26B-3-216. Medicaid waiver for fertility preservation services.
(1) As used in this section: "Iatrogenic infertility" means an impairment of fertility or reproductive functioning caused by surgery, chemotherapy, radiation, or other medical treatment. "Physician" means an individual licensed to practice under, or. Title 58, Chapter 67, Utah Medical Practice Act Title 58, Chapter 68, Utah Osteopathic Medical Practice Act "Qualified enrollee" means an individual who: is enrolled in the Medicaid program; has been diagnosed with a form of cancer by a physician; and needs treatment for that cancer that may cause a substantial risk of sterility or iatrogenic infertility, including surgery, radiation, or chemotherapy. "Standard fertility preservation service" means a fertility preservation procedure and service that: is not considered experimental or investigational by the American Society for Reproductive Medicine or the American Society of Clinical Oncology; and is consistent with established medical practices or professional guidelines published by the American Society for Reproductive Medicine or the American Society of Clinical Oncology, including: sperm banking; oocyte banking; embryo banking; banking of reproductive tissues; and storage of reproductive cells and tissues.
(2) Before January 1, 2022, the department shall apply for a Medicaid waiver or a state plan amendment with CMS to implement the coverage described in Subsection. (3)
(3) If the waiver or state plan amendment described in Subsectionis approved, the Medicaid program shall provide coverage to a qualified enrollee for standard fertility preservation services. (2)
(4) The Medicaid program may not provide the coverage described in Subsectionbefore the later of: (3) the day on which the waiver described in Subsectionis approved; and (2) January 1, 2023.
(5) Before November 1, 2023, and before November 1 of each third year after 2023, the department shall: calculate the change in state spending attributable to the coverage described in this section; and report the amount described in Subsectionto the Health and Human Services Interim Committee and the Social Services Appropriations Subcommittee. (5)(a)