AN ACT RELATING TO STATE AFFAIRS AND GOVERNMENT -- THE RHODE ISLAND MEDICAID REFORM ACT OF 2008 (Requires Medicaid to provide coverage for fertility medication, care, and services, for at least 3 cycles of fertility treatment, and intrauterine insemination.)

H8182

2026 -- H 8182
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LC005376
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STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2026
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A N A C T
RELATING TO STATE AFFAIRS AND GOVERNMENT -- THE RHODE ISLAND
MEDICAID REFORM ACT OF 2008

Introduced By:
Representatives Alzate, Casimiro, and Stewart

Date Introduced:
February 27, 2026

Referred To:
House Finance
It is enacted by the General Assembly as follows:
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SECTION 1. Chapter 42-12.4 of the General Laws entitled "The Rhode Island Medicaid
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Reform Act of 2008" is hereby amended by adding thereto the following section:
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42-12.4-10. Fertility.
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(a) Definitions: As used in this section, the following words or terms shall have the
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following meanings unless the context shall clearly indicate another or different meaning or intent:
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(1) "Fertility diagnostic care" means counseling, products, medications, procedures,
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genetic testing, and services intended to provide information about an individual's fertility,
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including laboratory assessments and imaging studies.
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(2) “Infertility” means:
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(i) The presence of a condition recognized by a health care provider that impacts an
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individual’s ability to establish a pregnancy or to carry a pregnancy based on an individual’s
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medical, sexual, and reproductive history; age; physical findings; diagnostic testing; or any
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combination of these factors. This includes infertility arising from disabilities or from medical
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treatments or conditions associated with disability;
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(ii) An individual’s inability to establish a pregnancy because the individual or the
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individual and the individual’s partner do not have the necessary gametes to establish a pregnancy;
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or
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(iii) An individual’s inability to establish a pregnancy or to carry a pregnancy to live birth

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after twelve (12) months of unprotected sexual intercourse when the individual and the individual’s
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partner have the necessary gametes to establish a pregnancy. Pregnancy loss does not restart the
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twelve-month period.
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(3) "Intrauterine insemination" means a procedure that places sperm directly into an
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individual's uterus at the time of ovulation to increase the chances of fertilization.
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(4) “Standard fertility preservation services” means counseling, products, medications,
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procedures, genetic testing, and services intended to preserve fertility, consistent with established
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medical practice and professional guidelines published by the American Society for Reproductive
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Medicine or the American Society for Clinical Oncology for an individual who has a medical or
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genetic condition, including conditions related to disability or chronic illness, or who is expected
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to receive medical treatment that has a side effect or possible side effect of a risk to an individual’s
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fertility and includes, but is not limited to expenses related to evaluation, laboratory assessments,
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medications, and treatment, as well as the procurement and cryopreservation of gametes, embryos,
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and reproductive material and storage.
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(5) “Department” means the executive office of health and human services (EOHHS).
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(b) Beginning January 1, 2027, the department shall provide Medicaid coverage for:
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(1) Fertility diagnostic care;
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(2) Standard fertility preservation including, but not limited to, storage from the time of
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cryopreservation provided that coverage for such storage shall extend until the individual reaches
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the age of thirty (30), or for a period five (5) years, whichever is later. Storage may be offered for
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a longer period of time; and
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(3) Treatment of infertility including any medically necessary ovulation-enhancing
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medications and medical services related to prescribing and monitoring the use of the ovulation-
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enhancing medications for at least three (3) cycles of ovulation-enhancing medication treatment;
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and at least six (6) cycles of intrauterine insemination. In the event that ovulation-enhancing
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medication treatment administered with intention to prepare for intrauterine insemination results in
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an ovulation response that counter-indicates intrauterine insemination, coverage for invitro
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fertilization and embryo transfer as recommended by the treating physician.
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(c) Coverage under this section shall not:
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(1) Impose a waiting period;
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(2) Use any prior diagnosis, an individual’s disability, or prior fertility treatment as a basis
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for excluding, limiting, or otherwise restricting the availability of coverage required by this section;
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(3) Impose any limitations on coverage for any fertility services based on an individual’s
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use of donor gametes; and

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(4) Impose different limitations on coverage for, provide different benefits to, or impose
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different requirements on a class of persons on account of their age, ancestry, color, disability,
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ethnicity, gender identity, genetic information, marital status, national origin, race, religion, sex, or
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sexual orientation.
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(d) On or before January 1, 2027, the department shall submit a report to the speaker of the
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house and president of the senate after consulting with the centers for Medicare & Medicaid
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Services on whether in vitro fertilization (IVF) is a medically reasonable and necessary procedure
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under federal law, possible methods for covering IVF as a Medicaid covered benefit for both fee-
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for-service and managed care organizations, including any potentially applicable waiver
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authorities, and the amount of money that would need to be allocated to federal and local funds for
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such coverage.
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(e) The provisions of this section shall apply to Medicaid state plans issued or renewed on
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or after January 1, 2027.
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SECTION 2. This act shall take effect upon passage.
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO STATE AFFAIRS AND GOVERNMENT -- THE RHODE ISLAND
MEDICAID REFORM ACT OF 2008
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This act would require Medicaid in this state to provide coverage for fertility diagnostic
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care, standard fertility preservation services, any medically necessary ovulation-enhancing drugs
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and medical services related to prescribing and monitoring the use of the ovulation-enhancing drugs
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for at least three cycles of ovulation-enhancing medication treatment, and intrauterine insemination.
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This act would take effect upon passage.
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