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(e) exclusions: experimental procedures, fertility drugs dispensed at a

licensed pharmacy, medical and other charges for surrogacy, donor

services/compensation in connection with pregnancy, storage of sperm,
eggs and/or embryo for longer than 6 months and high risk patients with

no reasonable expectation for pregnancy.
The Joint Committee on Health Benefits will work with the State and

Empire Plan carriers on the ongoing oversight of this benefit. Additionally,
ongoing Program oversight and evaluation of the lifetime coverage limit

will enable future modification if warranted.
§9.11 Empire Plan Voluntary Nurse Line

The medical component of the Empire Plan shall include a voluntary 24-
hour/7-days a week nurse-line feature to provide both clinical and benefit

information through a toll-free phone number.
The Joint Committee on Health Benefits will work with the State and

Empire Plan carriers on the ongoing oversight of this benefit.
§9.12 Empire Plan Disease Management Program

The Empire Plan medical component shall include a voluntary disease
management program. Disease Management covers those illnesses

identified to be chronic, high cost, impact quality of life, and rely
considerably on the patient's compliance with treatment protocols. The

current Integrated Disease Management Program includes, but is not
limited to: Chronic Obstructive Pulmonary Disease, Coronary Artery

Disease, Heart Failure, Asthma, Diabetes and Chronic Kidney Disease.
Nutritional services will be covered for those programs identified when

clinically appropriate.

The Joint Committee on Health Benefits will work with the State and
Empire Plan carriers on the selection, design, implementation and ongoing
oversight of the new and existing Disease Management Programs.

§9.13 Health Maintenance Organizations

Eligible employees in the State Health Insurance Plan may elect to
participate in a federally qualified or state certified Health Maintenance

Organization which has been approved to participate in the State Health
Insurance Program by the Joint Committee on Health Benefits. If more

than one HMO services the same geographic area, the Joint Committee on
Health Benefits reserves the right to approve a contract with only such

organization(s) deemed to be a quality, cost effective option(s). The Joint

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