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A BILL TO BE ENTITLED
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AN ACT
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relating to conditions applicable to health benefit plan coverage |
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of in vitro fertilization procedures. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1366.005, Insurance Code, is amended to |
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read as follows: |
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Sec. 1366.005. CONDITIONS APPLICABLE TO COVERAGE. The |
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coverage offered under Section 1366.003 is required only if: |
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(1) the patient for the in vitro fertilization |
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procedure is an individual covered under the group health benefit |
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plan; |
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(2) [the fertilization or attempted fertilization of |
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the patient's oocytes is made only with the sperm of the patient's |
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spouse; |
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[(3)] the patient or [and] the patient's spouse has |
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[have] a history of infertility of at least three [five] continuous |
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years' duration or the infertility is associated with: |
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(A) endometriosis; |
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(B) exposure in utero to diethylstilbestrol |
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(DES); |
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(C) blockage of or surgical removal of one or |
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both fallopian tubes; or |
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(D) oligospermia; |
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(3) [(4)] the patient has been unable to attain a |
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successful pregnancy through any less costly applicable |
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infertility treatments for which coverage is available under the |
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group health benefit plan; and |
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(4) [(5)] the in vitro fertilization procedures are |
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performed at a medical facility that conforms to the minimal |
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standards for programs of in vitro fertilization adopted by the |
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American Society for Reproductive Medicine. |
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SECTION 2. Section 1366.005, Insurance Code, as amended by |
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this Act, applies only to a health benefit plan delivered, issued |
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for delivery, or renewed on or after January 1, 2026. A health |
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benefit plan delivered, issued for delivery, or renewed before |
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January 1, 2026, is governed by the law as it existed immediately |
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before the effective date of this Act, and that law is continued in |
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effect for that purpose. |
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SECTION 3. This Act takes effect September 1, 2025. |