NEW YORK STATE
INSURANCE DEPARTMENT

THIRTY-SECOND AMENDMENT TO REGULATION NO. 62
(11 NYCRR 52)

MINIMUM STANDARDS FOR THE FORM, CONTENT AND SALE OF HEALTH INSURANCE, INCLUDING STANDARDS FOR FULL AND FAIR DISCLOSURE

I, GREGORY V. SERIO, Superintendent of Insurance of the State of New York, pursuant to the authority granted by Chapter 82, Laws of 2002 and by Sections 201, 301, 1109, 3201, 3217, 3221 and 4303 of the Insurance Law, do hereby promulgate the following thirty-second amendment to Part 52 of Title 11 of the Official Compilation of Codes, Rules and Regulations of the State of New York (Regulation No. 62), to take effect upon publication in the State Register.

(ALL MATTER NEW)

Section 52.17(a) is amended by adding a new paragraph (35) to read as follows:

(35) Insurers issuing policies and contracts subject to the provisions of Section 4303(s) of the Insurance Law shall use standards and guidelines no less favorable than those established and adopted by the American Society for Reproductive Medicine in relation to the following:

(i) the determination of infertility for purposes of compliance with Section 4303(s)(3) of the Insurance Law;

(ii) the identification of experimental procedures and treatments not covered for the diagnosis and treatment of infertility;

(iii) the identification of the required training, experience and other standards for health care providers for the provision of procedures and treatments for the diagnosis and treatment of infertility; and

(iv)    the determination of appropriate medical candidates by the treating physician.

Said standards and guidelines are taken from The American Society for Reproductive Medicine’s Practice Committee Opinions on The Definition of Experimental, The Definition of Infertility, The Guidelines for the Provision of Infertility Services and The Revised Minimum Standards for In Vitro Fertilization, Gamete Intrafallopian Transfer and Related Procedures. These Practice Committee Opinions were approved by the Practice Committee of the American Society for Reproductive Medicine (Formerly The American Fertility Society) on March 27, 1993 and approved by the Board of Directors of the American Society for Reproductive Medicine (Formerly The American Fertility Society) on May 17, 1993. The Practice Committee Opinions can be obtained from The American Society for Reproductive Medicine Formerly The American Fertility Society 1209 Montgomery Highway, Birmingham, Alabama 35216-2809 and are available for public inspection and copying from The New York State Insurance Department at either 25 Beaver Street, New York, New York 10004 or One Commerce Plaza, Albany, New York 12257.

Section 52.18(a) is amended by adding a new paragraph (10) to read as follows:

(10) Insurers issuing policies and contracts subject to the provisions of Sections 3221(k)(6) or 4303(s) of the Insurance Law shall use standards and guidelines no less favorable than those established and adopted by the American Society for Reproductive Medicine in relation to the following:

(i) the determination of infertility for the purposes of compliance with Sections 3221(k)(6)(C) and 4303(s)(3) of the Insurance Law;

(ii) the identification of experimental procedures and treatments not covered for the diagnosis and treatment of infertility;

(iii) the identification of the required training, experience and other standards for health care providers for the provision of procedures and treatments for the diagnosis and treatment of infertility; and

(iv) the determination of appropriate medical candidates by the treating physician.

Said standards and guidelines are taken from The American Society for Reproductive Medicine’s Practice Committee Opinions on The Definition of Experimental, The Definition of Infertility, The Guidelines for the Provision of Infertility Services and The Revised Minimum Standards for In Vitro Fertilization, Gamete Intrafallopian Transfer and Related Procedures. These Practice Committee Opinions were approved by the Practice Committee of the American Society for Reproductive Medicine (Formerly the American Fertility Society) on March 27, 1993 and approved by the Board of Directors of the American Society for Reproductive Medicine (Formerly the American Fertility Society) on May 17, 1993. The Practice Committee Opinions may be obtained from the American Society for Reproductive Medicine Formerly The American Fertility Society 1209 Montgomery Highway, Birmingham, Alabama 35216-2809 and are available for public inspection and copying from the New York State Insurance Department at either 25 Beaver Street, New York, New York 10004 or One Commerce Plaza, Albany, New York 12257.

I, GREGORY V. SERIO, Superintendent of Insurance of the State of New York, do hereby certify that the foregoing Thirty-second Amendment to 11 NYCRR Part 52 (Regulation 62) was duly adopted by me on this day pursuant to the authority granted by Chapter 82, Laws of 2002 and Sections 201, 301, 1109, 3201, 3217, 3221 and 4303 of the Insurance Law, to take effect upon publication in the State Register.

A prior notice of this regulation amendment was published in the State Register on August 11, 2004 as a Notice of Proposed Rulemaking. No other publication or prior notice is required by statute.

 

__________________________________________

Gregory V. Serio
Superintendent of Insurance

October 6, 2004