INFERTILITY TREATMENT: Employer Must Provide Coverage
In a "first of its kind" ruling in New York "and possibly in the country," the U.S. Equal Employment Opportunity Commission Tuesday determined that a company violated the Americans with Disabilities Act when it refused to "pay for an employee's infertility treatments," the New York Times reports. The case was brought by Rochelle Saks, an employee of the Franklin Covey Company, who filed suit last year "when the company's medical plan said she must pay almost $20,000 to the doctor who treated her" for infertility-related procedures. The Times reports that it is one of a series of cases that have come before the agency "mostly as the result of" the Supreme Court decision in Abbott v. Bragdon, which determined that reproduction is a "major life activity," and that "those who could not bear children were protected under" the ADA. Many infertility advocates hoped that the decision would eventually lead to broader coverage for infertility treatments. Based on the Bragdon precedent, the EEOC ruled that the woman's employer "had not provided adequate infertility- related benefits and that 'exclusion of medically necessary treatments for infertility,'" is an ADA violation. The New York Times reports that the company now has the option of settling the case administratively, or allowing it to move into the federal courts. Elizabeth Grossman, a supervisory trial lawyer for the EEOC's New York district office, said that "few infertility coverage cases have advanced from the administrative realm to court, where a ruling by a federal judge could have a huge impact on whether companies and insurers must pay for infertility procedures." In a statement, Franklin Covey said, "This is an insurance industrywide issue, and it's only the beginning of an E.E.O.C. administrative process that will continue to evolve" (Kennedy, New York Times, 4/29).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.