Bill
HB 1284
Requires PERS health plan to cover medically necessary fertility preservation for those facing fertility-impairing conditions or treatments, up to four cycles, with broad parity.
Status: Second reading — failed to pass (yeas 39, nays 48). Introduced: Nov 13, 2024. Sponsor(s): House members Brandenburg, Grueneich, Hanson, Satrom, Schauer, Schneider, Warrey; Senate sponsors Erbele, Hogan (committee engrossment). Act would have added a new section to NDCC ch. 54‑52.1 (public employee health benefits).
Purpose
- Require the public employees retirement system (PERS) health plan (the board’s plan under ch. 54‑52.1) to cover medically‑recommended fertility‑preservation services for covered individuals who have a medical or genetic condition — or who are expected to undergo medical treatment — that may impair fertility. Establish a temporary statutory pilot and require PERS to report back to the legislature.
Key provisions
- Definitions: “Medically necessary” tied to a licensed physician’s findings and to accepted standards (e.g., American Society for Reproductive Medicine, American Society of Clinical Oncology); “standard fertility preservation services” defined to include consultation, evaluation, testing, medications, treatments, and cryopreservation of eggs, sperm, embryos, or other reproductive tissue consistent with professional guidelines.
- Mandatory coverage: If a covered individual has a diagnosed condition (or will undergo treatment) that may impair fertility, the board must provide coverage for standard fertility preservation services when recommended and medically necessary.
- Scope of covered services: Must include consultation, evaluation, laboratory assessment, medication, procurement and storage of gametes/embryos/reproductive tissue, and all procedures required for cryopreservation.
- Number of cycles: Coverage limited to four preservation cycles.
- Parity and access: Coverage must be available to all covered individuals (including those entering coverage during special/open enrollment). Benefits may not be subject to restrictions (copayment, deductible, coinsurance, benefit maximum, waiting period, or other limits) that differ from other medical or surgical benefits under the plan.
- Exclusion: The section would not apply to Medicare Part D prescription drug coverage.
- Reporting / sunset: PERS must prepare and submit a bill to the 70th Legislative Assembly seeking repeal of the act’s expiration and to extend the mandate to all group and individual policies; the submission must include a report on the effect to system programs, utilization/costs, and a recommendation on continuation.
- Application and expiration: Applies to health benefits beginning after June 30, 2025, and the Act would expire June 30, 2027 (i.e., a two‑year window unless extended).
Who would be affected
- Primary: Public employees and other individuals enrolled in PERS group health plans and their covered dependents (any “covered individual” under the plan) in North Dakota.
- Secondary: PERS (administrators), plan providers, and ultimately state employer costs and budgetary exposure to utilization/costs for fertility preservation.
Procedural / timeline notes
- The bill established a temporary (through June 30, 2027) mandate and required PERS to produce a follow‑up bill and cost/utilization report to the next legislature.
- Legislative outcome: Failed on second reading (yeas 39, nays 48) and therefore did not become law during this session.
Potential fiscal/operational impacts (from bill text and requirements)
- The bill directed PERS to analyze and report utilization and cost impacts; actual cost implications were not specified in the bill text. If enacted, the coverage mandate could increase plan expenditures depending on utilization; administrative changes would be required to implement benefit terms and claims processing.
Compiled from official sources — confirm details with the bill’s official record.
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