Bill Summaries: S572 GREATER ACCESS TO FERTILITY MEDICATION.

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  • Summary date: Mar 25 2025 - View Summary

    Adds new GS 58-3-241 (pertaining to fertility treatment coverage), as follows. Defines experimental fertility procedure, fertility treatment, and insurer. Directs that, if health benefit plan provides fertility treatment coverage then (1) any limitation on coverage for ovulation medication cannot be different than the limits imposed on other prescription medications and (2) no annual or lifetime limits may apply to the coverage for ovulation medication and in-network ovulation induction cycles. Specifies that GS 58-3-241 cannot be construed to required coverage for fertility treatment or experimental fertility procedures under a health benefit plan. Applies to insurance contracts issued, renewed or amended on or after October 1, 2025.

    Requires the Board of Trustees for the State Health Plan for Teachers and State Employees to modify the plan’s provisions pertaining to ovulation medication and ovulation induction so that they mirror the provisions set forth above, effective January 1, 2026. Appropriates $300,000 in recurring funds for 2025-26 and $600,000 in recurring funds for 2026-27 from the General Fund to the Department of State Treasurer for the increased costs to the State Health Plan, effective July 1, 2025.