Bill

Bill > A1207


NJ A1207

NJ A1207
Requires unrestricted Medicaid coverage for ovulation enhancing drugs and medical services related to administering such drugs for certain beneficiaries experiencing infertility.


summary

Introduced
01/13/2026
In Committee
01/13/2026
Crossed Over
Passed
Dead

Introduced Session

2026-2027 Regular Session

Bill Summary

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. 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. 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

This bill mandates that Medicaid provide coverage for ovulation-enhancing drugs and related medical services for individuals aged 21 to 44 who are experiencing infertility, provided that federal funding is available. Infertility is defined as the inability to conceive, specifically the failure to achieve a clinical pregnancy after 12 months of unprotected intercourse for those aged 21-34, or after six months for those aged 35-44. The covered medical services are limited to office visits, hysterosalpingograms (a type of X-ray to check the uterus and fallopian tubes), pelvic ultrasounds, and blood tests. Coverage for both the drugs and services is capped at three treatment cycles per beneficiary's lifetime. The bill also clarifies that the definition of infertility should not be used to deny or delay treatment based on relationship status or sexual orientation.

Committee Categories

Health and Social Services

Sponsors (6)

Last Action

Introduced, Referred to Assembly Health Committee (on 01/13/2026)

bill text


bill summary

Loading...

bill summary

Loading...

bill summary

Loading...