HB 595

This bill enacts the " Freedom to Grow Our Tennessee Families Act, which requires a health insurer that issues, delivers, amends, or renews a health benefit plan that is to be in effect in this state on or after January 1, 2026, to provide coverage for f ertility diagnostic care, f ertility treatment, and f ertility preservation services. Relative to such coverage, a health insurer must not do any of the following:  Impose a waiting period .  Use a prior diagnosis or prior fertility treatment as a basis for excluding, limiting, or otherwise restricting the availability of such coverage .  Impose limitations on coverage for fertility services based on an enrollee's use of donor gametes, donor embryos, or surrogacy .  Impose different limitations on coverage for, provide different benefits to, or impose different requirements on a class of persons on account of an individual's actual or perceived race, color, sex, disability, ancestry, or relationship status. This bill requires a health insurer to cover at least three complete oocyte retrievals with unlimited embryo transfers from those oocyte retrievals or from any oocyte retrieval performed prior to January 1, 2026, in accordance with the guidelines of the American Society for Reproductive Medicine or a comparable organization, using single embryo transfer when recommended and medically approp riate . The coverage must b e provided regardless of whether donor gametes or embryos are used or an embryo is transferred to the uterus of a person acting as surrogate. This bill further requires c overage for fertility preservation services to be provide d regardless of an enrollee's past or present treatment for cancer, sickle cell disease, lupus, menorrhagia, endometriosis, or uterine fibroids. "" Fertility preservation services "" m eans procedures, products, medications, and services intended to preserve f ertility, consistent with established medical practice and professional guidelines published by the American Society for Reproductive Medicine or a comparable organization, for an individual who has a medical condition or who is expected to receive medical treatment that may cause or has the potential to cause a risk of impairment of fertility . Such preservation services i nclude evaluation expenses; laboratory assessments; medications; treatment associated with fertility preservation services; the procurem ent and cryopreservation of gametes, embryos, and reproductive material; and storage from the time of cryopreservation for a period of at least three years . LIMITATIONS This bill requires that a ny limitation a health insurer imposes on the coverage req uired by this bill be based on an enrollee's medical history and clinical guidelines adopted by the health insurer. Any clinical guidelines used by a health insurer must be based on current guidelines developed by the American Society for Reproductive Med icine or a comparable organization ; must cite with specificity any data or scientific reference relied upon; must be maintained in written form; and must be made available to an enrollee in writing upon request. This bill does not require a health insurer to provide coverage for a n experimental fertility procedure or n onmedical costs related to donor gametes, donor embryos, or surrogacy. An ""e xperimental fertility procedure "" i s a procedure for which the published medical evidence is not sufficient for the American Society for Reproductive Medicine, or a comparable organization, to regard the procedure as established medical practice . RULEMAKING This bill authorizes t he commissioner of commerce and insurance to promulga te rules to effectuate this bill . When promulgating such rules, the commissioner must consider the clinical guidelines developed by the American Society for Reproductive Medicine or a comparable organization . TENNCARE This bill adds fertility care for a fertility patient as described above to the kind of medical assistance to be covered by TennCare. TEMPORARY ASSISTANCE Under welfare-related programs and services for children, present law provides that a family is eligible for temporary assistance if all of the following conditions are met :  A dependent child resides in this state with a caretaker relative in that family, or an individual who applies for temporary assistance is pregnant, or as otherwise defined by the department of human services .  The family meets income standards based upon the standard of need for a family based upon its size and income and based upon resource limits as determined by the department in its rules .  The family members are engaged in work activities, unless exempted .  The caretaker relative has agreed to and complies with a personal responsibility plan as developed by the department .  The family or individual of the family is otherwise eligible pursuant to federal or state laws or regulations. Present law provides that a caretaker relative who becomes ineligible for any reason other than a failure to comply with work requirements or to cooperate with child support obligations is eligible for transitional childcare assistance for a period specified by the department while the caretaker relative is employed, in school, or in employment training. Childcare assistance terminated due to failure to comply with work requirements must be reinstated upon verification by the department that the work requirements were, in fact, being met immediately preceding such ineligibility. This bill removes these provisions and, instead, provides that a caretaker relative who becomes ineligible for any reason is eligible for transitional childcare assistance for a period of not less than s ix months. This bill requires the department of human services to pay childcare assistance on a sliding fee scale based upon a family's income for so long as federal funding or any related waiver is in effect."