An Act relative to step therapy and in vitro fertilization insurance coverage

This bill mandates that health insurance plans in Massachusetts cover medically necessary infertility diagnosis and treatment, including in vitro fertilization, for residents who meet specific time-based criteria for attempting conception. It applies to a wide range of providers, including state employee plans, Medicaid managed care organizations, and private insurance policies. A key provision prohibits insurers from requiring patients to undergo step therapy, meaning they cannot force individuals to try less effective medications or procedures before approving the treatment recommended by their physician. The legislation also defines infertility based on the duration of unsuccessful attempts to conceive, with shorter timeframes applied for women over the age of 35.