Senate Bill 2781

AN ACT TO CREATE THE HEALTH INSURANCE COVERAGE FOR FERTILITY PRESERVATION SERVICES ACT; TO ENSURE HEALTH INSURANCE COVERAGE FOR STANDARD FERTILITY PRESERVATION SERVICES WHEN MEDICALLY NECESSARY TREATMENT MAY DIRECTLY OR INDIRECTLY CAUSE IATROGENIC INFERTILITY CONSISTENT WITH ESTABLISHED MEDICAL PRACTICE AND PROFESSIONAL GUIDELINES; TO PROVIDE THAT A CARRIER OFFERING HEALTH INSURANCE COVERAGE IN THIS STATE SHALL PROVIDE COVERAGE FOR STANDARD FERTILITY PRESERVATION SERVICES FOR ANY COVERED INDIVIDUAL WHO MAY UNDERGO A MEDICALLY NECESSARY TREATMENT THAT MAY DIRECTLY OR INDIRECTLY CAUSE IATROGENIC INFERTILITY; TO PROHIBIT A CARRIER WHO OFFERS HEALTH INSURANCE COVERAGE IN THIS STATE FOR STANDARD FERTILITY PRESERVATION SERVICES FROM IMPOSING CERTAIN EXCLUSIONS, LIMITATIONS OR OTHER RESTRICTIONS; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. (1) This section shall be known and may be cited as the "Health Insurance Coverage for Fertility Preservation Services Act."

(2) For purposes of this section, the following terms shall have the meanings ascribed herein:

(a) "Covered individual" shall mean a policyholder, subscriber, enrollee, participant or other individual covered by an insurance policy, subscription contract or health care plan, including minors or dependents.

(b) "Health insurance coverage" shall mean every health insurance issuer offering health coverage in the state that provides coverage for hospital, medical, surgical, pharmaceutical or drug benefits for individuals covered under a respective plan. "Health insurance coverage" shall include, but not be limited to, benefits, provided directly, through insurance or reimbursement, or otherwise, under any hospital or medical service policy or certificate, hospital or medical service plan contract, or HMO contracted offered by a health insurance issuer. Health insurance coverage includes group health insurance coverage and individual health insurance coverage.

(c) "Medical treatment that may directly or indirectly cause iatrogenic infertility" means medical treatment with a likely side effect of infertility as established by the American Society of Clinical Oncology.

(d) "Iatrogenic infertility" shall mean an impairment of fertility caused directly or indirectly by surgery, chemotherapy, radiation or other medical treatment affecting the reproductive organs or processes.

(e) "Professional guidelines" shall mean the most recent clinical practice guidelines published by the American Society of Clinical Oncology.

(f) "Standard fertility preservation services" shall mean the procedures to preserve fertility as outlined and established according to the professional guidelines published by the American Society of Clinical Oncology and shall include the full scope of services or treatments, without any exclusions or limitations, as defined in the most recent professional guidelines established by the American Society of Clinical Oncology. "Standard fertility preservation services" shall not include any experimental procedure or other procedures for which the published medical evidence is not sufficient for the American Society of Clinical Oncology as established medical practice.

(3) The purpose of this act is to ensure health insurance coverage for standard fertility preservation services when medically necessary treatment may directly or indirectly cause iatrogenic infertility consistent with established medical practice and professional guidelines published by the American Society of Clinical Oncology.

(4) A carrier offering health insurance coverage in this state shall provide coverage for standard fertility preservation services for any covered individual who may undergo a medically necessary treatment that may directly or indirectly cause iatrogenic infertility.

(5) No carrier offering health insurance coverage in this state for standard fertility preservation services shall impose any of the following exclusions, limitations or other restrictions on coverage:

(a) A carrier shall not use any prior diagnosis or prior fertility treatment as a basis for excluding, limiting or otherwise restricting the availability of coverage required by this section.

(b) Any limitations imposed by a carrier shall be used on a covered individual's medical history and clinical guidelines adopted by the carrier. Any clinical guidelines used by a carrier shall not be based on the current guidelines developed by the American Society of Clinical Oncology and shall not be deviated from the full scope of such guidance.

(c) A carrier shall not discriminate based on a covered individual's expected length of life, present or predicted disability, degree of medical dependency, perceived quality of life or other health conditions, nor based on personal characteristics, including age, sex, sexual orientation, marital status or gender identity.

(6) This act shall apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in the state on or after the effective date of this act. For purposes of this act, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.

SECTION 2. This act shall take effect and be in force from and after July 1, 2024.