I 

108TH CONGRESS 

1ST SESSION H. R. 3026

To amend chapter 89 of title 5, United States Code, and chapter 55 of 

title 10, United States Code, to provide that any health benefits plan 

which provides obstetrical benefits shall be required also to provide coverage for the diagnosis and treatment of infertility. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 5, 2003

Mr. MEEHAN (for himself and Mr. WEINER) introduced the following bill; 

which was referred to the Committee on Government Reform, and in addition to the Committee on Armed Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such 

provisions as fall within the jurisdiction of the committee concerned 

A BILL

To amend chapter 89 of title 5, United States Code, and 

chapter 55 of title 10, United States Code, to provide 

that any health benefits plan which provides obstetrical 

benefits shall be required also to provide coverage for 

the diagnosis and treatment of infertility.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. INFERTILITY BENEFITS. 

4 (a) FEDERAL EMPLOYEE HEALTH BENEFITS

5 PLANS.—Section 8904 of title 5, United States Code, is 

6 amended by adding at the end the following: 
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1 ‘‘(c)(1) Each health benefits plan described by section 

2 8903 or 8903a which provides obstetrical benefits shall 

3 also provide coverage for the diagnosis and treatment of 

4 infertility, including nonexperimental assisted reproductive 

5 technology procedures. 

6 ‘‘(2) Under this subsection—

7 ‘‘(A) coverage for the diagnosis or treatment of 

8 infertility may not be subject to any copayment or 

9 deductible greater than applies with respect to ob10 stetrical benefits under the plan involved; and 

11 ‘‘(B) coverage for a procedure described in 

12 paragraph (5)(B) shall, in the case of any individual, 

13 be required only if—

14 ‘‘(i) such individual has been unable to 

15 carry a pregnancy to live birth through less 

16 costly, medically appropriate infertility treat17 ments for which such individual has coverage 

18 under this chapter; 

19 ‘‘(ii) the procedure (including any retrieval 

20 incident thereto) is performed at medical facili21 ties that conform to the standards of the Amer22 ican Society for Reproductive Medicine, the So23 ciety for Assisted Reproductive Technology, the 

24 American College of Obstetricians and Gyne25 cologists, or any other similar nationally-recog-
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1 nized organization, or a Federal agency that 

2 promulgates standards for infertility proce3 dures; and 

4 ‘‘(iii) if the services of a laboratory are re5 quired, such laboratory is accredited by the Col6 lege of American Pathologists’ Reproductive 

7 Laboratory Accreditation Program or any other 

8 similar nationally-recognized program, or a 

9 Federal agency performing a similar function. 

10 ‘‘(3)(A) Except as provided in subparagraph (B) or 

11 (C)—

12 ‘‘(i) coverage for a procedure described in para13 graph (5)(B) may be provided only if the individual 

14 involved has not already undergone 4 attempts to 

15 achieve a live birth using any such procedures; and 

16 ‘‘(ii) coverage for an oocyte retrieval may be 

17 provided only if the individual involved has not al18 ready undergone 4 complete oocyte retrievals. 

19 ‘‘(B) For purposes of clause (i) of subparagraph 

20 (A)—

21 ‘‘(i) if a live birth results from the third at22 tempt (using a procedure described in paragraph 

23 (5)(B)), such clause shall be applied by substituting 

24 ‘5’ for ‘4’; and 
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1 ‘‘(ii) if a live birth results from the fourth at2 tempt (using a procedure described in paragraph 

3 (5)(B)), such clause shall be applied by substituting 

4 ‘6’ for the otherwise applicable lifetime maximum. 

5 ‘‘(C) For purposes of clause (ii) of subparagraph 

6 (A)—

7 ‘‘(i) if a live birth results from the third oocyte 

8 retrieval, such clause shall be applied by substituting 

9 ‘5’ for ‘4’; and 

10 ‘‘(ii) if a live birth results from the fourth oo11 cyte retrieval, such clause shall be applied by sub12 stituting ‘6’ for the otherwise applicable lifetime 

13 maximum. 

14 ‘‘(4) In no event shall this subsection be considered 

15 to permit or require coverage—

16 ‘‘(A) if, or to the extent that, the health bene17 fits plan objects to such coverage on the basis of re18 ligious beliefs; or 

19 ‘‘(B) in connection with any procedure or treat20 ment, unless rendered by a physician or at the direc21 tion or request of a physician. 

22 ‘‘(5) For purposes of this subsection—

23 ‘‘(A) the term ‘infertility’ means—

24 ‘‘(i) the inability to conceive a pregnancy 

25 after 12 months of regular sexual relations
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1 without contraception or to carry a pregnancy 

2 to a live birth; or 

3 ‘‘(ii) the presence of a demonstrated condi4 tion determined by 2 physicians (at least 1 of 

5 whom specializes in infertility) to cause infer6 tility; and 

7 ‘‘(B) the term ‘nonexperimental assisted repro8 ductive technology procedure’ means in vitro fer9 tilization, gamete intrafallopian transfer, zygote 

10 intrafallopian transfer, and any other clinical treat11 ment or procedure the safety and efficacy of which 

12 are recognized by the American Society for Repro13 ductive Medicine, the American College of Obstetri14 cians and Gynecologists, or any other similar nation15 ally-recognized organization, or a Federal agency de16 scribed in paragraph (2)(B)(iii). 

17 ‘‘(6) The Office shall prescribe any regulations nec18 essary to carry out this subsection.’’. 

19 (b) DEFENSE HEALTH CARE PLANS.—(1) Chapter 

20 55 of title 10, United States Code, is amended by adding 

21 at the end the following new section:

22 ‘‘§ 1110a. Obstetrical and infertility benefits 

23 ‘‘(a)(1) Any health care plan under this chapter 

24 which provides obstetrical benefits shall also provide cov25 erage for the diagnosis and treatment of infertility, includ-
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1 ing nonexperimental assisted reproductive technology pro2 cedures. 

3 ‘‘(2) Under this subsection—

4 ‘‘(A) coverage for the diagnosis or treatment of 

5 infertility may not be subject to any copayment or 

6 deductible greater than applies with respect to ob7 stetrical benefits under the plan involved; and 

8 ‘‘(B) coverage for a procedure described in 

9 paragraph (5)(B) shall, in the case of any individual, 

10 be required only if—

11 ‘‘(i) such individual has been unable to 

12 carry a pregnancy to live birth through less 

13 costly, medically appropriate infertility treat14 ments for which such individual has coverage 

15 under this chapter; 

16 ‘‘(ii) the procedure (including any retrieval 

17 incident thereto) is performed at medical facili18 ties that conform to the standards of the Amer19 ican Society for Reproductive Medicine, the So20 ciety for Assisted Reproductive Technology, the 

21 American College of Obstetricians and Gyne22 cologists, or any other similar nationally-recog23 nized organization, or a Federal agency that 

24 promulgates standards for infertility proce25 dures; and 
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1 ‘‘(iii) if the services of a laboratory are re2 quired, such laboratory is accredited by the Col3 lege of American Pathologists’ Reproductive 

4 Laboratory Accreditation Program or any other 

5 similar nationally-recognized program, or a 

6 Federal agency performing a similar function. 

7 ‘‘(3)(A) Except as provided in subparagraph (B) or 

8 (C)—

9 ‘‘(i) coverage for a procedure described in para10 graph (5)(B) may be provided only if the individual 

11 involved has not already undergone 4 attempts to 

12 achieve a live birth using any such procedures; and 

13 ‘‘(ii) coverage for an oocyte retrieval may be 

14 provided only if the individual involved has not al15 ready undergone 4 complete oocyte retrievals. 

16 ‘‘(B) For purposes of clause (i) of subparagraph 

17 (A)—

18 ‘‘(i) if a live birth results from the third at19 tempt (using a procedure described in paragraph 

20 (5)(B)), such clause shall be applied by substituting 

21 ‘5’ for ‘4’; and 

22 ‘‘(ii) if a live birth results from the fourth at23 tempt (using a procedure described in paragraph 

24 (5)(B)), such clause shall be applied by substituting 

25 ‘6’ for the otherwise applicable lifetime maximum. 
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1 ‘‘(C) For purposes of clause (ii) of subparagraph 

2 (A)—

3 ‘‘(i) if a live birth results from the third oocyte 

4 retrieval, such clause shall be applied by substituting 

5 ‘5’ for ‘4’; and 

6 ‘‘(ii) if a live birth results from the fourth oo7 cyte retrieval, such clause shall be applied by sub8 stituting ‘6’ for the otherwise applicable lifetime 

9 maximum. 

10 ‘‘(4) In no event shall this subsection be considered 

11 to permit or require coverage—

12 ‘‘(A) if, or to the extent that, the health bene13 fits plan objects to such coverage on the basis of re14 ligious beliefs; or 

15 ‘‘(B) in connection with any procedure or treat16 ment, unless rendered by a physician or at the direc17 tion or request of a physician. 

18 ‘‘(5) For purposes of this subsection—

19 ‘‘(A) the term ‘infertility’ means—

20 ‘‘(i) the inability to conceive a pregnancy 

21 after 12 months of regular sexual relations 

22 without contraception or to carry a pregnancy 

23 to a live birth; or 

24 ‘‘(ii) the presence of a demonstrated condi25 tion determined by 2 physicians (at least 1 of 
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1 whom specializes in infertility) to cause infer2 tility; and 

3 ‘‘(B) the term ‘nonexperimental assisted repro4 ductive technology procedure’ means in vitro fer5 tilization, gamete intrafallopian transfer, zygote 

6 intrafallopian transfer, and any other clinical treat7 ment or procedure the safety and efficacy of which 

8 are recognized by the American Society for Repro9 ductive Medicine, the American College of Obstetri10 cians and Gynecologists, or any other similar nation11 ally-recognized organization, or a Federal agency de12 scribed in paragraph (2)(B)(iii). 

13 ‘‘(b) The Secretary of Defense shall prescribe any 

14 regulations necessary to carry out this section.’’.

15 (2) The table of sections at the beginning of such 

16 chapter is amended by adding at the end the following 

17 new item:

‘‘1110a. Obstetrical and infertility benefits.’’.

18 SEC. 2. EFFECTIVE DATE. 

19 The amendments made by this Act shall apply with 

20 respect to contracts entered into or renewed for any year 

21 beginning after the end of the 6-month period beginning 

22 on the date of enactment of this Act.

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