An Act To Provide Access to Infertility Treatment
Maine Legislature, Session 127, LD 0943
Committee: Insurance and Financial Services
Sponsors: MASON, CUSHING, WHITTEMORE, SHAW
Amends: 24 MRSA §2320-H, 24-A MRSA §2745-H, 24-A MRSA §2837-I, 24-A MRSA §4234-F

Legislative Document 
No. 943 
S.P. 334 
In Senate, March 17, 2015 
An Act To Provide Access to Infertility Treatment 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
HEATHER J.R. PRIEST 
Secretary of the Senate 
Presented by Senator MASON of Androscoggin. 
Cosponsored by Senators: CUSHING of Penobscot, WHITTEMORE of Somerset, 
Representative: SHAW of Standish. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  24 MRSA §2320-H is enacted to read: 
§2320-H.  Coverage for infertility treatment 
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A.  "Infertility" means the inability to become pregnant after one year of unprotected 
sex or the inability to carry a pregnancy to term. 
B.  "Treatment of infertility" means the following procedures provided for the 
purpose of the treatment of infertility: 
(1)  In vitro fertilization; 
(2)  Uterine embryo lavage; 
(3)  Embryo transfer; 
(4)  Artificial insemination; 
(5)  Gamete intrafallopian transfer; 
(6)  Zygote intrafallopian transfer; 
(7)  Intracytoplasmic sperm injection; 
(8)  Four completed egg retrievals per lifetime; and 
(9)  Low tubal ovum transfer. 
2.  Required coverage.  All individual and group nonprofit hospital and medical 
services plan policies, contracts and certificates and all nonprofit health care plan 
policies, contracts and certificates must provide coverage for the treatment of infertility.  
A contract, policy or certificate that provides coverage for the services required by this 
section may contain provisions requiring a 50% or lower copayment by the insured. 
3.  Limits.  The coverage required by this section is subject to the following 
conditions: 
A.  The covered individual must be married; 
B.  The covered individual's infertility may not be the result of a sexually transmitted 
disease; 
C.  The number of embryos implanted may not exceed the number set forth in rules 
adopted by the Department of Professional and Financial Regulation, Bureau of 
Insurance based on standards adopted by a nationally recognized society for 
reproductive medicine as outlined by a nationally recognized society for assisted 
reproductive technology; and 
D.  The contract, policy or certificate may not include coverage for procedures 
defined as experimental or investigational in rules adopted by the Department of 
Professional and Financial Regulation, Bureau of Insurance based on standards 
outlined by a nationally recognized society for reproductive medicine. 
Sec. 2.  24-A MRSA §2745-H is enacted to read: 
§2745-H.  Coverage for infertility treatment 
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A.  "Infertility" means the inability to become pregnant after one year of unprotected 
sex or the inability to carry a pregnancy to term. 
B.  "Treatment of infertility" means the following procedures provided for the 
purpose of the treatment of infertility: 
(1)  In vitro fertilization; 
(2)  Uterine embryo lavage; 
(3)  Embryo transfer; 
(4)  Artificial insemination; 
(5)  Gamete intrafallopian transfer; 
(6)  Zygote intrafallopian transfer; 
(7)  Intracytoplasmic sperm injection; 
(8)  Four completed egg retrievals per lifetime; and 
(9)  Low tubal ovum transfer. 
2.  Required coverage.  All individual insurance policies, contracts and certificates 
must provide coverage for the treatment of infertility.  A contract, policy or certificate 
that provides coverage for the services required by this section may contain provisions 
requiring a 50% or lower copayment by the insured. 
3.  Limits.  The coverage required by this section is subject to the following 
conditions: 
A.  The covered individual must be married; 
B.  The covered individual's infertility may not be the result of a sexually transmitted 
disease; 
C.  The number of embryos implanted may not exceed the number set forth in rules 
adopted by the bureau based on standards adopted by a nationally recognized society 
for reproductive medicine as outlined by a nationally recognized society for assisted 
reproductive technology; and 
D.  The contract, policy or certificate may not include coverage for procedures 
defined as experimental or investigational in rules adopted by the bureau based on 
standards outlined by a nationally recognized society for reproductive medicine. 
Sec. 3.  24-A MRSA §2837-I is enacted to read: 
§2837-I.  Coverage for infertility treatment 
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A.  "Infertility" means the inability to become pregnant after one year of unprotected 
sex or the inability to carry a pregnancy to term. 
B.  "Treatment of infertility" means the following procedures provided for the 
purpose of the treatment of infertility: 
(1)  In vitro fertilization; 
(2)  Uterine embryo lavage; 
(3)  Embryo transfer; 
(4)  Artificial insemination; 
(5)  Gamete intrafallopian transfer; 
(6)  Zygote intrafallopian transfer; 
(7)  Intracytoplasmic sperm injection; 
(8)  Four completed egg retrievals per lifetime; and 
(9)  Low tubal ovum transfer. 
2.  Required coverage.  All group insurance policies, contracts and certificates must 
provide coverage for the treatment of infertility.  A contract, policy or certificate that 
provides coverage for the services required by this section may contain provisions 
requiring a 50% or lower copayment by the insured. 
3.  Limits.  The coverage required by this section is subject to the following 
conditions: 
A.  The covered individual must be married; 
B.  The covered individual's infertility may not be the result of a sexually transmitted 
disease; 
C.  The number of embryos implanted may not exceed the number set forth in rules 
adopted by the bureau based on standards adopted by a nationally recognized society 
for reproductive medicine as outlined by a nationally recognized society for assisted 
reproductive technology; and 
D.  The contract, policy or certificate may not include coverage for procedures 
defined as experimental or investigational in rules adopted by the bureau based on 
standards outlined by a nationally recognized society for reproductive medicine. 
Sec. 4.  24-A MRSA §4234-F is enacted to read: 
§4234-F.  Coverage for infertility treatment 
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A.  "Infertility" means the inability to become pregnant after one year of unprotected 
sex or the inability to carry a pregnancy to term. 
B.  "Treatment of infertility" means the following procedures provided for the 
purpose of the treatment of infertility: 
(1)  In vitro fertilization; 
(2)  Uterine embryo lavage; 
(3)  Embryo transfer; 
(4)  Artificial insemination; 
(5)  Gamete intrafallopian transfer; 
(6)  Zygote intrafallopian transfer; 
(7)  Intracytoplasmic sperm injection; 
(8)  Four completed egg retrievals per lifetime; and 
(9)  Low tubal ovum transfer. 
2.  Required coverage.  All individual and group health maintenance organization 
contracts, policies and certificates must provide coverage for the treatment of infertility.  
A contract, policy or certificate that provides coverage for the services required by this 
section may contain provisions requiring a 50% or lower copayment by the insured. 
3.  Limits.  The coverage required by this section is subject to the following 
conditions: 
A.  The covered individual must be married; 
B.  The covered individual's infertility may not be the result of a sexually transmitted 
disease; 
C.  The number of embryos implanted may not exceed the number set forth in rules 
adopted by the bureau based on standards adopted by a nationally recognized society 
for reproductive medicine as outlined by a nationally recognized society for assisted 
reproductive technology; and 
D.  The contract, policy or certificate may not include coverage for procedures 
defined as experimental or investigational in rules adopted by the bureau based on 
standards outline by a nationally recognized society for reproductive medicine. 
Sec. 5.  Application.  This Act applies to all policies, contracts and certificates 
executed, delivered, issued for delivery, continued or renewed in this State on or after 
January 1, 2016.  For purposes of this Act, all contracts are deemed to be renewed no 
later than the next yearly anniversary of the contract date. 
SUMMARY 
This bill requires that health insurance policies include coverage for the treatment of 
infertility if: 
1.  The covered individual is married; 
2.  The covered individual's infertility is not the result of a sexually transmitted 
disease; and 
3.  The number of embryos implanted does not exceed the number set forth in rules 
adopted by the Department of Professional and Financial Regulation, Bureau of 
Insurance. 
Under this bill, a policy that provides such coverage may require a 50% or lower 
copayment by the insured. 
This bill applies to all policies in effect on or after January 1, 2016.