NY State Senate Bill 2025-S1813

Senate Bill S1813

2025-2026 Legislative Session

Requires DOH to develop a payment methodology for federally qualified health centers and rural health centers that dispense ovulation enhancing drugs

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Current Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 14, 2025	referred to health

co-Sponsors

2025-S1813 (ACTIVE) - Details

See Assembly Version of this Bill:: A2156
Current Committee:: Senate Health
Law Section:: Social Services Law
Laws Affected:: Amd §365-a, Soc Serv L
Versions Introduced in 2023-2024 Legislative Session:: S9158, A9833

2025-S1813 (ACTIVE) - Summary

Relates to medical assistance for patients in the process of oral or injectable ovulation enhancing drugs.

2025-S1813 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S1813

SPONSOR: FERNANDEZ
 
TITLE OF BILL:

An act to amend the social services law, in relation to medical assist-
ance for patients in the process of oral or injectable ovulation enhanc-
ing drugs

 
PURPOSE OR GENERAL IDEA OF BILL:

To require Medicaid coverage of oral and injectable forms of ovulation
enhancing drugs.

 
SUMMARY OF PROVISIONS:

Section 1 adds "oral or injectable" to paragraph (ee) of section 365-a
of the social services law to require Medicaid coverage of oral or
injectable ovulation enhancing drugs.

Section 2 provides the effective date.

 
JUSTIFICATION:

While some ovulation enhancing drugs used for fertility treatments are
currently covered by Medicaid, the more effective injectable drugs,
which provide better outcomes for patients, are currently not covered.
This imbalance of coverage has led to individuals on Medicaid not being
able to access the full spectrum of fertility treatments currently
available to patients with commercial insurance, including state employ-
ees.

This bill will require Medicaid coverage to include oral or injectable
ovulation enhancing drugs. While in New York, Medicaid includes coverage
of some oral ovulation enhancing drugs, injectables are not covered.
This lack of coverage presents an immense barrier to those who want to
start a family, but do not have access to the drugs that could help. By
requiring Medicaid coverage of oral and injectable ovulation enhancing
drugs, we allow individuals and couples struggling with fertility issues
to access the most effective treatments.

 
PRIOR LEGISLATIVE HISTORY:

2023-2024: S9158 / A9833

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

None.

 
EFFECTIVE DATE:
This act shall take effect on the 90th day after it shall become a law.

2025-S1813 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1813
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                             January 14, 2025
                                ___________
 
 Introduced by Sens. FERNANDEZ, FELDER -- read twice and ordered printed,
   and when printed to be committed to the Committee on Health
 
 AN  ACT to amend the social services law, in relation to medical assist-
   ance for patients in the  process  of  oral  or  injectable  ovulation
   enhancing drugs

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (ee) of subdivision 2 of  section  365-a  of  the
 social  services  law,  as added by section 4 of part S of chapter 57 of
 the laws of 2017, is amended to read as follows:
   (ee) Medical assistance  shall  include  the  coverage  of  a  set  of
 services  to ensure improved outcomes of [women] PATIENTS who are in the
 process of ORAL OR INJECTABLE ovulation enhancing drugs, limited to  the
 provision   of   such   treatment,  office  visits,  hysterosalpingogram
 services, pelvic ultrasounds,  and  blood  testing;  services  shall  be
 limited  to those necessary to monitor such treatment. In the event that
 ninety percent federal financial participation for such services is  not
 available,  the  state share of appropriations related to these services
 shall be used for a grant program intended to accomplish the purpose  of
 this section.
   §  2.  This  act shall take effect on the ninetieth day after it shall
 have become a law.
 
 
 
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05352-01-5

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Senate Bill S1813

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Sponsored By

Nathalia Fernandez