SF 1704

1st Engrossment - 93rd Legislature (2023 - 2024) Posted on 03/09/2023 09:26am

A bill for an act
relating to insurance; requiring the coverage for infertility treatment; proposing
coding for new law in Minnesota Statutes, chapter 62A.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [62A.0412] COVERAGE OF INFERTILITY TREATMENT.
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new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin This section applies to all health plans that provide maternity
benefits to Minnesota residents, including but not limited to health plans offered under
chapters 256B and 256L.
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new text begin Subd. 2. new text end

new text begin Required coverage. new text end

new text begin (a) Every health plan under subdivision 1 must provide
comprehensive coverage for the diagnosis of infertility, treatment for infertility, and standard
fertility preservation services that are:
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new text begin (1) considered medically necessary by the enrollee's treating health care provider; and
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new text begin (2) recognized by either the American Society for Reproductive Medicine, the American
College of Obstetrics and Gynecologists, or the American Society of Clinical Oncology.
new text end

new text begin (b) Coverage under this section must include but is not limited to ovulation induction,
procedures and devices to monitor ovulation, artificial insemination, oocyte retrieval
procedures, in vitro fertilization, gamete intrafallopian transfer, oocyte replacement,
cryopreservation techniques, micromanipulation of gametes, and standard fertility
preservation services.
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new text begin (c) Coverage under this section must include unlimited embryo transfers, but may impose
a limit of four completed oocyte retrievals. Single embryo transfer must be used when
medically appropriate and recommended by the treating health care provider.
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new text begin (d) Coverage for surgical reversal of elective sterilization is not required under this
section.
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new text begin (e) Cost-sharing requirements, including co-payments, deductibles, and coinsurance for
infertility coverage, must not be greater than the cost-sharing requirements for maternity
coverage under the enrollee's health plan.
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new text begin (f) Health plans under subdivision 1 may not include in the coverage under this section:
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new text begin (1) any exclusions, limitations, or other restrictions on coverage of fertility medications
that are different from those imposed on other prescription medications;
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new text begin (2) any exclusions, limitations, or other restrictions on coverage of any fertility services
based on a covered individual's participation in fertility services provided by or to a third
party; or
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new text begin (3) any benefit maximums, waiting periods, or any other limitations on coverage for the
diagnosis of infertility, treatment of infertility, and standard fertility preservation services,
except as provided in paragraphs (c) and (d), that are different from those imposed upon
benefits for services not related to infertility.
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new text begin Subd. 3. new text end

new text begin Definitions. new text end

new text begin For the purpose of this section, the definitions have the meanings
given them.
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new text begin (a) "Infertility" means a disease, condition, or status characterized by:
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new text begin (1) the failure of a person with a uterus to establish a pregnancy or to carry a pregnancy
to live birth after 12 months of unprotected sexual intercourse for a person under the age
of 35 or six months for a person 35 years of age or older, regardless of whether a pregnancy
resulting in miscarriage occurred during such time;
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new text begin (2) a person's inability to reproduce either as a single individual or with the person's
partner without medical intervention; or
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new text begin (3) a licensed health care provider's findings based on a patient's medical, sexual, and
reproductive history; age; physical findings; or diagnostic testing.
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new text begin (b) "Diagnosis of and treatment for infertility" means the recommended procedures and
medications from the direction of a licensed health care provider that are consistent with
established, published, or approved medical practices or professional guidelines from the
American College of Obstetricians and Gynecologists or the American Society for
Reproductive Medicine.
new text end

new text begin (c) "Standard fertility preservation services" means procedures that are consistent with
the established medical practices or professional guidelines published by the American
Society for Reproductive Medicine or the American Society of Clinical Oncology for a
person who has a medical condition or is expected to undergo medication therapy, surgery,
radiation, chemotherapy, or other medical treatment that is recognized by medical
professionals to cause a risk of impairment to fertility.
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new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2023, and applies to all health
plans issued or renewed on or after that date.
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