| 1 | 1 | | 87R889 SCL-D |
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| 2 | 2 | | By: Johnson S.B. No. 135 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to conditions applicable to health benefit plan coverage |
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| 8 | 8 | | of in vitro fertilization procedures. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Section 1366.005, Insurance Code, is amended to |
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| 11 | 11 | | read as follows: |
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| 12 | 12 | | Sec. 1366.005. CONDITIONS APPLICABLE TO COVERAGE. The |
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| 13 | 13 | | coverage offered under Section 1366.003 is required only if: |
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| 14 | 14 | | (1) the patient for the in vitro fertilization |
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| 15 | 15 | | procedure is an individual covered under the group health benefit |
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| 16 | 16 | | plan; |
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| 17 | 17 | | (2) [the fertilization or attempted fertilization of |
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| 18 | 18 | | the patient's oocytes is made only with the sperm of the patient's |
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| 19 | 19 | | spouse; |
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| 20 | 20 | | [(3)] the patient and the patient's spouse have a |
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| 21 | 21 | | history of infertility of at least five continuous years' duration |
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| 22 | 22 | | or the infertility is associated with: |
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| 23 | 23 | | (A) endometriosis; |
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| 24 | 24 | | (B) exposure in utero to diethylstilbestrol |
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| 25 | 25 | | (DES); |
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| 26 | 26 | | (C) blockage of or surgical removal of one or |
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| 27 | 27 | | both fallopian tubes; or |
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| 28 | 28 | | (D) oligospermia; |
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| 29 | 29 | | (3) [(4)] the patient has been unable to attain a |
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| 30 | 30 | | successful pregnancy through any less costly applicable |
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| 31 | 31 | | infertility treatments for which coverage is available under the |
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| 32 | 32 | | group health benefit plan; and |
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| 33 | 33 | | (4) [(5)] the in vitro fertilization procedures are |
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| 34 | 34 | | performed at a medical facility that conforms to the minimal |
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| 35 | 35 | | standards for programs of in vitro fertilization adopted by the |
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| 36 | 36 | | American Society for Reproductive Medicine. |
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| 37 | 37 | | SECTION 2. Section 1366.005, Insurance Code, as amended by |
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| 38 | 38 | | this Act, applies only to a health benefit plan delivered, issued |
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| 39 | 39 | | for delivery, or renewed on or after January 1, 2022. A health |
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| 40 | 40 | | benefit plan delivered, issued for delivery, or renewed before |
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| 41 | 41 | | January 1, 2022, is governed by the law as it existed immediately |
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| 42 | 42 | | before the effective date of this Act, and that law is continued in |
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| 43 | 43 | | effect for that purpose. |
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| 44 | 44 | | SECTION 3. This Act takes effect September 1, 2021. |
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