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SECOND REGULAR SESSION
HOUSE BILL NO. 2236
103RD GENERAL ASSEMBL Y
INTRODUCED BY REPRESENT A TIVE MURRA Y .
5740H.01I JOSEPH ENGLER, Chief Clerk
AN ACT
T o amend chapters 192 and 376, RSMo, by adding thereto three new sections relating to
access to fertility treatment, with penalty provisions.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Chapters 192 and 376, RSMo, are amended by adding thereto three new
2 sections, to be known as sections 192.1035, 192.1037, and 376.1246, to read as follows:
192.1035. 1. This section and sections 192.1037 and 376.1246 shall be known and
2 may be cited as the "Missouri Family Building and Fertility Access Act".
3 2. As used in this section and section 192.1037, the following terms mean:
4 (1) "Certified fertility clinic", a facility or pro vider offering fertility tr eatment
5 that is accr edited by the American Society for Reprod uctive Medicine or the American
6 College of Obstetricians and Gynecologists;
7 (2) "Fertility tr eatment", proced ures, services, and medications used to diagnose
8 or addr ess infertility , as the term "infertility" is defined by the American Society for
9 Repr oductive Medicine;
10 (3) "Pr ogram", the infertility access progr am established under subsection 3 of
11 this section.
12 3. Subject to appr opriation, the department of health and senior services shall
13 establish a prog ram to be known as the "Infertility Access Pr ogram" to impro ve access
14 to fertility tr eatment in this state.
15 4. The pr ogram shall:
16 (1) Pr ovide travel assistance, lodging stipends, or telehealth subsidies for
17 individuals in rural or medically underserved ar eas seeking fertility diagnosis or fertility
EXPLANA TION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law . Matter in bold-face type in the above bill is proposed language.
18 tr eatment at certified fertility clinics and who would otherwise be unable to access
19 services at a certified fertility clinic;
20 (2) Support telemedicine infrastructur e for fertility specialists serving shortage
21 ar eas designated by the department of health and senior services by rule; and
22 (3) Conduct community outr each and education on infertility car e and available
23 r esources .
24 5. The department of health and senior services may contract with local health
25 agencies or nonpro fit organizations to administer the prog ram.
26 6. (1) There is hereb y creat ed in the state tr easury the "Infertility Access Fund",
27 which shall consist of moneys appr opriated to it by the general assembly and any gifts,
28 contributions, grants, or bequests received from federal, private, or other sources . The
29 state tr easur er shall be custodian of the fund. In accordance with sections 30.170 and
30 30.180, the state tr easur er may appr ove disbursements. The fund shall be a dedicated
31 fund and, upon appr opriation, moneys in this fund shall be used solely to administer the
32 pr ogram established in this section.
33 (2) Notwithstanding the pro visions of section 33.080 to the contrary , any moneys
34 r emaining in the fund at the end of the biennium shall not r evert to the credit of the
35 general reven ue fund.
36 (3) The state tre asurer shall invest moneys in the fund in the same manner as
37 other funds ar e invested. Any interes t and moneys earned on such investments shall be
38 cr edited to the fund.
39 7. The department of health and senior services shall pr omulgate rules to
40 implement this section including, but not limited to, eligibility criteria for assistance
41 pr ovided thr ough the progra m. Any rule or portion of a rule, as that term is defined in
42 section 536.010, that is crea ted under the authority delegated in this section shall
43 become effective only if it complies with and is subject to all of the provi sions of chapter
44 536 and, if applicable, section 536.028. This section and chapter 536 are nonseverable
45 and if any of the powers vested with the general assembly pursuant to chapter 536 to
46 r eview , to delay the effective date, or to disappr ove and annul a rule are subsequently
47 held unconstitutional, then the grant of rulemaking authority and any rule pr oposed or
48 adopted after August 28, 2026, shall be invalid and void.
192.1037. 1. The department of health and senior services, in coordination with
2 the department of commer ce and insurance, shall pr oduce a rep ort every two years on
3 access to fertility trea tment and outcomes.
4 2. The r eport shall include:
5 (1) T r ends in infertility diagnoses, fertility tr eatment utilization, and outcomes
6 by r egion;
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7 (2) Barriers to car e, including cost, distance, and pr ovider availability;
8 (3) Recommendations for improvi ng access and equity; and
9 (4) Comparative data aligned with the state's maternal health dashboards.
10 3. The department of health and senior services shall submit the report to the
11 governor , the speaker of the house of r epresent atives, and the presiden t pro tempor e of
12 the senate and make the rep ort publicly available online.
376.1246. 1. As used in this section, the following terms mean:
2 (1) "Enro llee", the same meaning given to the term in section 376.1350;
3 (2) "Fertility trea tment", the same meaning given to the term in section
4 192.1035;
5 (3) "Health carrier", the same meaning given to the term in section 376.1350;
6 (4) "Participating enr ollee", an enr ollee who r eceives coverage of fertility
7 tr eatment by the enr ollee's health carrier .
8 2. Each health carrier offering coverage of fertility tr eatment shall publish a
9 plain-language summary of the fertility coverage on its publicly accessible website
10 including, but not limited to, information on eligibility , coverage limitations, and
11 pr ocedur es cover ed.
12 3. (1) Each health carrier offering coverage of fertility tr eatment shall, on or
13 befor e Mar ch first of each calendar year , submit to the department of health and senior
14 services and the department of commer ce and insurance an annual utilization report
15 including, but not limited to, the following information:
16 (a) The number of enrol lees who recei ved fertility tr eatment;
17 (b) The type of fertility tr eatment pr ovided to participating enr ollees;
18 (c) Geographic distribution of participating enr ollees by zip code; and
19 (d) Demographic data, including age, race, ethnicity , gender , and income range,
20 of participating enr ollees as repo rted voluntarily or as available thr ough claims data.
21 (2) All r eports submitted under this subsection shall exclude personally
22 identifiable information and comply with the federal Health Insurance Portability and
23 Accountability Act (42 U.S.C. Section 1320d et seq.) and state privacy laws.
24 (3) The department of health and senior services shall aggr egate the data fr om
25 the r eports submitted under this subsection and publish statewide findings annually on
26 its public website.
27 4. The department of commer ce and insurance may issue such administrative
28 orders or penalties as authorized under section 374.046 for failur e to comply with the
29 r eporting or publication requ irem ents of this section.
30 5. The department of commer ce and insurance may pr omulgate rules to enforce
31 compliance with this section. Any rule or portion of a rule, as that term is defined in
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32 section 536.010, that is crea ted under the authority delegated in this section shall
33 become effective only if it complies with and is subject to all of the provi sions of chapter
34 536 and, if applicable, section 536.028. This section and chapter 536 are nonseverable
35 and if any of the powers vested with the general assembly pursuant to chapter 536 to
36 r eview , to delay the effective date, or to disappr ove and annul a rule are subsequently
37 held unconstitutional, then the grant of rulemaking authority and any rule pr oposed or
38 adopted after August 28, 2026, shall be invalid and void.
✔
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