SF1961 (Legislative Session 94 (2025-2026))

Infertility treatment and standard fertility preservation services coverage by health plans requirement, MinnesotaCare and medical assistance coverage of infertility treatment and standard fertility preservation services requirement, and appropriation

Related bill: HF1758

AI Generated Summary

This bill proposes requiring health insurance plans in Minnesota to cover infertility treatments and standard fertility preservation services. It applies to all health plans that provide maternity benefits to Minnesota residents, as well as to medical assistance programs like MinnesotaCare.

Key provisions include:
- Definitions: Infertility is defined as the inability to conceive after a period of unprotected intercourse (12 months for individuals under 35, 6 months for those 35 and older) or a licensed healthcare provider's diagnosis. Standard fertility preservation services are for individuals undergoing medical treatments that may impair fertility.
- Required Coverage: Health plans must cover infertility diagnosis and treatment, as well as fertility preservation services. Coverage must include unlimited embryo transfers but may limit completed oocyte retrievals to four. Surgical reversal of elective sterilization is not required.
- Cost-Sharing Restrictions: Out-of-pocket costs (such as copayments, deductibles, and coinsurance) for infertility treatments cannot exceed those applied to maternity coverage.
- Exclusions and Limitations: Health plans cannot impose waiting periods, extra utilization reviews, or other restrictions beyond those applied to maternity benefits.
- Reimbursement: The Minnesota Department of Commerce will reimburse insurers for the costs of providing these benefits, but only for coverage that was not already included in plans as of January 1, 2025.
- Funding: Necessary funds will be appropriated annually to cover implementation and reimbursement costs.

This bill aims to improve access to infertility treatments and fertility preservation services in Minnesota by ensuring insurance coverage without additional financial burdens on patients.

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
February 26, 2025HouseFloorActionIntroduction and first reading
February 26, 2025SenateFloorActionIntroduction and first reading
February 26, 2025HouseFloorActionReferred toCommerce and Consumer Protection
February 26, 2025SenateFloorActionReferred toCommerce and Consumer Protection

Citations

 
[
  {
    "analysis": {
      "added": [
        "Additional subdivision for infertility treatment coverage."
      ],
      "removed": [],
      "summary": "This bill modifies medical assistance coverage for infertility treatment under section 256B.0625.",
      "modified": []
    },
    "citation": "256B.0625",
    "subdivision": "subdivision 13"
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "This reference sets requirements for federal reimbursement of additional benefits under health plans.",
      "modified": [
        "Establishes evaluation submissions and payments related to health plan coverage."
      ]
    },
    "citation": "Code of Federal Regulations title 45 section 155.170",
    "subdivision": ""
  }
]