Last month, Senators Tracy Pennycuick and Nick Miller introduced a bipartisan bill, Senate Bill No. 1315, that would require insurance coverage for standard fertility preservation services for cancer patients who undergo treatment effecting their fertility.
Below, KingSpry’s Adoption and ART Practice Chair and Family Law Attorney, Dorota Gasienica-Kozak, Esq., provides an overview of the proposed law and how it would support family-building in the Commonwealth.
In their memorandum, the bill’s sponsors recognized that more than 89,000 Pennsylvanians are diagnosed with cancer each year. Even though survival rates are on the rise, lifesaving treatments still pose a likelihood of permanent infertility.
As a result, fertility preservation may be medically recommended to cancer patients of reproductive age. These treatments, however, are often expensive and inconsistently covered by health insurers. This leaves many patients forced to make an impossible choice between lifesaving treatment and preserving their fertility.
The bill was proposed to prevent cancer patients from having to make that impossible choice, giving more patients access to fertility preservation services through the health insurance policies they are covered under.
Coverage for Certain Fertility Preservation Services
The proposed law will add a section to The Insurance Company Law of 1921, requiring “[a]n insurer that offers, issues or renews a health insurance policy in this Commonwealth [to] include fertility preservation services as a covered benefit for a covered person if a medically necessary treatment may directly or indirectly cause iatrogenic infertility in the covered person.”
Iatrogenic infertility means an impartment of fertility caused by a medically necessary treatment for cancer, such as surgery, chemotherapy, or radiation.
Fertility preservation services are procedures or services to preserve fertility in accordance with national guidelines, including egg retrieval, sperm retrieval, ovarian tissue removal, and cryopreservation.
Coverage under the proposed law must include storage (presumably of a covered person’s cells at an in-network facility for at least three (3) years. Additionally, coverage must be administered in a similar manner to other health care services provided under the health insurance policy.
Insurance Limitations
Insurers may impose a lifetime maximum benefit of not less than $100,000 for each covered person. Insurers may also limit coverage three (3) years after the date of treatment or if the covered person is no longer covered under the health insurance policy.
Religious Employers
The bill permits religious employers to request an exemption from the required fertility preservation coverage. However, an insurer should only grant the exemption “if the coverage conflicts with the religious employer’s bona fide religious beliefs and practices.”
Religious employers include (a) churches, (b) conventions or associations of churches, and (c) elementary or secondary schools that are controlled, operated, or supported by a church and qualifies as a tax-exempt organization.
Should a religious employer obtain an exemption, they must provide written notice of such to each prospective enrollee covered under their health insurance policy.
Key Takeaways
Senate Bill No. 1315 is a significant step towards giving more cancer patients access to fertility preservation services. “Both men and woman may experience infertility as a result of treatment,” the sponsor’s said, “but surviving cancer should not mean losing the opportunity to start or grow a family.”
The bill was just recently proposed, meaning it awaits passage by the Pennsylvania Senate and House of Representative before it becomes law. Individuals interested in supporting the proposed legislation are encouraged to contact their local representatives for more information.
