BILL NUMBER: S9535
SPONSOR: SCARCELLA-SPANTON
 
TITLE OF BILL:
An act to amend the insurance law, in relation to expanding insurance
coverage of in vitro fertilization, including individual health insur-
ance policy coverage
 
SUMMARY OF PROVISIONS:
Section 1 amends item (vii) of subparagraph (C) of paragraph 6 of
subsection (k) of section 3221 of the insurance law, by adding "in-vitro
fertilization" in the coverage policies of every large group policy
relating to medical, major medical or similar comprehensive-type cover-
age.
Section 2 amends subparagraph (G) of paragraph 3 of subsection (s) of
section 4303 of the insurance law, as amended by section 2 of part L of
chapter 57 of the laws of 2019, by adding medical, major medical or
similar comprehensive- type coverage shall provide coverage for  
THREE
CYCLES OF IN-VITRO in vitro fertilization in the treatment of infertil-
ity. Coverage may be subject to deductibles and coinsurance including
copayments.
Section 3 paragraph 13 of subsection (i) of section 3216 of the insur-
ance law, as added by chapter 897 of the laws of 1990 and renumbered by
chapter 131 of the laws of 1992 and subparagraph (C) as added by section
3 of part L of chapter 57 of the laws of 2019, is amended to read. Every
policy which provides coverage for hospital care shall exclude coverage
for hospital care for diagnosis and treatment of correctional medical
conditions otherwise covered by the policy solely because the medical
condition results in infertility. Subject to the provisions of subpara-
graph (C) of this paragraph, in no case shall such coverage exclude
surgical or medical procedures provided as part of such hospital care
which would correct malformation, disease or dysfunction resulting in
infertility and in no case shall such coverage exclude diagnostic tests
and procedures provided as part of such hospital care that are necessary
to determine infertility or that are necessary in connection with any
surgical or medical treatments or prescription drug coverage provided
pursuant to this paragraph, including such diagnostic tests and proce-
dures as hysterosalpingogram, hysteroscopy, endometrial biopsy, laparos-
copy, sono-hysterogram, post coital tests, testis biopsy, semen analy-
sis, blood test and ultrasound.
This act shall take effect on January 1, 2025, and shall apply to poli-
cies and contracts issued, renewed, modified, altered, or amended on or
after such a date.
 
JUSTIFICATION:
There are many cases where couples have trouble getting pregnant or
sustaining a pregnancy. Options of IVF and family planning are costly
and individuals struggling with infertility often face a lack of insur-
ance coverage needed for accessing fertility treatments. This legis-
lation will require insurers to cover in-vitro fertilization which is an
effective and safe fertility treatment that results in fewer pregnancy
complications and high-risk births. Several states including New Jersey,
Connecticut, Massachusetts, Rhode Island, Maryland, Delaware, Illinois,
Arkansas, Hawaii, New Hampshire, Utah, and Colorado have enacted legis-
lation that requires insurance coverage of IVF treatments. This legis-
lation would economically support New Yorkers as well as provide access
to safe infertility treatments.
 
PRIOR LEGISLATIVE HISTORY:
New bill.
 
FISCAL IMPLICATIONS:
None.
 
EFFECTIVE DATE:
This act shall take effect on January 1, 2025, and shall apply to poli-
cies and contracts issued, renewed, modified, altered, or amended on or
after such a date.

Statutes affected:
S9535: 3221 insurance law, 3221(k) insurance law