- Summary
- Actions
- Committee Votes
- Floor Votes
- Memo
- Text
- LFIN
- Chamber Video/Transcript
A02646 Summary:
BILL NO | A02646A |
  | |
SAME AS | SAME AS S03148-A |
  | |
SPONSOR | Simotas |
  | |
COSPNSR | Quart, Bronson, Solages, Braunstein, Bichotte, Steck, Seawright, Simon, Brindisi, Paulin, Barrett, Hevesi, McDonald, Lavine, Cymbrowitz, Mosley, Buchwald, Morelle, Dinowitz, Rozic, Sepulveda, Rosenthal L, Murray, Otis, Lifton, Jean-Pierre, Pellegrino, Wright, Weprin, Curran, Espinal |
  | |
MLTSPNSR | Englebright, Lentol |
  | |
Amd §§3216, 3221 & 4303, Ins L | |
  | |
Relates to insurance coverage of in vitro fertilization and other fertility preservation treatments. |
A02646 Actions:
BILL NO | A02646A | |||||||||||||||||||||||||||||||||||||||||||||||||
  | ||||||||||||||||||||||||||||||||||||||||||||||||||
01/20/2017 | referred to insurance | |||||||||||||||||||||||||||||||||||||||||||||||||
05/10/2017 | amend and recommit to insurance | |||||||||||||||||||||||||||||||||||||||||||||||||
05/10/2017 | print number 2646a | |||||||||||||||||||||||||||||||||||||||||||||||||
05/16/2017 | reported referred to codes | |||||||||||||||||||||||||||||||||||||||||||||||||
06/06/2017 | reported referred to ways and means | |||||||||||||||||||||||||||||||||||||||||||||||||
06/14/2017 | reported referred to rules | |||||||||||||||||||||||||||||||||||||||||||||||||
06/15/2017 | reported | |||||||||||||||||||||||||||||||||||||||||||||||||
06/15/2017 | rules report cal.375 | |||||||||||||||||||||||||||||||||||||||||||||||||
06/15/2017 | ordered to third reading rules cal.375 | |||||||||||||||||||||||||||||||||||||||||||||||||
06/19/2017 | passed assembly | |||||||||||||||||||||||||||||||||||||||||||||||||
06/19/2017 | delivered to senate | |||||||||||||||||||||||||||||||||||||||||||||||||
06/19/2017 | REFERRED TO RULES | |||||||||||||||||||||||||||||||||||||||||||||||||
01/03/2018 | DIED IN SENATE | |||||||||||||||||||||||||||||||||||||||||||||||||
01/03/2018 | RETURNED TO ASSEMBLY | |||||||||||||||||||||||||||||||||||||||||||||||||
01/03/2018 | ordered to third reading cal.209 | |||||||||||||||||||||||||||||||||||||||||||||||||
05/15/2018 | passed assembly | |||||||||||||||||||||||||||||||||||||||||||||||||
05/15/2018 | delivered to senate | |||||||||||||||||||||||||||||||||||||||||||||||||
05/15/2018 | REFERRED TO INSURANCE |
A02646 Committee Votes:
Cahill | Aye | Barclay | Nay | ||||||
Cook | Aye | Butler | Nay | ||||||
Pretlow | Aye | Hawley | Nay | ||||||
Rivera | Excused | Blankenbush | Nay | ||||||
Peoples-Stokes | Aye | Curran | Aye | ||||||
Cymbrowitz | Aye | Walter | Aye | ||||||
Lavine | Aye | Garbarino | Nay | ||||||
Moya | Aye | ||||||||
Hevesi | Aye | ||||||||
Skoufis | Aye | ||||||||
Steck | Aye | ||||||||
Crespo | Aye | ||||||||
Joyner | Aye | ||||||||
Dilan | Aye | ||||||||
Hunter | Aye | ||||||||
Simotas | Aye | ||||||||
Walker | Aye | ||||||||
Niou | Aye | ||||||||
Lentol | Aye | Graf | Aye | ||||||
Schimminger | Aye | Giglio | Aye | ||||||
Weinstein | Aye | McKevitt | Aye | ||||||
Pretlow | Aye | Montesano | Nay | ||||||
Cook | Aye | Ra | Aye | ||||||
Cymbrowitz | Aye | Morinello | Aye | ||||||
Titus | Aye | ||||||||
O'Donnell | Aye | ||||||||
Lavine | Aye | ||||||||
Perry | Aye | ||||||||
Zebrowski | Aye | ||||||||
Abinanti | Aye | ||||||||
Weprin | Aye | ||||||||
Mosley | Aye | ||||||||
Hevesi | Aye | ||||||||
Fahy | Aye | ||||||||
Farrell | Aye | Oaks | Nay | ||||||
Lentol | Aye | Crouch | Nay | ||||||
Schimminger | Nay | Barclay | Nay | ||||||
Gantt | Excused | Fitzpatrick | Nay | ||||||
Weinstein | Aye | Hawley | Nay | ||||||
Glick | Aye | Malliotakis | Aye | ||||||
Nolan | Excused | Walter | Aye | ||||||
Pretlow | Aye | Montesano | Nay | ||||||
Perry | Aye | Curran | Aye | ||||||
Colton | Aye | Ra | Aye | ||||||
Cook | Excused | ||||||||
Cahill | Aye | ||||||||
Aubry | Aye | ||||||||
Hooper | Excused | ||||||||
Thiele | Aye | ||||||||
Cusick | Aye | ||||||||
Ortiz | Excused | ||||||||
Benedetto | Aye | ||||||||
Moya | Aye | ||||||||
Weprin | Aye | ||||||||
Rodriguez | Excused | ||||||||
Ramos | Aye | ||||||||
Braunstein | Aye | ||||||||
McDonald | Aye | ||||||||
Rozic | Aye | ||||||||
Heastie | Aye | Kolb | Aye | ||||||
Gottfried | Aye | Oaks | Aye | ||||||
Lentol | Aye | Butler | Aye | ||||||
Farrell | Aye | Crouch | Aye | ||||||
Gantt | Aye | Finch | Aye | ||||||
Nolan | Aye | Barclay | Aye | ||||||
Weinstein | Aye | Raia | Aye | ||||||
Hooper | Aye | Hawley | Aye | ||||||
Ortiz | Aye | ||||||||
Pretlow | Aye | ||||||||
Cook | Excused | ||||||||
Glick | Aye | ||||||||
Morelle | Aye | ||||||||
Aubry | Aye | ||||||||
Englebright | Aye | ||||||||
Dinowitz | Aye | ||||||||
Colton | Aye | ||||||||
Magnarelli | Aye | ||||||||
Perry | Aye | ||||||||
Galef | Aye | ||||||||
Paulin | Aye | ||||||||
Titus | Aye | ||||||||
Peoples-Stokes | Aye | ||||||||
Go to top
A02646 Floor Votes:
Yes
Abbate
No
Crouch
No
Goodell
Yes
Lifton
ER
O'Donnell
Yes
Sepulveda
Yes
Abinanti
Yes
Curran
Yes
Gottfried
Yes
Lopez
Yes
Ortiz
Yes
Simanowitz
Yes
Arroyo
Yes
Cusick
No
Graf
Yes
Lupardo
Yes
Otis
Yes
Simon
Yes
Aubry
Yes
Cymbrowitz
Yes
Gunther
Yes
Lupinacci
Yes
Palmesano
Yes
Simotas
Yes
Barclay
ER
Davila
Yes
Harris
Yes
Magee
Yes
Palumbo
Yes
Skartados
Yes
Barnwell
Yes
De La Rosa
No
Hawley
Yes
Magnarelli
Yes
Paulin
Yes
Skoufis
Yes
Barrett
Yes
DenDekker
ER
Hevesi
Yes
Malliotakis
Yes
Pellegrino
Yes
Solages
Yes
Barron
ER
Dickens
Yes
Hikind
Yes
Mayer
Yes
Peoples-Stokes
Yes
Stec
Yes
Benedetto
Yes
Dilan
Yes
Hooper
Yes
McDonald
Yes
Perry
Yes
Steck
Yes
Bichotte
Yes
Dinowitz
Yes
Hunter
Yes
McDonough
Yes
Pheffer Amato
Yes
Stirpe
Yes
Blake
No
DiPietro
Yes
Hyndman
Yes
McKevitt
Yes
Pichardo
Yes
Thiele
No
Blankenbush
Yes
D'Urso
Yes
Jaffee
ER
McLaughlin
Yes
Pretlow
Yes
Titone
No
Brabenec
Yes
Englebright
Yes
Jean-Pierre
No
Miller B
Yes
Quart
Yes
Titus
Yes
Braunstein
No
Errigo
Yes
Jenne
Yes
Miller MG
Yes
Ra
Yes
Vanel
Yes
Brindisi
Yes
Fahy
No
Johns
Yes
Miller ML
Yes
Raia
Yes
Walker
Yes
Bronson
Yes
Farrell
Yes
Jones
No
Montesano
Yes
Ramos
No
Wallace
Yes
Buchwald
Yes
Finch
Yes
Joyner
Yes
Morelle
Yes
Richardson
No
Walsh
No
Butler
No
Fitzpatrick
Yes
Kavanagh
No
Morinello
Yes
Rivera
Yes
Walter
No
Byrne
No
Friend
Yes
Kearns
Yes
Mosley
ER
Rodriguez
Yes
Weinstein
Yes
Cahill
Yes
Galef
Yes
Kim
Yes
Moya
Yes
Rosenthal
Yes
Weprin
Yes
Carroll
Yes
Gantt
Yes
Kolb
Yes
Murray
Yes
Rozic
Yes
Williams
No
Castorina
Yes
Garbarino
No
Lalor
Yes
Niou
Yes
Ryan
No
Woerner
Yes
Colton
Yes
Giglio
Yes
Lavine
Yes
Nolan
Yes
Santabarbara
Yes
Wright
Yes
Cook
Yes
Gjonaj
No
Lawrence
No
Norris
No
Schimminger
Yes
Zebrowski
Yes
Crespo
Yes
Glick
Yes
Lentol
Yes
Oaks
Yes
Seawright
Yes
Mr. Speaker
‡ Indicates voting via videoconference
Yes
Abbate
Yes
Cook
Yes
Garbarino
Yes
Lupardo
Yes
Pellegrino
Yes
Stec
Yes
Abinanti
Yes
Crespo
Yes
Giglio
Yes
Magee
Yes
Peoples-Stokes
Yes
Steck
Yes
Arroyo
No
Crouch
Yes
Glick
Yes
Magnarelli
Yes
Perry
Yes
Stern
No
Ashby
Yes
Curran
No
Goodell
Yes
Malliotakis
Yes
Pheffer Amato
Yes
Stirpe
Yes
Aubry
Yes
Cusick
Yes
Gottfried
Yes
McDonald
ER
Pichardo
No
Tague
Yes
Barclay
Yes
Cymbrowitz
Yes
Gunther
No
McDonough
Yes
Pretlow
Yes
Taylor
Yes
Barnwell
Yes
Davila
No
Hawley
No
Mikulin
Yes
Quart
Yes
Thiele
Yes
Barrett
Yes
De La Rosa
Yes
Hevesi
No
Miller B
Yes
Ra
Yes
Titone
Yes
Barron
Yes
DenDekker
ER
Hikind
Yes
Miller MG
Yes
Raia
Yes
Titus
Yes
Benedetto
Yes
Dickens
Yes
Hooper
Yes
Miller ML
Yes
Ramos
Yes
Vanel
Yes
Bichotte
Yes
Dilan
Yes
Hunter
No
Montesano
Yes
Richardson
Yes
Walker
Yes
Blake
Yes
Dinowitz
Yes
Hyndman
Yes
Morelle
Yes
Rivera
No
Wallace
No
Blankenbush
No
DiPietro
Yes
Jaffee
No
Morinello
Yes
Rodriguez
Yes
Walsh
Yes
Bohen
Yes
D'Urso
ER
Jean-Pierre
Yes
Mosley
Yes
Rosenthal D
Yes
Walter
No
Brabenec
Yes
Englebright
Yes
Jenne
Yes
Murray
Yes
Rosenthal L
Yes
Weinstein
Yes
Braunstein
Yes
Epstein
Yes
Johns
Yes
Niou
Yes
Rozic
Yes
Weprin
Yes
Brindisi
ER
Errigo
Yes
Jones
Yes
Nolan
Yes
Ryan
Yes
Williams
Yes
Bronson
Yes
Espinal
Yes
Joyner
No
Norris
Yes
Santabarbara
No
Woerner
Yes
Buchwald
Yes
Fahy
Yes
Kim
Yes
Oaks
No
Schimminger
Yes
Wright
No
Butler
Yes
Fernandez
Yes
Kolb
Yes
O'Donnell
Yes
Seawright
Yes
Zebrowski
No
Byrne
Yes
Finch
No
Lalor
Yes
Ortiz
Yes
Simon
Yes
Mr. Speaker
Yes
Cahill
No
Fitzpatrick
Yes
Lavine
Yes
Otis
Yes
Simotas
Yes
Carroll
No
Friend
Yes
Lawrence
Yes
Palmesano
Yes
Skoufis
No
Castorina
Yes
Galef
Yes
Lentol
Yes
Palumbo
Yes
Smith
Yes
Colton
ER
Gantt
ER
Lifton
Yes
Paulin
Yes
Solages
‡ Indicates voting via videoconference
A02646 Memo:
Go to topNEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)   BILL NUMBER: A2646A SPONSOR: Simotas
  TITLE OF BILL: An act to amend the insurance law, in relation to insurance coverage of in vitro fertilization and other fertility preser- vation treatments   PURPOSE: To require health insurance policies to provide coverage for in-vitro fertilization   SUMMARY OF PROVISIONS: Sections one of the bill amends section 3216 of the Ins. L. to require that individual policies provide coverage for (1) in-vitro fertilization used in the treatment of infertility, and (2) fertility preservation services, regardless of length or quality of life, medical dependency, disability, or personal characteristics. Section two of the bill would amend section 3221 of the Ins. L. to require that group policies provide coverage for (1) in-vitro fertiliza- tion used in the treatment of infertility, and (2) fertility preserva- tion services, regardless of length or quality of life, medical depend- ency, disability, or personal characteristics. Section three of the bill would amend Section 4303 of the Ins. L. to require that policies issued by a medical expense indemnity corporation, hospital service corporation, or health service corporation provide coverage for (1) in-vitro fertilization used in the treatment of infer- tility, and (2) fertility preservation services, regardless of length or quality of life, medical dependency, disability, or personal character- istics. Section four of the bill amends subparagraph c of paragraph 6 of subsection k of section 3221 of the insurance law to repeal discrimina- tory age restrictions and provisions exempting in-vitro fertilization, gamete intrafallopian tube transfers or zygote intrafallopian tube transfers from coverage requirements for group or blanket accident and health insurance plans. Section five of the bill amends paragraph 3 of subsection S of section 4303 of the insurance law to apply the same requirements to benefits provided by a medical expense indemnity corporation, hospital service corporation, or health service corporation. Section six of the bill provides the effective date of the bill.   EXISTING LAW: Currently, New York requires coverage of some infertility treatments in the commercial market place for women between the ages of 21 and 44, However, current law does not require coverage for in-vitro fertiliza- tion (IVF), or fertility preservation.   JUSTIFICATION: It is estimated that one in eight individuals or couples have trouble getting pregnant or sustaining pregnancy. While family building options do exist for people affected by infertility, these options are often cost-prohibitive, with 67% of individuals or couples reporting spending at least $10,000. High costs present a major bather to medical treat- ment; nearly half of all individuals affected by infertility lack insur- ance coverage necessary for fertility treatment. The rapid advancement of medical technology in the past 20 years estab- lished in-vitro fertilization as the safest and most effective form of fertility treatment. Compared to treatments presently covered under New York state law, such as ovulation induction or ovulation enhancement, in-vitro fertilization results in fewer pregnancy complications and high-risk births. Several states, including Massachusetts, Rhode Island, New Jersey, Maryland, Illinois, Arkansas, Hawaii, and Connecticut, have already enacted laws requiring insurers to cover in-vitro fertilization. These states experience lower rates of multiple births and associated neo-natal and pediatric care costs. This legislation has the potential to save New York millions of dollars in long-term health care costs, since patients would no longer be forced to rely on higher risk medical procedures. Under current law, New York requires insurers to provide coverage for some diagnostic and treatment procedures for infertility. However, these requirements do not extend to in-vitro fertilization. This bill would update the existing law to reflect advances in modern medical technolo- gy, requiring coverage for in-vitro fertilization to expand access to this procedure and enable patients and their physicians to choose the best course of treatment for infertility. It would also provide a clear definition of infertility and ensure that cancer patients whose ability to conceive has been compromised by chemotherapy, radiation, surgery, or other medical procedures have fair access to fertility preservation methods. Lastly, this bill includes anti-discrimination protections for patients eligible for in-vitro fertilization, as required by the Afford- able Care Act.   LEGISLATIVE HISTORY: 2015-16: A10137   FISCAL IMPLICATIONS: None.   EFFECTIVE DATE: This act would 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.
A02646 Text:
Go to top STATE OF NEW YORK ________________________________________________________________________ 2646--A 2017-2018 Regular Sessions IN ASSEMBLY January 20, 2017 ___________ Introduced by M. of A. SIMOTAS, QUART, BRONSON, SOLAGES, BRAUNSTEIN, BICHOTTE, STECK, SEAWRIGHT, SIMON, BRINDISI, PAULIN, BARRETT, HEVESI, McDONALD, MOYA, LAVINE, CYMBROWITZ, MOSLEY, BUCHWALD, MORELLE, DINOW- ITZ -- Multi-Sponsored by -- M. of A. ENGLEBRIGHT, LENTOL -- read once and referred 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: 1 Section 1. Paragraph 13 of subsection (i) of section 3216 of the 2 insurance law is amended by adding three new subparagraphs (C), (D) and 3 (E) to read as follows: 4 (C) Every policy delivered or issued for delivery in this state that 5 provides coverage for hospital, surgical or medical care shall provide 6 coverage for: 7 (i) in vitro fertilization used in the treatment of infertility; and 8 (ii) standard fertility preservation services when a necessary medical 9 treatment may directly or indirectly cause iatrogenic infertility to a 10 covered person. 11 (D) (i) For the purposes of subparagraph (C) of this paragraph, 12 "infertility" means a disease or condition characterized by the incapac- 13 ity to impregnate another person or to conceive, as diagnosed or deter- 14 mined (I) by a physician licensed to practice medicine in this state, or 15 (II) by the failure to establish a clinical pregnancy after twelve 16 months of regular, unprotected sexual intercourse, or after six months 17 of regular, unprotected sexual intercourse in the case of a female thir- 18 ty-five years of age or older. 19 (ii) For the purposes of subparagraph (C) of this paragraph, "iatro- 20 genic infertility" means an impairment of fertility by surgery, radi- EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD04562-03-7A. 2646--A 2 1 ation, chemotherapy or other medical treatment affecting reproductive 2 organs or processes. 3 (E) No insurer providing coverage under this paragraph shall discrimi- 4 nate based on a covered individual's expected length of life, present or 5 predicted disability, degree of medical dependency, perceived quality of 6 life, or other health conditions, nor based on personal characteristics, 7 including age, sex, sexual orientation, marital status or gender identi- 8 ty. 9 § 2. Paragraph 6 of subsection (k) of section 3221 of the insurance 10 law is amended by adding three new subparagraphs (E), (F) and (G) to 11 read as follows: 12 (E) Every group policy delivered or issued for delivery in this state 13 that provides hospital, surgical or medical coverage shall provide 14 coverage for: 15 (i) in vitro fertilization used in the treatment of infertility; and 16 (ii) standard fertility preservation services when a necessary medical 17 treatment may directly or indirectly cause iatrogenic infertility to a 18 covered person. 19 (F) (i) For the purposes of subparagraph (E) of this paragraph, 20 "infertility" means a disease or condition characterized by the incapac- 21 ity to impregnate another person or to conceive, as diagnosed or deter- 22 mined (I) by a physician licensed to practice medicine in this state, or 23 (II) by the failure to establish a clinical pregnancy after twelve 24 months of regular, unprotected sexual intercourse, or after six months 25 of regular, unprotected sexual intercourse in the case of a female thir- 26 ty-five years of age or older. 27 (ii) For the purposes of subparagraph (E) of this paragraph, "iatro- 28 genic infertility" means an impairment of fertility by surgery, radi- 29 ation, chemotherapy or other medical treatment affecting reproductive 30 organs or processes. 31 (G) No insurer providing coverage under this paragraph shall discrimi- 32 nate based on a covered individual's expected length of life, present or 33 predicted disability, degree of medical dependency, perceived quality of 34 life, or other health conditions, nor based on personal characteristics, 35 including age, sex, sexual orientation, marital status or gender identi- 36 ty. 37 § 3. Subsection (s) of section 4303 of the insurance law, as amended 38 by section 2 of part F of chapter 82 of the laws of 2002, is amended by 39 adding three new paragraphs (5), (6) and (7) to read as follows: 40 (5) Every contract issued by a medical expense indemnity corporation, 41 hospital service corporation or health service corporation for delivery 42 in this state that provides hospital, surgical or medical coverage shall 43 provide coverage for: 44 (A) in vitro fertilization used in the treatment of infertility; and 45 (B) standard fertility preservation services when a necessary medical 46 treatment may directly or indirectly cause iatrogenic infertility to a 47 covered person. 48 (6) (A) For the purposes of paragraph five of this subsection, "infer- 49 tility" means a disease or condition characterized by the incapacity to 50 impregnate another person or to conceive, as diagnosed or determined (i) 51 by a physician licensed to practice medicine in this state, or (ii) by 52 the failure to establish a clinical pregnancy after twelve months of 53 regular, unprotected sexual intercourse, or after six months of regular, 54 unprotected sexual intercourse in the case of a female thirty-five years 55 of age or older.A. 2646--A 3 1 (B) For the purposes of paragraph five of this subsection, "iatrogenic 2 infertility" means an impairment of fertility by surgery, radiation, 3 chemotherapy or other medical treatment affecting reproductive organs or 4 processes. 5 (7) No medical expense indemnity corporation, hospital service corpo- 6 ration or health service corporation providing coverage under this 7 subsection shall discriminate based on a covered individual's expected 8 length of life, present or predicted disability, degree of medical 9 dependency, perceived quality of life, or other health conditions, nor 10 based on personal characteristics, including age, sex, sexual orien- 11 tation, marital status or gender identity. 12 § 4. Subparagraph (C) of paragraph 6 of subsection (k) of section 3221 13 of the insurance law, as amended by section 1 of part K of chapter 82 of 14 the laws of 2002, is amended to read as follows: 15 (C) Coverage of diagnostic and treatment procedures, including 16 prescription drugs, used in the diagnosis and treatment of infertility 17 as required by subparagraphs (A) and (B) of this paragraph shall be 18 provided in accordance with the provisions of this subparagraph. 19 (i) [Coverage shall be provided for persons whose ages range from20twenty-one through forty-four years, provided that nothing herein shall21preclude the provision of coverage to persons whose age is below or22above such range.23(ii)] Diagnosis and treatment of infertility shall be prescribed as 24 part of a physician's overall plan of care and consistent with the 25 guidelines for coverage as referenced in this subparagraph. 26 [(iii)] (ii) Coverage may be subject to co-payments, coinsurance and 27 deductibles as may be deemed appropriate by the superintendent and as 28 are consistent with those established for other benefits within a given 29 policy. 30 [(iv) Coverage shall be limited to those individuals who have been31previously covered under the policy for a period of not less than twelve32months, provided that for the purposes of this subparagraph "period of33not less than twelve months" shall be determined by calculating such34time from either the date the insured was first covered under the exist-35ing policy or from the date the insured was first covered by a previous-36ly in-force converted policy, whichever is earlier.37(v)] (iii) Coverage shall not be required to include the diagnosis and 38 treatment of infertility in connection with: (I) [in vitro fertiliza-39tion, gamete intrafallopian tube transfers or zygote intrafallopian tube40transfers; (II)] the reversal of elective sterilizations; [(III)] (II) 41 sex change procedures; [(IV)] (III) cloning; or [(V)] (IV) medical or 42 surgical services or procedures that are deemed to be experimental in 43 accordance with clinical guidelines referenced in clause [(vi)] (iv) of 44 this subparagraph. 45 [(vi)] (iv) The superintendent, in consultation with the commissioner 46 of health, shall promulgate regulations which shall stipulate the guide- 47 lines and standards which shall be used in carrying out the provisions 48 of this subparagraph, which shall include: 49 (I) [The determination of "infertility" in accordance with the stand-50ards and guidelines established and adopted by the American College of51Obstetricians and Gynecologists and the American Society for Reproduc-52tive Medicine;53(II)] The identification of experimental procedures and treatments not 54 covered for the diagnosis and treatment of infertility determined in 55 accordance with the standards and guidelines established and adopted byA. 2646--A 4 1 the American College of Obstetricians and Gynecologists and the American 2 Society for Reproductive Medicine; 3 [(III)] (II) The identification of the required training, experience 4 and other standards for health care providers for the provision of 5 procedures and treatments for the diagnosis and treatment of infertility 6 determined in accordance with the standards and guidelines established 7 and adopted by the American College of Obstetricians and Gynecologists 8 and the American Society for Reproductive Medicine; and 9 [(IV)] (III) The determination of appropriate medical candidates by 10 the treating physician in accordance with the standards and guidelines 11 established and adopted by the American College of Obstetricians and 12 Gynecologists and/or the American Society for Reproductive Medicine. 13 § 5. Paragraph 3 of subsection (s) of section 4303 of the insurance 14 law, as amended by section 2 of part K of chapter 82 of the laws of 15 2002, is amended to read as follows: 16 (3) Coverage of diagnostic and treatment procedures, including 17 prescription drugs used in the diagnosis and treatment of infertility as 18 required by paragraphs one and two of this subsection shall be provided 19 in accordance with this paragraph. 20 (A) [Coverage shall be provided for persons whose ages range from21twenty-one through forty-four years, provided that nothing herein shall22preclude the provision of coverage to persons whose age is below or23above such range.24(B)] Diagnosis and treatment of infertility shall be prescribed as 25 part of a physician's overall plan of care and consistent with the 26 guidelines for coverage as referenced in this paragraph. 27 [(C)] (B) Coverage may be subject to co-payments, coinsurance and 28 deductibles as may be deemed appropriate by the superintendent and as 29 are consistent with those established for other benefits within a given 30 policy. 31 [(D) Coverage shall be limited to those individuals who have been32previously covered under the policy for a period of not less than twelve33months, provided that for the purposes of this paragraph "period of not34less than twelve months" shall be determined by calculating such time35from either the date the insured was first covered under the existing36policy or from the date the insured was first covered by a previously37in-force converted policy, whichever is earlier.38(E)] (C) Coverage shall not be required to include the diagnosis and 39 treatment of infertility in connection with: (i) [in vitro fertiliza-40tion, gamete intrafallopian tube transfers or zygote intrafallopian tube41transfers; (ii)] the reversal of elective sterilizations; [(iii)] (ii) 42 sex change procedures; [(iv)] (iii) cloning; or [(v)] (iv) medical or 43 surgical services or procedures that are deemed to be experimental in 44 accordance with clinical guidelines referenced in subparagraph [(F)] (D) 45 of this paragraph. 46 [(F)] (D) The superintendent, in consultation with the commissioner of 47 health, shall promulgate regulations which shall stipulate the guide- 48 lines and standards which shall be used in carrying out the provisions 49 of this paragraph, which shall include: 50 (i) [The determination of "infertility" in accordance with the stand-51ards and guidelines established and adopted by the American College of52Obstetricians and Gynecologists and the American Society for Reproduc-53tive Medicine;54(ii)] The identification of experimental procedures and treatments not 55 covered for the diagnosis and treatment of infertility determined in 56 accordance with the standards and guidelines established and adopted byA. 2646--A 5 1 the American College of Obstetricians and Gynecologists and the American 2 Society for Reproductive Medicine; 3 [(iii)] (ii) The identification of the required training, experience 4 and other standards for health care providers for the provision of 5 procedures and treatments for the diagnosis and treatment of infertility 6 determined in accordance with the standards and guidelines established 7 and adopted by the American College of Obstetricians and Gynecologists 8 and the American Society for Reproductive Medicine; and 9 [(iv)] (iii) The determination of appropriate medical candidates by 10 the treating physician in accordance with the standards and guidelines 11 established and adopted by the American College of Obstetricians and 12 Gynecologists and/or the American Society for Reproductive Medicine. 13 § 6. This act shall take effect on the first day of January next 14 succeeding the date on which it shall have become a law and shall apply 15 to all policies issued, renewed, altered or modified on or after such 16 date.