This bill mandates that Medicaid provide unrestricted coverage for ovulation-enhancing drugs and related medical services for beneficiaries aged 21 to 44 who are experiencing infertility. The coverage includes expenses for medically necessary drugs and services such as office visits, hysterosalpingograms, pelvic ultrasounds, and blood testing, limited to 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, and after six months for those aged 35 to 44. The bill ensures that payments for these services are made in full to providers without imposing additional charges on recipients, and no copayment or cost-sharing will be required from eligible individuals, except as mandated by federal law.

Additionally, the bill amends existing law to include this new coverage under the Medicaid program and allows the Commissioner of Human Services to apply for necessary state plan amendments or waivers to secure federal financial participation for these Medicaid expenditures. The Commissioner is also required to adopt rules and regulations to implement the act, which will take effect four months after enactment, although anticipatory administrative actions may be taken beforehand.

Statutes affected:
Introduced: 30:4D-6