Bill Text: HI HB677 | 2018 | Regular Session | Introduced
Bill Title: Relating To In Vitro Fertilization Insurance Coverage.
Spectrum: Moderate Partisan Bill (Democrat 6-1)
Status: (Introduced - Dead) 2018-01-17 - Re-referred to HHS, CPC, FIN, referral sheet 1 [HB677 Detail]
Download: Hawaii-2018-HB677-Introduced.html
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
677 |
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TWENTY-NINTH LEGISLATURE, 2017 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
relating to in vitro fertilization insurance coverage.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that infertility is a disease of the reproductive system that impairs and substantially limits an individual's major life activity of reproduction. In the United States, infertility affects approximately seven million women and their partners. Approximately twelve per cent of women of childbearing age have used an infertility service. Since 1978, in vitro fertilization has provided a necessary solution for many diagnosed with infertility who desire to have a child and be a parent.
The legislature further finds that since 1987, Hawaii has required insurance coverage for the treatment of infertility through in vitro fertilization. The current law only provides for a one-time benefit; applies only to the insured or insured's spouse; requires fertilization with sperm from the patient's spouse; requires a history of infertility for at least five years; requires previous attempts at pregnancy through other applicable infertility treatments for which coverage is available; and applies only to a limited number of medical conditions associated with infertility.
The purpose of this Act is to provide in vitro fertilization insurance coverage for women who are diagnosed with infertility by requiring non-discriminatory coverage and ensuring quality of care in the diagnosis and treatment of infertility. It is the intent of the legislature to exempt religious institutions and organizations that believe the covered procedures violate their religious and moral teachings and beliefs. It is also the intent of the legislature that this Act not apply to the federal medicaid program.
SECTION 2. Section 431:10A-116.5, Hawaii Revised Statutes, is amended by amending subsections (a) and (b) to read as follows:
"(a) All individual and group accident
and health or sickness insurance policies which provide pregnancy-related
benefits shall include in addition to any other benefits for treating
infertility, a one-time only benefit for all outpatient expenses arising from
in vitro fertilization procedures performed on the insured or the insured's
dependent [spouse]; provided that:
(1) Benefits under this section shall be provided to the same extent as the benefits provided for other pregnancy-related benefits;
(2) The patient is the insured or a covered dependent of the insured;
[(3) The patient's oocytes are fertilized
with the patient's spouse's sperm;
(4) The:
(A) Patient and the patient's spouse
have a history of infertility of at least five years' duration; or
(B) Infertility] (3) The
infertility is associated with one or more of the following medical
conditions:
[(i)] (A)
Endometriosis;
[(ii)] (B)
Exposure in utero to diethylstilbestrol, commonly known as DES;
[(iii)] (C)
Blockage of, or surgical removal of, one or both fallopian tubes (lateral or
bilateral salpingectomy); or
[(iv)] (D) Abnormal male factors
contributing to the infertility;
[(5)] (4) The patient has been unable to
attain a successful pregnancy through other applicable infertility treatments
for which coverage [is] shall be available under the insurance
contract[;], unless the patient's physician determines that those
treatments are likely to be unsuccessful; and
[(6)] (5) The in vitro fertilization
procedures are performed at medical facilities that conform to the American College
of Obstetricians and Gynecologists guidelines for in vitro fertilization
clinics or to the American Society for Reproductive Medicine minimal standards
for programs of in vitro fertilization.
(b) For the purposes of this section, the term
["spouse" means a person who is lawfully married to the patient
under the laws of the State.] "infertility" means a disease,
defined by the failure to achieve a successful pregnancy after twelve months or
more of appropriate, timed unprotected intercourse or therapeutic donor
insemination. Earlier evaluation and treatment may be justified based on
medical history and physical findings and is warranted after six months for
women over thirty-five years of age."
SECTION 3. Section 432:1-604, Hawaii Revised Statutes, is amended by amending subsections (a) and (b) to read as follows:
"(a) All individual and group hospital or
medical service plan contracts which provide pregnancy-related benefits shall
include in addition to any other benefits for treating infertility, a one-time
only benefit for all outpatient expenses arising from in vitro fertilization
procedures performed on the subscriber or member or the subscriber's or
member's dependent [spouse]; provided that:
(1) Benefits under this section shall be provided to the same extent as the benefits provided for other pregnancy-related benefits;
(2) The patient is a subscriber or member or covered dependent of the subscriber or member;
[(3) The patient's oocytes are fertilized
with the patient's spouse's sperm;
(4) The:
(A) Patient and the patient's
spouse have a history of infertility of at least five years' duration; or
(B) Infertility] (3) The
infertility is associated with one or more of the following medical
conditions:
[(i)] (A) Endometriosis;
[(ii)] (B) Exposure in utero to
diethylstilbestrol, commonly known as DES;
[(iii)] (C) Blockage of, or surgical
removal of, one or both fallopian tubes (lateral or bilateral salpingectomy);
or
[(iv)] (D) Abnormal male factors
contributing to the infertility;
[(5)] (4) The patient has been unable to
attain a successful pregnancy through other applicable infertility treatments
for which coverage [is] shall be available under the contract[;]
unless the patient's physician determines that the treatments are unlikely
to succeed; and
[(6)] (5) The in vitro fertilization
procedures are performed at medical facilities that conform to the American
College of Obstetricians and Gynecologists guidelines for in vitro
fertilization clinics or to the American Society for Reproductive Medicine
minimal standards for programs of in vitro fertilization.
(b) For the purposes of this section, the term
["spouse" means a person who is lawfully married to the patient
under the laws of the State.] "infertility" means a disease,
defined by the failure to achieve a successful pregnancy after twelve months or
more of appropriate, timed unprotected intercourse or therapeutic donor
insemination. Earlier evaluation and treatment may be justified based on
medical history and physical findings and is warranted after six months for
women over thirty-five years of age."
SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 5. This Act shall take effect on July 1, 2017.
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INTRODUCED BY: |
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Report Title:
In Vitro Fertilization Procedure Coverage
Description:
Amends insurance coverage requirements for in vitro fertilization to allow for expanded applicability.
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
