Rep. Norm Thurston — Voting Record

Bill

Number

S.B. 35 (2024GS)

Sponsor

Sen. Escamilla, L.

Final action

Governor Signed 3/19/2024

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• eliminates the scheduled repeal of the expanded infertility treatment coverage pilot program;
• makes permanent the benefit for assisted reproductive technology for individuals within the state health insurance risk pool; and
• makes technical and conforming changes.

Every vote on this bill

Bill text

INFERTILITY TREATMENT COVERAGE AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Luz Escamilla
House Sponsor: 
 Rex P. Shipp
LONG TITLE
Committee Note:
The Retirement and Independent Entities Interim Committee recommended this bill.
Legislative Vote: 11 voting for 0 voting against 4 absent
General Description:
This bill modifies provisions related to the expanded infertility treatment coverage
health benefit.
Highlighted Provisions:
This bill:
▸ eliminates the scheduled repeal of the expanded infertility treatment coverage pilot
program;
▸ makes permanent the benefit for assisted reproductive technology for individuals
within the state health insurance risk pool; and
▸ makes technical and conforming changes.
Money Appropriated in this Bill:
None
Other Special Clauses:
This bill provides a special effective date.
Utah Code Sections Affected:
AMENDS:
49-20-418
, as last amended by Laws of Utah 2021, Chapters 64, 195
63I-1-249
, as last amended by Laws of Utah 2021, Chapter 195
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
49-20-418
 is amended to read:
49-20-418.
Expanded infertility treatment benefit.
(1) As used in this section:
(a) "Assisted reproductive technology" means the same as the term is defined in 42
U.S.C. Sec. 263a-7.
(b) "Physician" means the same as the term is defined in Section 
58-67-102
.
[
(c) "Pilot program" means the expanded infertility treatment coverage pilot program
described in Subsection (2).
]
[
(d)
] 
(c)
 "Qualified assisted reproductive technology cycle" means the use of assisted
reproductive technology to transfer a single embryo for implantation.
[
(e)
] 
(d)
 "Qualified individual" means [
a covered
] 
an
 individual who is
:
(i) covered within the state risk pool; and
(ii)
 eligible for maternity benefits under the program.
[
(2) (a) Beginning plan year 2018-19, and ending plan year 2023-24, the program shall
offer a pilot program within the state risk pool that provides coverage to a qualified individual
for the use of an assisted reproductive technology.
]
[
(b) (i) For plan year 2018-19, 2019-20, or 2020-21, the pilot program shall offer a
one-time benefit of $4,000 toward the costs of using an assisted reproductive technology for
each qualified individual.
]
[
(ii) For plan year 2021-22, 2022-23, or 2023-24, the pilot
] 
(2) (a) The
 program shall
offer a benefit of $4,000 to a qualified individual toward the costs of each qualified assisted
reproductive technology cycle.
[
(c) The benefits described in Subsection (2)(b) are
] 
(b) The benefit is
 subject to the
same cost sharing requirements as the [
covered
] 
qualified
 individual's plan.
(3) [
Coverage offered under the pilot program applies if:
] 
A qualified individual shall
receive the benefit described in Subsection (2) if:
(a) 
the qualified individual is
 the patient who will use the assisted reproductive
technology [
is a qualified individual
];
(b) (i) the patient's physician verifies that the patient or the patient's spouse has a
demonstrated condition recognized by a physician as a cause of infertility; or
(ii) the patient attests that the patient is unable to conceive a pregnancy or carry a
pregnancy to a live birth after a year or more of regular sexual relations without contraception;
(c) the patient attests that the patient has been unable to attain a successful pregnancy
through any less-costly, potentially effective infertility treatments for which coverage is
available under the health benefit plan; and
(d) the use of the assisted reproductive technology procedure 
complies with the
program's clinical policies and
 is performed at a medical facility that conforms to the minimal
standards for programs of assisted reproductive technology procedures adopted by the
American Society for Reproductive Medicine.
[
(4) Coverage offered under the pilot program:
] 
(4)
 (a) 
The provision of a benefit in accordance with this section
 shall satisfy, in
accordance with Subsection 
31A-22-610.1
(1)(c)(ii), the requirement to provide an adoption
indemnity benefit to a qualified individual under Section 
31A-22-610.1
[
;
]
.
(b) [
does not apply to a qualified individual if the
] 
If a
 qualified individual has received
the adoption indemnity benefit required under Section 
31A-22-610.1
[
; and
]
, the qualified
individual may not receive a benefit in accordance with this section.
[
(c) for plan year 2021-22, 2022-23, or 2023-24, shall apply to a qualified individual,
even if the qualified individual received the benefit described in Subsection (2)(b)(i).
]
[
(5) (a) The purpose of the pilot program is to study the efficacy of providing coverage
for the use of an assisted reproductive technology and is not a mandate for coverage of an
assisted reproductive technology within all health plans offered by the program.
]
[
(b) The program shall report to the Retirement and Independent Entities Interim
Committee regarding the costs and benefits of the pilot program:
]
[
(i) on or before October 1; and
]
[
(ii) during calendar years 2022 and 2023.
]
[
(6) Under Section 
63J-1-603
, the Legislature intends that the cost of the pilot program
will be paid from money above the minimum recommended level in the public employees' state
risk pool reserve.
]
Section 2. Section 
63I-1-249
 is amended to read:
63I-1-249.
Repeal dates: Title 49.
[
(1)
] Title 49, Chapter 11, Part 13, Phased Retirement, is repealed January 1, 2025.
[
(2) Section 
49-20-418
 is repealed January 1, 2025.
]
Section 3. 
Effective date.
This bill takes effect on July 1, 2024.