Bill > S728

This bill modifies several sections of Massachusetts law to expand insurance coverage for infertility treatment and prohibit step therapy practices in such treatments. Specifically, the bill requires that group insurance for state employees, Medicaid-related health plans, and various types of health insurance policies provide coverage for medically necessary infertility diagnosis and treatment to the same extent as other pregnancy-related procedures. The bill defines infertility as the inability to conceive within one year for women 35 and younger, or within six months for women over 35, and includes periods of attempted conception even if a pregnancy was conceived but not carried to live birth. A key provision prevents insurance providers from requiring patients to undergo alternative medications or procedures instead of those recommended by their physician, effectively eliminating step therapy protocols for infertility treatments. This means that patients and their doctors, rather than insurance companies, will have more control over determining the most appropriate medical approach for addressing fertility challenges.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/194/S728