,,ii ,calendar ,no4 #dac #aahth ,,congress #b;d ,session ,s4 #ddde ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,june #c1 #bjbd,ms4 ,duckworth 7for herself1 ,mrs4 ,murray1 ,mr4 ,booker1 ,mr4 ,schumer1 ,ms4 ,baldwin1 ,mr4 ,bennet1 ,mr4 ,blumenthal1 ,ms4 ,butler1 ,mr4 ,carper1 ,mr4 ,casey1 ,mr4 ,coons1 ,mr4 ,durbin1 ,mr4 ,fetterman1 ,mrs4 ,gillibrand1 ,ms4 ,hassan1 ,mr4 ,heinrich1 ,mr4 ,hickenlooper1 ,ms4 ,hirono1 ,mr4 ,kaine1 ,mr4 ,king1 ,ms4 ,klobuchar1 ,mr4 ,lujn1 ,mr4 ,markey1 ,mr4 ,merkley1 ,mr4 ,murphy1 ,mr4 ,padilla1 ,mr4 ,reed1 ,ms4 ,rosen1 ,mr4 ,sanders1 ,mr4 ,schatz1 ,ms4 ,smith1 ,ms4 ,stabenow1 ,ms4 ,warren1 ,mr4 ,welch1 ,mr4 ,whitehouse1 ,mr4 ,wyden1 ,mr4 ,warner1 and ,mr4 ,brown7 introduced the following bill2 which was read the first time ,june #d1 #bjbd,read the second time and placed on the calendar ,a ,,bill ,to protect and expand nationwide access to fertility treatment1 including in vitro fertilization4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,right to ,,ivf ,act4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,sec4 #b4 ,severability4,,title ,i--,access to ,family ,building,sec4 #aja4 ,short title4,sec4 #ajb4 ,purposes4,sec4 #ajc4 ,definitions4,sec4 #ajd4 ,fertility treatment rights4,sec4 #aje4 ,applicability and preemption4,,title ,,ii--,veteran ,families ,health ,services,sec4 #bjj4 ,short title4,subtitle ,a--,reproductive and fertility preservation assistance for members of the uniformed services,sec4 #bja4 ,definitions4,sec4 #bjb4 ,provision of fertility treatment and counseling to certain members of the uniformed services and spouses1 partners1 and gestational surrogates of such members4,sec4 #bjc4 ,establishment of fertility preservation procedures after an injury or illness4,sec4 #bjd4 ,cryopreservation and storage of reproductive genetic material of members of the uniformed services on active duty4,sec4 #bje4 ,assistance with and continuity of care regarding reproductive and fertility preservation services4,sec4 #bjf4 ,coordination between ,department of ,defense and ,department of ,veterans ,affairs on furnishing of fertility treatment and counseling4,sec4 #bjg4 ,regulations4,subtitle ,b--,reproductive assistance for veterans,sec4 #baa4 ,inclusion of fertility treatment and counseling under the definition of medical services in title #ch4,sec4 #bab4 ,fertility treatment and counseling for certain veterans and spouses1 partners1 and gestational surrogates of such veterans4,sec4 #bac4 ,assistance with and continuity of care regarding reproductive and fertility preservation services4,sec4 #bad4 ,coordination of reproduction and fertility research for veterans4,,title ,,iii--,access to fertility treatment and care,sec4 #cja4 ,short title4,sec4 #cjb4 ,standards relating to benefits for fertility treatment4,sec4 #cjc4 ,requirement for ,state ,medicaid plans to provide medical assistance for fertility treatment4,sec4 #cjd4 ,medicare coverage of fertility treatment4,,title ,,iv--,family building ,,fehb fairness,sec4 #dja4 ,short title4,sec4 #djb4 ,fertility treatment benefits4 #b4 ,severability ,if any provision of this ,act1 or the application of such provision to any person1 entity1 government1 or circumstance is held to be unconstitutional1 the remainder of this ,act1 or the application of such provision to all other persons1 entities1 governments1 or circumstances shall not be affected thereby4 ,i ,access to ,family ,building #aja4 ,short title ,this title may be cited as the ,access to ,family ,building ,act4 #ajb4 ,purposes ,the purposes of this title are as follows3 7#a7 ,to permit patients to seek and receive fertility treatment1 including assisted reproductive technology services1 and to permit health care providers that choose to provide fertility treatment1 to provide such services without ,states enacting harmful or unwarranted limitations or requirements that single out the provision of assisted reproductive services for restrictions that are not consistent with widely accepted and evidence-based medical standards of care1 and which do not significantly advance reproductive health or the efficacy and safety of fertility treatment1 or make fertility treatment more difficult to access4 7#b7 ,to promote the right and ability of a patient residing in any ,state to choose to receive fertility treatment provided in accordance with widely accepted and evidence-based medical standards of care by a health care provider who chooses to provide such services4 7#c7 ,to protect an individual's right to make decisions1 in consultation with the individual's health care provider1 about the most appropriate medical care to maximize the chance of becoming pregnant and giving birth to a healthy1 living1 human child with the help of fertility treatment4 #ajc4 ,definitions ,in this title3 7#a7 ,fertility treatment ,the term fertility treatment includes the following3 7,a7 ,preservation of human oocytes1 sperm1 or embryos for later reproductive use4 7,b7 ,artificial insemination1 including intravaginal insemination1 intracervical insemination1 and intrauterine insemination4 7,c7 ,assisted reproductive technology1 including in vitro fertilization and other treatments or procedures in which reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos1 are handled1 when clinically appropriate4 7,d7 ,genetic testing of embryos4 7,e7 ,medications prescribed or obtained over-the-counter1 as indicated for fertility4 7,f7 ,gamete donation4 7,g7 ,such other information1 referrals1 treatments1 procedures1 medications1 laboratory testing1 technologies1 and services relating to fertility as the ,secretary of ,health and ,human ,services determines appropriate4 7#b7 ,health care provider ,the term health care provider means any entity or individual 7including any physician1 nurse practitioner1 physician assistant1 pharmacist1 health care support personnel1 clinical staff1 and any other individual1 as determined by the ,secretary of ,health and ,human ,services7 that-- 7,a7 is engaged or seeks to engage in the delivery of fertility treatment1 including through the provision of evidence-based information1 counseling1 referrals1 or items and services that relate to1 aid in1 or provide fertility treatment2 and 7,b7 if required by ,state law to be licensed1 certified1 or otherwise authorized to engage in the delivery of such services-- 7i7 is so licensed1 certified1 or otherwise authorized2 or 7ii7 would be so licensed1 certified1 or otherwise authorized but for the fact that the individual or entity has provided1 is providing1 or plans to provide fertility treatment in accordance with section #ajd4 7#c7 ,health insurance issuer ,the term health insurance issuer has the meaning given such term in section #bgia7;b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ia7;b774 7#d7 ,manufacturer ,the term manufacturer means the manufacturer of a drug or device approved1 cleared1 authorized1 or licensed under section #eje1 #eaj7k71 #eac7;f77#b71 or #eae of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee1 #cfj7k71 #cfj;c7f77#b71 #cfj;e7 or section #cea of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bfb7 or otherwise legally marketed4 7#e7 ,state ,the term ,state includes each of the #ej ,states1 the ,district of ,columbia1 ,puerto ,rico1 each territory and possession of the ,united ,states1 and any political subdivision thereof4 7#f7 ,widely accepted and evidence-based medical standards of care ,the term widely accepted and evidence-based medical standards of care means any medical services1 procedures1 and practices that are in accordance with the guidelines of the ,american ,society for ,reproductive ,medicine4 #ajd4 ,fertility treatment rights 7a7 ,general rule 7#a7 ,individual rights ,an individual has a statutory right under this title1 without prohibition1 limitation1 interference1 or impediment1 to the extent that such prohibition1 limitation1 interference1 or impediment in any way or degree obstructs1 delays1 or affects commerce over which the ,federal ,government has jurisdiction1 to-- 7,a7 receive fertility treatment from a health care provider1 in accordance with widely accepted and evidence-based medical standards of care2 7,b7 continue or complete an ongoing fertility treatment previously initiated by a health care provider1 in accordance with widely accepted and evidence-based medical standards of care2 7,c7 make decisions and arrangements regarding the donation1 testing1 use1 storage1 or disposition of reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos2 and 7,d7 establish contractual agreements with a health care provider relating to the health care provider's services in handling1 testing1 storing1 shipping1 and disposing of the individual's reproductive genetic material in accordance with widely accepted and evidence-based medical standards of care4 7#b7 ,health care provider rights ,a health care provider has a statutory right under this title1 without prohibition1 limitation1 interference1 or impediment1 to the extent that such prohibition1 limitation1 interference1 or impediment in any way or degree obstructs1 delays1 or affects commerce over which the ,federal ,government has jurisdiction1 to-- 7,a7 provide1 or assist with the provision of1 fertility treatment provided in accordance with widely accepted and evidence-based medical standards of care2 7,b7 continue or complete the provision of1 or assistance with1 fertility treatment that was lawful when commenced and is provided in accordance with widely accepted and evidence-based medical standards of care2 7,c7 provide for1 or assist with1 the testing1 use1 storage1 or disposition of reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos1 in accordance with widely accepted and evidence-based medical standards of care2 and 7,d7 establish contractual agreements with individuals or manufacturers relating to the health care provider's services in handling1 testing1 storing1 shipping1 and disposing of the individual's reproductive genetic material4 7#c7 ,health insurance issuer rights ,a health insurance issuer has a statutory right under this title1 without prohibition1 limitation1 interference1 or impediment1 to the extent that such prohibition1 limitation1 interference1 or impediment in any way or degree obstructs1 delays1 or affects commerce over which the ,federal ,government has jurisdiction1 to cover the provision of fertility treatment provided in accordance with widely accepted and evidence-based medical standards of care4 7#d7 ,manufacturer rights ,a manufacturer of a drug or device that is approved1 cleared1 authorized1 or licensed under section #eje1 #eaj7k71 #eac7;f77#b71 or #eae of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cee2 #cfj7k72 #cfj;c7f77#b72 #cfj;e7 or section #cea of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bfb7 or otherwise legally marketed and intended for use in the provision of fertility treatment1 including the storage or transport of oocytes1 gametes1 fertilized eggs1 and embryos1 has a statutory right under this title1 without prohibition1 limitation1 interference1 or impediment1 to the extent that such prohibition1 limitation1 interference1 or impediment in any way or degree obstructs1 delays1 or affects commerce over which the ,federal ,government has jurisdiction1 to manufacture1 import1 market1 sell1 and distribute such drug or device4 7b7 ,state regulation of medicine ,the enforcement of ,state health and safety law regarding medical facilities or health care providers does not constitute a violation of subsection 7a7 if-- 7#a7 such regulations are in accordance with widely accepted and evidence-based medical standards of care for providing fertility treatment2 and 7#b7 the safety or health objective cannot be advanced by a different means that does not prohibit1 limit1 interfere with1 or impede the rights described in subsection 7a74 7c7 ,enforcement 7#a7 ,the ,attorney ,general 7,a7 ,in general ,the ,attorney ,general may commence a civil action on behalf of the ,united ,states against any ,state2 an individual1 employee1 official1 agency head1 contractor1 organization1 or instrumentality acting for1 or on behalf of1 such a ,state2 or any individual acting under the color of1 or pursuant to1 ,state law1 that implements1 enforces1 or threatens to enforce a limitation or requirement that prohibits1 limits1 interferes with1 or impedes the statutory rights of an individual1 a health care provider1 a health insurance issuer1 or a manufacturer under subsection 7a74 7,b7 ,effect of violations ,the court shall hold unlawful and set aside a limitation or requirement described in subparagraph 7,a7 if it is in violation of subsection 7a74 7#b7 ,private right of action 7,a7 ,in general ,any individual or entity adversely affected by an alleged violation of subsection 7a7 may commence a civil action against an individual1 employee1 official1 agency head1 contractor1 organization1 or instrumentality acting for1 or on behalf of1 such a ,state that enacts1 implements1 or enforces a limitation or requirement that prohibits1 limits1 interferes with1 or impedes the statutory rights of an individual1 a health care provider1 a health insurance issuer1 or a manufacturer under subsection 7a74 7,b7 ,effect of violations ,the court shall hold unlawful and enjoin a limitation or requirement described in subparagraph 7,a7 if it is in violation of subsection 7a74 7#c7 ,health care provider 7,a7 ,in general ,a health care provider may commence a civil action for relief on such provider's own behalf1 on behalf of the provider's staff1 or on behalf of the provider's patients who are or may be adversely affected by an alleged violation of subsection 7a74 7,b7 ,effect of violations ,the court shall hold unlawful and enjoin a limitation or requirement described in subparagraph 7,a7 if it is in violation of subsection 7a74 7#d7 ,equitable relief ,in any action under this section1 the court may award appropriate equitable relief1 including temporary1 preliminary1 or permanent injunctive relief4 7#e7 ,costs 7,a7 ,in general ,in any action under this section1 the court shall award costs of litigation1 as well as reasonable attorney's fees1 to any prevailing plaintiff4 7,b7 ,liability of plaintiffs ,a plaintiff shall not be liable to a defendant for costs or attorney's fees in any non-frivolous action under this section unless such costs or attorney's fees are imposed by the court as part of sanctions for violations committed during the discovery process4 7#f7 ,jurisdiction ,the district courts of the ,united ,states shall have jurisdiction over proceedings under this section and shall exercise the same without regard to whether the party aggrieved shall have exhausted any administrative or other remedies that may be provided for by law4 7#g7 ,right to remove 7,a7 ,in general ,any party shall have a right to remove an action brought under this subsection to the district court of the ,united ,states for the district and division embracing the place where such action is pending4 7,b7 ,review ,an order remanding the case to the ,state court from which it was removed under this paragraph is immediately reviewable by appeal or otherwise4 7d7 ,regulations ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services shall promulgate regulations to carry out this section4 7e7 ,rules of construction 7#a7 ,in general ,for purposes of this title1 a ,state law1 or the administration1 implementation1 or enforcement of a ,state law1 constitutes a prohibition1 limitation1 interference1 or impediment on a health care provider providing1 an individual receiving1 a health insurance issuer covering1 or a manufacturer marketing drugs or devices for fertility treatment1 provided in accordance with widely accepted and evidence-based medical standards of care1 as described in subsection #ajd1 if the administration1 implementation1 interpretation1 or enforcement of such law has an effect that-- 7,a7 imposes requirements or limitations that are inconsistent with providing1 receiving1 providing health insurance coverage for1 or providing drugs or devices for fertility treatment in accordance with widely accepted and evidence-based medical standards of care or that otherwise violate the purpose and requirements of this ,act1 which may include-- 7i7 requiring that a health care provider provide1 and patients undertake1 medically unnecessary procedures and services1 including tests and procedures1 providing medically inaccurate information regarding fertility treatment1 or requiring additional unnecessary in-person visits to a health care provider1 that are inconsistent with widely accepted and evidence-based medical standards of care2 7ii7 imposing limitations or requirements concerning physical offices1 clinics1 facilities1 equipment1 staffing1 or hospital transfer arrangements of facilities where fertility treatment is provided1 or the credentials or hospital privileges or status of personnel at such facilities1 that are not consistent with widely accepted and evidence-based medical standards of care2 or 7iii7 limiting a health care provider's right or ability to provide1 or a patient's right to receive1 or imposing limitations that reduce the efficacy of1 fertility treatment in accordance with widely accepted and evidence-based medical standards of care1 including retrieval of multiple eggs during oocyte retrieval2 performance of insemination procedures1 including intrauterine insemination2 intracytoplasmic sperm injections to fertilize multiple human eggs2 and cryopreservation of one or more eggs or embryos for fertility preservation and subsequent transfer1 if determined appropriate by the health care provider and patient2 7,b7 infringes1 limits1 or restricts the ability of a health care provider1 patient1 health insurance issuer1 or manufacturer1 to exercise or enforce their statutory rights under this title on the basis of marital status1 sex 7including sexual orientation and gender identity7 or any other protected class that is covered by ,federal law2 7,c7 limits a health care provider's or patient's right or ability to determine the most appropriate disposition of fertilized eggs or embryos1 including by defining a gamete or embryo in such a way as to prevent the disposition of gametes and embryos2 7,d7 limits a health care provider's ability to provide1 or a patient's ability to receive1 fertility treatment via telemedicine1 in accordance with widely accepted and evidence-based medical standards of care2 7,e7 limits or prohibits a health care provider's ability to provide1 or a patient's ability to receive1 fertility counseling or fertility treatment based on the residency of the patient1 or prohibits or limits the ability of any individual to assist or support a patient seeking fertility treatment2 7,f7 imposes requirements or limitations that compel health care providers to provide1 or patients to receive1 medically unnecessary care1 or withhold medically necessary care1 in a manner that is not consistent with widely accepted and evidence-based medical standards of care for fertility treatment1 including mandating the transfer of embryos that a health care provider would not reasonably expect1 based on widely accepted and evidence-based medical standards of care1 to lead to a healthy pregnancy or a live birth2 7,g7 limits a health care provider's right or ability to prescribe or dispense1 or a patient's right or ability to receive or use1 medications for fertility treatment in accordance with widely accepted and evidence-based medical standards of care1 unless such a limitation is generally applicable to the prescription1 dispensing1 or distribution of medications2 or 7,h7 limits a health care provider's right or ability to perform a human sperm retrieval procedure in accordance with widely accepted and evidence-based medical standards of care4 7#b7 ,clarification ,the descriptions of specific ,state laws that would violate the statutory rights and protections described in paragraph 7#a7 shall not be construed to limit potential violations of the statutory rights and protections under this title to only the restrictions and limitations listed in paragraph 7#a71 and potential violations of this title may result from novel ,state restrictions and limitations that are not listed under paragraph 7#a74 7#c7 ,exclusion ,it shall not constitute a prohibition1 limitation1 interference1 or impediment to a health care provider providing1 an individual receiving1 a health insurance issuer covering1 or a manufacturer marketing a drug or device for purposes of1 fertility treatment under this title for an entity to act in compliance with the ,food and ,drug ,administration's regulation of drugs1 devices1 biological products1 human cells1 tissues1 or cellular or tissue-based products used in fertility treatment1 consistent with widely accepted and evidence-based medical standards of care for fertility treatment4 #aje4 ,applicability and preemption 7a7 ,in general 7#a7 ,general application 7,a7 ,effect on ,state law ,this title supersedes any ,state law that is inconsistent with the statutory rights established under this title and precludes the implementation of such a law1 whether statutory1 common law1 or otherwise1 and whether adopted before or after the date of enactment of this ,act4 7,b7 ,prohibition ,no ,state shall administer1 implement1 or enforce any law1 rule1 regulation1 standard1 or other provision having the force and effect of law that conflicts with any provision of this title1 notwithstanding any other provision of ,federal law4 7#b7 ,exclusion ,preemption of ,state law under paragraph 7#a7 does not apply to-- 7,a7 ,state law regarding the resolution of disputes between #b individuals with rights described in section #ajd7;a77#a7 with respect to the same reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos2 or 7,b7 any other ,state law1 to the extent that such law does not conflict with this title and protects an individual's right and ability to receive fertility treatment in accordance with widely accepted and evidence-based medical standards of care1 including any such law that holds a health care provider accountable for not providing fertility treatment in accordance with widely accepted and evidence-based medical standards of care4 7#c7 ,preservation of ,federal public health authorities ,nothing in this title shall have the effect of superseding1 negating1 or limiting provisions of ,federal law1 including the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cja et seq47 or the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bja et seq471 and regulations promulgated under such statutes1 with respect to the regulation of drugs1 devices1 biological products1 human cells1 tissues1 or cellular or tissue-based products used in fertility treatment4 7#d7 ,preservation of ,,hipaa rules ,nothing in this title shall have the effect of superseding1 negating1 or limiting the provisions of the privacy1 security1 and breach notification regulations in parts #afj and #afd of title #de1 ,code of ,federal ,regulations 7or successor regulations74 7#e7 ,subsequently enacted ,federal legislation ,federal statutory law adopted after the date of the enactment of this ,act is subject to this title unless such law explicitly excludes such application by reference to this title4 7b7 ,defense ,in any cause of action against an individual or entity who is subject to a limitation or requirement that violates this title1 in addition to the remedies specified in section #ajd7;b71 this title shall also apply to1 and may be raised as a defense by1 such an individual or entity4 ,,ii ,veteran ,families ,health ,services #bjj4 ,short title ,this title may be cited as the ,veteran ,families ,health ,services ,act4 ,a ,reproductive and fertility preservation assistance for members of the uniformed services #bja4 ,definitions ,in this subtitle3 7#a7 ,active duty ,the term active duty has the meaning given that term in section #aja7ah7 of title #cg1 ,united ,states ,code4 7#b7 ,uniformed services ,the term uniformed services has the meaning given that term in section #aja7;a77#e7 of title #aj1 ,united ,states ,code4 #bjb4 ,provision of fertility treatment and counseling to certain members of the uniformed services and spouses1 partners1 and gestational surrogates of such members 7a7 ,fertility treatment and counseling 7#a7 ,in general ,the ,secretary of ,defense shall make available fertility treatment and counseling to a member of the uniformed services or a spouse1 partner1 or gestational surrogate of such a member4 7#b7 ,eligibility for treatment and counseling ,fertility treatment and counseling shall be furnished under paragraph 7#a7 without regard to the sex1 sex characteristics1 gender identity1 sexual orientation1 infertility diagnosis1 or marital status of the member of the uniformed services or their partner4 7#c7 ,in vitro fertilization ,in the case of in vitro fertilization treatment furnished under paragraph 7#a71 the ,secretary may furnish to an individual under such paragraph-- 7,a7 not more than three completed oocyte retrievals2 and 7,b7 unlimited embryo transfers4 7b7 ,procurement of reproductive genetic material ,if a member of the uniformed services is unable to provide their reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos1 for purposes of fertility treatment under subsection 7a71 the ,secretary shall1 at the election of such member1 allow such member to receive such treatment with donated reproductive genetic material and pay or reimburse such member the reasonable costs of procuring such material from a donor4 7c7 ,rules of construction 7#a7 ,impact on existing authority ,nothing in this section shall be construed to rescind the authority of the ,secretary to provide in vitro fertilization benefits pursuant to section #ajgd7;c77#d7 of title #aj1 ,united ,states ,code4 7#b7 ,sourcing of gestational surrogate or reproductive genetic material ,nothing in this section shall be construed to require the ,secretary-- 7,a7 to find or certify a gestational surrogate for a member of the uniformed services or to connect a gestational surrogate with such a member2 or 7,b7 to find or certify reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos1 from a donor for a member of the uniformed services or to connect such a member with reproductive genetic material from a donor4 7d7 ,definitions ,in this section3 7#a7 ,fertility treatment ,the term fertility treatment includes the following3 7,a7 ,preservation of human oocytes1 sperm1 or embryos for later reproductive use4 7,b7 ,artificial insemination1 including intravaginal insemination1 intracervical insemination1 and intrauterine insemination4 7,c7 ,assisted reproductive technology1 including in vitro fertilization and other treatments or procedures in which reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos1 are handled1 when clinically appropriate4 7,d7 ,genetic testing of embryos4 7,e7 ,medications prescribed or obtained over-the-counter1 as indicated for fertility4 7,f7 ,gamete donation4 7,g7 ,such other information1 referrals1 treatments1 procedures1 medications1 laboratory testing1 technologies1 and services relating to fertility as the ,secretary of ,defense determines appropriate4 7#b7 ,gestational surrogate ,the term gestational surrogate means an individual who agrees to become pregnant through in vitro fertilization under a gestational surrogacy agreement using gametes that are not the gametes of that individual4 7#c7 ,partner ,the term partner1 with respect to a member of the uniformed services1 means an individual selected by the member who agrees to be a parent1 with the member1 of a child born as a result of the use of any fertility treatment under this section4 #bjc4 ,establishment of fertility preservation procedures after an injury or illness 7a7 ,in general ,the ,secretary of ,defense1 acting through the ,assistant ,secretary of ,defense for ,health ,affairs1 shall establish procedures for the retrieval of reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos1 as soon as medically appropriate1 from a member of the uniformed services in cases in which the fertility of such member is potentially jeopardized as a result of an injury or illness incurred or aggravated while serving on active duty in the uniformed services in order to preserve the medical options of such member4 7b7 ,inclusion of information in advanced directives and military testamentary instruments ,the ,secretary of ,defense shall ensure that any advance medical directive1 as defined in section #ajdd;c7b7 of title #aj1 ,united ,states ,code1 or military testamentary instrument1 as defined in section #ajdd;d7b7 of such title1 completed by a member of the uniformed services includes questions about the consent of the member to fertility preservation procedures under subsection 7a74 7c7 ,disposal of reproductive genetic material ,subject to section #bjd1 in accordance with regulations prescribed by the ,secretary for purpose of this subsection1 the ,secretary shall dispose of reproductive genetic material retrieved from a member of the uniformed services under subsection 7a7-- 7#a7 with the specific consent of the member2 or 7#b7 if the member-- 7,a7 has lost the ability to consent permanently1 as determined by a medical professional1 or has died2 and 7,b7 has not specified the use of their reproductive genetic material in an advance directive or testamentary instrument executed by the member4 #bjd4 ,cryopreservation and storage of reproductive genetic material of members of the uniformed services on active duty 7a7 ,in general ,the ,secretary of ,defense shall provide members of the uniformed services on active duty in the uniformed services with the opportunity to cryopreserve and store their reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos1 prior to-- 7#a7 deployment to a combat zone2 or 7#b7 a duty assignment that includes a hazardous assignment1 including-- 7,a7 assignments resulting in exposure to perfluoroalkyl or polyfluoroalkyl substances2 and 7,b7 such other assignments as determined by the ,secretary4 7b7 ,period of time 7#a7 ,in general ,the ,secretary shall provide for the cryopreservation and storage of reproductive genetic material of any member of the uniformed services under subsection 7a7 in a facility of the ,department of ,defense or of a private entity and the transportation of such material1 at no cost to the member1 until the date that is one year after the retirement1 separation1 or release of the member from the uniformed services4 7#b7 ,continued cryopreservation and storage ,at the end of the one-year period specified in paragraph 7#a71 the ,secretary shall permit an individual whose reproductive genetic material was cryopreserved and stored as described in that paragraph to select1 including pursuant to an advance medical directive or military testamentary instrument completed under subsection 7c71 one of the following options3 7,a7 ,to continue such cryopreservation and storage in such facility with the cost of such cryopreservation and storage borne by the individual4 7,b7 ,to transfer the material to a private cryopreservation and storage facility selected by the individual4 7,c7 ,to transfer the material to a facility of the ,department of ,veterans ,affairs if cryopreservation and storage is available to the individual at such facility and the individual is eligible for such services4 7#c7 ,disposal of reproductive genetic material 7,a7 ,no selection ,if an individual described in paragraph 7#b7 does not make a selection under subparagraph 7,a71 7,b71 or 7,c7 of such paragraph1 the ,secretary may dispose of the reproductive genetic material of the individual not earlier than the date that is #ij days after the end of the one-year period specified in paragraph 7#a7 with respect to the individual4 7,b7 ,election by individual ,at the election of an individual described in paragraph 7#b71 the ,secretary may dispose of the reproductive genetic material of the individual4 7c7 ,advance medical directive and military testamentary instrument ,a member of the uniformed services who elects to cryopreserve and store their reproductive genetic material under this section must complete an advance medical directive1 as defined in section #ajdd;c7b7 of title #aj1 ,united ,states ,code1 and a military testamentary instrument1 as defined in section #ajdd;d7b7 of such title1 that explicitly specifies the use of their cryopreserved and stored reproductive genetic material if such member dies or otherwise loses the capacity to consent to the use of their cryopreserved and stored reproductive genetic material4 7d7 ,agreements ,to carry out this section1 the ,secretary may enter into agreements with private entities that provide cryopreservation1 transportation1 and storage services for reproductive genetic material4 #bje4 ,assistance with and continuity of care regarding reproductive and fertility preservation services ,the ,secretary of ,defense shall ensure that employees of the ,department of ,defense assist members of the uniformed services-- 7#a7 in navigating the services provided under this subtitle2 7#b7 in finding a provider that meets the needs of such members with respect to such services2 and 7#c7 in continuing the receipt of such services without interruption during a permanent change of station for such members4 #bjf4 ,coordination between ,department of ,defense and ,department of ,veterans ,affairs on furnishing of fertility treatment and counseling 7a7 ,in general ,the ,secretary of ,defense and the ,secretary of ,veterans ,affairs shall share best practices and facilitate referrals1 as they consider appropriate1 on the furnishing of fertility treatment and counseling to individuals eligible for the receipt of such counseling and treatment from the ,secretaries4 7b7 ,memorandum of understanding ,the ,secretary of ,defense and the ,secretary of ,veterans ,affairs shall enter into a memorandum of understanding-- 7#a7 providing that the ,secretary of ,defense will ensure access by the ,secretary of ,veterans ,affairs to reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos1 of veterans stored by the ,department of ,defense for purposes of furnishing fertility treatment under section #agbj,k of title #ch1 ,united ,states ,code1 as added by section #bab7;a72 and 7#b7 authorizing the ,department of ,veterans ,affairs to compensate the ,department of ,defense for the cryopreservation1 transportation1 and storage of reproductive genetic material of veterans under section #bjd7;b77#b77;,a74 #bjg4 ,regulations ,not later than two years after the date of the enactment of this ,act1 the ,secretary of ,defense shall prescribe regulations to carry out this subtitle4 ,b ,reproductive assistance for veterans #baa4 ,inclusion of fertility treatment and counseling under the definition of medical services in title #ch ,section #agja7f7 of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subparagraph3 7,j7 ,fertility treatment and counseling under section #agbj,k of this title4 4 #bab4 ,fertility treatment and counseling for certain veterans and spouses1 partners1 and gestational surrogates of such veterans 7a7 ,in general ,subchapter ,,ii of chapter #ag of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #agbj,k4 ,fertility treatment and counseling for certain veterans and spouses1 partners1 and gestational surrogates of such veterans 7a7 ,requirement 7#a7 ,in general ,notwithstanding any other provision of law1 including the surrogacy laws of any ,state1 the ,secretary shall furnish fertility treatment and counseling for the benefit of a covered veteran to the veteran and the spouse1 partner1 gamete donor1 or gestational surrogate of the veteran if the veteran1 and the spouse1 partner1 gamete donor1 or gestational surrogate of the veteran1 as applicable1 each provide informed consent for such treatment and counseling1 including for each cycle of treatment authorized under this section1 through a process prescribed by the ,secretary4 7#b7 ,provision of treatment and counseling ,fertility treatment and counseling shall be furnished under paragraph 7#a7 without regard to the sex1 sexual characteristics1 gender identity1 sexual orientation1 infertility diagnosis1 or marital status of the covered veteran or their partner4 7#c7 ,in vitro fertilization ,in the case of in vitro fertilization treatment furnished under paragraph 7#a71 the ,secretary may furnish to an individual under such paragraph-- 7,a7 not more than three completed oocyte retrievals2 and 7,b7 unlimited embryo transfers4 7#d7 ,copayment ,the ,secretary shall only furnish fertility treatment and counseling under paragraph 7#a7 to a covered veteran who is required to pay to the ,united ,states a copayment amount as a condition for the receipt of hospital care1 medical services1 or medications under this chapter if the covered veteran agrees to pay such applicable copayment amount to the ,united ,states for such treatment and counseling4 7b7 ,procurement of reproductive genetic material 7#a7 ,in general ,if a covered veteran is unable to provide their reproductive genetic material for purposes of fertility treatment under subsection 7a71 the ,secretary shall1 at the election of such veteran-- 7,a7 allow such veteran to receive such treatment with donated reproductive genetic material1 if the donor provides informed consent for use of such material2 and 7,b7 pay or reimburse the veteran1 donor1 or a party acting on behalf of the donor the reasonable costs of procuring such material from the donor4 7#b7 ,other expenses ,the ,secretary may pay or reimburse a covered veteran a reasonable amount for personal travel and incidental expenses associated with procuring material from a donor under paragraph 7#a74 7c7 ,outreach and training ,the ,secretary shall carry out an outreach and training program to ensure veterans and health care providers of the ,department are aware of-- 7#a7 the availability of and eligibility requirements for fertility treatment and counseling under this section2 and 7#b7 any changes to fertility treatment and counseling covered under this section4 7d7 ,ownership1 use1 or disposition of reproductive genetic material 7#a7 ,in general ,issues or disputes regarding ownership of reproductive genetic material or future use or disposition of such material shall be the sole responsibility of the covered veteran1 the spouse1 partner1 or gestational surrogate of the veteran1 as applicable1 and the private facility storing such material4 7#b7 ,agreement regarding donated reproductive genetic material ,as a condition of the use of donated gametes or embryos under this section1 the third-party donor and a provider of fertility treatment that has entered into a contract or agreement with the ,secretary to provide such treatment under this section are required to enter into an arrangement or agreement governing the terms of the donation1 to include ultimate disposition of any remaining gametes or embryos once a covered veteran has exhausted the fertility treatment available under this section1 unless the veteran or the spouse or partner of the veteran has agreed to assume liability for the continued preservation of any remaining gametes or embryos and the ,department is not party to the arrangement or agreement for such continued preservation4 7#c7 ,role of ,department ,the role of the ,secretary under this section is limited to furnishing the treatment and counseling required under this section when requested by a covered veteran and determined necessary by the ,secretary4 7#d7 ,ownership and custody of reproductive genetic material ,the ,secretary will not have ownership or custody of any reproductive genetic material obtained pursuant to treatment under this section and will not be involved in the ultimate disposition of such material or disputes between or among any parties with respect to such material4 7e7 ,rule of construction ,nothing in this section shall be construed to require the ,secretary-- 7#a7 to find or certify a gestational surrogate for a covered veteran or to connect a gestational surrogate with a covered veteran2 or 7#b7 to furnish maternity care to a covered veteran or spouse1 partner1 or gestational surrogate of a covered veteran beyond what is otherwise required or authorized by law4 7f7 ,definitions ,in this section3 7#a7 ,the term covered veteran means a veteran who is enrolled in the system of annual patient enrollment established under section #agje7;a7 of this title4 7#b7 ,the term fertility treatment includes the following3 7,a7 ,preservation of human oocytes1 sperm1 or embryos for later reproductive use4 7,b7 ,artificial insemination1 including intravaginal insemination1 intracervical insemination1 and intrauterine insemination4 7,c7 ,assisted reproductive technology1 including in vitro fertilization and other treatments or procedures in which reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos1 are handled1 when clinically appropriate4 7,d7 ,genetic testing of embryos4 7,e7 ,medications prescribed or obtained over-the-counter1 as indicated for fertility4 7,f7 ,gamete donation4 7,g7 ,such other information1 referrals1 treatments1 procedures1 medications1 laboratory testing1 technologies1 and services relating to fertility as the ,secretary determines appropriate4 7#c7 ,the term gestational surrogate means an individual who agrees to become pregnant through in vitro fertilization under a gestational surrogacy agreement using gametes that are not the gametes of that individual4 7#d7 ,the term partner1 with respect to a covered veteran1 means an individual selected by the veteran who agrees to be a parent1 with the veteran1 of a child born as a result of the use of any fertility treatment under this section4 4 7b7 ,clerical amendment ,the table of sections at the beginning of subchapter ,,ii of chapter #ag of such title is amended by inserting after the item relating to section #agbj;,j the following new item3 #agbj,k4 ,fertility treatment and counseling for certain veterans and spouses1 partners1 and gestational surrogates of such veterans4 4 7c7 ,sunset of existing authority ,the authority under section #bcd of the ,military ,construction1 ,veterans ,affairs1 and ,related ,agencies ,appropriations ,act1 #bjbd 7division ,a of ,public ,law #aah-db71 or any similar authority subsequently enacted by law1 shall cease on the effective date of regulations prescribed to carry out section #agbj,k of title #ch1 ,united ,states ,code1 as added by subsection 7a74 #bac4 ,assistance with and continuity of care regarding reproductive and fertility preservation services ,the ,secretary of ,veterans ,affairs shall ensure that employees of the ,department of ,veterans ,affairs assist veterans-- 7#a7 in navigating the services provided under this subtitle and the amendments made by this subtitle2 7#b7 in finding a provider that meets the needs of such veterans with respect to such services2 and 7#c7 in continuing the receipt of such services without interruption if such veterans move to a different geographic location4 #bad4 ,coordination of reproduction and fertility research for veterans 7a7 ,in general ,subchapter ,,ii of chapter #gc of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #gccj;,e4 ,coordination of reproduction and fertility research for veterans 7a7 ,coordination of research required ,the ,secretary shall coordinate with the ,secretary of ,defense and the ,secretary of ,health and ,human ,services to conduct research to improve the ability of the ,department of ,veterans ,affairs to meet the long-term reproductive health care needs of veterans who have a condition that affects the ability of the individual to reproduce4 7b7 ,dissemination of information ,the ,secretary shall ensure that information produced by the research under this section that may be useful for other activities of the ,department is disseminated throughout the ,department4 4 7b7 ,clerical amendment ,the table of sections at the beginning of subchapter ,,ii of chapter #gc of such title is amended by inserting after the item relating to section #gccj;,d the following new item3 #gccj;,e4 ,coordination of reproduction and fertility research for veterans4 4 ,,iii ,access to fertility treatment and care #cja4 ,short title ,this title may be cited as the ,access to ,fertility ,treatment and ,care ,act4 #cjb4 ,standards relating to benefits for fertility treatment 7a7 ,in general 7#a7 ,,phsa ,part ,d of title ,,xxvii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#aaa et seq47 is amended by adding at the end the following3 #bgii;,a-#aa4 ,standards relating to benefits for fertility treatment 7a7 ,in general ,a group health plan or a health insurance issuer offering group or individual health insurance coverage shall provide coverage for fertility treatment1 if such plan or coverage provides coverage for obstetrical services4 7b7 ,definition ,in this section1 the term fertility treatment includes the following3 7#a7 ,preservation of human oocytes1 sperm1 or embryos for later reproductive use4 7#b7 ,artificial insemination1 including intravaginal insemination1 intracervical insemination1 and intrauterine insemination4 7#c7 ,assisted reproductive technology1 including in vitro fertilization and other treatments or procedures in which reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos1 are handled1 when clinically appropriate4 7#d7 ,genetic testing of embryos4 7#e7 ,medications prescribed or obtained over-the-counter1 as indicated for fertility4 7#f7 ,gamete donation4 7#g7 ,such other information1 referrals1 treatments1 procedures1 medications1 laboratory testing1 technologies1 and services relating to fertility as the ,secretary determines appropriate4 7c7 ,required coverage ,a group health plan and a health insurance issuer offering group or individual health insurance coverage that includes coverage for obstetrical services shall provide coverage for fertility treatment determined appropriate by the health care provider1 regardless of whether the participant1 beneficiary1 or enrollee receiving such treatment has been diagnosed with infertility as defined by the ,american ,society for ,reproductive ,medicine1 if the treatment is performed at1 or prescribed by1 a medical facility that is in compliance with relevant standards set by an appropriate ,federal agency4 7d7 ,limitation ,cost-sharing1 including deductibles and coinsurance1 or other limitations for fertility treatment may not be imposed with respect to the services required to be covered under subsection 7c7 to the extent that such cost-sharing exceeds the cost-sharing applied to other medical services under the group health plan or health insurance coverage or such other limitations are different from limitations imposed with respect to such medical services1 except where such limitation is more favorable with respect to fertility treatment4 ,the ,secretary shall promulgate interim final regulations to carry out this subsection1 notwithstanding the notice and comment requirements of section #eec of title #e1 ,united ,states ,code4 7e7 ,prohibitions ,a group health plan and a health insurance issuer offering group or individual health insurance coverage may not-- 7#a7 provide incentives 7monetary or otherwise7 to a participant1 beneficiary1 or enrollee to encourage such participant1 beneficiary1 or enrollee not to seek or obtain fertility treatment to which such participant1 beneficiary1 or enrollee is entitled under this section or to providers to induce such providers not to provide medically appropriate fertility treatments to participants1 beneficiaries1 or enrollees2 7#b7 prohibit a provider from discussing with a participant1 beneficiary1 or enrollee fertility treatment relating to this section2 7#c7 penalize or otherwise reduce or limit the reimbursement of a provider because such provider provided fertility treatment to a qualified participant1 beneficiary1 or enrollee in accordance with this section2 or 7#d7 on the ground prohibited under title ,,vi of the ,civil ,rights ,act of #aifd1 title ,,ix of the ,education ,amendments of #aigb1 the ,age ,discrimination ,act of #aige1 section #ejd of the ,rehabilitation ,act of #aigc1 or section #aeeg of the ,patient ,protection and ,affordable ,care ,act1 exclude any individual from coverage in accordance with this section1 or discriminate against any individual with respect to such coverage4 7f7 ,rule of construction ,nothing in this section shall be construed to require a participant1 beneficiary1 or enrollee to undergo fertility treatment4 7g7 ,notice ,a group health plan and a health insurance issuer offering group or individual health insurance coverage shall provide notice to each participant1 beneficiary1 and enrollee under such plan or coverage regarding the coverage required by this section in accordance with regulations promulgated by the ,secretary4 ,such notice shall be in writing and prominently positioned in any literature or correspondence made available or distributed by the plan or issuer and shall be transmitted-- 7#a7 not later than the earlier of-- 7,a7 in the first standard mailing made by the plan or issuer to the participant1 beneficiary1 or enrollee following the effective date of such regulations2 7,b7 as part of any yearly informational packet sent to the participant1 beneficiary1 or enrollee2 or 7,c7 ,january #a1 #bjbf2 7#b7 in the case of a participant1 beneficiary1 or enrollee not enrolled in the plan or coverage on the date of transmission under paragraph 7#a71 upon initial enrollment of such participant1 beneficiary1 or enrollee2 and 7#c7 on an annual basis after the transmission under paragraph 7#a7 or 7#b74 7h7 ,level and type of reimbursements ,nothing in this section shall be construed to prevent a group health plan or a health insurance issuer offering group or individual health insurance coverage from negotiating the level and type of reimbursement with a provider for care provided in accordance with this section4 4 7#b7 ,,erisa 7,a7 ,in general ,subpart ,b of part #g of subtitle ,b of title ,i of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #aahe et seq47 is amended by adding at the end the following3 #gbf4 ,standards relating to benefits for fertility treatment 7a7 ,in general ,a group health plan or a health insurance issuer offering group health insurance coverage shall provide coverage for fertility treatment1 if such plan or coverage provides coverage for obstetrical services4 7b7 ,definition ,in this section1 the term fertility treatment includes the following3 7#a7 ,preservation of human oocytes1 sperm1 or embryos for later reproductive use4 7#b7 ,artificial insemination1 including intravaginal insemination1 intracervical insemination1 and intrauterine insemination4 7#c7 ,assisted reproductive technology1 including in vitro fertilization and other treatments or procedures in which reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos1 are handled1 when clinically appropriate4 7#d7 ,genetic testing of embryos4 7#e7 ,medications prescribed or obtained over-the-counter1 as indicated for fertility4 7#f7 ,gamete donation4 7#g7 ,such other information1 referrals1 treatments1 procedures1 medications1 laboratory testing1 technologies1 and services relating to fertility as the ,secretary of ,health and ,human ,services determines appropriate4 7c7 ,required coverage ,a group health plan and a health insurance issuer offering group health insurance coverage that includes coverage for obstetrical services shall provide coverage for fertility treatment determined appropriate by the health care provider1 regardless of whether the participant or beneficiary receiving such treatment has been diagnosed with infertility as defined by the ,american ,society for ,reproductive ,medicine1 if the treatment is performed at1 or prescribed by1 a medical facility that is in compliance with relevant standards set by an appropriate ,federal agency4 7d7 ,limitation ,cost-sharing1 including deductibles and coinsurance1 or other limitations for fertility treatment may not be imposed with respect to the services required to be covered under subsection 7c7 to the extent that such cost-sharing exceeds the cost-sharing applied to other medical services under the group health plan or health insurance coverage or such other limitations are different from limitations imposed with respect to such medical services1 except where such limitation is more favorable with respect to fertility treatment4 ,the ,secretary shall promulgate interim final regulations to carry out this subsection1 notwithstanding the notice and comment requirements of section #eec of title #e1 ,united ,states ,code4 7e7 ,prohibitions ,a group health plan and a health insurance issuer offering group health insurance coverage may not-- 7#a7 provide incentives 7monetary or otherwise7 to a participant or beneficiary to encourage such participant or beneficiary not to seek or obtain fertility treatment to which such participant or beneficiary is entitled under this section or to providers to induce such providers not to provide medically appropriate fertility treatments to participants or beneficiaries2 7#b7 prohibit a provider from discussing with a participant or beneficiary fertility treatment relating to this section2 7#c7 penalize or otherwise reduce or limit the reimbursement of a provider because such provider provided fertility treatment to a qualified participant or beneficiary in accordance with this section2 or 7#d7 on the ground prohibited under title ,,vi of the ,civil ,rights ,act of #aifd 7#db ,u4,s4,c4 #bjjj;d et seq471 title ,,ix of the ,education ,amendments of #aigb 7#bj ,u4,s4,c4 #afha et seq471 the ,age ,discrimination ,act of #aige 7#db ,u4,s4,c4 #faja et seq471 section #ejd of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gid71 or section #aeeg of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahaaf71 exclude any individual from coverage in accordance with this section1 or discriminate against any individual with respect to such coverage4 7f7 ,rule of construction ,nothing in this section shall be construed to require a participant or beneficiary to undergo fertility treatment4 7g7 ,notice ,a group health plan and a health insurance issuer offering group health insurance coverage shall provide notice to each participant and beneficiary under such plan or coverage regarding the coverage required by this section in accordance with regulations promulgated by the ,secretary4 ,such notice shall be in writing and prominently positioned in any literature or correspondence made available or distributed by the plan or issuer and shall be transmitted-- 7#a7 not later than the earlier of-- 7,a7 in the first standard mailing made by the plan or issuer to the participant or beneficiary following the effective date of such regulations2 7,b7 as part of any yearly informational packet sent to the participant or beneficiary2 or 7,c7 ,january #a1 #bjbf2 7#b7 in the case of a participant or beneficiary not enrolled in the plan or coverage on the date of transmission under paragraph 7#a71 upon initial enrollment of such participant or beneficiary2 and 7#c7 on an annual basis after the transmission under paragraph 7#a7 or 7#b74 7h7 ,level and type of reimbursements ,nothing in this section shall be construed to prevent a group health plan or a health insurance issuer offering group health insurance coverage from negotiating the level and type of reimbursement with a provider for care provided in accordance with this section4 4 7,b7 ,clerical amendment ,the table of contents in section #a of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #ajja et seq47 is amended by inserting after the item relating to section #gbe the following new item3 ,sec4 #gbf4 ,standards relating to benefits for fertility treatment4 4 7#c7 ,,irc 7,a7 ,in general ,subchapter ,b of chapter #ajj of the ,internal ,revenue ,code of #aihf is amended by adding at the end the following3 #ihbf4 ,standards relating to benefits for fertility treatment 7a7 ,in general ,a group health plan shall provide coverage for fertility treatment1 if such plan provides coverage for obstetrical services4 7b7 ,definition ,in this section1 the term fertility treatment includes the following3 7#a7 ,preservation of human oocytes1 sperm1 or embryos for later reproductive use4 7#b7 ,artificial insemination1 including intravaginal insemination1 intracervical insemination1 and intrauterine insemination4 7#c7 ,assisted reproductive technology1 including in vitro fertilization and other treatments or procedures in which reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos1 are handled1 when clinically appropriate4 7#d7 ,genetic testing of embryos4 7#e7 ,medications prescribed or obtained over-the-counter1 as indicated for fertility4 7#f7 ,gamete donation4 7#g7 ,such other information1 referrals1 treatments1 procedures1 medications1 laboratory testing1 technologies1 and services relating to fertility as the ,secretary of ,health and ,human ,services determines appropriate4 7c7 ,required coverage ,a group health plan that includes coverage for obstetrical services shall provide coverage for fertility treatment determined appropriate by the health care provider1 regardless of whether the participant or beneficiary receiving such treatment has been diagnosed with infertility as defined by the ,american ,society for ,reproductive ,medicine1 if the treatment is performed at1 or prescribed by1 a medical facility that is in compliance with relevant standards set by an appropriate ,federal agency4 7d7 ,limitation ,cost-sharing1 including deductibles and coinsurance1 or other limitations for fertility treatment may not be imposed with respect to the services required to be covered under subsection 7c7 to the extent that such cost-sharing exceeds the cost-sharing applied to other medical services under the group health plan or health insurance coverage or such other limitations are different from limitations imposed with respect to such medical services1 except where such limitation is more favorable with respect to fertility treatment4 ,the ,secretary shall promulgate interim final regulations to carry out this subsection1 notwithstanding the notice and comment requirements of section #eec of title #e1 ,united ,states ,code4 7e7 ,prohibitions ,a group health plan may not-- 7#a7 provide incentives 7monetary or otherwise7 to a participant or beneficiary to encourage such participant or beneficiary not to seek or obtain fertility treatment to which such participant or beneficiary is entitled under this section or to providers to induce such providers not to provide medically appropriate fertility treatments to participants or beneficiaries2 7#b7 prohibit a provider from discussing with a participant or beneficiary fertility treatment relating to this section2 7#c7 penalize or otherwise reduce or limit the reimbursement of a provider because such provider provided fertility treatment to a qualified participant or beneficiary in accordance with this section2 or 7#d7 on the ground prohibited under title ,,vi of the ,civil ,rights ,act of #aifd 7#db ,u4,s4,c4 #bjjj;d et seq471 title ,,ix of the ,education ,amendments of #aigb 7#bj ,u4,s4,c4 #afha et seq471 the ,age ,discrimination ,act of #aige 7#db ,u4,s4,c4 #faja et seq471 section #ejd of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gid71 or section #aeeg of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahaaf71 exclude any individual from coverage in accordance with this section1 or discriminate against any individual with respect to such coverage4 7f7 ,rule of construction ,nothing in this section shall be construed to require a participant or beneficiary to undergo fertility treatment4 7g7 ,notice ,a group health plan shall provide notice to each participant and beneficiary under such plan regarding the coverage required by this section in accordance with regulations promulgated by the ,secretary4 ,such notice shall be in writing and prominently positioned in any literature or correspondence made available or distributed by the plan and shall be transmitted-- 7#a7 not later than the earlier of-- 7,a7 in the first standard mailing made by the plan to the participant or beneficiary following the effective date of such regulations2 7,b7 as part of any yearly informational packet sent to the participant or beneficiary2 or 7,c7 ,january #a1 #bjbf2 7#b7 in the case of a participant or beneficiary not enrolled in the plan on the date of transmission under paragraph 7#a71 upon initial enrollment of such participant or beneficiary2 and 7#c7 on an annual basis after the transmission under paragraph 7#a7 or 7#b74 7h7 ,level and type of reimbursements ,nothing in this section shall be construed to prevent a group health plan from negotiating the level and type of reimbursement with a provider for care provided in accordance with this section4 4 7,b7 ,clerical amendment ,the table of sections for subchapter ,b of chapter #ajj of the ,internal ,revenue ,code of #aihf is amended by adding at the end the following new item3 ,sec4 #ihbf4 ,standards relating to benefits for fertility treatment4 4 7b7 ,conforming amendments 7#a7 ,,phsa ,section #bgbd7;c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#bc7;c77 is amended by striking section #bgjd and inserting sections #bgjd and #bgii;,a-#aa4 7#b7 ,,erisa ,section #gca7;c7 of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #aaia7;c77 is amended by striking section #gaa and inserting sections #gaa and #gbf4 7c7 ,effective dates 7#a7 ,in general ,the amendments made by subsections 7a7 and 7b7 shall apply for plan years beginning on or after the date that is #f months after the date of enactment of this ,act4 7#b7 ,collective bargaining exception 7,a7 ,in general ,in the case of a group health plan maintained pursuant to one or more collective bargaining agreements between employee representatives and one or more employers ratified before the date of enactment of this ,act1 the amendments made by subsection 7a7 shall not apply to plan years beginning before the later of-- 7i7 the date on which the last collective bargaining agreements relating to the plan terminates 7determined without regard to any extension thereof agreed to after the date of enactment of this ,act71 or 7ii7 the date occurring #f months after the date of the enactment of this ,act4 7,b7 ,clarification ,for purposes of subparagraph 7,a71 any plan amendment made pursuant to a collective bargaining agreement relating to the plan which amends the plan solely to conform to any requirement added by subsection 7a7 shall not be treated as a termination of such collective bargaining agreement4 #cjc4 ,requirement for ,state ,medicaid plans to provide medical assistance for fertility treatment 7a7 ,in general ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7 is amended-- 7#a7 in subsection 7a77#d77;,c71 by inserting 7which shall include fertility treatment provided in accordance with subsection 7kk77 after family planning services and supplies2 and 7#b7 by adding at the end the following new subsection3 7kk7 ,requirements for coverage of fertility treatment ,for purposes of subsection 7a77#d77;,c71 a ,state shall ensure that the medical assistance provided under the ,state plan 7or waiver of such plan7 for fertility treatment complies with the requirements of section #bgii;,a-#aa7;b7 of the ,public ,health ,service ,act in the same manner as such requirements and limitations apply to health insurance coverage offered by a group health plan or health insurance issuer4 4 7b7 ,technical amendment ,section #aijc7;a77#e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7a77#e77 is amended by inserting described in section #aije7;a77#d77;,c7 after family planning services and supplies4 7c7 ,effective date 7#a7 ,in general ,except as provided in paragraph 7#b71 the amendments made by this section shall take effect on ,october #a1 #bjbe4 7#b7 ,delay permitted if ,state legislation required ,in the case of a ,state plan approved under title ,,xix of the ,social ,security ,act which the ,secretary of ,health and ,human ,services determines requires ,state legislation 7other than legislation appropriating funds7 in order for the plan to meet the additional requirement imposed by this section1 the ,state plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of the failure of the plan to meet such additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the ,state legislature that ends after the #a-year period beginning with the date of the enactment of this section4 ,for purposes of the preceding sentence1 in the case of a ,state that has a #b-year legislative session1 each year of the session is deemed to be a separate regular session of the ,state legislature4 #cjd4 ,medicare coverage of fertility treatment 7a7 ,coverage ,section #ahfa7s77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7s77#b77 is amended-- 7#a7 in subparagraph 7,,jj71 by inserting and after the semicolon at the end2 and 7#b7 by adding at the end the following new subparagraph3 7,,kk7 fertility treatment 7as defined in section #bgii;,a-#aa7;b7 of the ,public ,health ,service ,act72 4 7b7 ,payment and waiver of coinsurance ,section #ahcc7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7a77#a77 is amended-- 7#a7 by striking and before 7,,hh72 and 7#b7 by inserting before the semicolon at the end the following3 1 and 7,,ii7 with respect to fertility treatment 7as described in section #ahfa7s77#b77,,kk771 the amount paid shall be equal to #ajj percent of the lesser of the actual charge for the treatment or the amount determined under the payment basis determined under section #ahdh4 7c7 ,waiver of application of deductible ,the first sentence of section #ahcc7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7b77 is amended-- 7#a7 by striking 1 and 7#ac7 and inserting 7#ac72 and 7#b7 by striking #ahfa7n744 and inserting #ahfa7n71 and 7#ad7 such deductible shall not apply with respect to fertility treatment 7as described in section #ahfa7s77#b77,,kk7744 7d7 ,payment under physician fee schedule ,section #ahdh7;j77#c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7;j77#c77 is amended by inserting 7#b77,,kk71 after risk assessment714 7e7 ,conforming amendment regarding coverage ,section #ahfb7;a77#a77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciey7a77#a77;,a77 is amended-- 7#a7 by striking or additional and inserting 1 additional2 and 7#b7 by inserting 1 or fertility treatment 7as described in section #ahfa7s77#b77,,kk77 after #ahfa7;ddd77#a774 7f7 ,effective date ,the amendments made by this section shall apply to services furnished on or after ,january #a1 #bjbe4 ,,iv ,family building ,,fehb fairness #dja4 ,short title ,this title may be cited as the ,family ,building ,,fehb ,fairness ,act4 #djb4 ,fertility treatment benefits 7a7 ,in general ,section #hijd of title #e1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#a71 by adding at the end the following3 7,g7 ,fertility treatment benefits4 2 and 7,b7 in paragraph 7#b7-- 7i7 by redesignating subparagraph 7,f7 as subparagraph 7,g72 and 7ii7 by inserting after subparagraph 7,e7 the following3 7,f7 ,fertility treatment benefits4 2 and 7#b7 by adding at the end the following3 7c7 ,in this section1 the term fertility treatment includes the following3 7#a7 ,preservation of human oocytes1 sperm1 or embryos for later reproductive use4 7#b7 ,artificial insemination1 including intravaginal insemination1 intracervical insemination1 and intrauterine insemination4 7#c7 ,assisted reproductive technology1 including in vitro fertilization and other treatments or procedures in which reproductive genetic material1 such as oocytes1 sperm1 fertilized eggs1 and embryos1 are handled1 when clinically appropriate4 7#d7 ,genetic testing of embryos4 7#e7 ,medications prescribed or obtained over-the-counter1 as indicated for fertility4 7#f7 ,gamete donation4 7#g7 ,such other information1 referrals1 treatments1 procedures1 medications1 laboratory services1 technologies1 and services relating to fertility as the ,director of the ,office of ,personnel ,management1 in coordination with the ,secretary of ,health and ,human ,services1 determines appropriate4 4 7b7 ,effective date ,the amendments made by this section shall take effect on the date that is #a year after the date of enactment of this ,act4 ,june #d1 #bjbd,read the second time and placed on the calendar