Bill Summary – FastDemocracy

PRINTER'S NO.     1542
                     THE GENERAL ASSEMBLY OF PENNSYLVANIA
                         HOUSE BILL
                         No. 1383
                                               Session of
                                                 2023
     INTRODUCED BY MALAGARI, O'MARA, INNAMORATO, TOMLINSON, MADDEN,
        CERRATO, KINSEY, SIEGEL, GUENST, SCHLOSSBERG, CIRESI, HILL-
        EVANS, DELLOSO, SANCHEZ, HOHENSTEIN, FLEMING, FREEMAN, KHAN,
        T. DAVIS AND SHUSTERMAN, JUNE 12, 2023
     REFERRED TO COMMITTEE ON INSURANCE, JUNE 12, 2023
                                    AN ACT
 Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
    act relating to insurance; amending, revising, and
    consolidating the law providing for the incorporation of
    insurance companies, and the regulation, supervision, and
    protection of home and foreign insurance companies, Lloyds
    associations, reciprocal and inter-insurance exchanges, and
    fire insurance rating bureaus, and the regulation and
    supervision of insurance carried by such companies,
    associations, and exchanges, including insurance carried by
    the State Workmen's Insurance Fund; providing penalties; and
    repealing existing laws," in casualty insurance, providing
    for infertility care coverage.
    The General Assembly of the Commonwealth of Pennsylvania
 hereby enacts as follows:
    Section 1.    The act of May 17, 1921 (P.L.682, No.284), known
 as The Insurance Company Law of 1921, is amended by adding a
 section to read:
    Section 635.9.    Infertility Care Coverage.--(a)   A health
 insurance policy covered under this section shall include
 coverage for infertility care and shall waive cost-sharing
 requirements related to infertility care.
    (b)   Infertility care coverage under this section shall be
 provided to covered individuals, including covered spouses and
 covered nonspouse dependents. Infertility care coverage under
 this section shall be provided without discrimination on the
 basis of age, ancestry, color, disability, domestic partner
 status, gender, gender expression, gender identity, genetic
 information, marital status, national origin, race, religion,
 sex or sexual orientation. Nothing in this subsection shall be
 construed to interfere with the clinical judgment of a
 physician.
    (c)    Infertility care coverage under this section shall be
 for the consultation, diagnosis and treatment of infertility,
 including the following:
    (1)    Intrauterine insemination.
    (2)    Cryopreservation and thawing of eggs, sperm and embryos.
    (3)    Cryopreservation of ovarian tissue.
    (4)    Cryopreservation of testicular tissue.
    (5)    Embryo biopsy.
    (6)    Diagnostic testing.
    (7)    Fresh and frozen embryo transfers.
    (8)    Egg retrievals with unlimited embryo transfers in
 accordance with the guidelines of the American Society for
 Reproductive Medicine, including the use of single embryo
 transfers when recommended and medically appropriate.
    (9)    In vitro fertilization, including in vitro fertilization
 through the use of donor eggs, sperm or embryos and in vitro
 fertilization that involves the transfer of embryos to a
 gestational carrier or surrogate.
    (10)    Assisted hatching.
    (11)    Intracytoplasmic sperm injection.
    (12)    Infertility medications.
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    (13)   Ovulation induction.
    (14)   Storage of oocytes, sperm, embryos and tissue.
    (15)   Surgery to address disorders of the female reproductive
 tract that impair fertility and to address disorders of sperm
 production or anatomic disorders of the male reproductive tract
 that impair fertility.
    (16)   Medical and laboratory services that reduce excess
 embryo creation through egg cryopreservation and thawing.
    (17)   Surrogacy, including the costs associated with the
 preparation for reception or introduction of embryos, oocytes or
 donor sperm into a surrogate or gestational carrier.
    (18)   Gamete intrafallopian transfers.
    (19)   Therapeutic devices.
    (20)   Standard fertility preservation services for an
 individual who has a medical condition and is expected to
 undergo medication therapy, surgery, radiation, chemotherapy or
 other medical treatment that is recognized by a medical
 professional to cause a risk of impairment to fertility.
    (21)   Any nonexperimental procedure for infertility
 recognized by the American Society for Reproductive Medicine,
 the American College of Obstetricians and Gynecologists or the
 Society for Assisted Reproductive Technology or by an
 infertility expert identified by the Department of Health.
    (22)   Any other services, procedures, medications or devices
 related to the consultation, diagnosis and treatment of
 infertility.
    (d)    A health insurance policy covered under this section may
 not:
    (1)    contain preexisting condition exclusions, preexisting
 condition waiting periods to access the infertility care
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 coverage required under this section;
    (2)    use the prior diagnosis of infertility or prior
 treatment for infertility as a basis for excluding, limiting or
 otherwise restricting the availability of infertility care
 coverage required under this section; or
    (3)    contain limitations on coverage for infertility benefits
 based solely on arbitrary factors, including the number of
 infertility care attempts or cost of infertility care.
    (e)    This section does not include any of the following types
 of health insurance policies:
    (1)    Accident only.
    (2)    Limited benefit.
    (3)    Credit only.
    (4)    Long-term care or disability income.
    (5)    Specified disease.
    (6)    Medicare supplement.
    (7)    Tricare, including the Civilian Health and Medical
 Program of the Uniformed Services (CHAMPUS) supplement.
    (8)    Fixed indemnity.
    (9)    Hospital indemnity.
    (10)    Dental only.
    (11)    Vision only.
    (12)    Workers' compensation.
    (13)    An automobile medical payment under 75 Pa.C.S.
 (relating to vehicles).
    (f)    As used in this section, the following words and phrases
 shall have the meanings given to them in this subsection unless
 the context clearly indicates otherwise:
    "Cost-sharing."    The share of costs covered by the patient,
 including a deductible, coinsurance, copayment or similar
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 charge. The term does not include the payment of a health
 insurance policy premium.
    "Health insurance policy."     Any individual or group health
 insurance policy, subscriber contract, certificate or plan that
 provides medical or health care coverage by a health care
 facility or licensed health care provider on an expense-incurred
 service or prepaid basis and that is offered by or is governed
 under any of the following:
    (1)     This act, including section 630.
    (2)     The children's health insurance program under Article
 XXIII-A.
    (3)     Subdivision (f) of Article IV of the act of June 13,
 1967 (P.L.31, No.21), known as the "Human Services Code."
    (4)     The act of December 29, 1972 (P.L.1701, No.364), known
 as the "Health Maintenance Organization Act."
    (5)     40 Pa.C.S. Chs. 61 (relating to hospital plan
 corporations) and 63 (relating to professional health services
 plan corporations).
    "Infertility."     A disease historically defined by the failure
 to achieve a successful pregnancy after six (6) to twelve (12)
 months or more of regular, unprotected sexual intercourse or due
 to an individual's status and capacity to reproduce as an
 individual or with a partner.
    "Physician."     An individual licensed as a medical doctor by
 the State Board of Medicine to practice in this Commonwealth.
    Section 2.     This act shall take effect in 60 days.
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Statutes/Laws affected: 
Printer's No. 1542: P.L.682, No.284