Bill Text: MI HB6048 | 2023-2024 | 102nd Legislature | Introduced
Bill Title: Human services: medical services; Medicaid coverage for fertility preservation; provide for.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2024-11-12 - Bill Electronically Reproduced 11/12/2024 [HB6048 Detail]
Download: Michigan-2023-HB6048-Introduced.html
HOUSE BILL NO. 6048
A bill to amend 1939 PA 280, entitled
"The social welfare act,"
(MCL 400.1 to 400.119b) by adding section 109p.
the people of the state of michigan enact:
Sec. 109p. (1) Beginning January 1, 2026, the department shall provide coverage under the medical assistance program for fertility diagnostic care, intrauterine insemination, and any medically necessary ovulation-enhancing drugs and medical services related to prescribing and monitoring the use of the ovulation-enhancing drugs that is intended to treat infertility and achieve a pregnancy that results in a live birth that includes at least 3 cycles of ovulation-enhancing medication treatment over a medical assistance recipient's lifetime.
(2) Coverage under this section must be provided without discrimination on the basis of age, ancestry, disability, domestic partner status, gender, gender identity or expression, genetic information, marital status, national origin, race, religion, sex, or sexual orientation.
(3) Not later than 180 days after the effective date of the amendatory act that added this section, the department shall, after consultation with the Centers for Medicare and Medicaid Services, submit a report to the legislature on whether in-vitro fertilization and standard fertility preservation services are medically reasonable and necessary procedures under federal law, possible methods for covering in-vitro fertilization and standard fertility preservation services as a medical assistance covered benefit for both fee-for-service and managed care organizations, including any potentially applicable waiver authorities, and the amount of money that would need to be allocated to federal and local funds for coverage.
(4) As used in this section:
(a) "Fertility diagnostic care" means procedures, products, genetic testing, medications, counseling, and services intended to provide information and counseling about an individual's fertility, including laboratory assessments and imaging studies.
(b) "Gamete" means sperm or egg.
(c) "Health care provider" means any of the following:
(i) Nurse practitioner. As used in this subparagraph, "nurse practitioner" means an individual who is licensed as a registered professional nurse under part 172 of the public health code, 1978 PA 368, MCL 333.17201 to 333.17242, who has been granted a specialty certification as a nurse practitioner by the Michigan board of nursing under section 17210 of the public health code, 1978 PA 368, MCL 333.17210.
(ii) Physician.
(iii) Physician's assistant. As used in this subparagraph, "physician's assistant" means an individual who is licensed to engage in the practice as a physician's assistant under part 170, 175, or 180 of the public health code, 1978 PA 368, MCL 333.17001 to 333.17097, MCL 333.17501 to 333.17556, and MCL 333.18001 to 333.18058.
(d) "Infertility" means any of the following:
(i) The presence of a condition recognized by a health care provider as a cause of loss or impairment of fertility, based on an individual's medical, sexual, and reproductive history, age, physical findings, diagnostic testing, or any combination of those factors.
(ii) An individual's inability to establish a pregnancy or to carry a pregnancy to live birth after 12 months of unprotected sexual intercourse when the individual and the individual's partner have the necessary gametes to achieve pregnancy.
(iii) An individual's inability to establish pregnancy after 6 months of unprotected sexual intercourse due to the individual's age when the individual and the individual's partner have the necessary gametes to achieve pregnancy.
(iv) An individual's inability to achieve pregnancy as an individual or with a partner because the individual or the individual and the individual's partner do not have the necessary gametes to achieve a pregnancy.
(v) An individual's increased risk, independently or with the individual's partner, of transmitting a serious, inheritable genetic or chromosomal abnormality to a child.
(vi) As defined by the American Society of Reproductive Medicine, its successor organization, or a comparable organization. Pregnancy resulting in a loss does not cause the time period of trying to achieve a pregnancy to be restarted.
(e) "Intrauterine insemination" means a procedure that places sperm directly into a person's uterus at the time of ovulation to increase the chances of fertilization.
(f) "Physician" means either of the following:
(i) A physician licensed to engage in the practice of medicine under part 170 of the public health code, 1978 PA 368, MCL 333.17001 to 333.17097.
(ii) A physician licensed to engage in the practice of osteopathic medicine and surgery under part 175 of the public health code, 1978 PA 368, MCL 333.17501 to 333.17556.
(g) "Standard fertility preservation services" means procedures, products, genetic testing, medications, counseling, and services intended to preserve fertility, consistent with established medical practice and professional guidelines published by the American Society for Reproductive Medicine, its successor organization, or a comparable organization, for an individual who has a medical or genetic condition or who is expected to undergo treatment that has a possible side effect of or may directly or indirectly cause a risk of impairment of fertility, and includes, but is not limited to, the procurement, cryopreservation, and storage of gametes, embryos, and reproductive material.
