1     
GENETIC TESTING COVERAGE AMENDMENTS

2     
2019 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Raymond P. Ward

5     
Senate Sponsor: ____________

6     

7     LONG TITLE
8     General Description:
9          This bill amends the Medical Assistance Act and the Public Employees' Benefit and
10     Insurance Program Act.
11     Highlighted Provisions:
12          This bill:
13          ▸     requires the Department of Health to apply for a Medicaid waiver or state plan
14     amendment to allow the program to provide coverage for in vitro fertilization and
15     genetic testing for certain individuals;
16          ▸     requires the Public Employees' Health Benefit Program to provide coverage for in
17     vitro fertilization and genetic testing for certain individuals; and
18          ▸     creates reporting requirements.
19     Money Appropriated in this Bill:
20          None
21     Other Special Clauses:
22          None
23     Utah Code Sections Affected:
24     AMENDS:
25          63I-2-226, as last amended by Laws of Utah 2018, Chapters 38 and 281
26          63I-2-249, as last amended by Laws of Utah 2018, Chapters 38 and 281
27     ENACTS:
28          26-18-419, Utah Code Annotated 1953
29          49-20-419, Utah Code Annotated 1953
30     

31     Be it enacted by the Legislature of the state of Utah:
32          Section 1. Section 26-18-419 is enacted to read:
33          26-18-419. Coverage for in vitro fertilization and genetic testing.
34          (1) As used in this section, "qualified enrollee" means an individual who:
35          (a) is enrolled in the Medicaid program; and
36          (b) has been diagnosed by a physician with:
37          (i) cystic fibrosis;
38          (ii) spinal muscular atrophy; or
39          (iii) Morquio Syndrome.
40          (2) Before January 1, 2020, the department shall apply for a Medicaid waiver or a state
41     plan amendment with the Centers for Medicare and Medicaid Services within the United States
42     Department of Health and Human Services to implement the coverage described in Subsection
43     (3).
44          (3) If the waiver described in Subsection (2) is approved, the Medicaid program shall
45     provide coverage to a qualified enrollee for:
46          (a) in vitro fertilization;
47          (b) genetic testing of a qualified enrollee who receives in vitro fertilization under
48     Subsection (3)(a); and
49          (c) genetic testing of an embryo that results from the in vitro fertilization described in
50     Subsection (3)(a).
51          (4) Before November 1, 2021, and before November 1 of every third year thereafter,
52     the department shall:
53          (a) calculate the change in state spending attributable to the coverage under this
54     section; and
55          (b) report the amount described in Subsection (4)(a) to the Health and Human Services
56     Interim Committee and the Social Services Appropriations Subcommittee.
57          Section 2. Section 49-20-419 is enacted to read:
58          49-20-419. Coverage for in vitro fertilization and genetic testing.
59          (1) As used in this section, "qualified enrollee" means an individual who:
60          (a) is a covered individual within the state risk pool; and
61          (b) has been diagnosed by a physician with:
62          (i) cystic fibrosis;
63          (ii) spinal muscular atrophy; or
64          (iii) Morquio Syndrome.
65          (2) For a plan year that begins on or after July 1, 2019, the program shall provide
66     coverage for a qualified enrollee for:
67          (a) in vitro fertilization;
68          (b) genetic testing of a qualified enrollee who receives in vitro fertilization under
69     Subsection (2)(a); and
70          (c) genetic testing of an embryo that results from the in vitro fertilization described in
71     Subsection (2)(a).
72          (3) Before November 1, 2021, and before November 1 of every third year thereafter,
73     the program shall:
74          (a) calculate the change in state spending attributable to the coverage under this
75     section; and
76          (b) report the amount described in Subsection (3)(a) to the Health and Human Services
77     Interim Committee and the Social Services Appropriations Subcommittee.
78          Section 3. Section 63I-2-226 is amended to read:
79          63I-2-226. Repeal dates -- Title 26.
80          (1) Subsection 26-7-8(3) is repealed January 1, 2027.
81          [(2) Subsection 26-7-9(5) is repealed January 1, 2019.]
82          [(3)] (2) Section 26-8a-107 is repealed July 1, 2019.
83          [(4)] (3) Subsection 26-8a-203(3)(a)(i) is repealed January 1, 2023.
84          [(5)] (4) Subsection 26-18-2.3(5) is repealed January 1, 2020.
85          [(6)] (5) Subsection 26-18-2.4(3)(e) is repealed January 1, 2023.
86          [(7) Subsection 26-18-408(6) is repealed January 2, 2019.]
87          [(8)] (6) Subsection 26-18-410(5) is repealed January 1, 2026.
88          [(9)] (7) Subsection 26-18-411(5) is repealed January 1, 2023.
89          (8) Subsection 26-18-419(4), regarding a requirement to report to the Legislature, is
90     repealed January 1, 2029.
91          [(10)] (9) Subsection 26-18-604(2) is repealed January 1, 2020.
92          [(11)] (10) Subsection 26-21-28(2)(b) is repealed January 1, 2021.
93          [(12)] (11) Subsection 26-33a-106.1(2)(a) is repealed January 1, 2023.
94          [(13)] (12) Subsection 26-33a-106.5(6)(c)(iii) is repealed January 1, 2020.
95          [(14)] (13) Title 26, Chapter 46, Utah Health Care Workforce Financial Assistance
96     Program, is repealed July 1, 2027.
97          [(15)] (14) Subsection 26-50-202(7)(b) is repealed January 1, 2020.
98          [(16)] (15) Subsections 26-54-103(6)(d)(ii) and (iii) are repealed January 1, 2020.
99          [(17)] (16) Subsection 26-55-107(8) is repealed January 1, 2021.
100          [(18)] (17) Subsection 26-56-103(9)(d) is repealed January 1, 2020.
101          [(19)] (18) Title 26, Chapter 59, Telehealth Pilot Program, is repealed January 1, 2020.
102          [(20)] (19) Subsection 26-61-202(4)(b) is repealed January 1, 2022.
103          [(21)] (20) Subsection 26-61-202(5) is repealed January 1, 2022.
104          Section 4. Section 63I-2-249 is amended to read:
105          63I-2-249. Repeal dates -- Title 49.
106          (1) Section 49-20-106 is repealed January 1, 2021.
107          (2) Subsection 49-20-417(5)(b) is repealed January 1, 2020.
108          (3) Subsection 49-20-419(3), regarding a requirement to report to the Legislature, is
109     repealed January 1, 2029.