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 those 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, ensuring that individuals facing infertility have access to essential treatments without financial barriers. The bill also emphasizes that payments for these services will be made in full to providers, prohibiting any additional charges to recipients.

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

Statutes affected:
Introduced: 30:4D-6