S08866 Summary:
| BILL NO | S08866 |
| SAME AS | SAME AS A00885 |
| SPONSOR | SALAZAR |
| COSPNSR | |
| MLTSPNSR | |
| Amd §§3221 & 4303, Ins L | |
| Establishes "The Equity in Fertility Treatment Act"; relates to the definition of infertility and health insurance coverage for the treatment of infertility. | |
S08866 Text:
Go to topSTATE OF NEW YORK ________________________________________________________________________ 8866 IN SENATE January 12, 2026 ___________ Introduced by Sen. SALAZAR -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to the definition of infertility and health insurance coverage for in-vitro fertilization The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. This act shall be known and may be cited as "The Equity in 2 Fertility Treatment Act". 3 § 2. Items (v) and (vii) of subparagraph (C) of paragraph 6 of 4 subsection (k) of section 3221 of the insurance law, as amended by 5 section 1 of part L of chapter 57 of the laws of 2019, are amended to 6 read as follows: 7 (v)(I) For the purposes of this paragraph, "infertility" means a 8 disease or condition characterized by the incapacity to impregnate 9 another person or to conceive, defined by (a) the failure to establish a 10 clinical pregnancy after twelve months of regular, unprotected sexual 11 intercourse or therapeutic donor insemination, or after six months of 12 regular, unprotected sexual intercourse or therapeutic donor insemina- 13 tion for a female thirty-five years of age or older; (b) a person's 14 inability to reproduce either as a single individual or with their part- 15 ner without medical intervention; or (c) a licensed physician's or 16 osteopathic physician's findings based on a patient's medical, sexual, 17 or reproductive history, age, physical findings, or diagnostic testing. 18 Earlier evaluation and treatment may be warranted based on an individ- 19 ual's medical, sexual, or reproductive history [or], age, physical find- 20 ings, or diagnostic testing. 21 (II) For purposes of this paragraph, "iatrogenic infertility" means an 22 impairment of fertility by surgery, radiation, chemotherapy or other 23 medical treatment affecting reproductive organs or processes. 24 (vii) Every large group policy delivered or issued for delivery in 25 this state that provides medical, major medical or similar comprehen- 26 sive-type coverage shall provide coverage for three [cycles of] 27 completed oocyte retrievals and in-vitro fertilization [used in the28treatment of infertility] with unlimited embryo transfers from fresh or EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD03493-01-5S. 8866 2 1 frozen oocytes or embryos from a covered retrieval, in accordance with 2 the guidelines of the American Society for Reproductive Medicine, using 3 single embryo transfer (SET) when recommended and medically appropriate 4 for the treatment of infertility. Coverage (I) shall not be denied based 5 on a covered individual's participation in fertility services provided 6 by or to a third party, and (II) may be subject to annual deductibles 7 and coinsurance, including copayments, as may be deemed appropriate by 8 the superintendent and as are consistent with those established for 9 other benefits within a given policy. [For purposes of this item, a10"cycle" is defined as either all treatment that starts when: preparatory11medications are administered for ovarian stimulation for oocyte12retrieval with the intent of undergoing in-vitro fertilization using a13fresh embryo transfer; or medications are administered for endometrial14preparation with the intent of undergoing in-vitro fertilization using a15frozen embryo transfer.] 16 § 3. Subparagraphs (E) and (G) of paragraph 3 of subsection (s) of 17 section 4303 of the insurance law, as amended by section 2 of part L of 18 chapter 57 of the laws of 2019, are amended to read as follows: 19 (E)(i) For the purposes of this subsection, "infertility" means a 20 disease or condition characterized by the incapacity to impregnate 21 another person or to conceive, defined by (a) the failure to establish a 22 clinical pregnancy after twelve months of regular, unprotected sexual 23 intercourse or therapeutic donor insemination, or after six months of 24 regular, unprotected sexual intercourse or therapeutic donor insemina- 25 tion for a female thirty-five years of age or older; (b) a person's 26 inability to reproduce either as a single individual or with their part- 27 ner without medical intervention; or (c) a licensed physician's or 28 osteopathic physician's findings based on a patient's medical, sexual, 29 or reproductive history, age, physical findings, or diagnostic testing. 30 Earlier evaluation and treatment may be warranted based on an individ- 31 ual's medical history or physical findings. 32 (ii) For purposes of this subsection, "iatrogenic infertility" means 33 an impairment of fertility by surgery, radiation, chemotherapy or other 34 medical treatment affecting reproductive organs or processes. 35 (G) Every large group contract that provides medical, major medical or 36 similar comprehensive-type coverage shall provide coverage for three 37 [cycles of] completed oocyte retrievals and in-vitro fertilization [used38in the treatment of infertility] with unlimited embryo transfers from 39 fresh or frozen oocytes or embryos from a covered retrieval, in accord- 40 ance with the guidelines of the American Society for Reproductive Medi- 41 cine, using single embryo transfer (SET) when recommended and medically 42 appropriate for the treatment of infertility. Coverage (i) shall not be 43 denied based on a covered individual's participation in fertility 44 services provided by or to a third party, and (ii) may be subject to 45 annual deductibles and coinsurance, including copayments, as may be 46 deemed appropriate by the superintendent and as are consistent with 47 those established for other benefits within a given contract. [For48purposes of this subparagraph, a "cycle" is defined as either all treat-49ment that starts when: preparatory medications are administered for50ovarian stimulation for oocyte retrieval with the intent of undergoing51in-vitro fertilization using a fresh embryo transfer; or medications are52administered for endometrial preparation with the intent of undergoing53in-vitro fertilization using a frozen embryo transfer.] 54 § 4. This act shall take effect immediately.