SENATE HEALTH, HUMAN SERVICES AND SENIOR CITIZENS COMMITTEE
STATEMENT TO
SENATE COMMITTEE SUBSTITUTE FOR
SENATE, Nos. 4294 and 693
STATE OF NEW JERSEY
DATED: DECEMBER 4, 2025
The Senate Health, Human Services and Senior Citizens Committee reports favorably a Senate Committee Substitute for Senate Bill Nos. 4294 and 693.
This substitute 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