Fair Access to Fertility Treatment Act (FAFTA) Sponsors

NY Senator

Diane Savino

NY Assemblywoman

Aravella Simotas

New York State Assembly FAFTA 2018 Cosponsors

Asm Barrett

Asm Barrett

 
Asm Bichotte

Asm Bichotte

 
Asm Braunstein

Asm Braunstein

 
Asm Brindisi

Asm Brindisi

 
Asm Bronson

Asm Bronson

 
Asm Buchwald

Asm Buchwald

 
Asm Cymbrowitz

Asm Cymbrowitz

 
Asm Dinowitz

Asm Dinowitz

 
Asm Hevesi

Asm Hevesi

 
Asm Lavine

Asm Lavine

 
Asm Lifton

Asm Lifton

 
Asm McDonald

Asm McDonald

 
Asm Morelle

Asm Morelle

 
Asm Mosley

Asm Mosley

 
Asm Murray

Asm Murray

 
Asm Otis

Asm Otis

 
Asm Paulin

Asm Paulin

 
Asm Quart

Asm Quart

 
Asm L Rosenthal

Asm L Rosenthal

 
Asm Rozic

Asm Rozic

 
Asm Seawright

Asm Seawright

 
Asm Sepulveda

Asm Sepulveda

 
Asm Simon

Asm Simon

 
Asm Solages

Asm Solages

 
Asm Steck

Asm Steck

 

New York State Senate FAFTA 2018 Cosponsors

Sen Alcantara

Sen Alcantara

 
Sen Avella

Sen Avella

 
Sen Bailey

Sen Bailey

 
Sen Bonacic

Sen Bonacic

 
Sen Carlucci

Sen Carlucci

 
Sen Croci

Sen Croci

 
Sen Hamilton

Sen Hamilton

 
Sen Helming

Sen Helming

 
Sen Hoylman

Sen Hoylman

 
Sen Jacobs

Sen Jacobs

 
Sen Kaminsky

Sen Kaminsky

 
Sen Peralta

Sen Peralta

 
Sen Phillips

Sen Phillips

 
Sen Robach

Sen Robach

 
Sen Sanders Jr

Sen Sanders Jr

 
Sen Valesky

Sen Valesky

 

Text of the Fair Access to Fertility Treatment Act (FAFTA)

3148--A
2017-2018 Regular Sessions
I N S E N A T E
January 20, 2017
___________ Introduced by Sens. SAVINO, ALCANTARA, AVELLA, BAILEY, CARLUCCI, CROCI, HAMILTON, HOYLMAN, KAMINSKY, LATIMER, PERALTA, ROBACH, VALESKY -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the insurance law, in relation to insurance coverage of in vitro fertilization and other fertility preservation treatments THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph 13 of subsection (i) of section 3216 of the insurance law is amended by adding three new subparagraphs (C), (D) and (E) to read as follows: (C) EVERY POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL OR MEDICAL CARE SHALL PROVIDE COVERAGE FOR: (I) IN VITRO FERTILIZATION USED IN THE TREATMENT OF INFERTILITY; AND (II) STANDARD FERTILITY PRESERVATION SERVICES WHEN A NECESSARY MEDICAL TREATMENT MAY DIRECTLY OR INDIRECTLY CAUSE IATROGENIC INFERTILITY TO A COVERED PERSON. (D) (I) FOR THE PURPOSES OF SUBPARAGRAPH (C) OF THIS PARAGRAPH, "INFERTILITY" MEANS A DISEASE OR CONDITION CHARACTERIZED BY THE INCAPAC- ITY TO IMPREGNATE ANOTHER PERSON OR TO CONCEIVE, AS DIAGNOSED OR DETER- MINED (I) BY A PHYSICIAN LICENSED TO PRACTICE MEDICINE IN THIS STATE, OR (II) BY THE FAILURE TO ESTABLISH A CLINICAL PREGNANCY AFTER TWELVE MONTHS OF REGULAR, UNPROTECTED SEXUAL INTERCOURSE, OR AFTER SIX MONTHS OF REGULAR, UNPROTECTED SEXUAL INTERCOURSE IN THE CASE OF A FEMALE THIR- TY-FIVE YEARS OF AGE OR OLDER. (II) FOR THE PURPOSES OF SUBPARAGRAPH (C) OF THIS PARAGRAPH, "IATRO- GENIC INFERTILITY" MEANS AN IMPAIRMENT OF FERTILITY BY SURGERY, RADI- ATION, CHEMOTHERAPY OR OTHER MEDICAL TREATMENT AFFECTING REPRODUCTIVE ORGANS OR PROCESSES. EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD04562-04-7
S. 3148--A                          2

  (E) NO INSURER PROVIDING COVERAGE UNDER THIS PARAGRAPH SHALL DISCRIMI-
NATE 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 IDENTI-
TY.
  S  2.  Paragraph  6 of subsection (k) of section 3221 of the insurance
law is amended by adding three new subparagraphs (E),  (F)  and  (G)  to
read as follows:
  (E)  EVERY GROUP POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE
THAT PROVIDES HOSPITAL,  SURGICAL  OR  MEDICAL  COVERAGE  SHALL  PROVIDE
COVERAGE FOR:
  (I) IN VITRO FERTILIZATION USED IN THE TREATMENT OF INFERTILITY; AND
  (II) STANDARD FERTILITY PRESERVATION SERVICES WHEN A NECESSARY MEDICAL
TREATMENT  MAY  DIRECTLY OR INDIRECTLY CAUSE IATROGENIC INFERTILITY TO A
COVERED PERSON.
  (F) (I) FOR THE  PURPOSES  OF  SUBPARAGRAPH  (E)  OF  THIS  PARAGRAPH,
"INFERTILITY" MEANS A DISEASE OR CONDITION CHARACTERIZED BY THE INCAPAC-
ITY  TO IMPREGNATE ANOTHER PERSON OR TO CONCEIVE, AS DIAGNOSED OR DETER-
MINED (I) BY A PHYSICIAN LICENSED TO PRACTICE MEDICINE IN THIS STATE, OR
(II) BY THE FAILURE TO  ESTABLISH  A  CLINICAL  PREGNANCY  AFTER  TWELVE
MONTHS  OF  REGULAR, UNPROTECTED SEXUAL INTERCOURSE, OR AFTER SIX MONTHS
OF REGULAR, UNPROTECTED SEXUAL INTERCOURSE IN THE CASE OF A FEMALE THIR-
TY-FIVE YEARS OF AGE OR OLDER.
  (II) FOR THE PURPOSES OF SUBPARAGRAPH (E) OF THIS  PARAGRAPH,  "IATRO-
GENIC  INFERTILITY"  MEANS  AN IMPAIRMENT OF FERTILITY BY SURGERY, RADI-
ATION, CHEMOTHERAPY OR OTHER MEDICAL  TREATMENT  AFFECTING  REPRODUCTIVE
ORGANS OR PROCESSES.
  (G) NO INSURER PROVIDING COVERAGE UNDER THIS PARAGRAPH SHALL DISCRIMI-
NATE 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 IDENTI-
TY.
  S  3.  Subsection (s) of section 4303 of the insurance law, as amended
by section 2 of part F of chapter 82 of the laws of 2002, is amended  by
adding three new paragraphs (5), (6) and (7) to read as follows:
  (5)  EVERY CONTRACT ISSUED BY A MEDICAL EXPENSE INDEMNITY CORPORATION,
HOSPITAL SERVICE CORPORATION OR HEALTH SERVICE CORPORATION FOR  DELIVERY
IN THIS STATE THAT PROVIDES HOSPITAL, SURGICAL OR MEDICAL COVERAGE SHALL
PROVIDE COVERAGE FOR:
  (A) IN VITRO FERTILIZATION USED IN THE TREATMENT OF INFERTILITY; AND
  (B)  STANDARD FERTILITY PRESERVATION SERVICES WHEN A NECESSARY MEDICAL
TREATMENT MAY DIRECTLY OR INDIRECTLY CAUSE IATROGENIC INFERTILITY  TO  A
COVERED PERSON.
  (6) (A) FOR THE PURPOSES OF PARAGRAPH FIVE OF THIS SUBSECTION, "INFER-
TILITY"  MEANS A DISEASE OR CONDITION CHARACTERIZED BY THE INCAPACITY TO
IMPREGNATE ANOTHER PERSON OR TO CONCEIVE, AS DIAGNOSED OR DETERMINED (I)
BY A PHYSICIAN LICENSED TO PRACTICE MEDICINE IN THIS STATE, OR  (II)  BY
THE  FAILURE  TO  ESTABLISH  A CLINICAL PREGNANCY AFTER TWELVE MONTHS OF
REGULAR, UNPROTECTED SEXUAL INTERCOURSE, OR AFTER SIX MONTHS OF REGULAR,
UNPROTECTED SEXUAL INTERCOURSE IN THE CASE OF A FEMALE THIRTY-FIVE YEARS
OF AGE OR OLDER.
  (B) FOR THE PURPOSES OF PARAGRAPH FIVE OF THIS SUBSECTION, "IATROGENIC
INFERTILITY" MEANS AN IMPAIRMENT OF  FERTILITY  BY  SURGERY,  RADIATION,

S. 3148--A                          3

CHEMOTHERAPY OR OTHER MEDICAL TREATMENT AFFECTING REPRODUCTIVE ORGANS OR
PROCESSES.
  (7)  NO MEDICAL EXPENSE INDEMNITY CORPORATION, HOSPITAL SERVICE CORPO-
RATION OR HEALTH  SERVICE  CORPORATION  PROVIDING  COVERAGE  UNDER  THIS
SUBSECTION  SHALL  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  ORIEN-
TATION, MARITAL STATUS OR GENDER IDENTITY.
  S 4. Subparagraph (C) of paragraph 6 of subsection (k) of section 3221
of the insurance law, as amended by section 1 of part K of chapter 82 of
the laws of 2002, is amended to read as follows:
  (C)   Coverage  of  diagnostic  and  treatment  procedures,  including
prescription drugs, used in the diagnosis and treatment  of  infertility
as  required  by  subparagraphs  (A)  and (B) of this paragraph shall be
provided in accordance with the provisions of this subparagraph.
  (i) [Coverage shall be provided for  persons  whose  ages  range  from
twenty-one  through forty-four years, provided that nothing herein shall
preclude the provision of coverage to persons  whose  age  is  below  or
above such range.
  (ii)]  Diagnosis  and  treatment of infertility shall be prescribed as
part of a physician's overall plan  of  care  and  consistent  with  the
guidelines for coverage as referenced in this subparagraph.
  [(iii)]  (II)  Coverage may be subject to co-payments, coinsurance and
deductibles as may be deemed appropriate by the  superintendent  and  as
are  consistent with those established for other benefits within a given
policy.
  [(iv) Coverage shall be limited to those  individuals  who  have  been
previously covered under the policy for a period of not less than twelve
months,  provided  that for the purposes of this subparagraph "period of
not less than twelve months" shall be  determined  by  calculating  such
time from either the date the insured was first covered under the exist-
ing policy or from the date the insured was first covered by a previous-
ly in-force converted policy, whichever is earlier.
  (v)] (III) Coverage shall not be required to include the diagnosis and
treatment  of  infertility  in connection with: (I) [in vitro fertiliza-
tion, gamete intrafallopian tube transfers or zygote intrafallopian tube
transfers; (II)] the reversal of elective sterilizations;  [(III)]  (II)
sex  change  procedures;  [(IV)] (III) cloning; or [(V)] (IV) medical or
surgical services or procedures that are deemed to  be  experimental  in
accordance  with clinical guidelines referenced in clause [(vi)] (IV) of
this subparagraph.
  [(vi)] (IV) The superintendent, in consultation with the  commissioner
of health, shall promulgate regulations which shall stipulate the guide-
lines  and  standards which shall be used in carrying out the provisions
of this subparagraph, which shall include:
  (I) [The determination of "infertility" in accordance with the  stand-
ards  and  guidelines established and adopted by the American College of
Obstetricians and Gynecologists and the American Society  for  Reproduc-
tive Medicine;
  (II)] The identification of experimental procedures and treatments not
covered  for  the  diagnosis  and treatment of infertility determined in
accordance with the standards and guidelines established and adopted  by
the American College of Obstetricians and Gynecologists and the American
Society for Reproductive Medicine;

S. 3148--A                          4

  [(III)]  (II)  The identification of the required training, experience
and other standards for health  care  providers  for  the  provision  of
procedures and treatments for the diagnosis and treatment of infertility
determined  in  accordance with the standards and guidelines established
and  adopted  by the American College of Obstetricians and Gynecologists
and the American Society for Reproductive Medicine; and
  [(IV)] (III) The determination of appropriate  medical  candidates  by
the  treating  physician in accordance with the standards and guidelines
established and adopted by the American  College  of  Obstetricians  and
Gynecologists and/or the American Society for Reproductive Medicine.
  S  5.  Paragraph  3 of subsection (s) of section 4303 of the insurance
law, as amended by section 2 of part K of chapter  82  of  the  laws  of
2002, is amended to read as follows:
  (3)   Coverage  of  diagnostic  and  treatment  procedures,  including
prescription drugs used in the diagnosis and treatment of infertility as
required by paragraphs one and two of this subsection shall be  provided
in accordance with this paragraph.
  (A)  [Coverage  shall  be  provided  for persons whose ages range from
twenty-one through forty-four years, provided that nothing herein  shall
preclude  the  provision  of  coverage  to persons whose age is below or
above such range.
  (B)] Diagnosis and treatment of infertility  shall  be  prescribed  as
part  of  a  physician's  overall  plan  of care and consistent with the
guidelines for coverage as referenced in this paragraph.
  [(C)] (B) Coverage may be  subject  to  co-payments,  coinsurance  and
deductibles  as  may  be deemed appropriate by the superintendent and as
are consistent with those established for other benefits within a  given
policy.
  [(D)  Coverage  shall  be  limited  to those individuals who have been
previously covered under the policy for a period of not less than twelve
months, provided that for the purposes of this paragraph "period of  not
less  than  twelve  months" shall be determined by calculating such time
from either the date the insured was first covered  under  the  existing
policy  or  from  the date the insured was first covered by a previously
in-force converted policy, whichever is earlier.
  (E)] (C) Coverage shall not be required to include the  diagnosis  and
treatment  of  infertility  in connection with: (i) [in vitro fertiliza-
tion, gamete intrafallopian tube transfers or zygote intrafallopian tube
transfers; (ii)] the reversal of elective sterilizations;  [(iii)]  (II)
sex  change  procedures;  [(iv)] (III) cloning; or [(v)] (IV) medical or
surgical services or procedures that are deemed to  be  experimental  in
accordance with clinical guidelines referenced in subparagraph [(F)] (D)
of this paragraph.
  [(F)] (D) The superintendent, in consultation with the commissioner of
health,  shall  promulgate  regulations which shall stipulate the guide-
lines and standards which shall be used in carrying out  the  provisions
of this paragraph, which shall include:
  (i)  [The determination of "infertility" in accordance with the stand-
ards and guidelines established and adopted by the American  College  of
Obstetricians  and  Gynecologists and the American Society for Reproduc-
tive Medicine;
  (ii)] The identification of experimental procedures and treatments not
covered for the diagnosis and treatment  of  infertility  determined  in
accordance  with the standards and guidelines established and adopted by
the American College of Obstetricians and Gynecologists and the American
Society for Reproductive Medicine;

S. 3148--A                          5

  [(iii)] (II) The identification of the required  training,  experience
and  other  standards  for  health  care  providers for the provision of
procedures and treatments for the diagnosis and treatment of infertility
determined in accordance with the standards and  guidelines  established
and  adopted  by the American College of Obstetricians and Gynecologists
and the American Society for Reproductive Medicine; and
  [(iv)] (III) The determination of appropriate  medical  candidates  by
the  treating  physician in accordance with the standards and guidelines
established and adopted by the American  College  of  Obstetricians  and
Gynecologists and/or the American Society for Reproductive Medicine.
  S  6.  This  act  shall  take  effect on the first day of January next
succeeding the date on which it shall have become a law and shall  apply
to  all  policies  issued, renewed, altered or modified on or after such
date.