The bill proposes amendments to the General Laws concerning health insurance coverage for infertility diagnosis and treatment. It removes the age restriction that previously limited coverage to women between the ages of 25 and 42. The bill also mandates coverage for preimplantation genetic testing (PGT) in conjunction with in vitro fertilization (IVF) and standard fertility-preservation services for individuals at risk of iatrogenic infertility due to medical treatment. The definition of infertility is specified as the inability to conceive or sustain a pregnancy over a period of one year for a healthy individual. The bill includes provisions for a lifetime coverage cap of $100,000 and ensures that same-sex couples are eligible for reimbursement for infertility tests or treatments. Additionally, it addresses genetic testing by prohibiting the release of genetic information without written authorization, except in certain research settings, and prevents discrimination based on genetic test results in health insurance coverage.
Furthermore, the bill updates the laws related to "Nonprofit Hospital Service Corporations" and "Nonprofit Medical Service Corporations" to align with the aforementioned changes in coverage for infertility treatments. It specifies that subscriber copayments for such treatments may not exceed 20%. The bill also clarifies the definitions of "standard fertility-preservation services," "iatrogenic infertility," and the conditions under which a treatment may cause infertility, referencing guidelines by professional organizations. It prohibits health maintenance organizations from using genetic test results to influence insurance policy decisions and requires coverage for infertility diagnosis and treatment, including PGT with IVF, in all health insurance contracts, plans, or policies that include pregnancy-related benefits. The act is set to take effect on January 1, 2025.