Pennsylvania 2025-2026 Regular Session

Pennsylvania House Bill HB922 Latest Draft

Bill / Introduced Version

                             
PRINTER'S NO. 971 
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL 
No.922 
Session of 
2025 
INTRODUCED BY MAYES, O'MARA, MALAGARI, GIRAL, WAXMAN, MADDEN, 
ABNEY, CERRATO, FREEMAN, HANBIDGE, KENYATTA, SCHLOSSBERG, 
HOHENSTEIN, OTTEN, SANCHEZ, INGLIS AND RABB, MARCH 17, 2025 
REFERRED TO COMMITTEE ON INSURANCE, MARCH 17, 2025 
AN ACT
Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An 
act relating to insurance; amending, revising, and 
consolidating the law providing for the incorporation of 
insurance companies, and the regulation, supervision, and 
protection of home and foreign insurance companies, Lloyds 
associations, reciprocal and inter-insurance exchanges, and 
fire insurance rating bureaus, and the regulation and 
supervision of insurance carried by such companies, 
associations, and exchanges, including insurance carried by 
the State Workmen's Insurance Fund; providing penalties; and 
repealing existing laws," in casualty insurance, providing 
for fertility preservation coverage.
The General Assembly of the Commonwealth of Pennsylvania 
hereby enacts as follows:
Section 1.  The act of May 17, 1921 (P.L.682, No.284), known 
as The Insurance Company Law of 1921, is amended by adding a 
section to read:
Section  635.11 .  Fertility Preservation Coverage.--(a)  An  
individual or group health insurance policy offered, issued or 
renewed in this Commonwealth or a government program shall 
include coverage for fertility preservation services as 
specified in subsection (b) and shall waive cost-sharing 
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22 requirements related to fertility preservation care.
(b)  Fertility preservation specified under subsection (c) 
shall apply to covered individuals not older than forty-five 
(45) years of age who are at risk of iatrogenic infertility.
(c)  Fertility preservation care services under this section 
shall include services related to fertility preservation as a 
result of iatrogenic infertility, including for the 
consultation, diagnosis and treatment of iatrogenic infertility, 
as well as the following:
(1)  Cryopreservation and thawing of eggs, sperm and embryos.
(2)  Cryopreservation of ovarian tissue.
(3)  Cryopreservation of testicular tissue.
(4)  Intrauterine insemination.
(5)  Embryo biopsy.
(6)  Diagnostic testing.
(7)  Fresh and frozen embryo transfers.
(8)  Egg retrievals with unlimited embryo transfers in 
accordance with the guidelines determined by the Department of 
Health. The guidelines should be informed by standards of 
practice as developed by the American Society for Reproductive 
Medicine, including the use of single embryo transfers when 
recommended and medically appropriate.
(9)  Assisted hatching.
(10)  Intracytoplasmic sperm injection.
(11)  Ovulation induction.
(12)  Storage of oocytes, sperm, embryos and tissue.
(13)  Medical and laboratory services that reduce excess 
embryo creation through egg cryopreservation and thawing.
(14)  Therapeutic devices.
(15)  Standard fertility preservation services for an 
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30 individual who has a medical condition and is expected to 
undergo medication therapy, surgery, radiation, chemotherapy or 
other medical treatment that is recognized by a medical 
professional to cause a risk of impairment to fertility.
(16)  Any nonexperimental procedure for infertility 
determined by the Department of Health.
(17)  Any other services, procedures, medications or devices 
related to the consultation, diagnosis and treatment for 
fertility preservation.
(18)  In vitro fertilization, including in vitro 
fertilization through the use of donor eggs, sperm or embryos 
and in vitro fertilization that involves the transfer of embryos 
to a gestational carrier or surrogate.
(d)  A health insurance policy or government program covered 
under this section may not:
(1)  contain preexisting condition exclusions or preexisting 
waiting periods to access fertility preservation care coverage 
required under this section;
(2)  contain limitations on coverage for fertility 
preservation benefits based solely on arbitrary factors, 
including the number of fertility preservation attempts or cost 
of fertility preservation care.
(e)  Storage requirements under subsection (c)(12) shall be 
covered by a health insurance policy or a government program for 
five consecutive years unless:
(1)  If the covered individual receiving service coverage 
under subsection (b) is not yet eighteen (18) years of age, in 
addition to requirements under this subsection, a health 
insurance policy or government program shall also cover storage 
requirements as necessary until the covered individual attains 
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30 eighteen (18) years of age.
(2)  If a covered individual receiving services under 
subsection (c)(12) under one health insurance policy or 
government program changes coverage to another health insurance 
policy or government program during the five-consecutive-year 
window under this subsection, the subsequent health insurance 
policy or government program shall continue to provide coverage 
of services required under subsection (c)(12) for the remaining 
storage time under this subsection.
(f)  Nothing in this section shall be construed to interfere 
with the clinical judgment of a physician.
(g)  As used in this section, the following words and phrases 
shall have the meanings given to them in this subsection unless 
the context clearly indicates otherwise:
"Cost-sharing" means the share of costs covered by the 
patient, including a deductible, coinsurance, copayment or 
similar charge. The term does not include the payment of a 
health insurance policy or government program premium.
"Covered individual" means an individual covered under a 
health insurance policy or government program, including covered 
spouses and covered nonspouse dependents which is provided 
without discrimination on the basis of ancestry, color, 
disability, domestic partner status, gender, gender expression, 
gender identity, genetic information, marital status, national 
origin, race, religion, sex or sexual orientation.
"Fertility preservation" means health care services used in 
saving or protecting embryos, eggs, ovarian tissue, sperm or 
testicular tissue for future reproduction.
"Government program" means a program of government sponsored 
or subsidized health care coverage, including:
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30 (1)  The children's health insurance program under Article 
XXIII-A.
(2)  Subdivision (f) of Article IV of the act of June 13, 
1967 (P.L.31, No.21), known as the "Human Services Code."
"Health insurance policy" means as follows:
(1)  The term includes an individual or group health 
insurance policy, subscriber contract, certificate or plan that 
provides medical or health care coverage on an expense-incurred 
service or prepaid basis and that is offered by or is governed 
under any of the following:
(i)  This act, including section 630.
(ii)  The act of December 29, 1972 (P.L.1701, No.364), known 
as the "Health Maintenance Organization Act."
(iii)   40 Pa.C.S. Chs. 61 (relating to hospital plan  
corporations) and 63 (relating to professional health services 
plan corporations).
(2)  The term does not include any of the following plans:
(i)  Accident only.
(ii)  Credit only.
(iii)  Long-term care or disability income.
(iv)  Specified disease.
(v)  Medicare supplement.
(vi)  TRICARE, including the Civilian Health and Medical 
Program of the Uniformed Services (CHAMPUS) supplement.
(vii)  Fixed indemnity.
(viii)  Dental only.
(ix)  Vision only.
(x)  Workers' compensation.
(xi)  An automobile medical payment under 75 Pa.C.S. 
(relating to vehicles).
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30 "Iatrogenic infertility" means infertility arising from 
medical treatments that directly or indirectly cause 
infertility.
"Infertility" means a disease historically defined by the 
failure to achieve a successful pregnancy after six to twelve 
months or more of regular, unprotected sexual intercourse or due 
to an individual's status and capacity to reproduce as an 
individual or with a partner.
"Physician" means an individual licensed as a medical doctor 
by the State Board of Medicine to practice in this Commonwealth.
Section 2.  The following shall apply:
(1)  For health insurance policies for which either rates 
or forms are required to be filed with the Federal Government 
or the Insurance Department, this act shall apply to any 
policy for which a form or rate is first filed on or after 
the effective date of this section.
(2)  For health insurance policies for which rates or 
forms are required to be filed with the Federal Government or 
the Insurance Department, this act shall apply to any policy 
issued or renewed on or after 180 days after the effective 
date of this section.
Section 3.  This act shall take effect in 60 days.
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