan. Stat. Ann. § 65-1, 157a (1999, 2004) enacts the Newborn Infant Hearing Act, which requires that every child born in the state receive a screening examination for detection of significant hearing loss. Informed consent must be obtained from the newborn’s parents or guardian. The law also authorizes the secretary of health and environment to apply for and receive grants or other moneys that may be available from the federal government. Amended in 2004 by providing rules and regulations on the equipment, protocols, and personnel. | ||
| Kentucky | Ky. Rev. Stat. § 216.2970, 211.645, 211.647, 213.046 (2000) require all hospitals offering obstetric services and certain alternative birthing centers to provide an auditory screening for all infants. A screening report of potential hearing loss is required to be forwarded within 48 hours to the attending physician, the parents and the Commission for Children with Special Health Care Needs. The commission is directed to provide an evaluation and referral to the Kentucky Early Intervention System if necessary. If a birth occurs outside of a healthcare institution, information regarding the importance of infant auditory screening and a list of options available for obtaining screening tests will be forwarded to the parents by the Cabinet for Health and Family Services. (2000 Ky. Acts, Chap. 308) | ||
| Louisiana | La. Rev. Stat. Ann. § 46:2261 et seq. (1999) requires the Department of Health and Hospitals in conjunction with the Louisiana Commission for the Deaf to establish a program for early identification and follow-up of hearing impaired infants and those who are at risk of developing a progressive hearing impairment. The law requires all newborn infants to receive a hearing screening prior to discharge. | ||
| Maine | Me. Rev. Stat. Ann. Tit. 22, § 8821 et seq. (2000) establishes the Newborn Hearing Program to provide hearing screening, evaluation, treatment and intervention services for newborns and children up to three months of age. The law establishes a hearing screening advisory board and requires specified health insurance policies to provide coverage for the screening. (LD 1814)Me. Rev. Stat. Ann. Tit. 22 § 8824 (2007) amends Tit. 22, § 8821 et seq. (2000) and authorizes the Department of Health to enact evaluative measures for hearing screening and services for children from birth to age three. Evaluations should include a tracking system for services to allow for better integration of services. Hospitals must report their screening and treatment data to the Department of Health. (LD 1142) | ||
| Maryland | Md. Health-General Code Ann. § 4-208, 13-601 et seq., 19-308.5 a, and Md. Insurance Code Ann. § 15-817 (1999) modifies the Program for Hearing-Impaired Infants to include a universal newborn hearing screening component. The law alters the composition and responsibilities of the Advisory Council for the Program, requiring the Advisory Council to advise the Department of Health and Mental Hygiene on the implementation of universal hearing screening of newborns. In addition, the law requires certain carriers to provide coverage for the screening and for hospitals to provide the results of the universal hearing screening of the newborn to the Department as part of the required birth event information. | ||
| Massachusetts | Mass. Gen. Laws Ann. 32A § 17F, 118E § 10B, 175 § 47C, 176A § 8B, 176B § 4C, 176G § 4K (1998) requires that a hearing screening test must be performed on all newborns in a birthing hospital or center prior to discharge unless the parents object on religious grounds. The law requires that an advisory committee be established to advise the department on a statewide newborn hearing-screening program. The cost of providing the screening will be a covered benefit reimbursable by all health insurers. In the absence of a third-party payer, the commonwealth will pay the charges. | ||
| Michigan | Mich. Comp. Laws Ann. 333.5432 requires all newborn and infant hearing test results be reported to the Michigan Department of Health. | ||
| Minnesota | Minn. Stat. Ann. § 144.966 (2007) instructs every hospital to set up early hearing detection and intervention programs that test each newborn before discharge from the hospital in accordance with the Department of Health’s guidelines. Hospitals are required to notify the parents, primary care physician and Department of Health about the screening results. Also establishes the Newborn Hearing Screening Advisory Committee to help the Departments of Health and Education establish guidelines for these programs (HF 1078). | ||
| Mississippi | Miss. Code Ann. § 41-86-17 (1998) requires the Mississippi Children’s Health Insurance Program to cover the benefit of hearing screening. | ||
| Miss. Code Ann. § 41-90-1 et seq. (1997) requires a newborn in a hospital to be tested or evaluated for potential hearing impairment. The law establishes a confidential registration program of newborns, infants and toddlers who suffer from impaired hearing and requires that the department of health maintain the registry. In addition, the law requires that an advisory committee be created. | |||
| Missouri | Mo. Ann. Stat. § 191.928 (2007) allows hospitals to release the results of newborn screening tests to the child’s primary care doctor.Mo. Ann. Stat. § 191.931 (2002) revises a provision pertaining to hearing screening for newborns. The law requires any facility, which transfers a newborn to a different facility for further acute care prior to the completion of the newborn hearing screening to notify the receiving facility of the current status of the hearing screening. If the hearing screening is incomplete, the receiving facility is responsible for completing the hearing screening for newborns.
Mo. Rev. Stat. § 191.925 (1999) declares that every newborn delivered on or after January 1, 2002, in an ambulatory surgical center or hospital must be screened for hearing loss prior to discharge unless the parents object on religious grounds. The law also creates a Newborn Hearing Screening Advisory Committee. Mo. Rev. Stat. § 376.1220 (1999) mandates that health insurance policies and Medicaid are to cover newborn hearing screenings and additional diagnostic exams. |
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| Montana | Mont. Code Ann. § 53-19-401 et seq. (2001, 2007) In 2001 the universal newborn hearing screening program was implemented, which encourages a hearing screening test for all newborns for identification of newborn infant hearing loss. The law also creates a task force on hearing loss in newborns for the purpose of advising the Department of Public Health and Human Services on the collection and reporting of information. (HB 468) In 2007 this was revised to state that the Department of Health must implement a universal newborn hearing screening program to assess each child within the first month of life. Instructs the Department of Health to ensure that hospitals are completing the screenings within specified guidelines, providing education and ensuring that children referred for further screening or services receive these screenings and services within three months of birth. Health care centers must report monthly to Department of Health. | ||
| Nebraska | Neb. Rev. Stat. § 71-4734 et seq. (2000) creates the Infant Hearing Act, which requires the department of health and human services to implement a system that tracks newborns identified with a hearing loss. The law requires that every birthing facility educate the parents of newborns on the importance of receiving a hearing screening test and necessary follow-up care. The law also requires that by December 1, 2003, each birthing facility include a hearing screening test as part of its standard of care for newborns and establish a mechanism for compliance review. At this time, 95 percent of newborns must receive a hearing-screening test. Requires payment for hearing screening tests under medical assistance and health insurance plans. | ||
| Nevada | Nev. Rev. Stat. § 442.500 et seq. (2001) requires licensed hospitals and licensed obstetric centers that provide services for maternity care and the care of newborn children to provide a hearing screening exam prior to discharge of a newborn child, unless the parent or legal guardian objects. This requirement does not apply to hospitals that have fewer than 500 births annually. (Nev. Laws, Chap. 510; AB 250) | ||
| New Hampshire | N.H. Laws, Chap. 234 (2000) establishes the New Hampshire task force on deafness and hearing loss and defines its duties. The task force is required to submit a report to specified members of the General Court and the governor within a specified time period. (HB 1602) | ||
| N.H. Laws, Chap. 131 (2000) requires the commissioner of the Department of Health and Human Services to develop standards for testing newborns for deafness. This includes, but is not limited to types of equipment, qualifications of heath care providers who perform the test, and follow-up programs. (SB 456)N.H Laws, Chap. 0022 (2002) establishes a study committee to review and determine steps to fully implement the infant deafness program (HB 1337) | |||
| New Jersey | N.J. Rev. Stat. § 26:2-103.1 et seq. (2000) states that prior to the discharge from any hospital or birthing center, all newborns are to be given a hearing screening examination and the parents or legal guardians of the newborn shall be provided with literature describing the normal development of auditory function.N.J. Rev. Stat. § 17:48-6m, 17:48e-35.10; 17b:27-46.11, 17b:27a-7, 17b:27a-19; 26:2j-4.10 requires Medicaid and private insurers who offer maternity care to cover newborn and infant hearing screening. | ||
| New Mexico | N.M. Stat. Ann. § 24-1-6.1 (2001) requires the Department of Health to adopt rules by July 1, 2001 that require infants that are born in health facilities licensed by the department to be screened for hearing sensitivity prior to being discharged. The rules also require the testing of newborns brought to licensed health facilities after birth who have not received a hearing sensitivity screening. The newborn’s parents are to be notified of the results of the hearing sensitivity screening and they are given the right to object to the screening on the grounds that it conflicts with their religious beliefs. (SB 101)N.M. Stat. Ann. § 24-1-6 (2005) relates to newborn child medical test requirements; expands the number of medical tests required for newborn children; includes tests for hearing and other deficiencies and congenital diseases (HB479). | ||
| New York | N.Y. Public Health Law § 2500-g (1999) directs the health commissioner to establish a program to screen newborns for hearing problems. In addition, providers of the services will be reimbursed. (AB 4152-A)N.Y. Public Health Law § 69-8 provides general requirements for newborn and infant hearing screening procedures. Infants will be tested prior to discharge from the facility and parents provided with information and results related to the screening test. Follow-up will include referral to the Early Intervention Program if the child is suspected of having hearing loss. Facilities providing screening tests will report aggregate data to the Department of Health and establish quality assurance protocols. | ||
| North Carolina | N.C. Gen. Stat. § 130A-125 (1991, 1992, and 1998) establishes a newborn screening program and directs the Commission for Health Services to include hearing screening in the program. Parents or guardians may object to screening.N.C. Gen Stat. § 58-3-260 requires newborn hearing screening to be included in insurance coverage. | ||
| North Dakota | |||
| Ohio | Ohio Rev. Code Ann. § 3701.503 et seq. (2002) requires the Department of Health to establish and maintain a statewide hearing screening, tracking, and early intervention program. The department will also be responsible for establishing protocols for the treatment and follow-up care of newborns and infants with hearing impairment. Requires the department of health to pay for screening if the facility is not reimbursed by a third-party payer and parents are unable to pay. | ||
| Oklahoma | Okla. Stat. § 63-1-543 (2000, 2006) requires the screening of all infants for the detection of hearing impairments. The law requires that the screening be administered by a physician, audiologist or other qualified person and the State Board of Health is to develop procedures and guidelines for the administration of screening procedures for the detection of hearing impairments. In 2006, the statute was amended to provide exceptions for the State Department of Health and clarify requirements. (S.B.1097) | ||
| Oregon | Or. Rev. Stat. § 433.321 et seq. (1999, 2003) requires hospitals and birthing centers with more than 200 live births per year to provide newborn hearing screenings within one month of birth, unless the parents object on religious grounds. All hospitals and birthing centers with fewer than 200 live births must provide information regarding the importance of hearing screening to parents and guardians. The law also establishes an advisory committee. In 2003, some provisions of the law related to disclosure of information were changed. The amendment also includes several language changes. (HB 3246) | ||
| Pennsylvania | Penn. Stat. 11 § 876-1 et seq. (2001) establishes the Infant Hearing Education, Assessment, Reporting and Referral Program. The law specifies powers and duties of the Department of Health. The law provides that newborn screening is not required if the parent objects for any reason. (SB 100) | ||
| Puerto Rico | Laws of Puerto Rico Ann. 24 § 3521 et seq. establishes a Neonatal Universal Newborn Hearing Screening Program, an Advisory Committe to oversee the program, and health insurance coverage for screenings. | ||
| Rhode Island | R.I. Gen Laws § 23-13-13 (1992) requires that all newborns be screened for hearing, unless the parents of the infant object to the screening on religious grounds. The screening is to be a covered benefit reimbursable by all health insurers. This law creates a hearing impairment testing advisory committee that will advise the director of the department of health regarding the validity and cost of testing procedures.R.I. Gen Laws § 16-21-14 (2000) establishes the statewide hearing screening and conservation program. The act requires the program to provide for hearing, speech, and vision examinations for all children in schools, and the preservation of records of the examinations of the children and notification of the parent or guardian of any child where there is a deviation from the normal. | ||
| South Carolina | S.C. Code § 44-37-40 (2000) enacts the Universal Newborn Hearing Screening and Intervention Act, that requires newborn hearing screenings to be conducted prior to discharge on all newborns born in hospitals that average more than 100 deliveries per year. The law requires every hospital to provide educational information to the parents of newborns born in that hospital concerning the hearing screening procedure and the importance of the screening. The law also establishes the Newborn Hearing Screening and Intervention Advisory Council to advise the Department of Health and Environmental Control on matters related to the implementation of this act. The department will establish procedures on the reimbursement for expenses incurred. | ||
| South Dakota | |||
| Tennessee | 2008 Tenn. Pub. Acts, Chap. 768 creates “Claire’s Law,” requiring every newborn infant to be screened for hearing loss prior to discharge from the birthing facility unless the parents of the child object on religious grounds to the test. Follow-up tests will be performed on infants at high risk for hearing loss, and the results of these tests shall be reported to the Department of Health. Any child who does not pass the hearing screening test will be referred to the Tennessee Early Intervention System in order to provide comprehensive follow-up services. Also provides for insurance and managed care coverage for infant hearing screening tests. (S.B.3191) | ||
| Texas | Tex. Health and Safety Code Ann. § 47.001 et seq. (1999) requires hospitals and birthing centers that offer obstetrical services in counties with more than 50,000 people to offer newborn hearing screening prior to discharge. Facilities that provide the hearing screenings are also required to provide educational materials and to report results to the parents, attending physician and the department.Tex. Health and Safety Code Ann. § 47.008d (2003) adds the provision that statistical or aggregated information about activities conducted under this chapter, that could not be used to individually identify a newborn, infant, or patient or a parent or guardian of a newborn, infant, or patient is not confidential.
Texas Insurance Code § 1367.101 et seq. requires that insurance cover newborn and infant hearing screening. |
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| U.S. Virgin Islands | |||
| Utah | Utah Code Ann. 26-10-6 (1998) requires hospitals and other settings with 100 or more live births annually to test newborn infants for hearing loss unless the parents or guardian object on religious grounds. The law also establishes the Newborn Hearing Screening Committee, which shall test the validity and cost of newborn hearing loss testing procedures. | ||
| Vermont | |||
| Virginia | Va. Code § 2.2-2818 (2004, 2006) adds nurse practitioners to the list of medical professionals state employee benefits plans are required to cover for newborn hearing screenings. (HB 855) Amended in 2006 to include physician assistants on this list of medical professionals. (H.B. 300)Va. Code § 38.2-3411.4 (2001, 2006) requires health insurers, health maintenance organizations, and corporations providing subscription contracts for health care coverage to provide coverage for infant hearing screenings and certain other audiological examinations. These requirements are also made applicable to the state’s health care coverage plan for state employees and to Medicaid. (SB 1200) Amended in 2006 to require that insurance providers cover the cost of newborn hearing screenings. (H.B. 300)
Va. Code § 32.1-64.1 (1998) establishes the Virginia Hearing Impairment Identification and Monitoring System, and requires it to be initiated in all hospitals with neonatal intensive care services, hospitals with newborn nurseries and other birthing places or centers. The law requires that all infants have a hearing-screening test. The law also requires an advisory committee to be created to assist in the design, implementation, and revision of this identification and monitoring system. |
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| Washington | |||
| West Virginia | W. Va. Code § 16-22A-1 et seq. (1998) requires that physicians test all newborns by procedures approved by the state for hearing impairments unless parents refuse. The law mandates that all health insurers cover the benefits of newborn hearing screening and that the state pays when the child is eligible for medical assistance. If there is no third-party payer, charges for the testing will be paid by the hospital or other health care facility where the infant’s birth occurred. The law also establishes an advisory board to advise on the administration of the program. (HB 2388) | ||
| Wisconsin | Wis. Stat. § 253.115 (1999) requires the Department of Health and Family Services to collect annual data on newborn deliveries in hospitals and the availability of hospital newborn hearing screening programs beginning July 1, 2002. If, by August 5, 2003, the department determines that less than 88 percent of all deliveries are performed in hospitals that have a newborn hearing screening program, then the law will require every hospital (by January 1, 2004), to have a newborn hearing screening program that is available to all infants. | ||
| Wyoming | Wyo. Stat. § 35-4-801 (1999, 2007) requires medical examinations for the detection of major hearing defects for every child born in the state if the parents do not object. The exam must be given within three to five days of birth for a normal full-term baby and five to eight days of birth for a premature baby. Amended in 2007 to create a fee schedule that will be paid to the Department of Health for infant hearing screenings.(SB 86) | ||
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