SENATE HEALTH, HUMAN SERVICES AND SENIOR CITIZENS COMMITTEE

STATEMENT TO

[First Reprint]

ASSEMBLY, No. 5383

STATE OF NEW JERSEY

DATED:  DECEMBER 8, 2025

      The Senate Health, Human Services and Senior Citizens Committee reports favorably Assembly Bill No. 5383 (1R).

This bill requires Medicaid coverage for ovulation enhancing drugs and the medical services related to administering such drugs for certain beneficiaries who are experiencing infertility. 

     Specifically, the bill mandates that Medicaid is to provide coverage for expenses incurred in the provision of medically necessary ovulation enhancing drugs and the medical services related to prescribing and monitoring the use of such drugs for individuals 21 through 44 years of age who are experiencing infertility, provided that there is federal financial participation available.  As defined under the bill, “infertility” means a condition characterized by the incapacity to conceive, as defined by either:  the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse for individuals 21 through 34 years of age; or the failure to establish a clinical pregnancy after six months of regular, unprotected sexual intercourse for individuals 35 through 44 years of age.

     Medical services covered under the bill are limited to office visits, hysterosalpingograms, pelvic ultrasounds, and blood testing.  Moreover, coverage of ovulation enhancing drugs and medical services under the bill is limited to three cycles of treatment per lifetime of the beneficiary.

      As reported by the committee, Assembly Bill No. 5383 (1R) is identical to the Senate Committee Substitute for Senate Bill Nos. 4294 and 693, which was also reported by the committee on this date.