Relating to health care coverage benefits for the diagnosis and treatment of infertility, and for fertility preservation services, and including applicability provisions

This bill relates to health care coverage benefits for the diagnosis and treatment of infertility, and for fertility preservation services. The bill defines “infertility” as a health condition, illness, injury, or disease characterized by the failure to establish a pregnancy or to carry a pregnancy to live birth after regular, unprotected sexual intercourse; or the inability of an individual to reproduce without medical intervention either as a single individual or with a partner; or a health care professional’s diagnosis based on a covered person’s sex, age, medical history, sexual history, or reproductive history; or a physical examination or diagnostic testing. The bill defines “diagnosis and treatment for infertility” as health care services or prescription drugs recommended by an individual’s health care professional and that are consistent with the established medical practices or published guidelines of the American college of obstetricians and gynecologists, or of the American society for reproductive medicine, for the diagnosis and treatment of infertility. “Health care professional” is defined in the bill. “Fertility preservation services” is defined in the bill as health care services recommended by a individual’s health care professional and that are consistent with the established medical practices or published guidelines of the American society for reproductive medicine, or of the American society of clinical oncology, for the treatment of an individual who has a medical condition or is expected to undergo medication therapy, surgery, radiation, chemotherapy, or other medical treatment that creates a risk of impairment of the individual’s fertility. The bill requires a health carrier that offers individual, group, or small group contracts, policies, or plans in this state that provide for third-party payment or prepayment of health or medical expenses to provide coverage for the diagnosis and treatment of infertility, and for fertility preservation services. The coverage cannot be subject to cost-sharing, waiting periods, or exclusions that are different than the cost-sharing, waiting periods, or exclusions that the policy, contract, or plan imposes for other covered health or medical expenses. The bill applies to the third-party payment providers enumerated in the bill. The bill specifies the types of specialized health-related insurance which are not subject to the coverage requirements of the bill. The commissioner of insurance must adopt rules to administer the requirements of the bill. The bill applies to third-party payment provider contracts, policies, or plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2022.