; and (2) the treatment limitations (as defined in such section) applicable to such item or service are no more restrictive than the predominant treatment limitations applied to substantially all medical and surgical benefits covered by the plan, and that there are no separate treatment limitations that are applicable only with respect to such item or service. (c) Prohibition on review of medical necessity A group health plan may not deny or otherwise limit coverage of any item or service described in subsection (a) furnished to a qualifying individual on the basis of a review of the medical necessity of such item or service by such plan or issuer. (d) Qualifying individual defined For purposes of this section, the term qualifying individual means an individual that a physician (as defined in section 1861(r) of the Social Security Act ( 42 U.S.C. 1395x(r) )) or qualified audiologist (as defined in section 1861(ll)(4)(B) of such Act ( 42 U.S.C. 1395x(ll)(4)(B) )) determines meets an indication (including unilateral or bilateral hearing loss) for an auditory implant device and external sound processor described in subsection (a)(1). . (2) Clerical amendment The table of sections for subchapter B of chapter 100 of the Internal Revenue Code of 1986 is amended by inserting after the item relating to section 9825 the following new item: Sec. 9826. Coverage of hearing devices and systems. . (d) Application to grandfathered health plans Section 1251(a)(4)(A) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18011(a)(4)(A) ) is amended— (1) by striking title and inserting title, or as added after the date of the enactment of this Act) ; and (2) by adding at the end the following new clause: (v) Section 2799A–11 (relating to hearing devices and systems). . (3) Effective date The amendments made by this subsection shall apply with respect to plan years beginning on or after January 1, 2025.