Connecticut HB 7022: AN ACT PROMOTING EQUITY IN MEDICAID COVERAGE FOR FERTILITY HEALTH CARE.

Bill Text

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General Assembly Raised Bill No. 7022
January Session, 2025 LCO No. 4399

Referred to Committee on HUMAN SERVICES

Introduced by:
(HS)

AN ACT PROMOTING EQUITY IN MEDICAID COVERAGE FOR
FERTILITY HEALTH CARE.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:

Section 1. (NEW) (Effective January 1, 2026) (a) As used in this section: 1
(1) "Fertility diagnostic care" means procedures, products, 2
medications and services intended to provide information and 3
counseling about an individual's fertility, including, but not limited to, 4
laboratory assessments and imaging studies. 5
(2) "Fertility preservation services" (A) means procedures, products, 6
medications and services intended to preserve fertility, consistent with 7
established medical practice and professional guidelines published by 8
the American Society for Reproductive Medicine, its successor 9
organization or a comparable organization for an individual who has a 10
medical or genetic condition or who is expected to undergo treatment 11
that may directly or indirectly cause a risk of impairment of fertility, and 12
(B) includes, but is not limited to, the procurement and cryopreservation 13
of gametes, embryos and reproductive material and storage from the 14
date of cryopreservation until the individual reaches the age of thirty, 15

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or for a period of not less than five years, whichever is later. 16
(3) "Fertility treatment" means procedures, products, genetic testing, 17
medications and services intended to achieve pregnancy that result in a 18
live birth and that are provided in a manner consistent with established 19
medical practice and professional guidelines published by the American 20
Society for Reproductive Medicine, its successor organization or a 21
comparable organization. 22
(4) "Gamete" means a sperm or egg. 23
(5) "Infertility" means (A) the presence of a condition recognized by a 24
licensed physician as a cause of loss or impairment of fertility, based on 25
an individual's medical, sexual and reproductive history, age, physical 26
findings, diagnostic testing or any combination of those factors, (B) an 27
individual's inability to achieve pregnancy after twelve months of 28
unprotected sexual intercourse when the individual and the 29
individual's partner have the necessary gametes to achieve pregnancy, 30
(C) an individual's inability to achieve pregnancy after six months of 31
unprotected sexual intercourse due to the individual's age, (D) an 32
individual's increased risk of transmitting a serious, inheritable genetic 33
or chromosomal abnormality to a child, either through the individual or 34
the individual's partner, or (E) "infertility" as defined by the American 35
Society of Reproductive Medicine, its successor organization or a 36
comparable organization. 37
(b) The Commissioner of Social Services shall amend the Medicaid 38
state plan to provide coverage for fertility diagnostic care, fertility 39
preservation services and fertility treatment. Such coverage shall 40
provide for: 41
(1) Any medically necessary ovulation-enhancing drugs and medical 42
services related to prescribing and monitoring the use of ovulation-43
enhancing drugs that is intended to treat infertility and achieve a 44
pregnancy that results in a live birth, and 45

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(2) At least three cycles of ovulation-enhancing medication treatment. 46
(c) Not later than July 1, 2026, the Commissioner of Social Services 47
shall, after consultation with the Centers for Medicare and Medicaid 48
Services, submit a report to the joint standing committees of the General 49
Assembly having cognizance of matters relating to appropriations and 50
human services on the costs and benefits of establishing in-vitro 51
fertilization as a covered benefit under the fee-for-service state medical 52
assistance program and any future model of the state medical assistance 53
program involving managed care organizations. The commissioner 54
shall include in the report (1) any potential Medicaid waivers that may 55
be necessary to establish such covered benefit, and (2) the amount of 56
state funds that may be needed to establish such covered benefit. For 57
purposes of this subsection, "state medical assistance program" means 58
the HUSKY Health program as defined in section 17b-290 of the general 59
statutes. 60
This act shall take effect as follows and shall amend the following
sections:

Section 1 January 1, 2026 New section

Statement of Purpose:
To expand Medicaid coverage for fertility health care.

[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]