| | | Be it enacted by the People of the State of Maine as follows: |
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| | | Sec. 1. 24 MRSA §2317-B, sub-§16-B is enacted to read: |
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| | | 16-B.__Title 24-A, sections 2847-L and 4252.__Group coverage | | of infertility treatment, Title 24-A, sections 2847-L and | | 4252; |
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| | | Sec. 2. 24-A MRSA §2847-L is enacted to read: |
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| | | §2847-L.__Infertility coverage |
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| | | 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. |
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| | | 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. |
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| | | 3.__Limits.__The coverage required by this section is | | subject to the following conditions: |
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| | | A.__The female partner must be 21 years of age or older | | and under 45 years of age; |
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| | | 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; |
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| | | C.__Coverage for procedures for intrauterine insemination | | with ovarian stimulation and procedures requiring oocyte | | retrieval may be limited in accordance with the following. |
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| | | (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. |
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| | | (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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