Bill would protect assisted reproduction and require fertility coverage

Government entities would be barred from substantially burdening access to assisted reproduction, related medicines, information, or reproductive genetic material. The rules would cover Nevada state and local governments, health care providers, insurers, and people using or providing assisted reproduction. A government could impose a burden only by showing clear and convincing evidence that it serves a compelling interest and uses the least restrictive means. A person, provider, or coverage organization could raise a violation in court, and a winning party would receive court costs and attorney fees. Courts could deny further claims from a person or organization found to be a vexatious litigant, meaning someone who files meritless or harassing claims. Protection from liability would not cover negligence, crimes, or services outside a person’s or organization’s professional training and authority. The proposed government-protection rules would apply beginning July 1, 2025; the provisions on legal status before implantation and the related general section would take effect upon passage and approval.

Many health plans would have to cover medically necessary infertility treatment and at least five years of standard fertility-preservation services. The requirements would generally apply to group plans covering more than 50 employees or members, Medicaid, public employee plans, and several managed-care plans, with some plan exclusions. Coverage would include at least three but no more than five completed egg retrievals and three but no more than five embryo transfers when medically appropriate. Fertility preservation would apply when a medical condition or expected treatment may cause infertility and would include services such as sperm, egg, embryo, or reproductive-tissue storage. Plans could not impose higher cost-sharing, extra prior authorization, longer waiting periods, or other limits than they use for similar nonfertility benefits. Coverage would not be required when infertility was caused solely by unreversed voluntary sterilization, and religiously affiliated insurers could refuse coverage after written notice. Most proposed private-plan requirements would apply to policies issued or renewed on or after January 1, 2026; Medicaid and certain public or managed-care requirements would generally apply July 1, 2027, subject to federal funding or approval.

Health insurers and employers that provide health benefits would have to let a person enroll after a qualified provider confirms pregnancy. The proposed rule would cover several individual and group health plans, employer health plans, health maintenance organizations, and certain pregnancy-and-childbirth plans, but not cafeteria plans. Enrollment would be available without an added fee or penalty. The person could choose coverage beginning the first day of the month when pregnancy was confirmed or the first day of the following month. The enrollment window would generally be at least 30 days for employer or group plans and at least 60 days for individual-market plans. Most proposed enrollment provisions would apply for purposes other than preparation on January 1, 2026; related Medicaid managed-care provisions would be delayed until January 1, 2027 or July 1, 2027, depending on the section.