State laws and regulations addressing third-party reimbursement for infertility treatment: implications for cancer survivors

Objective To examine codified state policies related to infertility and assess their implications for cancer patients. Lack of insurance is often identified as a barrier to use of fertility preservation (FP) services. Design None. Setting A keyword search was developed to identify statutes and administrative regulations of insurance coverage for FP in the United States. Patient(s) N/A Intervention(s) N/A Main Outcome Measure(s) Laws addressing the general population but pertaining to FP were compiled using Lexis-Nexis. Data were analyzed by reviewing the “plain meaning” of the text, legislative/administrative history, and annotated case law. Legal reasoning and common rules of statutory construction and legislative interpretation were used. Result(s) Fifteen states (29.4%) had laws relating to insurance coverage for infertility or in vitro fertilization (IVF) procedures and two states (CA and IL) specifically excluded IVF from a mandatory offer of coverage. No state laws or regulations addressed insurance coverage for FP methods specific to cancer patients. Conclusion(s) There is an argument for policies that require coverage for FP for cancer survivors before treatment.