H1191 — An Act improving access to infertility treatment

Summary

An Act improving access to infertility treatment

Bill Text

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The bill clarifies and expands the definition of infertility across multiple sections of Massachusetts law and enhances coverage requirements for infertility treatment.

• Section 47H of chapter 175

  (6) provide different benefits to, or impose different requirements for different groups, based on diagnosis.

  The bill removes provisions allowing for different benefits based on diagnosis.

• Section 47H of chapter 175

  this section shall not be construed to interfere with a medical provider’s, physician’s, or surgeon’s clinical judgment.

  The bill clarifies that the section does not interfere with medical professionals' clinical judgments.

• Section 47H of chapter 175

  The definition of "infertility" shall include a condition or status characterized by any of the following: → For purposes of this section, “infertility” means a condition or status characterized by any of the following:

  The bill specifies the definition of infertility.

• Section 47H of chapter 175

  shalls be based on clinical guidelines and the patient’s medical history. → , clinical guidelines shall be maintained in written form and available to any enrollee.

  The bill mandates that clinical guidelines be documented and accessible to enrollees.

• Section 47H of chapter 175

  or gestational carrier that enables an intended parent, member, and/or partner of a member to become a parent. → and (ii) a gestational carrier that enables an intended parent, member, and/or partner of a member to become a parent.

  The bill clarifies the definition of third party regarding fertility services.

• Section 8K of chapter 176A

  this section shall not be construed to interfere with a medical provider’s, physician’s, or surgeon’s clinical judgment.

  The bill clarifies that the section does not interfere with medical professionals' clinical judgments.

• Section 8K of chapter 176A

  (6) provide different benefits to, or impose different requirements for different groups, based on diagnosis.

  The bill removes provisions allowing for different benefits based on diagnosis.

• Section 8K of chapter 176A

  Limitations on coverage coverage for medically necessary expenses of diagnosis and treatment of infertility shall be based on clinical guidelines and the patient's medical history. → , clinical guidelines shall be maintained in written form and available to any enrollee.

  The bill mandates that clinical guidelines be documented and accessible to enrollees.

• Section 8K of chapter 176A

  (4) exclude services based on the quantity of the patient’s existing cryopreserved oocyte, sperm, or embryos; the provider’s discretion will determine if cryopreserved oocyte, sperm, or embryo provides a reasonable chance of success and whether additional fertility services are required;

  The bill prohibits excluding services based on the quantity of cryopreserved materials.

• Section 4J of chapter 176B

  the provisions shall not interfere with a medical provider’s, physician’s, or surgeon’s clinical judgment.

  The bill clarifies that the provisions do not interfere with medical professionals' clinical judgments.

• Section 4J of chapter 176B

  (6) provide different benefits to, or impose different requirements for different groups, based on diagnosis.

  The bill removes provisions allowing for different benefits based on diagnosis.

• Section 4J of chapter 176B

  Limitations on coverage coverage for medically necessary expenses of diagnosis and treatment of infertility shall be based on clinical guidelines and the patient's medical history. → , clinical guidelines shall be maintained in written form and available to any enrollee.

  The bill mandates that clinical guidelines be documented and accessible to enrollees.

• Section 4J of chapter 176B

  this section shall not be construed to deny or restrict any existing right or benefit to coverage and treatment of infertility or fertility services under an existing law, plan, or policy.

  The bill ensures existing rights or benefits to infertility treatments are not denied.

• Section 4J of chapter 176B

  (4) exclude services based on the quantity of the patient’s existing cryopreserved oocyte, sperm, or embryos; the provider’s discretion will determine if cryopreserved oocyte, sperm, or embryo provides a reasonable chance of success and whether additional fertility services are required;

  The bill prohibits excluding services based on the quantity of cryopreserved materials.

Sponsors

• Kevin G. Honan · Primary

Subjects