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DOI defines abortion-related care
January 19, 2023

Update issued: April 18, 2023
We have clarified the definition of abortion

This article is for providers caring for our members

The Reproductive and Gender-affirming Care Act (Chapter 127 of the Acts of 2022) became effective January 1, 2023 as accounts renew, as we noted in our news article about 2023 changes to our products and benefits. The law:

  • Mandates coverage for abortion and abortion-related care without cost share for fully-insured members for coverage upon renewal starting January 1, 2023.
    • Accounts that are church or church-controlled organizations may opt out.
    • Deductibles will apply to these services for high-deductible health plans, consistent with federal rules for HSAs.
  • Provides legal protections around abortion, abortion-related, and gender-affirming care.
  • Does not add new mandates related to gender-affirming care.

New guidance issued

The Division of Insurance recently issued Bulletin 2023-01 Relative to Abortion and Abortion-related Care. The Bulletin affirms the statutory definition of “abortion” as “any medical treatment intended to induce the termination of, or to terminate, a clinically diagnosable pregnancy except for the purpose of producing a live birth; provided, however, that ‘abortion’ shall not include providing care related to a miscarriage.” This definition includes surgical or medication-assisted (including Mifepristone in combination with Misoprostol or Misoprostal alone) abortions.

The Bulletin also affirms the application of an existing regulatory definition of “abortion-related care” to include the following services:

  1. Pre-operative evaluation and examination
  2. Pre-operative counseling
  3. Laboratory services, including pregnancy testing, blood type, and Rh factor
  4. Rh (D) immune globulin (human)
  5. Anesthesia (general or local)
  6. Post-operative care
  7. Follow-up
  8. Advice on contraception or referral to family planning services.