This bill expands Medicaid coverage to include medically necessary ovulation enhancing drugs and related medical services for individuals aged 21 to 44 who are experiencing infertility. The covered medical services consist of office visits, hysterosalpingograms, pelvic ultrasounds, and blood testing, with a limit of three treatment cycles per beneficiary's lifetime. Infertility is defined as the inability to conceive after 12 months of unprotected intercourse for individuals aged 21 to 34, or after six months for those aged 35 to 44. The bill amends Section 6 of P.L.1968, c.413 (C.30:4D-6) to specify these inclusions and definitions.

To facilitate the implementation of this coverage, the bill authorizes the Commissioner of Human Services to apply for necessary state plan amendments or waivers to secure federal financial participation for these Medicaid expenditures. It also mandates the Commissioner to adopt rules and regulations for the act's implementation, which will take effect four months after enactment, although preparatory administrative actions may commence prior to that. This legislative change aims to enhance access to fertility treatments for eligible individuals under the Medicaid program, addressing a critical healthcare need.

Statutes affected:
Introduced: 30:4D-6