Medicare coverage of assisted reproductive technology and intrauterine insemination
Title III — Access to assisted reproductive technology and intrauterine insemination
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(a) Coverage Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is amended— (1) in subparagraph (JJ), by striking and at the end; (2) in subparagraph (KK), by inserting and at the end; and (3) by adding at the end the following new subparagraph: (LL) assisted reproductive technology and intrauterine insemination (as defined in section 2799A–12(b) of the Public Health Service Act);. (b) Payment and waiver of coinsurance Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended— (1) by striking and before (HH); and (2) by inserting before the semicolon at the end the following:, and (II) with respect to assisted reproductive technology and intrauterine insemination (as described in section 1861(s)(2)(LL)), the amount paid shall be equal to 100 percent of the lesser of the actual charge for the treatment or the amount determined under the payment basis determined under section 1848. (c) Waiver of application of deductible The first sentence of section 1833(b) of the Social Security Act (42 U.S.C. 1395l(b)) is amended— (1) by striking, and (13) and inserting (13); and (2) by striking 1861(n).. and inserting 1861(n), and (14) such deductible shall not apply with respect to assisted reproductive technology (as described in section 1861(s)(2)(LL)).. (d) Payment under physician fee schedule Section 1848(j)(3) of the Social Security Act (42 U.S.C. 1395w–4(j)(3)) is amended by inserting (2)(LL) after risk assessment),. (e) Conforming amendment regarding coverage Section 1862(a)(1)(A) of the Social Security Act (42 U.S.C. 1395y(a)(1)(A)) is amended by inserting, or assisted reproductive technology (as described in section 1861(s)(2)(LL)) and intrauterine insemination after 1861(ddd)(1)). (f) Effective date The amendments made by this section shall apply to services furnished on or after January 1, 2027.