26B-3-215. Coverage for in vitro fertilization and genetic testing.
| (1) |
As used in this section:
Terms Used In Utah Code 26B-3-215- Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
- Medicaid program: means the state program for medical assistance for persons who are eligible under the state plan adopted pursuant to Title XIX of the federal Social Security Act. See Utah Code 26B-3-101
- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
- United States: includes each state, district, and territory of the United States of America. See Utah Code 68-3-12.5
| (a) |
“Qualified condition” means:
| (ii) |
spinal muscular atrophy; |
| (iv) |
myotonic dystrophy; or |
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| (b) |
“Qualified enrollee” means an individual who:
| (i) |
is enrolled in the Medicaid program; |
| (ii) |
has been diagnosed by a physician as having a genetic trait associated with a qualified condition; and |
| (iii) |
intends to get pregnant with a partner who is diagnosed by a physician as having a genetic trait associated with the same qualified condition as the individual. |
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| (2) |
Before January 1, 2021, the department shall apply for a Medicaid waiver or a state plan amendment with the Centers for Medicare and Medicaid Services within the United States Department of Health and Human Services to implement the coverage described in Subsection (3). |
| (3) |
If the waiver described in Subsection (2) is approved, the Medicaid program shall provide coverage to a qualified enrollee for:
| (a) |
in vitro fertilization services; and |
| (b) |
genetic testing of a qualified enrollee who receives in vitro fertilization services under Subsection (3)(a). |
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| (4) |
The Medicaid program may not provide the coverage described in Subsection (3) before the later of:
| (a) |
the day on which the waiver described in Subsection (2) is approved; and |
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| (5) |
Before November 1, 2022, and before November 1 of every third year thereafter, the department shall:
| (a) |
calculate the change in state spending attributable to the coverage under this section; and |
| (b) |
report the amount described in Subsection (5)(a) to the Health and Human Services Interim Committee and the Social Services Appropriations Subcommittee. |
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Renumbered and Amended by Chapter 306, 2023 General Session
