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53	53	STATE OF OKLAHOMA
54	54
55	55	2nd Session of the 59th Legislature (2024)
56	56
57	57	HOUSE BILL 3841 By: Pittman
58	58
59	59
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63	63	AS INTRODUCED
64	64
65	65	An Act relating to infertility insurance coverage;
66	66	defining terms; requiring insurance coverage for
67	67	certain infertility care; specifying terms of
68	68	coverage; providing for codification ; and providing
69	69	an effective date.
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77	77	BE IT ENACTED BY THE PEOPLE OF T HE STATE OF OKLAHOMA:
78	78	SECTION 1. NEW LAW A new section of law to be codified
79	79	in the Oklahoma Statutes as Section 6060.2a of Title 36, unless
80	80	there is created a duplication in numbering, reads as follows:
81	81	As used in this act:
82	82	1. "ACOG" means the American College of Obstetricians and
83	83	Gynecologists or its successor organization ;
84	84	2. "ASCO" means the American Society of Clinical Oncology or
85	85	its successor organization ;
86	86	3. "ASRM" means the American Society for Reproductive Medicine
87	87	or its successor organization;
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139	139	4. "Diagnosis of and treatment for infertility " means the
140	140	procedures and medication s recommended by a licensed physician that
141	141	are consistent with established, published, or approved medical
142	142	practices or professional guidelines from ACOG or ASRM for
143	143	diagnosing and treating infertility ;
144	144	5. "Infertility" means a disease or condition charac terized by:
145	145	a. the failure to impregnate or conceive ,
146	146	b. a person's inability to reproduce either as an
147	147	individual or with the person 's partner, or
148	148	c. a licensed physician 's findings based on a patient 's
149	149	medical, sexual, and reproductive history, age,
150	150	physical findings, or diagnostic testing;
151	151	6. "Licensed physician" means a person licensed by the Oklahoma
152	152	State Board of Medical Licensure and Supervision or the State Board
153	153	of Osteopathic Examiners to practice medicine in this state ; and
154	154	7. "Standard fertility preservation services" means procedures
155	155	and services that are consistent with esta blished medical practices
156	156	or professional guidelines published by ASRM or ASCO for a person
157	157	who has a medical condition or is expected to undergo medication
158	158	therapy, surgery, radiation, chemotherapy, or other medical
159	159	treatment that is recognized by medic al professionals to cause a
160	160	risk of impairment to fertility .
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212	212	SECTION 2. NEW LAW A new section of law to be codified
213	213	in the Oklahoma Statutes as Sect ion 6060.2b of Title 36, unless
214	214	there is created a duplication in numbering, reads as follows:
215	215	A. All individual and group health benefit plans issued or
216	216	renewed in this state, including any insurance plan provided by the
217	217	Employee Group Insurance Division of the Office of Management and
218	218	Enterprise Services, shall provide coverage for the diagnosis of and
219	219	treatment for infertility and standard fertility preser vation
220	220	services.
221	221	B. The coverage required by this act includes three completed
222	222	oocyte retrievals with unlimited embryo transfers in accordance with
223	223	the guidelines of the American Society of Clinical Oncology , using
224	224	single embryo transfer when recommended and medically appropriate.
225	225	C. The health benefit plan shall not impose:
226	226	1. Any exclusions, limita tions, or other restrictions on
227	227	coverage of fertility medications that are different from the
228	228	exclusions, limitations, or other restrictions imposed on any o ther
229	229	prescription medications covered under the health benefit plan; or
230	230	2. Deductibles, copayment s, coinsurance, benefit maximums,
231	231	waiting periods, or other limitations on coverage for the diagnosis
232	232	of and treatment for infertility and standard fertility preservation
233	233	services, except as otherwise specified in this act, that are
234	234	different from deductib les, copayments, coinsurance, benefit
235	235	maximums, waiting periods, or other limitations imposed on benefits
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287	287	for services covered under the health benefit plan that are not
288	288	related to infertility.
289	289	D. The Oklahoma Insurance Commissioner shall adopt rules
290	290	consistent with and as are necessary to implement this act.
291	291	E. A religious employer may request and a carrier subject to
292	292	this act shall grant an exclusion from the coverage required under
293	293	this act in a health benefit plan if the required coverage conflicts
294	294	with the religious organization's bona fide religious beliefs and
295	295	practices. A religious employer that obtains an exclusion under
296	296	this act shall provide its employees reasonable and timely notice of
297	297	the exclusion of the coverage described in this act from the health
298	298	benefit plan the religious employer of fers to its employees.
299	299	F. 1. Within one hundred twenty (120) days after the effective
300	300	date of this act, the Oklahoma Insurance Department shall submit to
301	301	the federal Department of Health and Human Services its
302	302	determination as to whether the coverage spe cified in this act is in
303	303	addition to essential health benefits and would be subject to
304	304	defrayal by the state pursuant to 42 U.S.C., Section 18031 (d)(3)(b)
305	305	and a request that the federal Department confirm th e Department's
306	306	determination within sixty (60) days after receipt of the
307	307	Department's request and submission of its determination.
308	308	2. This act applies to health benefit plans issued or renewed
309	309	in this state that are subject to this act, and the Oklahoma
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361	361	Insurance Department shall implement the requireme nts of this act,
362	362	if:
363	363	a. the Department receives confirmation from the federal
364	364	Department of Health and Human Services that the
365	365	coverage specified in this act does not constitute an
366	366	additional benefit that re quires defrayal by the state
367	367	pursuant to 42 U.S.C., Section 18031 (d)(3)(b), or
368	368	b. more than three hundred sixty -five (365) days have
369	369	passed since the Department submitted its
370	370	determination and request for confirmation that the
371	371	coverage specified in this act is not an additional
372	372	benefit that requires stat e defrayal pursuant to 42
373	373	U.S.C., Section 18031 (d)(3)(b), and the federal
374	374	Department of Health and Human Services has failed to
375	375	respond to the request within that period, in which
376	376	case the Department shall consider the federal
377	377	Department's unreasonable delay a preclusion from
378	378	requiring defrayal by the state.
379	379	SECTION 3. This act shall become e ffective November 1, 2024.
380	380
381	381	59-2-9650 TJ 01/18/24

Oklahoma 2024 Regular Session

Oklahoma House Bill HB3841 Compare Versions