This bill mandates that Medicaid provide unrestricted 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 covered medical services include office visits, hysterosalpingograms, pelvic ultrasounds, and blood testing, with a limit of three treatment cycles per beneficiary's lifetime. The legislation ensures that payments for these services are made in full to providers without imposing additional charges on recipients, and emphasizes that no copayment or cost-sharing will be required from eligible individuals, except as mandated by federal law.

Furthermore, the bill amends existing Medicaid provisions to include these new services and allows the Commissioner of Human Services to apply for necessary state plan amendments or waivers to implement these changes and secure federal financial participation. It also requires the Commissioner to adopt rules and regulations under the "Administrative Procedure Act" to facilitate the bill's implementation. The act is set to take effect four months after its enactment, although anticipatory administrative actions may be taken beforehand.

Statutes affected:
Introduced: 30:4D-6