Raised Bill No. 5240, introduced in the February Session, 2024, proposes an act concerning Medicaid coverage for infertility treatment. The bill, effective October 1, 2024, mandates that starting January 1, 2025, the Commissioner of Social Services must provide Medicaid coverage for the medically necessary expenses of diagnosing and treating infertility. This coverage must align with the requirements of individual and group health insurance policies as specified in sections 38a-509 and 38a-536 of the general statutes, respectively, and must also meet federal law requirements for Medicaid reimbursement. The terms "medically necessary" and "infertility" are to be defined as per sections 17b-259b and 38a-509 of the general statutes.
Furthermore, the bill requires the Commissioner of Social Services to submit a report by January 1, 2026, to the joint standing committee of the General Assembly with jurisdiction over human services. This report should detail the number of Medicaid recipients who received the necessary diagnosis and treatment for infertility between January 1, 2025, and December 31, 2025, and include any policy change recommendations to ensure all eligible Medicaid recipients have access to such services. The bill introduces a new section to take effect on October 1, 2024, and does not include any deletions from the current law.