SENATE BILL NO. 1131


   May 14, 1998, Introduced by Senators PETERS, CHERRY, VAUGHN, 
        MILLER, A. SMITH and O'BRIEN and referred to the Committee   
        on Health Policy and Senior Citizens.



        A bill to amend 1980 PA 350, entitled

   "The nonprofit health care corporation reform act,"

   (MCL 550.1101 to 550.1704) by adding section 416b.

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 1         SEC. 416B.  (1) ON AND AFTER JANUARY 1, 1998, IN EACH GROUP

 2    CERTIFICATE THAT COVERS 10 OR MORE MEMBERS AND PROVIDES

 3    PREGNANCY-RELATED COVERAGE, A HEALTH CARE CORPORATION SHALL PRO-

 4    VIDE BENEFITS FOR THE DIAGNOSIS AND TREATMENT OF INFERTILITY,

 5    INCLUDING, BUT NOT LIMITED TO, IN VITRO FERTILIZATION, EMBRYO

 6    TRANSFER, ARTIFICIAL INSEMINATION, GAMETE INTRAFALLOPIAN TUBE

 7    TRANSFER, ZYGOTE INTRAFALLOPIAN TUBE TRANSFER, AND INTRACYTOPLAS-

 8    MIC SPERM INJECTION.

 9         (2) COVERAGE UNDER SUBSECTION (1) FOR PROCEDURES FOR IN

10    VITRO FERTILIZATION, GAMETE INTRAFALLOPIAN TUBE TRANSFER, OR




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 1    ZYGOTE INTRAFALLOPIAN TUBE TRANSFER IS REQUIRED ONLY IF ALL OF

 2    THE FOLLOWING APPLY:

 3         (A) THE MEMBER HAS BEEN UNABLE TO ATTAIN OR SUSTAIN A SUC-

 4    CESSFUL PREGNANCY THROUGH REASONABLE, LESS COSTLY MEDICALLY

 5    APPROPRIATE INFERTILITY TREATMENTS FOR WHICH COVERAGE IS AVAIL-

 6    ABLE UNDER THE CERTIFICATE.

 7         (B) THE MEMBER HAS NOT UNDERGONE 3 OR MORE COMPLETED OOCYTE

 8    RETRIEVALS.  HOWEVER, IF A LIVE BIRTH FOLLOWS A COMPLETED OOCYTE

 9    RETRIEVAL, THEN 2 MORE COMPLETED OOCYTE RETRIEVALS SHALL BE

10    COVERED.

11         (C) THE PROCEDURES ARE PERFORMED AT MEDICAL FACILITIES THAT

12    CONFORM TO THE AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE GUIDE-

13    LINES FOR IN VITRO FERTILIZATION CLINICS AND MINIMAL STANDARDS

14    FOR PROGRAMS OF IN VITRO FERTILIZATION.

15         (3) THE PROCEDURES REQUIRED TO BE COVERED UNDER THIS SECTION

16    ARE NOT REQUIRED TO BE CONTAINED IN ANY CERTIFICATE ISSUED TO A

17    RELIGIOUS INSTITUTION OR ORGANIZATION OR TO AN ENTITY SPONSORED

18    BY A RELIGIOUS INSTITUTION OR ORGANIZATION THAT FINDS THE PROCE-

19    DURES REQUIRED TO BE COVERED UNDER THIS SECTION TO VIOLATE ITS

20    RELIGIOUS AND MORAL TEACHINGS AND BELIEFS.

21         (4) AS USED IN THIS SECTION, "INFERTILITY" MEANS THE INABIL-

22    ITY TO CONCEIVE AFTER 1 YEAR OF UNPROTECTED SEXUAL INTERCOURSE OR

23    THE INABILITY TO SUSTAIN A SUCCESSFUL PREGNANCY.











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