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 intercourse for individuals aged 21 to 34, or after six months for those aged 35 to 44. The covered medical services include office visits, hysterosalpingograms, pelvic ultrasounds, and blood testing. The bill ensures that payments for these services are made in full to providers, prohibiting any additional charges to recipients, and emphasizes that no copayment or cost-sharing will be imposed on eligible individuals, except as required by federal law.

Furthermore, the bill amends existing Medicaid provisions to include this new coverage and allows the Commissioner of Human Services to apply for necessary state plan amendments or waivers to implement these changes and secure federal funding. It also requires the Commissioner to adopt rules and regulations in accordance with the "Administrative Procedure Act" to facilitate 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