Federal Legislation Needed To Improve Oversight Of In Vitro Fertilization, Opinion Piece States

Main Category: Fertility
Also Included In: Health Insurance / Medical Insurance
Article Date: 25 Jun 2009 - 5:00 PDT

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The Family Building Act of 2009 (H.R. 697, S. 1258) "takes an important first step toward improving the way insurers view infertility," but it is "not a silver bullet for improving the way [in vitro fertilization] treatments are conducted and covered," John Zhang, founder and director of the New Hope Fertility Center in New York City, writes in an opinion piece in The Hill. The bill, introduced by Rep. Anthony Weiner (D-N.Y.) in the House and Sen. Kirsten Gillibrand (D-N.Y.) in the Senate, would require health insurance companies that cover obstetrical services to cover non-experimental treatment of infertility, including IVF.

Zhang writes that one of the "most significant issues is that multiple-embryo transfers have become common practice," which increase the risk for premature delivery, contribute to infant mortality rates and add to costs. According to Zhang, the lack of federal guidelines, "coupled with failure by the insurance industry to cover IVF treatment in the U.S., has encouraged patients to insist on multiple embryo transfer to get the most out of the enormous out-of-pocket fees they incur per cycle." In addition, "because doctors are rewarded for better success rates, the emphasis moves from quality to quantity so that clinics may boost their success rates despite potentially dangerous and expensive health complications," Zhang writes.

Zhang continues that if IVF "were more accessible and reimbursed by health insurers, and if embryo transfers were regulated, there would be consequences for clinics and physicians who practice irresponsibly," and it "would be nearly impossible for IVF to lead to high-order multiples with their attendant risks." Although the Family Building Act "addresses this problem from an insurance perspective, it does not incorporate all the critical pieces that would encourage more responsible IVF practices among patients and physicians," according to Zhang.

Zhang suggests that lawmakers "set age limitations on insurance coverage to encourage responsible spending" and that regulators "revise the outdated IVF reporting system and start providing incentives that encourage responsible medical practices." He concludes that it is "crucial that legislators and doctors work together to create a regulated and safe environment for IVF patients that upholds the integrity of our country's medical profession" (Zhang, The Hill, 6/22).

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