The text as introduced · 316 words
90R3563 SCL-D
By: González of Dallas
H.B. No. 232
A BILL TO BE ENTITLED
AN ACT
relating to conditions applicable to health benefit plan coverage
of in vitro fertilization procedures.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1366.005, Insurance Code, is amended to
read as follows:
Sec. 1366.005. CONDITIONS APPLICABLE TO COVERAGE. The
coverage offered under Section 1366.003 is required only if:
(1) the patient for the in vitro fertilization
procedure is an individual covered under the group health benefit
plan;
(2) [ the fertilization or attempted fertilization of
the patient's oocytes is made only with the sperm of the patient's
spouse;
[ (3) ] the patient or [ and ] the patient's spouse has
[ have ] a history of infertility of at least three [ five ] continuous
years' duration or the infertility is associated with:
(A) endometriosis;
(B) exposure in utero to diethylstilbestrol
(DES);
(C) blockage of or surgical removal of one or
both fallopian tubes; or
(D) oligospermia;
(3) [ (4) ] the patient has been unable to attain a
successful pregnancy through any less costly applicable
infertility treatments for which coverage is available under the
group health benefit plan; and
(4) [ (5) ] the in vitro fertilization procedures are
performed at a medical facility that conforms to the minimal
standards for programs of in vitro fertilization adopted by the
American Society for Reproductive Medicine.
SECTION 2. Section 1366.005, Insurance Code, as amended by
this Act, applies only to a health benefit plan delivered, issued
for delivery, or renewed on or after January 1, 2028. A health
benefit plan delivered, issued for delivery, or renewed before
January 1, 2028, is governed by the law as it existed immediately
before the effective date of this Act, and that law is continued in
effect for that purpose.
SECTION 3. This Act takes effect September 1, 2027.