Bill > A5369

Introduced Session

This bill requires Medicaid coverage for ovulation enhancing drugs and the medical services related to administering such drugs for certain beneficiaries who are experiencing infertility. In doing so, this bill mirrors the existing infertility benefit provided under Medicaid in New York. Specifically, the bill mandates that Medicaid is to provide coverage for expenses incurred in the provision of medically necessary ovulation enhancing drugs and the medical services related to prescribing and monitoring the use of such drugs for individuals 21 through 44 years of age who are experiencing infertility, provided that there is federal financial participation available. As defined under the bill, "infertility" means a condition characterized by the incapacity to conceive, as defined by either: the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse for individuals 21 through 34 years of age; or the failure to establish a clinical pregnancy after six months of regular, unprotected sexual intercourse for individuals 35 through 44 years of age. Medical services covered under the bill are limited to office visits, hysterosalpingograms, pelvic ultrasounds, and blood testing. A hysterosalpingogram is an x-ray procedure used to see whether the patient's fallopian tubes are open and if the inside of the uterus is normal. Moreover, coverage of ovulation enhancing drugs and medical services under the bill is limited to three cycles of treatment per lifetime of the beneficiary.

AI Summary

Committee Categories

Sean Kean (R)*,  Edward Thomson (R)*, 

Introduced, Referred to Assembly Human Services Committee (on 05/08/2023)

Official Document