Bill S.449

SENATE DOCKET, NO. 831 FILED ON: 1/17/2013

SENATE . . . . . . . . . . . . . . No. 449

By Mr. Joyce, a petition (accompanied by bill, Senate, No. 449) of Brian A. Joyce for legislation relative to in vitro fertilization for the purposes of genetic testing. Financial Services.

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE SENATE, NO. 430 OF 2011-2012.]

The Commonwealth of Massachusetts

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In the Year Two Thousand Thirteen

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An Act relative to in vitro fertilization for the purposes of genetic testing.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. Chapter 175 of the General Laws, is hereby amended by striking out section 47H, as appearing in the 2010 Official Edition, and inserting in place thereof the following section:-

Section 47H. Infertility, pregnancy-related benefits.

(a) Any blanket or general policy of insurance, except a blanket or general policy of insurance which provides supplemental coverage to medicare or other governmental programs, described in subdivisions (A), (C) or (D) of section 110 of this chapter, which provides hospital expense or surgical expense insurance which includes pregnancy-related benefits and which is issued or subsequently renewed by agreement between the insurer and the policyholder, within or without the commonwealth, while this provision is effective, or any policy of accident and sickness insurance as described in section 108 of this chapter which provides hospital expense or surgical expense insurance which includes pregnancy-related benefits and which is delivered or issued for delivery or subsequently renewed by agreement between the insurer and the policyholder in the commonwealth while this provision is effective, or any employees' health and welfare fund which provides hospital expense and surgical expense benefits which includes pregnancy-related benefits and which is promulgated or renewed to any person or group of persons in the commonwealth while this provision is effective shall provide, to the same extent that benefits are provided for other pregnancy-related procedures, coverage for the medically necessary expenses of diagnosis and treatment of infertility to persons residing within the commonwealth.

(b) For purposes of this section, “infertility” shall mean the condition of:

(1) an individual who is either unable to conceive or produce conception during a period of 1 year if the female is age 35 or younger or during a period of 6 months if the female is over the age of 35. For purposes of meeting the criteria for infertility in this section, if a person conceives but is unable to carry that pregnancy to live birth, the period of time she attempted to conceive prior to achieving that pregnancy shall be included in the calculation of the 1 year or 6 month period, as applicable; or

(2) any of the following:

(i) both partners are known carriers of the same single gene autosomal recessive gene disorder;

(ii) one or both partners are known carriers of a single gene autosomal dominant gene disorder; or

(iii) one or both partners are known carriers of a single X-linked disorder.

SECTION 2. Chapter 176A of the General Laws, is hereby amended by striking out section 8K, as appearing in the 2010 Official Edition, and inserting in place thereof the following section:-

Section 8K. Infertility diagnosis and treatment benefits.

(a) Any contract, except contracts providing supplemental coverage to medicare or other governmental programs, between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued for delivery or renewed in the commonwealth while this provision is effective and which provides pregnancy-related benefits shall provide as a benefit for all individual subscribers or members within the commonwealth and all group members having a principal place of employment within the commonwealth, to the same extent that benefits are provided for other pregnancy-related procedures, coverage for medically necessary expenses of diagnosis and treatment of infertility. Said infertility benefits shall meet all other terms and conditions of the subscriber certificate.

(b) For purposes of this section, “infertility” shall mean the condition of:

(2) any of the following:

(i) both partners are known carriers of the same single gene autosomal recessive gene disorder;

(ii) one or both partners are known carriers of a single gene autosomal dominant gene disorder; or

(iii) one or both partners are known carriers of a single X-linked disorder.

SECTION 3. Chapter 176B of the General Laws, is hereby amended by striking out section 4J, as appearing in the 2010 Official Edition, and inserting in place thereof the following section:-

Section 4J. Infertility diagnosis and treatment benefits.

(a) Any subscription certificate under an individual or group medical service agreement, except certificates which provide supplemental coverage to medicare or other governmental programs, which is delivered, issued for delivery or renewed in the commonwealth while this section is effective shall provide as a benefit for all individual subscribers or members within the commonwealth and all group members having a principal place of employment within the commonwealth, to the same extent that benefits are provided for other pregnancy-related procedures and subject to the other terms and conditions of the subscription certificate, coverage for medically necessary expenses of diagnosis and treatment of infertility. Said infertility benefits shall meet all other terms and conditions of the subscription certificate. (b) For purposes of this section, “infertility” shall mean the condition of:

(2) any of the following:

(i) both partners are known carriers of the same single gene autosomal recessive gene disorder;

(ii) one or both partners are known carriers of a single gene autosomal dominant gene disorder; or

(iii) one or both partners are known carriers of a single X-linked disorder.

SECTION 4. This act shall take effect upon passage.

Name:	District/Address:
Brian A. Joyce	Norfolk, Bristol and Plymouth