4090

VETOES

3. BLOCKAGE OF, OR SURGICAL REMOVAL OF,
ONE OR BOTH FALLOPIAN TUBES (LATERAL OR BILATERAL SALPHINGECTOMY
SALPINGECTOMY);

(4) (5) THE PATIENT HAS BEEN UNABLE TO ATTAIN A
SUCCESSFUL PREGNANCY THROUGH ANY LESS COSTLY APPLICABLE
INFERTILITY TREATMENTS FOR WHICH COVERAGE IS AVAILABLE UNDER THE
CONTRACT OR CERTIFICATION; AND

(5) (6) THE IN VITRO FERTILIZATION PROCEDURES ARE
PERFORMED AT MEDICAL FACILITIES THAT CONFORM TO THE AMERICAN
COLLEGE OF OBSTETRIC AND GYNECOLOGY GUIDELINES FOR IN VITRO
FERTILIZATION CLINICS OR TO THE AMERICAN FERTILITY SOCIETY
MINIMAL STANDARDS FOR PROGRAMS OF IN VITRO FERTILIZATION.

470V.

EACH HOSPITAL OR MAJOR MEDICAL INSURANCE POLICY WRITTEN ON
AN EXPENSE INCURRED BASIS, WHICH IS DELIVERED OR ISSUED FOR
DELIVERY IN THE STATE, AND WHICH PROVIDES PREGNANCY-RELATED
BENEFITS, SHALL INCLUDE MAY NOT EXCLUDE BENEFITS FOR INPATIENT OR
ALL OUTPATIENT EXPENSES ARISING FROM IN VITRO FERTILIZATION
PROCEDURES PERFORMED ON THE POLICY HOLDER OR THE POLICY HOLDER'S
DEPENDENT SPOUSE, PROVIDED THAT:

(1) BENEFITS UNDER THIS SECTION SHALL BE PROVIDED TO
THE SAME EXTENT AS BENEFITS PROVIDED FOR OTHER PREGNANCY-RELATED
PROCEDURES;

(1) (2) THE PATIENT IS A SUBSCRIBER POLICYHOLDER OR
COVERED DEPENDENT OF THE SUBSCRIBER POLICYHOLDER;

(2) (3) THE PATIENT'S OOCYTES ARE FERTILIZED WITH THE
PATIENT'S SPOUSE'S SPERM;

(3) (4) (I) THE PATIENT AND THE PATIENT'S SPOUSE HAVE
A HISTORY OF INFERTILITY OF AT LEAST 5 YEARS' DURATION; OR

(II) THE INFERTILITY IS ASSOCIATED WITH ONE OR
MORE OF THE FOLLOWING MEDICAL CONDITIONS:

1. ENDOMETRIOSIS;

2. EXPOSURE IN UTERO TO

DIETHYLSTILBESTROL, COMMONLY KNOWN AS PES; OR

3. BLOCKAGE OF, OR SURGICAL REMOVAL OF,
ONE OR BOTH FALLOPIAN TUBES (LATERAL OR BILATERAL SALPHINGECTOMY
SALPINGECTOMY);

(4) (5) THE PATIENT HAS BEEN UNABLE TO ATTAIN A
SUCCESSFUL PREGNANCY THROUGH ANY LESS COSTLY APPLICABLE