Simotas for Inclusion of In-Vitro in Ind. & Small Group Market Health Insurance Plans

May 12, 2019

NEW YORK – In a letter to the Department of Financial Services’ Superintendent Linda Lacewell and Governor Andrew Cuomo, Assemblymember Simotas requested that New York select a new Essential Health Benefits (EHB) benchmark plan that includes in-vitro fertilization (IVF) coverage. This year, the Centers for Medicare & Medicaid Services (CMS) is granting states greater flexibility to update their plans by providing three new options.

Assemblymember Aravella Simotas in her letter said, “To stay consistent with New York State’s Women’s Agenda Initiatives recently proposed by Governor Andrew Cuomo, and the policy changes that were adopted in the 2019-2020 State Budget for large group market plans, the benchmark plan that is chosen must provide access to in-vitro fertilization (IVF) treatment, which is now deemed the optimal standard of care for infertility.”

In the Assembly, Simotas has been advocating for access to infertility services since 2016, when she first introduced legislation requiring all insurance companies provide coverage for IVF and fertility preservation treatments. A measure was finally included in this year’s state budget granting only large market insurers access to three cycles of IVF coverage. However, many small business owners and employees of small non-profit organizations are still unable to access such care. Simotas has now introduced a bill (A7478) in the Assembly removing the exclusionary language for small market and individual insurers’ plans and is requesting that the Department of Financial Services and Governor Cuomo act now to ensure middle class and lower income New Yorkers are given the essential benefits they are entitled to.

“If all New Yorkers cannot access this standard of care, then the problem is not fixed. We need to keep our commitment to our constituents and make sure that exclusionary language is not what keeps New Yorkers from building families. I will continue to stand with families and advocates until all citizens across our state can access IVF,” Simotas said.

Barbara Collura, President & CEO of RESOLVE: The National Infertility Association said, “We applaud Assemblymember Simotas for her continued commitment to help all New Yorkers struggling to build their families; now New York State, under the leadership of DFS Superintendent Lacewell, has an opportunity to ensure more New Yorkers can access the family building care they need by selecting a benchmark plan for 2020 that includes coverage for IVF.”

The full text of the letter can be read here: https://www.scribd.com/document/409018813/Simotas-Letter-to-DFS-Governor-docx


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