,i  #aah? ,,congress  #b;d ,session  ,h4
 ,r4 #ifdc  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,septemb] #ag1        
#bjbd,ms4 ,wild 7= h]self1 ,mr4         
,connolly1 ,ms4 ,de,lauro1 & ,mr4 ,l>s5 
( ,wa%+ton7 introduc$ ! foll[+ bill2 :i*
 0 ref]r$ to ! ,committee on ,en]gy &   
,comm]ce1 & 9 addition to ! ,committees 
on ,vet]ans' ,affairs1 ,arm$ ,s]vices1  
,education & ! ,work=ce1 ,ways & ,means1
 & ,ov]sight & ,acc\ntability1 = a p]iod
 to be subsequ5tly det]m9$ by ! ,speak]1
 9 ea* case = consid]ation ( su*        
provisions z fall )9 ! jurisdiction ( ! 
committee conc]n$  ,a ,,bill  ,to       
protect & exp& nationwide access to     
f]tility treatm5t1 includ+ 9 vitro      
f]tilization4  #a4 ,%ort title2 table ( 
cont5ts  7a7 ,%ort title ,?is ,act may  
be cit$ z ! ,"r to ,,ivf ,act4  7b7     
,table ( cont5ts ,! table ( cont5ts =   
?is ,act is z foll[s3 ,sec4 #a4 ,%ort   
title2 table ( cont5ts4,sec4 #b4        
,sev]ability4,,title ,i--,access to     
,family ,building,sec4 #aja4 ,%ort      

title4,sec4 #ajb4 ,purposes4,sec4 #ajc4 
,def9itions4,sec4 #ajd4 ,f]tility       
treatm5t rights4,sec4 #aje4             
,applicability & preemption4,,title     
,,ii--,vet]an ,families ,heal?          
,services,sec4 #bjj4 ,%ort              
title4,subtitle ,a--,reproductive &     
f]tility pres]vation assi/ance = memb]s 
( ! uni=m$ services,sec4 #bja4          
,def9itions4,sec4 #bjb4 ,provision (    
f]tility treatm5t & c\nsel+ to c]ta9    
memb]s ( ! uni=m$ s]vices & sp\ses1     
p>tn]s1 & ge/ational surrogates ( su*   
memb]s4,sec4 #bjc4 ,e/abli%m5t (        
f]tility pres]vation proc$ures aft] an  
injury or illness4,sec4 #bjd4           
,cryopres]vation & /orage ( reproductive
 g5etic mat]ial ( memb]s ( ! uni=m$     
s]vices on active duty4,sec4 #bje4      
,assi/ance ) & cont9uity ( c>e reg>d+   
reproductive & f]tility pres]vation     
s]vices4,sec4 #bjf4 ,coord9ation betwe5 
,dep>tm5t ( ,def5se & ,dep>tm5t (       
,vet]ans ,affairs on furni%+ ( f]tility 
treatm5t & c\nsel+4,sec4 #bjg4          

,regulations4,subtitle ,b--,reproductive
 assi/ance = veterans,sec4 #baa4        
,inclusion ( f]tility treatm5t & c\nsel+
 "u ! def9ition ( m$ical s]vices 9 title
 #ch4,sec4 #bab4 ,f]tility treatm5t &   
c\nsel+ = c]ta9 vet]ans & sp\ses1       
p>tn]s1 & ge/ational surrogates ( su*   
vet]ans4,sec4 #bac4 ,assi/ance ) &      
cont9uity ( c>e reg>d+ reproductive &   
f]tility pres]vation s]vices4,sec4 #bad4
 ,coord9ation ( reproduction & f]tility 
rese>* = vet]ans4,,title ,,iii--,access 
to f]tility treatm5t & care,sec4 #cja4  
,%ort title4,sec4 #cjb4 ,/&>ds relat+ to
 b5efits = f]tility treatm5t4,sec4 #cjc4
 ,requirem5t = ,/ate ,m$icaid plans ,to 
provide m$ical assi/ance = f]tility     
treatm5t4,sec4 #cjd4 ,m$ic>e cov]age (  
f]tility treatm5t4,,title ,,iv--,family 
build+ ,,fehb fairness,sec4 #dja4 ,%ort 
title4,sec4 #djb4 ,f]tility treatm5t    
b5efits4  #b4 ,sev]ability ,if any      
provision ( ?is ,act1 or ! application (
 su* provision to any p]son1 entity1    
gov]nm5t1 or circum/ance is held to be  

uncon/itutional1 ! rema9d] ( ?is ,act1  
or ! application ( su* provision to all 
o!r p]sons1 entities1 gov]nm5ts1 or     
circum/ances %all n be affect$ !reby4   
,i ,access to ,family ,build+  #aja4    
,%ort title ,?is title may be cit$ z !  
,access to ,family ,build+ ,act4  #ajb4 
,purposes ,! purposes ( ?is title are z 
foll[s3 7#a7 ,to p]mit pati5ts to seek &
 receive f]tility treatm5t1 includ+     
assi/$ reproductive te*nology s]vices1 &
 to p]mit heal? c>e provid]s t *oose to 
provide f]tility treatm5t1 to provide   
su* s]vices )\t ,/ates enact+ h>mful or 
unw>rant$ limitations or requirem5ts t  
s+le out ! provision ( assi/$           
reproductive s]vices = re/rictions t are
 n consi/5t ) widely accept$ &          
evid5ce-bas$ m$ical /&>ds ( c>e1 & :i* d
 n significantly advance reproductive   
heal? or ! efficacy & safety ( f]tility 
treatm5t1 or make f]tility treatm5t m   
difficult to access4  7#b7 ,to promote !
 "r & ability ( a pati5t resid+ 9 any   
,/ate to *oose to receive f]tility      

treatm5t provid$ 9 accordance ) widely  
accept$ & evid5ce-bas$ m$ical /&>ds (   
c>e by a heal? c>e provid] :o *ooses to 
provide su* s]vices4  7#c7 ,to protect  
an individual's "r to make decisions1 9 
consultation ) ! individual's heal? c>e 
provid]1 ab\t ! mo/ appropriate m$ical  
c>e to maximize ! *ance ( becom+        
pregnant & giv+ bir? to a heal?y1 liv+1 
human *ild ) ! help ( f]tility treatm5t4
  #ajc4 ,def9itions ,9 ?is title3 7#a7  
,f]tility treatm5t ,! t]m f]tility      
treatm5t includes ! foll[+3 7,a7        
,pres]vation ( human oocytes1 sp]m1 or  
embryos = lat] reproductive use4  7,b7  
,artificial insem9ation1 includ+        
intravag9al insem9ation1 intrac]vical   
insem9ation1 & intraut]9e insem9ation4  
7,c7 ,assi/$ reproductive te*nology1    
includ+ 9 vitro f]tilization & o!r      
treatm5ts or proc$ures 9 :i*            
reproductive g5etic mat]ial1 su* z      
oocytes1 sp]m1 f]tiliz$ eggs1 & embryos1
 are h&l$1 :5 cl9ically appropriate4    
7,d7 ,g5etic te/+ ( embryos4  7,e7      

,m$ications prescrib$ or obta9$         
ov]-!-c\nt]1 z indicat$ = f]tility4     
7,f7 ,gamete donation4  7,g7 ,su* o!r   
in=mation1 ref]rals1 treatm5ts1         
proc$ures1 m$ications1 laboratory te/+1 
te*nologies1 & s]vices relat+ to        
f]tility z ! ,secret>y ( ,heal? & ,human
 ,s]vices det]m9es appropriate4  7#b7   
,heal? c>e provid] ,! t]m heal? c>e     
provid] means any entity or individual  
7includ+ any physician1 nurse           
practition]1 physician assi/ant1        
ph>maci/1 heal? c>e support p]sonnel1   
cl9ical /aff1 & any o!r individual1 z   
det]m9$ by ! ,secret>y ( ,heal? & ,human
 ,s]vices7 t-- 7,a7 is engag$ or seeks  
to engage 9 ! deliv]y ( f]tility        
treatm5t1 includ+ ?r\gh ! provision (   
evid5ce-bas$ in=mation1 c\nsel+1        
ref]rals1 or items & s]vices t relate   
to1 aid 91 or provide f]tility treatm5t2
 &  7,b7 if requir$ by ,/ate law to be  
lic5s$1 c]tifi$1 or o!rwise au?oriz$ to 
engage 9 ! deliv]y ( su* s]vices-- 7i7  
is s lic5s$1 c]tifi$1 or o!rwise        

au?oriz$2 or  7ii7 w\ld be s lic5s$1    
c]tifi$1 or o!rwise au?oriz$ b = ! fact 
t ! individual or entity has provid$1 is
 provid+1 or plans to provide f]tility  
treatm5t 9 accordance ) section #ajd4   
7#c7 ,heal? insurance issu] ,! t]m heal?
 insurance issu] has ! mean+ giv5 su*   
t]m 9 section #bgia7;b7 ( ! ,public     
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjj;gg-#ia7;b774  7#d7 ,manufactur] ,! 
t]m manufactur] means ! manufactur] ( a 
drug or device approv$1 cle>$1 au?oriz$1
 or lic5s$ "u section #eje1 #eaj7k71    
#eac7;f77#b71 or #eae ( ! ,f$]al ,food1 
,drug1 & ,cosmetic ,act 7#ba ,u4,s4,c4  
#cee1 #cfj7k71 #cfj;c7f77#b71 #cfj;e7 or
 section #cea ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #bfb7 or o!rwise   
legally m>ket$4  7#e7 ,/ate ,! t]m ,/ate
 includes ea* ( ! #ej ,/ates1 ! ,di/rict
 ( ,columbia1 ,pu]to ,rico1 ea* t]ritory
 & possession ( ! ,unit$ ,/ates1 & any  
political subdivision !re(4  7#f7       
,widely accept$ & evid5ce-bas$ m$ical   
/&>ds ( c>e ,! t]m widely accept$ &     

evid5ce-bas$ m$ical /&>ds ( c>e means   
any m$ical s]vices1 proc$ures1 &        
practices t are 9 accordance ) !        
guidel9es ( ! ,am]ican ,society =       
,reproductive ,m$ic9e4  #ajd4 ,f]tility 
treatm5t rights  7a7 ,g5]al rule  7#a7  
,individual rights ,an individual has a 
/atutory "r "u ?is title1 )\t           
prohibition1 limitation1 int]f]5ce1 or  
imp$im5t1 to ! ext5t t su* prohibition1 
limitation1 int]f]5ce1 or imp$im5t 9 any
 way or degree ob/ructs1 delays1 or     
affects comm]ce ov] :i* ! ,f$]al        
,gov]nm5t has jurisdiction1 to-- 7,a7   
receive f]tility treatm5t f a heal? c>e 
provid]1 9 accordance ) widely accept$ &
 evid5ce-bas$ m$ical /&>ds ( c>e2  7,b7 
cont9ue or complete an ongo+ f]tility   
treatm5t previ\sly initiat$ by a heal?  
c>e provid]1 9 accordance ) widely      
accept$ & evid5ce-bas$ m$ical /&>ds (   
c>e2  7,c7 make decisions & arrangem5ts 
reg>d+ ! donation1 te/+1 use1 /orage1 or
 disposition ( reproductive g5etic      
mat]ial1 su* z oocytes1 sp]m1 f]tiliz$  

eggs1 & embryos2 &  7,d7 e/abli%        
contractual agreem5ts ) a heal? c>e     
provid] relat+ to ! heal? c>e provid]'s 
s]vices 9 h&l+1 te/+1 /or+1 %ipp+1 &    
dispos+ ( ! individual's reproductive   
g5etic mat]ial 9 accordance ) widely    
accept$ & evid5ce-bas$ m$ical /&>ds (   
c>e4  7#b7 ,heal? c>e provid] rights ,a 
heal? c>e provid] has a /atutory "r "u  
?is title1 )\t prohibition1 limitation1 
int]f]5ce1 or imp$im5t1 to ! ext5t t su*
 prohibition1 limitation1 int]f]5ce1 or 
imp$im5t 9 any way or degree ob/ructs1  
delays1 or affects comm]ce ov] :i* !    
,f$]al ,gov]nm5t has jurisdiction1 to-- 
7,a7 provide1 or assi/ ) ! provision (1 
f]tility treatm5t provid$ 9 accordance )
 widely accept$ & evid5ce-bas$ m$ical   
/&>ds ( c>e2  7,b7 cont9ue or complete !
 provision (1 or assi/ance )1 f]tility  
treatm5t t 0 lawful :5 comm5c$ & is     
provid$ 9 accordance ) widely accept$ & 
evid5ce-bas$ m$ical /&>ds ( c>e2  7,c7  
provide =1 or assi/ )1 ! te/+1 use1     
/orage1 or disposition ( reproductive   

g5etic mat]ial1 su* z oocytes1 sp]m1    
f]tiliz$ eggs1 & embryos1 9 accordance )
 widely accept$ & evid5ce-bas$ m$ical   
/&>ds ( c>e2 &  7,d7 e/abli% contractual
 agreem5ts ) individuals or manufactur]s
 relat+ to ! heal? c>e provid]'s s]vices
 9 h&l+1 te/+1 /or+1 %ipp+1 & dispos+ ( 
! individual's reproductive g5etic      
mat]ial4  7#c7 ,heal? insurance issu]   
rights ,a heal? insurance issu] has a   
/atutory "r "u ?is title1 )\t           
prohibition1 limitation1 int]f]5ce1 or  
imp$im5t1 to ! ext5t t su* prohibition1 
limitation1 int]f]5ce1 or imp$im5t 9 any
 way or degree ob/ructs1 delays1 or     
affects comm]ce ov] :i* ! ,f$]al        
,gov]nm5t has jurisdiction1 to cov] !   
provision ( f]tility treatm5t provid$ 9 
accordance ) widely accept$ &           
evid5ce-bas$ m$ical /&>ds ( c>e4  7#d7  
,manufactur] rights ,a manufactur] ( a  
drug or device t is approv$1 cle>$1     
au?oriz$1 or lic5s$ "u section #eje1    
#eaj7k71 #eac7;f77#b71 or #eae ( !      
,f$]al ,food1 ,drug1 & ,cosmetic ,act   

7#ba ,u4,s4,c4 #cee2 #cfj7k72           
#cfj;c7f77#b72 #cfj;e7 or section #cea (
 ! ,public ,heal? ,s]vice ,act 7#db     
,u4,s4,c4 #bfb7 or o!rwise legally      
m>ket$ & int5d$ = use 9 ! provision (   
f]tility treatm5t1 includ+ ! /orage or  
transport ( oocytes1 gametes1 f]tiliz$  
eggs1 & embryos1 has a /atutory "r "u   
?is title1 )\t prohibition1 limitation1 
int]f]5ce1 or imp$im5t1 to ! ext5t t su*
 prohibition1 limitation1 int]f]5ce1 or 
imp$im5t 9 any way or degree ob/ructs1  
delays1 or affects comm]ce ov] :i* !    
,f$]al ,gov]nm5t has jurisdiction1 to   
manufacture1 import1 m>ket1 sell1 &     
di/ribute su* drug or device4  7b7 ,/ate
 regulation ( m$ic9e ,! en=cem5t ( ,/ate
 heal? & safety law reg>d+ m$ical       
facilities or heal? c>e provid]s does n 
con/itute a violation ( subsection 7a7  
if-- 7#a7 su* regulations are 9         
accordance ) widely accept$ &           
evid5ce-bas$ m$ical /&>ds ( c>e =       
provid+ f]tility treatm5t2 &  7#b7 !    
safety or heal? objective _c be advanc$ 

by a diff]5t means t does n prohibit1   
limit1 int]f]e )1 or imp$e ! rights     
describ$ 9 subsection 7a74  7c7         
,en=cem5t  7#a7 ,! ,attorney ,g5]al     
7,a7 ,9 g5]al ,! ,attorney ,g5]al may   
comm5ce a civil action on behalf ( !    
,unit$ ,/ates aga9/ any ,/ate2 an       
individual1 employee1 (ficial1 ag5cy    
head1 contractor1 organization1 or      
in/rum5tality act+ =1 or on behalf (1   
su* a ,/ate2 or any individual act+ "u !
 color (1 or pursuant to1 ,/ate law1 t  
implem5ts1 en=ces1 or ?reat5s to en=ce a
 limitation or requirem5t t prohibits1  
limits1 int]f]es )1 or imp$es ! /atutory
 rights ( an individual1 a heal? c>e    
provid]1 a heal? insurance issu]1 or a  
manufactur] "u subsection 7a74  7,b7    
,effect ( violations ,! c\rt %all hold  
unlawful & set aside a limitation or    
requirem5t describ$ 9 subp>agraph 7,a7  
if x is 9 violation ( subsection 7a74   
7#b7 ,private "r ( action  7,a7 ,9 g5]al
 ,any individual or entity adv]sely     
affect$ by an alleg$ violation (        

subsection 7a7 may comm5ce a civil      
action aga9/ an individual1 employee1   
(ficial1 ag5cy head1 contractor1        
organization1 or in/rum5tality act+ =1  
or on behalf (1 su* a ,/ate t enacts1   
implem5ts1 or en=ces a limitation or    
requirem5t t prohibits1 limits1 int]f]es
 )1 or imp$es ! /atutory rights ( an    
individual1 a heal? c>e provid]1 a heal?
 insurance issu]1 or a manufactur] "u   
subsection 7a74  7,b7 ,effect (         
violations ,! c\rt %all hold unlawful & 
enjo9 a limitation or requirem5t        
describ$ 9 subp>agraph 7,a7 if x is 9   
violation ( subsection 7a74  7#c7 ,heal?
 c>e provid]  7,a7 ,9 g5]al ,a heal? c>e
 provid] may comm5ce a civil action =   
relief on su* provid]'s own behalf1 on  
behalf ( ! provid]'s /aff1 or on behalf 
( ! provid]'s pati5ts :o are or may be  
adv]sely affect$ by an alleg$ violation 
( subsection 7a74  7,b7 ,effect (       
violations ,! c\rt %all hold unlawful & 
enjo9 a limitation or requirem5t        
describ$ 9 subp>agraph 7,a7 if x is 9   

violation ( subsection 7a74  7#d7       
,equitable relief ,9 any action "u ?is  
section1 ! c\rt may aw>d appropriate    
equitable relief1 includ+ tempor>y1     
prelim9>y1 or p]man5t injunctive relief4
  7#e7 ,co/s  7,a7 ,9 g5]al ,9 any      
action "u ?is section1 ! c\rt %all aw>d 
co/s ( litigation1 z well z reasonable  
attorney's fees1 to any prevail+        
pla9tiff4  7,b7 ,liability ( pla9tiffs  
,a pla9tiff %all n be liable to a       
def5dant = co/s or attorney's fees 9 any
 non-frivol\s action "u ?is section     
unless su* co/s or attorney's fees are  
impos$ by ! c\rt z "p ( sanctions =     
violations committ$ dur+ ! discov]y     
process4  7#f7 ,jurisdiction ,! di/rict 
c\rts ( ! ,unit$ ,/ates %all h          
jurisdiction ov] proce$+s "u ?is section
 & %all ex]cise ! same )\t reg>d to :e!r
 ! p>ty aggriev$ %all h exhau/$ any     
adm9i/rative or o!r rem$ies t may be    
provid$ = by law4  7#g7 ,"r to remove   
7,a7 ,9 g5]al ,any p>ty %all h a "r to  
remove an action br\ght "u ?is          

subsection to ! di/rict c\rt ( ! ,unit$ 
,/ates = ! di/rict & division embrac+ ! 
place :]e su* action is p5d+4  7,b7     
,review ,an ord] rem&+ ! case to ! ,/ate
 c\rt f :i* x 0 remov$ "u ?is p>agraph  
is imm$iately reviewable by appeal or   
o!rwise4  7d7 ,regulations ,n lat] ?an  
#ahj days aft] ! date ( enactm5t ( ?is  
,act1 ! ,secret>y ( ,heal? & ,human     
,s]vices %all promulgate regulations to 
c>ry out ?is section4  7e7 ,rules (     
con/ruction  7#a7 ,9 g5]al ,= purposes (
 ?is title1 a ,/ate law1 or !           
adm9i/ration1 implem5tation1 or en=cem5t
 ( a ,/ate law1 con/itutes a            
prohibition1 limitation1 int]f]5ce1 or  
imp$im5t on a heal? c>e provid] provid+1
 an individual receiv+1 a heal?         
insurance issu] cov]+1 or a manufactur] 
m>ket+ drugs or devices = f]tility      
treatm5t1 provid$ 9 accordance ) widely 
accept$ & evid5ce-bas$ m$ical /&>ds (   
c>e1 z describ$ 9 subsection #ajd1 if ! 
adm9i/ration1 implem5tation1            
int]pretation1 or en=cem5t ( su* law has

 an effect t-- 7,a7 imposes requirem5ts 
or limitations t are inconsi/5t )       
provid+1 receiv+1 provid+ heal?         
insurance cov]age =1 or provid+ drugs or
 devices = f]tility treatm5t 9          
accordance ) widely accept$ &           
evid5ce-bas$ m$ical /&>ds ( c>e or t    
o!rwise violate ! purpose & requirem5ts 
( ?is ,act1 :i* may include-- 7i7       
requir+ t a heal? c>e provid] provide1 &
 pati5ts und]take1 m$ically unnecess>y  
proc$ures & s]vices1 includ+ te/s &     
proc$ures1 provid+ m$ically inaccurate  
in=mation reg>d+ f]tility treatm5t1 or  
requir+ additional unnecess>y 9-p]son   
visits to a heal? c>e provid]1 t are    
inconsi/5t ) widely accept$ &           
evid5ce-bas$ m$ical /&>ds ( c>e2  7ii7  
impos+ limitations or requirem5ts       
conc]n+ physical (fices1 cl9ics1        
facilities1 equipm5t1 /aff+1 or hospital
 transf] arrangem5ts ( facilities :]e   
f]tility treatm5t is provid$1 or !      
cr$5tials or hospital privileges or     
/atus ( p]sonnel at su* facilities1 t   

are n consi/5t ) widely accept$ &       
evid5ce-bas$ m$ical /&>ds ( c>e2 or     
7iii7 limit+ a heal? c>e provid]'s "r or
 ability to provide1 or a pati5t's "r to
 receive1 or impos+ limitations t r$uce 
! efficacy (1 f]tility treatm5t 9       
accordance ) widely accept$ &           
evid5ce-bas$ m$ical /&>ds ( c>e1 includ+
 retrieval ( multiple eggs dur+ oocyte  
retrieval2 p]=mance ( insem9ation       
proc$ures1 includ+ intraut]9e           
insem9ation2 intracytoplasmic sp]m      
injections to f]tilize multiple human   
eggs2 & cryopres]vation ( "o or m eggs  
or embryos = f]tility pres]vation &     
subsequ5t transf]1 if det]m9$           
appropriate by ! heal? c>e provid] &    
pati5t2  7,b7 infr+es1 limits1 or       
re/ricts ! ability ( a heal? c>e        
provid]1 pati5t1 heal? insurance issu]1 
or manufactur]1 to ex]cise or en=ce _!  
/atutory rights "u ?is title on ! basis 
( m>ital /atus1 sex 7includ+ sexual     
ori5tation & g5d] id5tity7 or any o!r   
protect$ class t is cov]$ by ,f$]al law2

  7,c7 limits a heal? c>e provid]'s or  
pati5t's "r or ability to det]m9e ! mo/ 
appropriate disposition ( f]tiliz$ eggs 
or embryos1 includ+ by def9+ a gamete or
 embryo 9 su* a way z to prev5t !       
disposition ( gametes & embryos2  7,d7  
limits a heal? c>e provid]'s ability to 
provide1 or a pati5t's ability to       
receive1 f]tility treatm5t via          
telem$ic9e1 9 accordance ) widely       
accept$ & evid5ce-bas$ m$ical /&>ds (   
c>e2  7,e7 limits or prohibits a heal?  
c>e provid]'s ability to provide1 or a  
pati5t's ability to receive1 f]tility   
c\nsel+ or f]tility treatm5t bas$ on !  
resid5cy ( ! pati5t1 or prohibits or    
limits ! ability ( any individual to    
assi/ or support a pati5t seek+ f]tility
 treatm5t2  7,f7 imposes requirem5ts or 
limitations t compel heal? c>e provid]s 
to provide1 or pati5ts to receive1      
m$ically unnecess>y c>e1 or )hold       
m$ically necess>y c>e1 9 a mann] t is n 
consi/5t ) widely accept$ & evid5ce-bas$
 m$ical /&>ds ( c>e = f]tility treatm5t1

 includ+ m&at+ ! transf] ( embryos t a  
heal? c>e provid] w\ld n reasonably     
expect1 bas$ on widely accept$ &        
evid5ce-bas$ m$ical /&>ds ( c>e1 to lead
 to a heal?y pregnancy or a live bir?2  
7,g7 limits a heal? c>e provid]'s "r or 
ability to prescribe or disp5se1 or a   
pati5t's "r or ability to receive or    
use1 m$ications = f]tility treatm5t 9   
accordance ) widely accept$ &           
evid5ce-bas$ m$ical /&>ds ( c>e1 unless 
su* a limitation is g5]ally applicable  
to ! prescription1 disp5s+1 or          
di/ribution ( m$ications2 or  7,h7      
limits a heal? c>e provid]'s "r or      
ability to p]=m a human sp]m retrieval  
proc$ure 9 accordance ) widely accept$ &
 evid5ce-bas$ m$ical /&>ds ( c>e4  7#b7 
,cl>ification ,! descriptions ( specific
 ,/ate laws t w\ld violate ! /atutory   
rights & protections describ$ 9 p>agraph
 7#a7 %all n be con/ru$ to limit        
pot5tial violations ( ! /atutory rights 
& protections "u ?is title to only !    
re/rictions & limitations li/$ 9        

p>agraph 7#a71 & pot5tial violations (  
?is title may result f novel ,/ate      
re/rictions & limitations t are n li/$  
"u p>agraph 7#a74  7#c7 ,exclusion ,x   
%all n con/itute a prohibition1         
limitation1 int]f]5ce1 or imp$im5t to a 
heal? c>e provid] provid+1 an individual
 receiv+1 a heal? insurance issu] cov]+1
 or a manufactur] m>ket+ a drug or      
device = purposes (1 f]tility treatm5t  
"u ?is title = an entity to act 9       
compliance ) ! ,food & ,drug            
,adm9i/ration's regulation ( drugs1     
devices1 biological products1 human     
cells1 tissues1 or cellul> or           
tissue-bas$ products us$ 9 f]tility     
treatm5t1 consi/5t ) widely accept$ &   
evid5ce-bas$ m$ical /&>ds ( c>e =       
f]tility treatm5t4  #aje4 ,applicability
 & preemption  7a7 ,9 g5]al  7#a7 ,g5]al
 application  7,a7 ,effect on ,/ate law 
,?is title sup]s$es any ,/ate law t is  
inconsi/5t ) ! /atutory rights e/abli%$ 
"u ?is title & precludes ! implem5tation
 ( su* a law1 :e!r /atutory1 common law1

 or o!rwise1 & :e!r adopt$ be=e or aft] 
! date ( enactm5t ( ?is ,act4  7,b7     
,prohibition ,no ,/ate %all adm9i/]1    
implem5t1 or en=ce any law1 rule1       
regulation1 /&>d1 or o!r provision hav+ 
! =ce & effect ( law t conflicts ) any  
provision ( ?is title1 not)/&+ any o!r  
provision ( ,f$]al law4  7#b7 ,exclusion
 ,preemption ( ,/ate law "u p>agraph    
7#a7 does n apply to-- 7,a7 ,/ate law   
reg>d+ ! resolution ( disputes betwe5 #b
 individuals ) rights describ$ 9 section
 #ajd7;a77#a7 ) respect to ! same       
reproductive g5etic mat]ial1 su* z      
oocytes1 sp]m1 f]tiliz$ eggs1 & embryos2
 or  7,b7 any o!r ,/ate law1 to ! ext5t 
t su* law does n conflict ) ?is title & 
protects an individual's "r & ability to
 receive f]tility treatm5t 9 accordance 
) widely accept$ & evid5ce-bas$ m$ical  
/&>ds ( c>e1 includ+ any su* law t holds
 a heal? c>e provid] acc\ntable = n     
provid+ f]tility treatm5t 9 accordance )
 widely accept$ & evid5ce-bas$ m$ical   
/&>ds ( c>e4  7#c7 ,pres]vation ( ,f$]al

 public heal? au?orities ,no?+ 9 ?is    
title %all h ! effect ( sup]s$+1 negat+1
 or limit+ provisions ( ,f$]al law1     
includ+ ! ,f$]al ,food1 ,drug1 &        
,cosmetic ,act 7#ba ,u4,s4,c4 #cja et   
seq47 or ! ,public ,heal? ,s]vice ,act  
7#db ,u4,s4,c4 #bja et seq471 &         
regulations promulgat$ "u su* /atutes1 )
 respect to ! regulation ( drugs1       
devices1 biological products1 human     
cells1 tissues1 or cellul> or           
tissue-bas$ products us$ 9 f]tility     
treatm5t4  7#d7 ,pres]vation ( ,,hipaa  
rules ,no?+ 9 ?is title %all h ! effect 
( sup]s$+1 negat+1 or limit+ !          
provisions ( ! privacy1 security1 &     
brea* notification regulations 9 p>ts   
#afj & #afd ( title #de1 ,code ( ,f$]al 
,regulations 7or successor regulations74
  7#e7 ,subsequ5tly enact$ ,f$]al       
legislation ,f$]al /atutory law adopt$  
aft] ! date ( ! enactm5t ( ?is ,act is  
subject to ?is title unless su* law     
explicitly excludes su* application by  
ref]5ce to ?is title4  7b7 ,def5se ,9   

any cause ( action aga9/ an individual  
or entity :o is subject to a limitation 
or requirem5t t violates ?is title1 9   
addition to ! rem$ies specifi$ 9 section
 #ajd7;b71 ?is title %all also apply to1
 & may be rais$ z a def5se by1 su* an   
individual or entity4  ,,ii ,vet]an     
,families ,heal? ,s]vices  #bjj4 ,%ort  
title ,?is title may be cit$ z ! ,vet]an
 ,families ,heal? ,s]vices ,act4  ,a    
,reproductive & f]tility pres]vation    
assi/ance = memb]s ( ! uni=m$ s]vices   
#bja4 ,def9itions ,9 ?is subtitle3 7#a7 
,active duty ,! t]m active duty has !   
mean+ giv5 t t]m 9 section #aja7ah7 (   
title #cg1 ,unit$ ,/ates ,code4  7#b7   
,uni=m$ s]vices ,! t]m uni=m$ s]vices   
has ! mean+ giv5 t t]m 9 section        
#aja7;a77#e7 ( title #aj1 ,unit$ ,/ates 
,code4  #bjb4 ,provision ( f]tility     
treatm5t & c\nsel+ to c]ta9 memb]s ( !  
uni=m$ s]vices & sp\ses1 p>tn]s1 &      
ge/ational surrogates ( su* memb]s  7a7 
,f]tility treatm5t & c\nsel+  7#a7 ,9   
g5]al ,! ,secret>y ( ,def5se %all make  

available f]tility treatm5t & c\nsel+ to
 a memb] ( ! uni=m$ s]vices or a sp\se1 
p>tn]1 or ge/ational surrogate ( su* a  
memb]4  7#b7 ,eligibility = treatm5t &  
c\nsel+ ,f]tility treatm5t & c\nsel+    
%all be furni%$ "u p>agraph 7#a7 )\t    
reg>d to ! sex1 sex *>act]i/ics1 g5d]   
id5tity1 sexual ori5tation1 inf]tility  
diagnosis1 or m>ital /atus ( ! memb] ( !
 uni=m$ s]vices or _! p>tn]4  7#c7 ,9   
vitro f]tilization ,9 ! case ( 9 vitro  
f]tilization treatm5t furni%$ "u        
p>agraph 7#a71 ! ,secret>y may furni% to
 an individual "u su* p>agraph-- 7,a7 n 
m ?an ?ree complet$ oocyte retrievals2 &
  7,b7 unlimit$ embryo transf]s4  7b7   
,procurem5t ( reproductive g5etic       
mat]ial ,if a memb] ( ! uni=m$ s]vices  
is unable to provide _! reproductive    
g5etic mat]ial1 su* z oocytes1 sp]m1    
f]tiliz$ eggs1 & embryos1 = purposes (  
f]tility treatm5t "u subsection 7a71 !  
,secret>y %all1 at ! election ( su*     
memb]1 all[ su* memb] to receive su*    
treatm5t ) donat$ reproductive g5etic   

mat]ial & pay or reimburse su* memb] !  
reasonable co/s ( procur+ su* mat]ial f 
a donor4  7c7 ,rules ( con/ruction  7#a7
 ,impact on exi/+ au?ority ,no?+ 9 ?is  
section %all be con/ru$ to resc9d !     
au?ority ( ! ,secret>y to provide 9     
vitro f]tilization b5efits pursuant to  
section #ajgd7;c77#d7 ( title #aj1      
,unit$ ,/ates ,code4  7#b7 ,s\rc+ (     
ge/ational surrogate or reproductive    
g5etic mat]ial ,no?+ 9 ?is section %all 
be con/ru$ to require ! ,secret>y-- 7,a7
 to f9d or c]tify a ge/ational surrogate
 = a memb] ( ! uni=m$ s]vices or to     
connect a ge/ational surrogate ) su* a  
memb]2 or  7,b7 to f9d or c]tify        
reproductive g5etic mat]ial1 su* z      
oocytes1 sp]m1 f]tiliz$ eggs1 & embryos1
 f a donor = a memb] ( ! uni=m$ s]vices 
or to connect su* a memb] ) reproductive
 g5etic mat]ial f a donor4  7d7         
,def9itions ,9 ?is section3 7#a7        
,f]tility treatm5t ,! t]m f]tility      
treatm5t includes ! foll[+3 7,a7        
,pres]vation ( human oocytes1 sp]m1 or  

embryos = lat] reproductive use4  7,b7  
,artificial insem9ation1 includ+        
intravag9al insem9ation1 intrac]vical   
insem9ation1 & intraut]9e insem9ation4  
7,c7 ,assi/$ reproductive te*nology1    
includ+ 9 vitro f]tilization & o!r      
treatm5ts or proc$ures 9 :i*            
reproductive g5etic mat]ial1 su* z      
oocytes1 sp]m1 f]tiliz$ eggs1 & embryos1
 are h&l$1 :5 cl9ically appropriate4    
7,d7 ,g5etic te/+ ( embryos4  7,e7      
,m$ications prescrib$ or obta9$         
ov]-!-c\nt]1 z indicat$ = f]tility4     
7,f7 ,gamete donation4  7,g7 ,su* o!r   
in=mation1 ref]rals1 treatm5ts1         
proc$ures1 m$ications1 laboratory te/+1 
te*nologies1 & s]vices relat+ to        
f]tility z ! ,secret>y ( ,def5se        
det]m9es appropriate4  7#b7 ,ge/ational 
surrogate ,! t]m ge/ational surrogate   
means an individual :o agrees to become 
pregnant ?r\gh 9 vitro f]tilization "u a
 ge/ational surrogacy agreem5t us+      
gametes t are n ! gametes ( t           
individual4  7#c7 ,p>tn] ,! t]m p>tn]1 )

 respect to a memb] ( ! uni=m$ s]vices1 
means an individual select$ by ! memb]  
:o agrees to be a p>5t1 ) ! memb]1 ( a  
*ild born z a result ( ! use ( any      
f]tility treatm5t "u ?is section4  #bjc4
 ,e/abli%m5t ( f]tility pres]vation     
proc$ures aft] an injury or illness  7a7
 ,9 g5]al ,! ,secret>y ( ,def5se1 act+  
?r\gh ! ,assi/ant ,secret>y ( ,def5se = 
,heal? ,affairs1 %all e/abli% proc$ures 
= ! retrieval ( reproductive g5etic     
mat]ial1 su* z oocytes1 sp]m1 f]tiliz$  
eggs1 & embryos1 z soon z m$ically      
appropriate1 f a memb] ( ! uni=m$       
s]vices 9 cases 9 :i* ! f]tility ( su*  
memb] is pot5tially jeop>diz$ z a result
 ( an injury or illness incurr$ or      
aggravat$ :ile s]v+ on active duty 9 !  
uni=m$ s]vices 9 ord] to pres]ve !      
m$ical options ( su* memb]4  7b7        
,inclusion ( in=mation 9 advanc$        
directives & milit>y te/am5t>y in/rum5ts
 ,! ,secret>y ( ,def5se %all ensure t   
any advance m$ical directive1 z def9$ 9 
section #ajdd;c7b7 ( title #aj1 ,unit$  

,/ates ,code1 or milit>y te/am5t>y      
in/rum5t1 z def9$ 9 section #ajdd;d7b7 (
 su* title1 complet$ by a memb] ( !     
uni=m$ s]vices includes que/ions ab\t ! 
cons5t ( ! memb] to f]tility pres]vation
 proc$ures "u subsection 7a74  7c7      
,disposal ( reproductive g5etic mat]ial 
,subject to section #bjd1 9 accordance )
 regulations prescrib$ by ! ,secret>y = 
purpose ( ?is subsection1 ! ,secret>y   
%all dispose ( reproductive g5etic      
mat]ial retriev$ f a memb] ( ! uni=m$   
s]vices "u subsection 7a7-- 7#a7 ) !    
specific cons5t ( ! memb]2 or  7#b7 if !
 memb]-- 7,a7 has lo/ ! ability to      
cons5t p]man5tly1 z det]m9$ by a m$ical 
pr(essional1 or has di$2 &  7,b7 has n  
specifi$ ! use ( _! reproductive g5etic 
mat]ial 9 an advance directive or       
te/am5t>y in/rum5t execut$ by ! memb]4  
#bjd4 ,cryopres]vation & /orage (       
reproductive g5etic mat]ial ( memb]s ( !
 uni=m$ s]vices on active duty  7a7 ,9  
g5]al ,! ,secret>y ( ,def5se %all       
provide memb]s ( ! uni=m$ s]vices on    

active duty 9 ! uni=m$ s]vices ) !      
opportunity to cryopres]ve & /ore _!    
reproductive g5etic mat]ial1 su* z      
oocytes1 sp]m1 f]tiliz$ eggs1 & embryos1
 prior to-- 7#a7 deploym5t to a combat  
zone2 or  7#b7 a duty assignm5t t       
includes a haz>d\s assignm5t1 includ+-- 
7,a7 assignm5ts result+ 9 exposure to   
p]fluoroalkyl or polyfluoroalkyl        
sub/ances2 &  7,b7 su* o!r assignm5ts z 
det]m9$ by ! ,secret>y4  7b7 ,p]iod ( "t
  7#a7 ,9 g5]al ,! ,secret>y %all       
provide = ! cryopres]vation & /orage (  
reproductive g5etic mat]ial ( any memb] 
( ! uni=m$ s]vices "u subsection 7a7 9 a
 facility ( ! ,dep>tm5t ( ,def5se or ( a
 private entity & ! transportation ( su*
 mat]ial1 at no co/ to ! memb]1 until ! 
date t is "o ye> aft] ! retirem5t1      
sep>ation1 or release ( ! memb] f !     
uni=m$ s]vices4  7#b7 ,cont9u$          
cryopres]vation & /orage ,at ! end ( !  
"o-ye> p]iod specifi$ 9 p>agraph 7#a71 !
 ,secret>y %all p]mit an individual ^:  
reproductive g5etic mat]ial 0           

cryopres]v$ & /or$ z describ$ 9 t       
p>agraph to select1 includ+ pursuant to 
an advance m$ical directive or milit>y  
te/am5t>y in/rum5t complet$ "u          
subsection 7c71 "o ( ! foll[+ options3  
7,a7 ,to cont9ue su* cryopres]vation &  
/orage 9 su* facility ) ! co/ ( su*     
cryopres]vation & /orage borne by !     
individual4  7,b7 ,to transf] ! mat]ial 
to a private cryopres]vation & /orage   
facility select$ by ! individual4  7,c7 
,to transf] ! mat]ial to a facility ( ! 
,dep>tm5t ( ,vet]ans ,affairs if        
cryopres]vation & /orage is available to
 ! individual at su* facility & !       
individual is eligible = su* s]vices4   
7#c7 ,disposal ( reproductive g5etic    
mat]ial  7,a7 ,no selection ,if an      
individual describ$ 9 p>agraph 7#b7 does
 n make a selection "u subp>agraph 7,a71
 7,b71 or 7,c7 ( su* p>agraph1 !        
,secret>y may dispose ( ! reproductive  
g5etic mat]ial ( ! individual n e>li]   
?an ! date t is #ij days aft] ! end ( ! 
"o-ye> p]iod specifi$ 9 p>agraph 7#a7 ) 

respect to ! individual4  7,b7 ,election
 by individual ,at ! election ( an      
individual describ$ 9 p>agraph 7#b71 !  
,secret>y may dispose ( ! reproductive  
g5etic mat]ial ( ! individual4  7c7     
,advance m$ical directive & milit>y     
te/am5t>y in/rum5t ,a memb] ( ! uni=m$  
s]vices :o elects to cryopres]ve & /ore 
_! reproductive g5etic mat]ial "u ?is   
section mu/ complete an advance m$ical  
directive1 z def9$ 9 section #ajdd;c7b7 
( title #aj1 ,unit$ ,/ates ,code1 & a   
milit>y te/am5t>y in/rum5t1 z def9$ 9   
section #ajdd;d7b7 ( su* title1 t       
explicitly specifies ! use ( _!         
cryopres]v$ & /or$ reproductive g5etic  
mat]ial if su* memb] dies or o!rwise    
loses ! capacity to cons5t to ! use ( _!
 cryopres]v$ & /or$ reproductive g5etic 
mat]ial4  7d7 ,agreem5ts ,to c>ry out   
?is section1 ! ,secret>y may ent] into  
agreem5ts ) private entities t provide  
cryopres]vation1 transportation1 &      
/orage s]vices = reproductive g5etic    
mat]ial4  #bje4 ,assi/ance ) & cont9uity

 ( c>e reg>d+ reproductive & f]tility   
pres]vation s]vices ,! ,secret>y (      
,def5se %all ensure t employees ( !     
,dep>tm5t ( ,def5se assi/ memb]s ( !    
uni=m$ s]vices-- 7#a7 9 navigat+ !      
s]vices provid$ "u ?is subtitle2  7#b7 9
 f9d+ a provid] t meets ! ne$s ( su*    
memb]s ) respect to su* s]vices2 &  7#c7
 9 cont9u+ ! receipt ( su* s]vices )\t  
int]ruption dur+ a p]man5t *ange (      
/ation = su* memb]s4  #bjf4 ,coord9ation
 betwe5 ,dep>tm5t ( ,def5se & ,dep>tm5t 
( ,vet]ans ,affairs on furni%+ (        
f]tility treatm5t & c\nsel+  7a7 ,9     
g5]al ,! ,secret>y ( ,def5se & !        
,secret>y ( ,vet]ans ,affairs %all %>e  
be/ practices & facilitate ref]rals1 z  
!y consid] appropriate1 on ! furni%+ (  
f]tility treatm5t & c\nsel+ to          
individuals eligible = ! receipt ( su*  
c\nsel+ & treatm5t f ! ,secret>ies4  7b7
 ,memor&um ( und]/&+ ,! ,secret>y (     
,def5se & ! ,secret>y ( ,vet]ans        
,affairs %all ent] into a memor&um (    
und]/&+-- 7#a7 provid+ t ! ,secret>y (  

,def5se w ensure access by ! ,secret>y (
 ,vet]ans ,affairs to reproductive      
g5etic mat]ial1 su* z oocytes1 sp]m1    
f]tiliz$ eggs1 & embryos1 ( vet]ans /or$
 by ! ,dep>tm5t ( ,def5se = purposes (  
furni%+ f]tility treatm5t "u section    
#agbj,k ( title #ch1 ,unit$ ,/ates      
,code1 z add$ by section #bab7;a72 &    
7#b7 au?oriz+ ! ,dep>tm5t ( ,vet]ans    
,affairs to comp5sate ! ,dep>tm5t (     
,def5se = ! cryopres]vation1            
transportation1 & /orage ( reproductive 
g5etic mat]ial ( vet]ans "u section     
#bjd7;b77#b77;,a74  #bjg4 ,regulations  
,n lat] ?an two ye>s aft] ! date ( !    
enactm5t ( ?is ,act1 ! ,secret>y (      
,def5se %all prescribe regulations to   
c>ry out ?is subtitle4  ,b ,reproductive
 assi/ance = vet]ans  #baa4 ,inclusion (
 f]tility treatm5t & c\nsel+ "u !       
def9ition ( m$ical s]vices 9 title #ch  
,section #agja7f7 ( title #ch1 ,unit$   
,/ates ,code1 is am5d$ by add+ at ! end 
! foll[+ new subp>agraph3  7,j7         
,f]tility treatm5t & c\nsel+ "u section 

#agbj,k ( ?is title4  4  #bab4 ,f]tility
 treatm5t & c\nsel+ = c]ta9 vet]ans &   
sp\ses1 p>tn]s1 & ge/ational surrogates 
( su* vet]ans  7a7 ,9 g5]al ,sub*apt]   
,,ii ( *apt] #ag ( title #ch1 ,unit$    
,/ates ,code1 is am5d$ by add+ at ! end 
! foll[+ new section3  #agbj,k4         
,f]tility treatm5t & c\nsel+ = c]ta9    
vet]ans & sp\ses1 p>tn]s1 & ge/ational  
surrogates ( su* vet]ans  7a7           
,requirem5t  7#a7 ,9 g5]al ,not)/&+ any 
o!r provision ( law1 includ+ ! surrogacy
 laws ( any ,/ate1 ! ,secret>y %all     
furni% f]tility treatm5t & c\nsel+ = !  
b5efit ( a cov]$ vet]an to ! vet]an & ! 
sp\se1 p>tn]1 gamete donor1 or          
ge/ational surrogate ( ! vet]an if !    
vet]an1 & ! sp\se1 p>tn]1 gamete donor1 
or ge/ational surrogate ( ! vet]an1 z   
applicable1 ea* provide in=m$ cons5t =  
su* treatm5t & c\nsel+1 includ+ = ea*   
cycle ( treatm5t au?oriz$ "u ?is        
section1 ?r\gh a process prescrib$ by ! 
,secret>y4  7#b7 ,provision ( treatm5t &
 c\nsel+ ,f]tility treatm5t & c\nsel+   

%all be furni%$ "u p>agraph 7#a7 )\t    
reg>d to ! sex1 sexual *>act]i/ics1 g5d]
 id5tity1 sexual ori5tation1 inf]tility 
diagnosis1 or m>ital /atus ( ! cov]$    
vet]an or _! p>tn]4  7#c7 ,9 vitro      
f]tilization ,9 ! case ( 9 vitro        
f]tilization treatm5t furni%$ "u        
p>agraph 7#a71 ! ,secret>y may furni% to
 an individual "u su* p>agraph-- 7,a7 n 
m ?an ?ree complet$ oocyte retrievals2 &
  7,b7 unlimit$ embryo transf]s4  7#d7  
,copaym5t ,! ,secret>y %all only furni% 
f]tility treatm5t & c\nsel+ "u p>agraph 
7#a7 to a cov]$ vet]an :o is requir$ to 
pay to ! ,unit$ ,/ates a copaym5t am\nt 
z a condition = ! receipt ( hospital    
c>e1 m$ical s]vices1 or m$ications "u   
?is *apt] if ! cov]$ vet]an agrees to   
pay su* applicable copaym5t am\nt to !  
,unit$ ,/ates = su* treatm5t & c\nsel+4 
7b7 ,procurem5t ( reproductive g5etic   
mat]ial  7#a7 ,9 g5]al ,if a cov]$      
vet]an is unable to provide _!          
reproductive g5etic mat]ial = purposes (
 f]tility treatm5t "u subsection 7a71 ! 

,secret>y %all1 at ! election ( su*     
vet]an-- 7,a7 all[ su* vet]an to receive
 su* treatm5t ) donat$ reproductive     
g5etic mat]ial1 if ! donor provides     
in=m$ cons5t = use ( su* mat]ial2 &     
7,b7 pay or reimburse ! vet]an1 donor1  
or a p>ty act+ on behalf ( ! donor !    
reasonable co/s ( procur+ su* mat]ial f 
! donor4  7#b7 ,o!r exp5ses ,! ,secret>y
 may pay or reimburse a cov]$ vet]an a  
reasonable am\nt = p]sonal travel &     
incid5tal exp5ses associat$ ) procur+   
mat]ial f a donor "u p>agraph 7#a74  7c7
 ,outrea* & tra9+ ,! ,secret>y %all c>ry
 out an outrea* & tra9+ program to      
ensure vet]ans & heal? c>e provid]s ( ! 
,dep>tm5t are aw>e (-- 7#a7 !           
availability ( & eligibility requirem5ts
 = f]tility treatm5t & c\nsel+ "u ?is   
section2 &  7#b7 any *anges to f]tility 
treatm5t & c\nsel+ cov]$ "u ?is section4
  7d7 ,own]%ip1 use1 or disposition (   
reproductive g5etic mat]ial  7#a7 ,9    
g5]al ,issues or disputes reg>d+ own]%ip
 ( reproductive g5etic mat]ial or future

 use or disposition ( su* mat]ial %all  
be ! sole responsibility ( ! cov]$      
vet]an1 ! sp\se1 p>tn]1 or ge/ational   
surrogate ( ! vet]an1 z applicable1 & ! 
private facility /or+ su* mat]ial4  7#b7
 ,agreem5t reg>d+ donat$ reproductive   
g5etic mat]ial ,z a condition ( ! use ( 
donat$ gametes or embryos "u ?is        
section1 ! ?ird-p>ty donor & a provid] (
 f]tility treatm5t t has ent]$ into a   
contract or agreem5t ) ! ,secret>y to   
provide su* treatm5t "u ?is section are 
requir$ to ent] into an arrangem5t or   
agreem5t gov]n+ ! t]ms ( ! donation1 to 
include ultimate disposition ( any      
rema9+ gametes or embryos once a cov]$  
vet]an has exhau/$ ! f]tility treatm5t  
available "u ?is section1 unless !      
vet]an or ! sp\se or p>tn] ( ! vet]an   
has agre$ to assume liability = !       
cont9u$ pres]vation ( any rema9+ gametes
 or embryos & ! ,dep>tm5t is n p>ty to !
 arrangem5t or agreem5t = su* cont9u$   
pres]vation4  7#c7 ,role ( ,dep>tm5t ,! 
role ( ! ,secret>y "u ?is section is    

limit$ to furni%+ ! treatm5t & c\nsel+  
requir$ "u ?is section :5 reque/$ by a  
cov]$ vet]an & det]m9$ necess>y by !    
,secret>y4  7#d7 ,own]%ip & cu/ody (    
reproductive g5etic mat]ial ,! ,secret>y
 w n h own]%ip or cu/ody ( any          
reproductive g5etic mat]ial obta9$      
pursuant to treatm5t "u ?is section & w 
n be involv$ 9 ! ultimate disposition ( 
su* mat]ial or disputes betwe5 or among 
any p>ties ) respect to su* mat]ial4    
7e7 ,rule ( con/ruction ,no?+ 9 ?is     
section %all be con/ru$ to require !    
,secret>y-- 7#a7 to f9d or c]tify a     
ge/ational surrogate = a cov]$ vet]an or
 to connect a ge/ational surrogate ) a  
cov]$ vet]an2 or  7#b7 to furni%        
mat]nity c>e to a cov]$ vet]an or sp\se1
 p>tn]1 or ge/ational surrogate ( a     
cov]$ vet]an beyond :at is o!rwise      
requir$ or au?oriz$ by law4  7f7        
,def9itions ,9 ?is section3 7#a7 ,! t]m 
cov]$ vet]an means a vet]an :o is       
enroll$ 9 ! sy/em ( annual pati5t       
enrollm5t e/abli%$ "u section #agje7;a7 

( ?is title4  7#b7 ,! t]m f]tility      
treatm5t includes ! foll[+3 7,a7        
,pres]vation ( human oocytes1 sp]m1 or  
embryos = lat] reproductive use4  7,b7  
,artificial insem9ation1 includ+        
intravag9al insem9ation1 intrac]vical   
insem9ation1 & intraut]9e insem9ation4  
7,c7 ,assi/$ reproductive te*nology1    
includ+ 9 vitro f]tilization & o!r      
treatm5ts or proc$ures 9 :i*            
reproductive g5etic mat]ial1 su* z      
oocytes1 sp]m1 f]tiliz$ eggs1 & embryos1
 are h&l$1 :5 cl9ically appropriate4    
7,d7 ,g5etic te/+ ( embryos4  7,e7      
,m$ications prescrib$ or obta9$         
ov]-!-c\nt]1 z indicat$ = f]tility4     
7,f7 ,gamete donation4  7,g7 ,su* o!r   
in=mation1 ref]rals1 treatm5ts1         
proc$ures1 m$ications1 laboratory te/+1 
te*nologies1 & s]vices relat+ to        
f]tility z ! ,secret>y det]m9es         
appropriate4  7#c7 ,! t]m ge/ational    
surrogate means an individual :o agrees 
to become pregnant ?r\gh 9 vitro        
f]tilization "u a ge/ational surrogacy  

agreem5t us+ gametes t are n ! gametes (
 t individual4  7#d7 ,! t]m p>tn]1 )    
respect to a cov]$ vet]an1 means an     
individual select$ by ! vet]an :o agrees
 to be a p>5t1 ) ! vet]an1 ( a *ild born
 z a result ( ! use ( any f]tility      
treatm5t "u ?is section4  4  7b7        
,cl]ical am5dm5t ,! table ( sections at 
! beg9n+ ( sub*apt] ,,ii ( *apt] #ag (  
su* title is am5d$ by ins]t+ aft] ! item
 relat+ to section #agbj;,j ! foll[+ new
 item3  #agbj,k4 ,f]tility treatm5t &   
c\nsel+ = c]ta9 vet]ans & sp\ses1       
p>tn]s1 & ge/ational surrogates ( su*   
vet]ans4  4  7c7 ,sunset ( exi/+        
au?ority ,! au?ority "u section #bcd ( !
 ,milit>y ,con/ruction1 ,vet]ans        
,affairs1 & ,relat$ ,ag5cies            
,appropriations ,act1 #bjbd 7division ,a
 ( ,public ,law #aah-db71 or any simil> 
au?ority subsequ5tly enact$ by law1 %all
 cease on ! effective date ( regulations
 prescrib$ to c>ry out section #agbj,k (
 title #ch1 ,unit$ ,/ates ,code1 z add$ 
by subsection 7a74  #bac4 ,assi/ance ) &

 cont9uity ( c>e reg>d+ reproductive &  
f]tility pres]vation s]vices ,!         
,secret>y ( ,vet]ans ,affairs %all      
ensure t employees ( ! ,dep>tm5t (      
,vet]ans ,affairs assi/ vet]ans-- 7#a7 9
 navigat+ ! s]vices provid$ "u ?is      
subtitle & ! am5dm5ts made by ?is       
subtitle2  7#b7 9 f9d+ a provid] t meets
 ! ne$s ( su* vet]ans ) respect to su*  
s]vices2 &  7#c7 9 cont9u+ ! receipt (  
su* s]vices )\t int]ruption if su*      
vet]ans move to a diff]5t geographic    
location4  #bad4 ,coord9ation (         
reproduction & f]tility rese>* = vet]ans
  7a7 ,9 g5]al ,sub*apt] ,,ii ( *apt]   
#gc ( title #ch1 ,unit$ ,/ates ,code1 is
 am5d$ by add+ at ! end ! foll[+ new    
section3  #gccj;,e4 ,coord9ation (      
reproduction & f]tility rese>* = vet]ans
  7a7 ,coord9ation ( rese>* requir$ ,!  
,secret>y %all coord9ate ) ! ,secret>y (
 ,def5se & ! ,secret>y ( ,heal? & ,human
 ,s]vices to conduct rese>* to improve !
 ability ( ! ,dep>tm5t ( ,vet]ans       
,affairs to meet ! long-t]m reproductive

 heal? c>e ne$s ( vet]ans :o h a        
condition t affects ! ability ( !       
individual to reproduce4  7b7           
,dissem9ation ( in=mation ,! ,secret>y  
%all ensure t in=mation produc$ by !    
rese>* "u ?is section t may be useful = 
o!r activities ( ! ,dep>tm5t is         
dissem9at$ ?r\gh\t ! ,dep>tm5t4  4  7b7 
,cl]ical am5dm5t ,! table ( sections at 
! beg9n+ ( sub*apt] ,,ii ( *apt] #gc (  
su* title is am5d$ by ins]t+ aft] ! item
 relat+ to section #gccj;,d ! foll[+ new
 item3  #gccj;,e4 ,coord9ation (        
reproduction & f]tility rese>* =        
vet]ans4  4  ,,iii ,access to f]tility  
treatm5t & c>e  #cja4 ,%ort title ,?is  
title may be cit$ z ! ,access to        
,f]tility ,treatm5t & ,c>e ,act4  #cjb4 
,/&>ds relat+ to b5efits = f]tility     
treatm5t  7a7 ,9 g5]al  7#a7 ,,phsa ,"p 
,d ( title ,,xxvii ( ! ,public ,heal?   
,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#aaa
 et seq47 is am5d$ by add+ at ! end !   
foll[+3  #bgii;,a-#aa4 ,/&>ds relat+ to 
b5efits = f]tility treatm5t  7a7 ,9     

g5]al ,a gr\p heal? plan or a heal?     
insurance issu] (f]+ gr\p or individual 
heal? insurance cov]age %all provide    
cov]age = f]tility treatm5t1 if su* plan
 or cov]age provides cov]age =          
ob/etrical s]vices4  7b7 ,def9ition ,9  
?is section1 ! t]m f]tility treatm5t    
includes ! foll[+3 7#a7 ,pres]vation (  
human oocytes1 sp]m1 or embryos = lat]  
reproductive use4  7#b7 ,artificial     
insem9ation1 includ+ intravag9al        
insem9ation1 intrac]vical insem9ation1 &
 intraut]9e insem9ation4  7#c7 ,assi/$  
reproductive te*nology1 includ+ 9 vitro 
f]tilization & o!r treatm5ts or         
proc$ures 9 :i* reproductive g5etic     
mat]ial1 su* z oocytes1 sp]m1 f]tiliz$  
eggs1 & embryos1 are h&l$1 :5 cl9ically 
appropriate4  7#d7 ,g5etic te/+ (       
embryos4  7#e7 ,m$ications prescrib$ or 
obta9$ ov]-!-c\nt]1 z indicat$ =        
f]tility4  7#f7 ,gamete donation4  7#g7 
,su* o!r in=mation1 ref]rals1 treatm5ts1
 proc$ures1 m$ications1 laboratory te/+1
 te*nologies1 & s]vices relat+ to       

f]tility z ! ,secret>y det]m9es         
appropriate4  7c7 ,requir$ cov]age ,a   
gr\p heal? plan & a heal? insurance     
issu] (f]+ gr\p or individual heal?     
insurance cov]age t includes cov]age =  
ob/etrical s]vices %all provide cov]age 
= f]tility treatm5t det]m9$ appropriate 
by ! heal? c>e provid]1 reg>dless ( :e!r
 ! p>ticipant1 b5efici>y1 or enrollee   
receiv+ su* treatm5t has be5 diagnos$ ) 
inf]tility z def9$ by ! ,am]ican        
,society = ,reproductive ,m$ic9e1 if !  
treatm5t is p]=m$ at1 or prescrib$ by1 a
 m$ical facility t is 9 compliance )    
relevant /&>ds set by an appropriate    
,f$]al ag5cy4  7d7 ,limitation ,co/-%>+1
 includ+ d$uctibles & co9surance1 or o!r
 limitations = f]tility treatm5t may n  
be impos$ ) respect to ! s]vices requir$
 to be cov]$ "u subsection 7c7 to !     
ext5t t su* co/-%>+ exce$s ! co/-%>+    
appli$ to o!r m$ical s]vices "u ! gr\p  
heal? plan or heal? insurance cov]age or
 su* o!r limitations are diff]5t f      
limitations impos$ ) respect to su*     

m$ical s]vices1 except :]e su*          
limitation is m favorable ) respect to  
f]tility treatm5t4 ,! ,secret>y %all    
promulgate int]im f9al regulations to   
c>ry out ?is subsection1 not)/&+ !      
notice & comm5t requirem5ts ( section   
#eec ( title #e1 ,unit$ ,/ates ,code4   
7e7 ,prohibitions ,a gr\p heal? plan & a
 heal? insurance issu] (f]+ gr\p or     
individual heal? insurance cov]age may  
n-- 7#a7 provide inc5tives 7monet>y or  
o!rwise7 to a p>ticipant1 b5efici>y1 or 
enrollee to enc\rage su* p>ticipant1    
b5efici>y1 or enrollee n to seek or     
obta9 f]tility treatm5t to :i* su*      
p>ticipant1 b5efici>y1 or enrollee is   
entitl$ "u ?is section or to provid]s to
 induce su* provid]s n to provide       
m$ically appropriate f]tility treatm5ts 
to p>ticipants1 b5efici>ies1 or         
enrollees2  7#b7 prohibit a provid] f   
discuss+ ) a p>ticipant1 b5efici>y1 or  
enrollee f]tility treatm5t relat+ to ?is
 section2  7#c7 p5alize or o!rwise r$uce
 or limit ! reimbursem5t ( a provid]    

because su* provid] provid$ f]tility    
treatm5t to a qualifi$ p>ticipant1      
b5efici>y1 or enrollee 9 accordance )   
?is section2 or  7#d7 on ! gr\nd        
prohibit$ "u title ,,vi ( ! ,civil      
,rights ,act ( #aifd1 title ,,ix ( !    
,education ,am5dm5ts ( #aigb1 ! ,age    
,discrim9ation ,act ( #aige1 section    
#ejd ( ! ,rehabilitation ,act ( #aigc1  
or section #aeeg ( ! ,pati5t ,protection
 & ,af=dable ,c>e ,act1 exclude any     
individual f cov]age 9 accordance ) ?is 
section1 or discrim9ate aga9/ any       
individual ) respect to su* cov]age4    
7f7 ,rule ( con/ruction ,no?+ 9 ?is     
section %all be con/ru$ to require a    
p>ticipant1 b5efici>y1 or enrollee to   
und]go f]tility treatm5t4  7g7 ,notice  
,a gr\p heal? plan & a heal? insurance  
issu] (f]+ gr\p or individual heal?     
insurance cov]age %all provide notice to
 ea* p>ticipant1 b5efici>y1 & enrollee  
"u su* plan or cov]age reg>d+ ! cov]age 
requir$ by ?is section 9 accordance )   
regulations promulgat$ by ! ,secret>y4  

,su* notice %all be 9 writ+ & prom95tly 
position$ 9 any lit]ature or            
correspond5ce made available or         
di/ribut$ by ! plan or issu] & %all be  
transmitt$-- 7#a7 n lat] ?an ! e>li] (--
 7,a7 9 ! fir/ /&>d mail+ made by ! plan
 or issu] to ! p>ticipant1 b5efici>y1 or
 enrollee foll[+ ! effective date ( su* 
regulations2  7,b7 z "p ( any ye>ly     
in=mational packet s5t to ! p>ticipant1 
b5efici>y1 or enrollee2 or  7,c7 ,janu>y
 #a1 #bjbf2  7#b7 9 ! case ( a          
p>ticipant1 b5efici>y1 or enrollee n    
enroll$ 9 ! plan or cov]age on ! date ( 
transmission "u p>agraph 7#a71 ^u       
initial enrollm5t ( su* p>ticipant1     
b5efici>y1 or enrollee2 &  7#c7 on an   
annual basis aft] ! transmission "u     
p>agraph 7#a7 or 7#b74  7h7 ,level &    
type ( reimbursem5ts ,no?+ 9 ?is section
 %all be con/ru$ to prev5t a gr\p heal? 
plan or a heal? insurance issu] (f]+    
gr\p or individual heal? insurance      
cov]age f negotiat+ ! level & type (    
reimbursem5t ) a provid] = c>e provid$ 9

 accordance ) ?is section4  4  7#b7     
,,erisa  7,a7 ,9 g5]al ,subp>t ,b ( "p  
#g ( subtitle ,b ( title ,i ( !         
,employee ,retirem5t ,income ,security  
,act ( #aigd 7#bi ,u4,s4,c4 #aahe et    
seq47 is am5d$ by add+ at ! end !       
foll[+3  #gbf4 ,/&>ds relat+ to b5efits 
= f]tility treatm5t  7a7 ,9 g5]al ,a    
gr\p heal? plan or a heal? insurance    
issu] (f]+ gr\p heal? insurance cov]age 
%all provide cov]age = f]tility         
treatm5t1 if su* plan or cov]age        
provides cov]age = ob/etrical s]vices4  
7b7 ,def9ition ,9 ?is section1 ! t]m    
f]tility treatm5t includes ! foll[+3    
7#a7 ,pres]vation ( human oocytes1 sp]m1
 or embryos = lat] reproductive use4    
7#b7 ,artificial insem9ation1 includ+   
intravag9al insem9ation1 intrac]vical   
insem9ation1 & intraut]9e insem9ation4  
7#c7 ,assi/$ reproductive te*nology1    
includ+ 9 vitro f]tilization & o!r      
treatm5ts or proc$ures 9 :i*            
reproductive g5etic mat]ial1 su* z      
oocytes1 sp]m1 f]tiliz$ eggs1 & embryos1

 are h&l$1 :5 cl9ically appropriate4    
7#d7 ,g5etic te/+ ( embryos4  7#e7      
,m$ications prescrib$ or obta9$         
ov]-!-c\nt]1 z indicat$ = f]tility4     
7#f7 ,gamete donation4  7#g7 ,su* o!r   
in=mation1 ref]rals1 treatm5ts1         
proc$ures1 m$ications1 laboratory te/+1 
te*nologies1 & s]vices relat+ to        
f]tility z ! ,secret>y ( ,heal? & ,human
 ,s]vices det]m9es appropriate4  7c7    
,requir$ cov]age ,a gr\p heal? plan & a 
heal? insurance issu] (f]+ gr\p heal?   
insurance cov]age t includes cov]age =  
ob/etrical s]vices %all provide cov]age 
= f]tility treatm5t det]m9$ appropriate 
by ! heal? c>e provid]1 reg>dless ( :e!r
 ! p>ticipant or b5efici>y receiv+ su*  
treatm5t has be5 diagnos$ ) inf]tility z
 def9$ by ! ,am]ican ,society =         
,reproductive ,m$ic9e1 if ! treatm5t is 
p]=m$ at1 or prescrib$ by1 a m$ical     
facility t is 9 compliance ) relevant   
/&>ds set by an appropriate ,f$]al      
ag5cy4  7d7 ,limitation ,co/-%>+1       
includ+ d$uctibles & co9surance1 or o!r 

limitations = f]tility treatm5t may n be
 impos$ ) respect to ! s]vices requir$  
to be cov]$ "u subsection 7c7 to ! ext5t
 t su* co/-%>+ exce$s ! co/-%>+ appli$  
to o!r m$ical s]vices "u ! gr\p heal?   
plan or heal? insurance cov]age or su*  
o!r limitations are diff]5t f           
limitations impos$ ) respect to su*     
m$ical s]vices1 except :]e su*          
limitation is m favorable ) respect to  
f]tility treatm5t4 ,! ,secret>y %all    
promulgate int]im f9al regulations to   
c>ry out ?is subsection1 not)/&+ !      
notice & comm5t requirem5ts ( section   
#eec ( title #e1 ,unit$ ,/ates ,code4   
7e7 ,prohibitions ,a gr\p heal? plan & a
 heal? insurance issu] (f]+ gr\p heal?  
insurance cov]age may n-- 7#a7 provide  
inc5tives 7monet>y or o!rwise7 to a     
p>ticipant or b5efici>y to enc\rage su* 
p>ticipant or b5efici>y n to seek or    
obta9 f]tility treatm5t to :i* su*      
p>ticipant or b5efici>y is entitl$ "u   
?is section or to provid]s to induce su*
 provid]s n to provide m$ically         

appropriate f]tility treatm5ts to       
p>ticipants or b5efici>ies2  7#b7       
prohibit a provid] f discuss+ ) a       
p>ticipant or b5efici>y f]tility        
treatm5t relat+ to ?is section2  7#c7   
p5alize or o!rwise r$uce or limit !     
reimbursem5t ( a provid] because su*    
provid] provid$ f]tility treatm5t to a  
qualifi$ p>ticipant or b5efici>y 9      
accordance ) ?is section2 or  7#d7 on ! 
gr\nd prohibit$ "u title ,,vi ( ! ,civil
 ,rights ,act ( #aifd 7#db ,u4,s4,c4    
#bjjj;d et seq471 title ,,ix ( !        
,education ,am5dm5ts ( #aigb 7#bj       
,u4,s4,c4 #afha et seq471 ! ,age        
,discrim9ation ,act ( #aige 7#db        
,u4,s4,c4 #faja et seq471 section #ejd (
 ! ,rehabilitation ,act ( #aigc 7#bi    
,u4,s4,c4 #gid71 or section #aeeg ( !   
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahaaf71 exclude any
 individual f cov]age 9 accordance ) ?is
 section1 or discrim9ate aga9/ any      
individual ) respect to su* cov]age4    
7f7 ,rule ( con/ruction ,no?+ 9 ?is     

section %all be con/ru$ to require a    
p>ticipant or b5efici>y to und]go       
f]tility treatm5t4  7g7 ,notice ,a gr\p 
heal? plan & a heal? insurance issu]    
(f]+ gr\p heal? insurance cov]age %all  
provide notice to ea* p>ticipant &      
b5efici>y "u su* plan or cov]age reg>d+ 
! cov]age requir$ by ?is section 9      
accordance ) regulations promulgat$ by !
 ,secret>y4 ,su* notice %all be 9 writ+ 
& prom95tly position$ 9 any lit]ature or
 correspond5ce made available or        
di/ribut$ by ! plan or issu] & %all be  
transmitt$-- 7#a7 n lat] ?an ! e>li] (--
 7,a7 9 ! fir/ /&>d mail+ made by ! plan
 or issu] to ! p>ticipant or b5efici>y  
foll[+ ! effective date ( su*           
regulations2  7,b7 z "p ( any ye>ly     
in=mational packet s5t to ! p>ticipant  
or b5efici>y2 or  7,c7 ,janu>y #a1      
#bjbf2  7#b7 9 ! case ( a p>ticipant or 
b5efici>y n enroll$ 9 ! plan or cov]age 
on ! date ( transmission "u p>agraph    
7#a71 ^u initial enrollm5t ( su*        
p>ticipant or b5efici>y2 &  7#c7 on an  

annual basis aft] ! transmission "u     
p>agraph 7#a7 or 7#b74  7h7 ,level &    
type ( reimbursem5ts ,no?+ 9 ?is section
 %all be con/ru$ to prev5t a gr\p heal? 
plan or a heal? insurance issu] (f]+    
gr\p heal? insurance cov]age f negotiat+
 ! level & type ( reimbursem5t ) a      
provid] = c>e provid$ 9 accordance ) ?is
 section4  4  7,b7 ,cl]ical am5dm5t ,!  
table ( cont5ts 9 section #a ( !        
,employee ,retirem5t ,income ,security  
,act ( #aigd 7#bi ,u4,s4,c4 #ajja et    
seq47 is am5d$ by ins]t+ aft] ! item    
relat+ to section #gbe ! foll[+ new     
item3  ,sec4 #gbf4 ,/&>ds relat+ to     
b5efits = f]tility treatm5t4  4  7#c7   
,,irc  7,a7 ,9 g5]al ,sub*apt] ,b (     
*apt] #ajj ( ! ,int]nal ,rev5ue ,code ( 
#aihf is am5d$ by add+ at ! end !       
foll[+3  #ihbf4 ,/&>ds relat+ to b5efits
 = f]tility treatm5t  7a7 ,9 g5]al ,a   
gr\p heal? plan %all provide cov]age =  
f]tility treatm5t1 if su* plan provides 
cov]age = ob/etrical s]vices4  7b7      
,def9ition ,9 ?is section1 ! t]m        

f]tility treatm5t includes ! foll[+3    
7#a7 ,pres]vation ( human oocytes1 sp]m1
 or embryos = lat] reproductive use4    
7#b7 ,artificial insem9ation1 includ+   
intravag9al insem9ation1 intrac]vical   
insem9ation1 & intraut]9e insem9ation4  
7#c7 ,assi/$ reproductive te*nology1    
includ+ 9 vitro f]tilization & o!r      
treatm5ts or proc$ures 9 :i*            
reproductive g5etic mat]ial1 su* z      
oocytes1 sp]m1 f]tiliz$ eggs1 & embryos1
 are h&l$1 :5 cl9ically appropriate4    
7#d7 ,g5etic te/+ ( embryos4  7#e7      
,m$ications prescrib$ or obta9$         
ov]-!-c\nt]1 z indicat$ = f]tility4     
7#f7 ,gamete donation4  7#g7 ,su* o!r   
in=mation1 ref]rals1 treatm5ts1         
proc$ures1 m$ications1 laboratory te/+1 
te*nologies1 & s]vices relat+ to        
f]tility z ! ,secret>y ( ,heal? & ,human
 ,s]vices det]m9es appropriate4  7c7    
,requir$ cov]age ,a gr\p heal? plan t   
includes cov]age = ob/etrical s]vices   
%all provide cov]age = f]tility treatm5t
 det]m9$ appropriate by ! heal? c>e     

provid]1 reg>dless ( :e!r ! p>ticipant  
or b5efici>y receiv+ su* treatm5t has   
be5 diagnos$ ) inf]tility z def9$ by !  
,am]ican ,society = ,reproductive       
,m$ic9e1 if ! treatm5t is p]=m$ at1 or  
prescrib$ by1 a m$ical facility t is 9  
compliance ) relevant /&>ds set by an   
appropriate ,f$]al ag5cy4  7d7          
,limitation ,co/-%>+1 includ+ d$uctibles
 & co9surance1 or o!r limitations =     
f]tility treatm5t may n be impos$ )     
respect to ! s]vices requir$ to be cov]$
 "u subsection 7c7 to ! ext5t t su*     
co/-%>+ exce$s ! co/-%>+ appli$ to o!r  
m$ical s]vices "u ! gr\p heal? plan or  
heal? insurance cov]age or su* o!r      
limitations are diff]5t f limitations   
impos$ ) respect to su* m$ical s]vices1 
except :]e su* limitation is m favorable
 ) respect to f]tility treatm5t4 ,!     
,secret>y %all promulgate int]im f9al   
regulations to c>ry out ?is subsection1 
not)/&+ ! notice & comm5t requirem5ts ( 
section #eec ( title #e1 ,unit$ ,/ates  
,code4  7e7 ,prohibitions ,a gr\p heal? 

plan may n-- 7#a7 provide inc5tives     
7monet>y or o!rwise7 to a p>ticipant or 
b5efici>y to enc\rage su* p>ticipant or 
b5efici>y n to seek or obta9 f]tility   
treatm5t to :i* su* p>ticipant or       
b5efici>y is entitl$ "u ?is section or  
to provid]s to induce su* provid]s n to 
provide m$ically appropriate f]tility   
treatm5ts to p>ticipants or b5efici>ies2
  7#b7 prohibit a provid] f discuss+ ) a
 p>ticipant or b5efici>y f]tility       
treatm5t relat+ to ?is section2  7#c7   
p5alize or o!rwise r$uce or limit !     
reimbursem5t ( a provid] because su*    
provid] provid$ f]tility treatm5t to a  
qualifi$ p>ticipant or b5efici>y 9      
accordance ) ?is section2 or  7#d7 on ! 
gr\nd prohibit$ "u title ,,vi ( ! ,civil
 ,rights ,act ( #aifd 7#db ,u4,s4,c4    
#bjjj;d et seq471 title ,,ix ( !        
,education ,am5dm5ts ( #aigb 7#bj       
,u4,s4,c4 #afha et seq471 ! ,age        
,discrim9ation ,act ( #aige 7#db        
,u4,s4,c4 #faja et seq471 section #ejd (
 ! ,rehabilitation ,act ( #aigc 7#bi    

,u4,s4,c4 #gid71 or section #aeeg ( !   
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahaaf71 exclude any
 individual f cov]age 9 accordance ) ?is
 section1 or discrim9ate aga9/ any      
individual ) respect to su* cov]age4    
7f7 ,rule ( con/ruction ,no?+ 9 ?is     
section %all be con/ru$ to require a    
p>ticipant or b5efici>y to und]go       
f]tility treatm5t4  7g7 ,notice ,a gr\p 
heal? plan %all provide notice to ea*   
p>ticipant & b5efici>y "u su* plan      
reg>d+ ! cov]age requir$ by ?is section 
9 accordance ) regulations promulgat$ by
 ! ,secret>y4 ,su* notice %all be 9     
writ+ & prom95tly position$ 9 any       
lit]ature or correspond5ce made         
available or di/ribut$ by ! plan & %all 
be transmitt$-- 7#a7 n lat] ?an ! e>li] 
(-- 7,a7 9 ! fir/ /&>d mail+ made by !  
plan to ! p>ticipant or b5efici>y foll[+
 ! effective date ( su* regulations2    
7,b7 z "p ( any ye>ly in=mational packet
 s5t to ! p>ticipant or b5efici>y2 or   
7,c7 ,janu>y #a1 #bjbf2  7#b7 9 ! case (

 a p>ticipant or b5efici>y n enroll$ 9 !
 plan on ! date ( transmission "u       
p>agraph 7#a71 ^u initial enrollm5t (   
su* p>ticipant or b5efici>y2 &  7#c7 on 
an annual basis aft] ! transmission "u  
p>agraph 7#a7 or 7#b74  7h7 ,level &    
type ( reimbursem5ts ,no?+ 9 ?is section
 %all be con/ru$ to prev5t a gr\p heal? 
plan f negotiat+ ! level & type (       
reimbursem5t ) a provid] = c>e provid$ 9
 accordance ) ?is section4  4  7,b7     
,cl]ical am5dm5t ,! table ( sections =  
sub*apt] ,b ( *apt] #ajj ( ! ,int]nal   
,rev5ue ,code ( #aihf is am5d$ by add+  
at ! end ! foll[+ new item3  ,sec4      
#ihbf4 ,/&>ds relat+ to b5efits =       
f]tility treatm5t4  4  7b7 ,con=m+      
am5dm5ts  7#a7 ,,phsa ,section #bgbd7;c7
 ( ! ,public ,heal? ,s]vice ,act 7#db   
,u4,s4,c4 #cjj;gg-#bc7;c77 is am5d$ by  
/rik+ section #bgjd & ins]t+ sections   
#bgjd & #bgii;,a-#aa4  7#b7 ,,erisa     
,section #gca7;c7 ( ! ,employee         
,retirem5t ,income ,security ,act (     
#aigd 7#bi ,u4,s4,c4 #aaia7;c77 is am5d$

 by /rik+ section #gaa & ins]t+ sections
 #gaa & #gbf4  7c7 ,effective dates     
7#a7 ,9 g5]al ,! am5dm5ts made by       
subsections 7a7 & 7b7 %all apply = plan 
ye>s beg9n+ on or aft] ! date t is #f   
mon?s aft] ! date ( enactm5t ( ?is ,act4
  7#b7 ,collective b>ga9+ exception     
7,a7 ,9 g5]al ,9 ! case ( a gr\p heal?  
plan ma9ta9$ pursuant to "o or m        
collective b>ga9+ agreem5ts betwe5      
employee repres5tatives & "o or m       
employ]s ratifi$ be=e ! date ( enactm5t 
( ?is ,act1 ! am5dm5ts made by          
subsection 7a7 %all n apply to plan ye>s
 beg9n+ be=e ! lat] (-- 7i7 ! date on   
:i* ! la/ collective b>ga9+ agreem5ts   
relat+ to ! plan t]m9ates 7det]m9$ )\t  
reg>d to any ext5sion !re( agre$ to aft]
 ! date ( enactm5t ( ?is ,act71 or  7ii7
 ! date occurr+ #f mon?s aft] ! date ( !
 enactm5t ( ?is ,act4  7,b7             
,cl>ification ,= purposes ( subp>agraph 
7,a71 any plan am5dm5t made pursuant to 
a collective b>ga9+ agreem5t relat+ to !
 plan :i* am5ds ! plan solely to con=m  

to any requirem5t add$ by subsection 7a7
 %all n be treat$ z a t]m9ation ( su*   
collective b>ga9+ agreem5t4  #cjc4      
,requirem5t = ,/ate ,m$icaid plans ,to  
provide m$ical assi/ance = f]tility     
treatm5t  7a7 ,9 g5]al ,section #aije ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acif;d7 is am5d$-- 7#a7 9 subsection   
7a77#d77;,c71 by ins]t+ 7:i* %all       
include f]tility treatm5t provid$ 9     
accordance ) subsection 7kk77 aft]      
family plann+ s]vices & supplies2 &     
7#b7 by add+ at ! end ! foll[+ new      
subsection3  7kk7 ,requirem5ts = cov]age
 ( f]tility treatm5t ,= purposes (      
subsection 7a77#d77;,c71 a ,/ate %all   
ensure t ! m$ical assi/ance provid$ "u !
 ,/ate plan 7or waiv] ( su* plan7 =     
f]tility treatm5t complies ) !          
requirem5ts ( section #bgii;,a-#aa7;b7 (
 ! ,public ,heal? ,s]vice ,act 9 ! same 
mann] z su* requirem5ts & limitations   
apply to heal? insurance cov]age (f]$ by
 a gr\p heal? plan or heal? insurance   
issu]4  4  7b7 ,te*nical am5dm5t        

,section #aijc7;a77#e7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acif;b7a77#e77 is am5d$ by ins]t+      
describ$ 9 section #aije7;a77#d77;,c7   
aft] family plann+ s]vices & supplies4  
7c7 ,effective date  7#a7 ,9 g5]al      
,except z provid$ 9 p>agraph 7#b71 !    
am5dm5ts made by ?is section %all take  
effect on ,octob] #a1 #bjbe4  7#b7      
,delay p]mitt$ if ,/ate legislation     
requir$ ,9 ! case ( a ,/ate plan approv$
 "u title ,,xix ( ! ,social ,security   
,act :i* ! ,secret>y ( ,heal? & ,human  
,s]vices det]m9es requires ,/ate        
legislation 7o!r ?an legislation        
appropriat+ funds7 9 ord] = ! plan to   
meet ! additional requirem5t impos$ by  
?is section1 ! ,/ate plan %all n be     
reg>d$ z fail+ to comply ) ! requirem5ts
 ( su* title solely on ! basis ( !      
failure ( ! plan to meet su* additional 
requirem5t be=e ! fir/ day ( ! fir/     
cal5d> qu>t] beg9n+ aft] ! close ( !    
fir/ regul> session ( ! ,/ate           
legislature t ends aft] ! #a-ye> p]iod  

beg9n+ ) ! date ( ! enactm5t ( ?is      
section4 ,= purposes ( ! prec$+ s5t5ce1 
9 ! case ( a ,/ate t has a #b-ye>       
legislative session1 ea* ye> ( ! session
 is deem$ to be a sep>ate regul> session
 ( ! ,/ate legislature4  #cjd4 ,m$ic>e  
cov]age ( f]tility treatm5t  7a7        
,cov]age ,section #ahfa7s77#b7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#aciex7s77#b77 is am5d$-- 7#a7 9        
subp>agraph 7,,jj71 by ins]t+ & aft] !  
semicolon at ! end2 &  7#b7 by add+ at !
 end ! foll[+ new subp>agraph3  7,,kk7  
f]tility treatm5t 7z def9$ 9 section    
#bgii;,a-#aa7;b7 ( ! ,public ,heal?     
,s]vice ,act72  4  7b7 ,paym5t & waiv] (
 co9surance ,section #ahcc7;a77#a7 ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#aciel7a77#a77 is am5d$-- 7#a7 by /rik+ 
& be=e 7,,hh72 &  7#b7 by ins]t+ be=e ! 
semicolon at ! end ! foll[+3 1 & 7,,ii7 
) respect to f]tility treatm5t 7z       
describ$ 9 section #ahfa7s77#b77,,kk771 
! am\nt paid %all be equal to #ajj p]c5t
 ( ! less] ( ! actual *>ge = ! treatm5t 

or ! am\nt det]m9$ "u ! paym5t basis    
det]m9$ "u section #ahdh4  7c7 ,waiv] ( 
application ( d$uctible ,! fir/ s5t5ce (
 section #ahcc7;b7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #aciel7b77 is      
am5d$-- 7#a7 by /rik+ 1 & 7#ac7 & ins]t+
 7#ac72 &  7#b7 by /rik+ #ahfa7n744 &   
ins]t+ #ahfa7n71 & 7#ad7 su* d$uctible  
%all n apply ) respect to f]tility      
treatm5t 7z describ$ 9 section          
#ahfa7s77#b77,,kk7744  7d7 ,paym5t "u   
physician fee s*$ule ,section           
#ahdh7;j77#c7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #aciew-#d7;j77#c77 is   
am5d$ by ins]t+ 7#b77,,kk71 aft] risk   
assessm5t714  7e7 ,con=m+ am5dm5t reg>d+
 cov]age ,section #ahfb7;a77#a77;,a7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#aciey7a77#a77;,a77 is am5d$-- 7#a7 by  
/rik+ or additional & ins]t+ 1          
additional2 &  7#b7 by ins]t+ 1 or      
f]tility treatm5t 7z describ$ 9 section 
#ahfa7s77#b77,,kk77 aft]                
#ahfa7;ddd77#a774  7f7 ,effective date  
,! am5dm5ts made by ?is section %all    

apply to s]vices furni%$ on or aft]     
,janu>y #a1 #bjbe4  ,,iv ,family build+ 
,,fehb fairness  #dja4 ,%ort title ,?is 
title may be cit$ z ! ,family ,build+   
,,fehb ,fairness ,act4  #djb4 ,f]tility 
treatm5t b5efits  7a7 ,9 g5]al ,section 
#hijd ( title #e1 ,unit$ ,/ates ,code1  
is am5d$-- 7#a7 9 subsection 7a7-- 7,a7 
9 p>agraph 7#a71 by add+ at ! end !     
foll[+3  7,g7 ,f]tility treatm5t        
b5efits4  2 &  7,b7 9 p>agraph 7#b7--   
7i7 by r$esignat+ subp>agraph 7,f7 z    
subp>agraph 7,g72 &  7ii7 by ins]t+ aft]
 subp>agraph 7,e7 ! foll[+3  7,f7       
,f]tility treatm5t b5efits4  2 &  7#b7  
by add+ at ! end ! foll[+3  7c7 ,9 ?is  
section1 ! t]m f]tility treatm5t        
includes ! foll[+3 7#a7 ,pres]vation (  
human oocytes1 sp]m1 or embryos = lat]  
reproductive use4  7#b7 ,artificial     
insem9ation1 includ+ intravag9al        
insem9ation1 intrac]vical insem9ation1 &
 intraut]9e insem9ation4  7#c7 ,assi/$  
reproductive te*nology1 includ+ 9 vitro 
f]tilization & o!r treatm5ts or         

proc$ures 9 :i* reproductive g5etic     
mat]ial1 su* z oocytes1 sp]m1 f]tiliz$  
eggs1 & embryos1 are h&l$1 :5 cl9ically 
appropriate4  7#d7 ,g5etic te/+ (       
embryos4  7#e7 ,m$ications prescrib$ or 
obta9$ ov]-!-c\nt]1 z indicat$ =        
f]tility4  7#f7 ,gamete donation4  7#g7 
,su* o!r in=mation1 ref]rals1 treatm5ts1
 proc$ures1 m$ications1 laboratory      
s]vices1 te*nologies1 & s]vices relat+  
to f]tility z ! ,director ( ! ,(fice (  
,p]sonnel ,managem5t1 9 coord9ation ) ! 
,secret>y ( ,heal? & ,human ,s]vices1   
det]m9es appropriate4  4  7b7 ,effective
 date ,! am5dm5ts made by ?is section   
%all take effect on ! date t is #a ye>  
aft] ! date ( enactm5t ( ?is ,act4