The HOPE with Fertility Services Act requires group health insurance plans to cover infertility and iatrogenic infertility treatments if they offer obstetrical services. The bill defines infertility as the inability to achieve pregnancy after 12 months of unprotected intercourse or after standard clinical treatment, and iatrogenic infertility as fertility damage caused by surgery, radiation, chemotherapy, or other medical treatments. Covered treatments include in vitro fertilization, egg and embryo preservation, fertility preservation services for patients undergoing cancer treatment, and other fertility procedures performed at compliant medical facilities. Health plans can apply the same cost-sharing requirements and coverage limits to fertility treatments as they do to other medical services, but cannot incentivize patients or providers to avoid these treatments or penalize providers for offering them. The law takes effect on January 1, 2027, and requires health insurers to submit analyses of their utilization management practices for the first five years and annually notify enrollees about fertility coverage. The government can impose penalties up to $100 per day for violations.
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