The bill mandates unrestricted Medicaid coverage for medically necessary ovulation enhancing drugs and related medical services for individuals aged 21 to 44 who are experiencing infertility. It defines infertility as the inability to conceive after 12 months of unprotected sexual intercourse for individuals aged 21 to 34, and after six months for those aged 35 to 44. The coverage includes expenses for office visits, hysterosalpingograms, pelvic ultrasounds, and blood testing, with a limit of three treatment cycles per beneficiary's lifetime. To implement this, the bill amends Section 6 of P.L.1968, c.413 (C.30:4D-6) by adding provisions that clarify the coverage and parameters for infertility.

Additionally, the bill empowers 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 requires the Commissioner to adopt rules and regulations for the implementation of the act, which will take effect four months after enactment, although anticipatory administrative actions may be taken beforehand. This expansion of Medicaid services aims to improve access to fertility treatments for eligible individuals, addressing a significant healthcare need.

Statutes affected:
Introduced: 30:4D-6