Chapter
411
2007 -- S 0453 SUBSTITUTE A
Enacted 07/06/07
A N A C T
RELATING
TO INSURANCE
Introduced
By: Senators Walaska, and Perry
Date
Introduced: February 13, 2007
It is enacted by the General Assembly as
follows:
SECTION 1. Section
27-18-30 of the General Laws in Chapter 27-18 entitled "Accident
and Sickness Insurance Policies" is hereby
amended to read as follows:
27-18-30.
Health insurance contracts -- Infertility. -- (a) Any health insurance
contract,
plan, or policy delivered or issued for delivery
or renewed in this state, except contracts providing
supplemental coverage to Medicare or other
governmental programs, which includes pregnancy
related benefits, shall provide coverage for
medically necessary expenses of diagnosis and
treatment of infertility for women between the
ages of twenty-five (25) and forty (40) forty-two
(42) years. To the extent that a health insurance
contract provides reimbursement for a test or
procedure used in the diagnosis or treatment of
conditions other than infertility, the tests and
procedures shall not be excluded from
reimbursement when provided attendant to the diagnosis
and treatment of infertility for women between
the ages of twenty-five (25) and forty (40) forty-
two (42) years; provided, that a subscriber co-payment
not to exceed twenty percent (20%) may
be required for those programs and/or procedures
the sole purpose of which is the treatment of
infertility.
(b) For the
purpose of this section, "infertility" means the condition of an
otherwise
presumably healthy married individual who is
unable to conceive or produce conception or
sustain a pregnancy during a period of two
(2) years one year.
(c) Notwithstanding
the provisions of section 27-18-19 or any other provision to the
contrary, this section shall apply to blanket or
group policies of insurance.
(d) The health
insurance contract may limit coverage to a lifetime cap of one hundred
thousand dollars ($100,000).
SECTION 2. Section
27-19-23 of the General Laws in Chapter 27-19 entitled "Nonprofit
Hospital Service Corporations" is hereby
amended to read as follows:
27-19-23.
Coverage for infertility. -- (a) Any nonprofit hospital service
contract, plan,
or insurance policies delivered, issued for
delivery, or renewed in this state, except contracts
providing supplemental coverage to Medicare or
other governmental programs, which includes
pregnancy related benefits shall provide
coverage for medically necessary expenses of diagnosis
and treatment of infertility for women between
the ages of twenty-five (25) and forty (40) forty-
two (42) years. To the extent that a nonprofit hospital
service corporation provides reimbursement
for a test or procedure used in the diagnosis or
treatment of conditions other than infertility, those
tests and procedures shall not be excluded from
reimbursement when provided attendant to the
diagnosis and treatment of infertility for women
between the ages of twenty-five (25) and forty
(40) forty-two (42) years; provided, that a
subscriber copayment, not to exceed twenty percent
(20%), may be required for those programs and/or
procedures the sole purpose of which is the
treatment of infertility.
(b) For the
purposes of this section, "infertility" means the condition of an
otherwise
presumably healthy married individual who is
unable to conceive or produce conception or
sustain a pregnancy during a period of two
(2) years one year.
(c) The health
insurance contract may limit coverage to a lifetime cap of one hundred
thousand dollars ($100,000).
SECTION 3. Section
27-20-20 of the General Laws in Chapter 27-20 entitled "Nonprofit
Medical Service Corporations" is hereby amended
to read as follows:
27-20-20.
Coverage for infertility. -- (a) Any nonprofit medical service
contract, plan,
or insurance policies delivered, issued for
delivery, or renewed in this state, except contracts
providing supplemental coverage to Medicare or
other governmental programs, which includes
pregnancy related benefits shall provide
coverage for the medically necessary expenses of
diagnosis and treatment of infertility for women
between the ages of twenty-five (25) and forty
(40) forty-two (42) years. To the extent that
a nonprofit medical service corporation provides
reimbursement for a test or procedure used in
the diagnosis or treatment of conditions other than
infertility, those tests and procedures shall
not be excluded from reimbursement when provided
attendant to the diagnosis and treatment of
infertility for women between the ages of twenty-five
(25) and forty (40) forty-two (42)
years. Provided, that subscriber copayment, not to exceed
twenty percent (20%), may be required for those
programs and/or procedures the sole purpose of
which is the treatment of infertility.
(b) For the
purposes of this section, "infertility" means the condition of an
otherwise
presumably healthy married individual who is
unable to conceive or produce conception or
sustain a pregnancy during a period of two
(2) years one year.
(c) The health
insurance contract may limit coverage to a lifetime cap of one hundred
thousand dollars ($100,000).
SECTION 4. Section
27-41-33 of the General Laws in Chapter 27-41 entitled "Health
Maintenance Organizations" is hereby
amended to read as follows:
27-41-33.
Coverage for infertility. -- (a) Any health maintenance organization
service
contract plan or policy delivered, issued for
delivery, or renewed in this state, except a contract
providing supplemental coverage to Medicare or
other governmental programs, which includes
pregnancy related benefits, shall provide
coverage for medically necessary expenses of diagnosis
and treatment of infertility for women between
the ages of twenty-five (25) and forty (40) forty-
two (42) years. To the extent that a health maintenance
organization provides reimbursement for
a test or procedure used in the diagnosis or
treatment of conditions other than infertility, those
tests and procedures shall not be excluded from
reimbursement when provided attendant to the
diagnosis and treatment of infertility for women
between the ages of twenty-five (25) and forty
(40) forty-two (42) years; provided, that subscriber
copayment, not to exceed twenty percent
(20%), may be required for those programs and/or
procedures the sole purpose of which is the
treatment of infertility.
(b) For the
purpose of this section, "infertility" means the condition of an otherwise
healthy married individual who is unable to
conceive or produce conception or sustain a
pregnancy during a period of two (2) years one
year.
(c) The health
insurance contract may limit coverage to a lifetime cap of one hundred
thousand dollars ($100,000).
SECTION 5. This
act shall take effect upon passage.
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LC01754/SUB
A
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