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S 728

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

194th Legislature (2025-2026) Introduced by Bill Driscoll

Massachusetts bill restricts step therapy requirements and expands IVF insurance coverage to improve treatment access and reduce patient costs.

Accompanied a study order, see S2931
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Bill Summary · S 728

Legislative bill overview

S 728 addresses two insurance coverage issues in Massachusetts: step therapy requirements (where insurers require patients to try cheaper treatments before approving more expensive ones) and coverage for in vitro fertilization (IVF). The bill aims to modify how health insurers handle these treatment pathways and fertility care access.

Why is this important

Step therapy protocols can delay access to medically necessary treatments, particularly affecting patients with complex conditions. IVF coverage directly impacts fertility treatment affordability for Massachusetts residents, as many state insurance plans currently limit or exclude these services. These policies affect both medical outcomes and out-of-pocket costs for patients.

Potential points of contention

  • Step therapy restrictions: Insurance companies argue step therapy controls costs and prevents unnecessary expensive treatments; patient advocates contend it delays care and creates barriers for patients whose physicians recommend specific treatments
  • IVF coverage mandates: Expanding coverage increases insurance premiums for all policyholders; fertility advocates argue coverage promotes family formation and addresses medical conditions affecting reproduction
  • Regulatory scope: Questions about whether the state should mandate private insurance coverage versus addressing this through public programs or subsidies

Compiled from official sources — confirm details with the bill’s official record.

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