LD 213
pg. 1
LD 213 Title Page An Act To Assist Maine's Infertile Citizens Page 2 of 5
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LR 751
Item 1

 
Be it enacted by the People of the State of Maine as follows:

 
Sec. 1. 24 MRSA §2317-B, sub-§16-B is enacted to read:

 
16-B.__Title 24-A, sections 2847-L and 4252.__Group coverage
of infertility treatment, Title 24-A, sections 2847-L and
4252;

 
Sec. 2. 24-A MRSA §2847-L is enacted to read:

 
§2847-L.__Infertility coverage

 
1.__Definition.__For the purposes of this section,
"infertility" means the disease or condition that results in
the abnormal function of the reproductive system such that a
male is not able to impregnate a female or a female is not
able to become pregnant and maintain a pregnancy to full term
after one year of attempting pregnancy.

 
2.__Coverage.__All group health insurance policies and
contracts that provide coverage for pregnancy-related benefits
must provide coverage for the diagnosis and treatment of
infertility, including, but not limited to, in vitro
fertilization, embryo transfer, artificial insemination,
gamete intrafallopian tube transfer, zygote intrafallopian
tube transfer and low tubal ovum transfer.

 
3.__Limits.__The coverage required by this section is
subject to the following conditions:

 
A.__The female partner must be 21 years of age or older
and under 45 years of age;

 
B.__For a policy that provides prescription drug coverage,
the policy may not impose special restrictions on
prescription medications or a restriction or limitation on
the number of procedures used for infertility diagnosis or
treatment, except as provided in this subsection;

 
C.__Coverage for procedures for intrauterine insemination
with ovarian stimulation and procedures requiring oocyte
retrieval may be limited in accordance with the following.

 
(1)__The policy may require that the covered
individual has been unable to attain or sustain a
successful pregnancy through reasonable, less costly
medically appropriate infertility treatments for
which coverage is available under the policy or
contract.

 
(2)__The policy may limit the covered individual to a maximum
of 6 completed intrauterine inseminations with ovarian
stimulation, except that if the individual has


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