,i #aai? ,,congress #a/ ,session ,h4 ,r4 #cdhj ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,may #ai1 #bjbe,ms4 ,und]wood introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce ,a ,,bill ,to am5d ! ,pati5t ,protection & ,af=dable ,c>e ,act to include f]tility treatm5t & c>e z an ess5tial heal? b5efit4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,heal? ,cov]age = ,inclusive & ,valu$ ,families ,act ( #bjbe or ! ,heal? ,cov]age = ,,ivf ,act ( #bjbe4 #b4 ,includ+ f]tility treatm5t & c>e z an ess5tial heal? b5efit 7a7 ,9 g5]al ,section #acjb7;b7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjbb7;b77 is am5d$-- 7#a7 9 p>agraph 7#a7-- 7,a7 9 ! matt] prec$+ subp>agraph 7,a71 by /rik+ p>agraph 7#b7 & ins]t+ p>agraphs 7#b7 & 7#f72 & 7,b7 by add+ at ! end ! foll[+ new subp>agraph3 7,k7 ,f]tility treatm5t & c>e4 2 & 7#b7 by add+ at ! end ! foll[+ new p>agraph3 7#f7 ,f]tility treatm5t & c>e def9$ ,= purposes ( p>agraph 7#a77,k71 ! t]m f]tility treatm5t & c>e means ! foll[+ m$ically appropriate items & s]vices furni%$ to an individual3 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$1 :5 cl9ically appropriate1 & includ+ at lea/ #c complete oocyte retrievals & an unlimit$ numb] ( embryo transf]s f su* retrievals 7reg>dless ( :e!r su* retrieval 0 p]=m$ on1 be=e1 or aft] ! date ( ! enactm5t ( ?is p>agraph7 9 accordance ) ! guidel9es ( ! ,am]ican ,society = ,reproductive ,m$ic9e & us+ s+le embryo transf] :5 recomm5d$ & m$ically appropriate4 7,d7 ,g5etic te/+ ( embryos4 7,e7 ,m$ications prescrib$1 z indicat$ = 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 4 7b7 ,additional requirem5ts ,subp>t ,,ii ( "p ,a ( title ,,xxvii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#aa et seq47 is am5d$ by add+ at ! end ! foll[+ new section3 #bgcj4 ,requirem5ts relat+ to f]tility treatm5t & c>e 7a7 ,9 g5]al ,9 ! case ( heal? insurance cov]age (f]$ 9 ! individual or small gr\p m>ket t provides bo? m$ical & surgical b5efits & b5efits = f]tility treatm5t & c>e 7z def9$ 9 section #acjb7;b7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act71 su* cov]age %all ensure t-- 7#a7 ! f9ancial requirem5ts applicable to su* f]tility treatm5t & c>e b5efits are no m re/rictive ?an ! pr$om9ant f9ancial requirem5ts appli$ to sub/antially all m$ical & surgical b5efits cov]$ by ! cov]age1 & !re are no sep>ate co/ %>+ requirem5ts t are applicable only ) respect to f]tility treatm5t & c>e b5efits2 & 7#b7 ! treatm5t limitations applicable to su* f]tility treatm5t & c>e b5efits are no m re/rictive ?an ! pr$om9ant treatm5t limitations appli$ to sub/antially all m$ical & surgical b5efits cov]$ by ! cov]age & !re are no sep>ate treatm5t limitations t are applicable only ) respect to f]tility treatm5t & c>e b5efits4 7b7 ,prohibition on d5ial ( c>e ,a heal? insurance issu] (f]+ heal? insurance cov]age 9 ! individual or small gr\p m>ket may n d5y b5efits = f]tility treatm5t & c>e = individual on ! basis t su* individual lacks a diagnosis ( inf]tility4 7c7 ,utilization managem5t tools 7#a7 ,9 g5]al ,a heal? insurance issu] (f]+ heal? insurance cov]age 9 ! individual or small gr\p m>ket t imposes any utilization managem5t tool ) respect to f]tility treatm5t & c>e %all1 = ea* ( ! fir/ #e plan ye>s beg9n+ on or aft] ! date t is #a ye> aft] ! date ( ! enactm5t ( ?is ,act 7&1 ^u reque/ ( ! ,secret>y or ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates1 = any subsequ5t plan ye>71 conduct an analysis ( ! application ( any su* tool to su* treatm5t & c>e & submit su* analysis to ! ,secret>y & to ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates4 ,su* analysis %all conta9 ! foll[+ in=mation3 7,a7 ,! specific cov]age t]ms or o!r relevant t]ms reg>d+ ! application ( su* tools to su* b5efits & a description ( all su* b5efits4 7,b7 ,! factors us$ to det]m9e :5 utilization managem5t tools apply to su* b5efits4 7,c7 ,! evid5ti>y /&>ds us$ 9 design+ ! application ( su* tools ) respect to su* b5efits & any o!r s\rce or evid5ce us$ to det]m9e ! application ( su* tools to su* b5efits4 7,d7 ,in=mation demon/rat+ h[ application ( su* tools to su* b5efits are consi/5t ) cl9ical guidel9es = f]tility treatm5t & c>e4 7,e7 ,any f9d+s by ! issu] t su* cov]age is n 9 compliance ) ?is section4 7#b7 ,report ,= plan ye>s beg9n+ on or aft] ! date t is #a ye> aft] ! date ( ! enactm5t ( ?is section1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ,congress & make publicly available a report t conta9s ! foll[+3 7,a7 ,a summ>y ( ! analyses submitt$ "u p>agraph 7#a7 ) respect to su* plan ye>4 7,b7 ,an id5tification ( ea* heal? insurance issu] t fail$ to submit an analysis "u p>agraph 7#a74 7,c7 ,) respect to ea* heal? insurance issu] t did submit su* an analysis1 a specification z to :e!r su* issu] submitt$ in=mation suffici5t to det]m9e :e!r su* issu] 0 9 compliance ) su* requirem5ts4 7,d7 ,= ea* heal? insurance issu] t did submit in=mation suffici5t to det]m9e su* compliance1 a f9d+ ( :e!r su* issu] 0 9 compliance ) su* requirem5ts4 7d7 ,def9itions ,! t]ms f9ancial requirem5t1 pr$om9ant1 & treatm5t limitation h ! mean+ giv5 su* t]ms 9 section #bgbf7;a77#c74 4 7c7 ,effective date ,! am5dm5ts made by ?is section %all apply to plan ye>s beg9n+ on or aft] ! date t is #a ye> aft] ! date ( ! enactm5t ( ?is ,act4