MISSISSIPPI LEGISLATURE
2007 Regular Session
To: Insurance; Appropriations
By: Representative Staples
AN ACT TO REQUIRE THAT CERTAIN HEALTH INSURANCE POLICIES PROVIDE COVERED BENEFITS FOR THE TREATMENT OF INFERTILITY; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. (1) Every alternative delivery system, every individual and group health medical and hospitalization insurance policy, certificate, plan or program, and every subscriber contract provided by a nonprofit health service plan, corporation or health maintenance organization, that is regulated by the State of Mississippi and issued, renewed or continued after July 1, 2007, shall provide covered benefits for the diagnosis and treatment of infertility, except for policies which only provide coverage for specified diseases and other limited benefit health insurance policies and negotiated labor contracts.
(2) Covered benefits for inpatient or outpatient treatment of infertility in insurance policies and other contracts shall be limited to such inpatient or outpatient services, as the case may be, that are certified as necessary by a health service provider.
(3) The benefits provided in this section shall be subject to the same annual deductibles or coinsurance established for all other covered benefits within a given policy or contract. Before an insured party may qualify to receive benefits under this section, a health service provider shall certify that the individual is infertile and shall refer the individual for the appropriate treatment.
(4) All infertility treatment or services with respect to such treatment eligible for health insurance coverage shall be subject to professional utilization and peer review procedures.
(5) For purposes of this section, "infertility" means a disease or condition that results in the abnormal functioning of the male or female reproductive system and includes conception difficulty and the inability to carry a pregnancy that results in a live birth.
(6) The lifetime payments for treatment of infertility shall be no less than Twenty Thousand Dollars ($20,000.00).
(7) The Commissioner of Insurance shall enforce the provisions of this section.
SECTION 2. This act shall take effect and be in force from and after July 1, 2007.