HLS 22RS-648 REENGROSSED
2022 Regular Session
HOUSE BILL NO. 537
BY REPRESENTATIVES DAVIS, ADAMS, BAGLEY, BOURRIAQUE, BOYD, BRASS,
BROWN, BRYANT, BUTLER, CARPENTER, CARRIER, DUBUISSON,
DUPLESSIS, FISHER, FREEMAN, FREIBERG, GADBERRY, GOUDEAU,
GREEN, HARRIS, HILFERTY, HORTON, HUGHES, ILLG, IVEY, JEFFERSON,
JENKINS, TRAVIS JOHNSON, JORDAN, KERNER, LACOMBE, LAFLEUR,
LANDRY, LARVADAIN, MAGEE, MARCELLE, MARINO, MCKNIGHT,
MCMAHEN, DUSTIN MILLER, NEWELL, CHARLES OWEN, ROBERT OWEN,
PRESSLY, SCHEXNAYDER, SCHLEGEL, SELDERS, STAGNI, VILLIO,
WILLARD, AND ZERINGUE
INSURANCE/HEALTH: Requires health insurance coverage for infertility treatments
1 AN ACT
2To enact R.S. 22:1036.1, relative to health insurance issuers; to require health coverage
3 plans to cover services and benefits relative to standard fertility preservation
4 services; to require patients to meet certain conditions; to provide for exemptions;
5 to provide for definitions; to provide for effectiveness; and to provide for related
6 matters.
7Be it enacted by the Legislature of Louisiana:
8 Section 1. R.S. 22:1036.1 is hereby enacted to read as follows:
9 ยง1036.1. Required coverage for standard fertility preservation services; conditions
10 applicable to coverage; exemptions; definitions
11 A.(1) A health insurance issuer offering health coverage plans in this state
12 that provide hospital, medical, or surgical benefits for individuals covered under a
13 respective plan shall provide coverage for medically necessary expenses for standard
14 fertility preservation services for an individual who undergoes a medical treatment
15 that may directly or indirectly cause iatrogenic infertility.
16 (2) A patient is entitled to coverage benefits if either of the following
17 conditions is met:
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HB NO. 537
1 (a) The patient has a medical condition that may cause infertility.
2 (b) The patient is expected to undergo medication therapy, surgery, radiation,
3 chemotherapy, or other medical treatment that may directly or indirectly cause
4 iatrogenic infertility.
5 B. Notwithstanding any provision of this Section, the coverage requirements
6 of this Section do not apply to any health coverage plan offered by an entity that does
7 all of the following:
8 (1) Opposes providing coverage for some or all of the services described in
9 this Section on account of religious objections.
10 (2) Operates and is organized as a nonprofit entity pursuant to state law.
11 (3) Holds itself out as a religious organization.
12 C. For purposes of this Section, the following terms apply:
13 (1) "Health coverage plan" means any hospital, health, or medical expense
14 insurance policy, hospital or medical service contract, employee welfare benefit plan,
15 contract or agreement with a health maintenance organization or a preferred provider
16 organization, health and accident insurance policy, or any other insurance contract
17 of this type. "Health coverage plan" does not include a plan providing coverage for
18 excepted benefits as defined in R.S. 22:1061, limited benefit health insurance plans,
19 short-term policies that have a term of less than twelve months, nor any plan offered
20 through the office of group benefits.
21 (2) "Iatrogenic infertility" means an impairment of fertility caused directly
22 or indirectly by surgery, radiation, chemotherapy, or other medical treatment.
23 (3) "Medical treatment that may directly or indirectly cause iatrogenic
24 infertility" means medical treatment with a potential side effect of impaired fertility
25 as established by the American Society of Clinical Oncology or the American
26 Society for Reproductive Medicine.
27 (4) "Standard fertility preservation services" means procedures to preserve
28 fertility that are consistent with established medical practices or professional
29 guidelines published by the American Society of Clinical Oncology or the American
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HB NO. 537
1 Society for Reproductive Medicine. "Standard fertility preservation services" does
2 not include the creation or freezing of embryos nor the fertilization of eggs.
3 Section 2. This Act shall be known and may be cited as "The Medically Necessary
4Fertility Preservation Act".
5 Section 3.(A) This Act shall become effective on January 1, 2024.
6 (B) This Act shall apply to any new policy, contract, or health coverage plan issued,
7delivered, amended, or renewed in this state on or after January 1, 2023.
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 537 Reengrossed 2022 Regular Session Davis
Abstract: Requires health coverage benefits for standard fertility preservation services
under certain conditions.
Proposed law requires a health coverage plan in this state that provides hospital, medical,
or surgical benefits to cover medically necessary expenses for standard fertility preservation
services for a covered individual who undergoes a medical treatment that may directly or
indirectly cause iatrogenic infertility.
For coverage eligibility, proposed law requires the individual to have a medical condition
that may cause infertility or medication therapy, surgery, radiation, chemotherapy, or other
medical treatment that may directly or indirectly cause iatrogenic infertility.
Proposed law exempts an organization that opposes providing coverage on account of
religious objections, operates and is organized as a nonprofit entity, and holds itself out as
a religious organization.
Proposed law defines "health coverage plan", "iatrogenic infertility", "medical treatment that
may directly or indirectly cause iatrogenic infertility", and "standard fertility preservation
services".
Proposed law may be known and cited as "The Medically Necessary Fertility Preservation
Act".
Effective Jan. 1, 2024.
(Adds R.S. 22:1036.1)
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Insurance to the
original bill:
1. Add intrauterine insemination, IVF procedures, and standard fertility
preservation services for insurance coverage pursuant to proposed law.
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HB NO. 537
2. Define "health coverage plan".
3. Decrease the required history of infertility from 5 years to 1 year.
4. Remove exposure in utero to diethylstilbestrol (DES) as a condition for which
a patient may present as a reason for infertility.
5. Add polycystic ovary syndrome and male factor infertility as conditions for
which a patient may present as reasons for infertility.
6. Require a patient to have experienced as least 3 unsuccessful intrauterine
inseminations prior to coverage eligibility for IVF procedures.
7. Add conditions for patient coverage eligibility for standard fertility preservation
services. Require a patient to have a medical condition that may cause infertility
or an expectation of undergoing a medical treatment, including but not limited
to chemotherapy and radiation, that is recognized by medical professionals to
cause a risk of impairment to fertility. Further add that standard fertility
preservation services are "standard" as recognized by the American Society of
Clinical Oncology or the American Society for Reproductive Medicine.
8. Exempt an organization that opposes providing coverage on account of religious
objections, operates and is organized as a nonprofit entity, and holds itself out as
a religious organization.
The House Floor Amendments to the engrossed bill:
1. Remove mandatory health coverage benefits and relevant provisions with respect
to in vitro fertilization procedures and intrauterine inseminations.
2. Redefine "health coverage plan" and define "iatrogenic infertility", "medical
treatment that may directly or indirectly cause iatrogenic infertility", and
"standard fertility preservation services".
3. Provide for proposed law to be known and cited as "The Medically Necessary
Fertility Preservation Act".
4. Add the effective date of Jan. 1, 2024 and further require a new policy, contract,
or health coverage plan in this state to comply with proposed law on and after
Jan. 1, 2023.
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