I 

109TH CONGRESS 

1ST SESSION H. R. 1418 

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 

MARCH 17, 2005 

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. SHORT TITLE. 

4 This Act may be cited as the ‘‘Infertility Coverage 

5 for Federal Employees, Military Personnel, and their 

6 Families Act’’. 
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1 SEC. 2. INFERTILITY BENEFITS. 

2 (a) FEDERAL EMPLOYEE HEALTH BENEFITS

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

4 amended by adding at the end the following: 

5 ‘‘(c)(1) Each health benefits plan described by section 

6 8903 or 8903a which provides obstetrical benefits shall 

7 also provide coverage for the diagnosis and treatment of 

8 infertility, including nonexperimental assisted reproductive 

9 technology procedures. 

10 ‘‘(2) Under this subsection— 

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

12 infertility may not be subject to any copayment or 

13 deductible greater than applies with respect to ob14 stetrical benefits under the plan involved; and 

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

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

17 be required only if— 

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

19 carry a pregnancy to live birth through less 

20 costly, medically appropriate infertility treat21 ments for which such individual has coverage 

22 under this chapter; 

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

24 incident thereto) is performed at medical facili25 ties that conform to the standards of the Amer26 ican Society for Reproductive Medicine, the So-
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1 ciety for Assisted Reproductive Technology, the 

2 American College of Obstetricians and Gyne3 cologists, or any other similar nationally-recog4 nized organization, or a Federal agency that 

5 promulgates standards for infertility proce6 dures; and 

7 ‘‘(iii) if the services of a laboratory are re8 quired, such laboratory is accredited by the Col9 lege of American Pathologists’ Reproductive 

10 Laboratory Accreditation Program or any other 

11 similar nationally-recognized program, or a 

12 Federal agency performing a similar function. 

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

14 (C)— 

15 ‘‘(i) coverage for a procedure described in para16 graph (5)(B) may be provided only if the individual 

17 involved has not already undergone 4 attempts to 

18 achieve a live birth using any such procedures; and 

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

20 provided only if the individual involved has not al21 ready undergone 4 complete oocyte retrievals. 

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

23 (A)— 

24 ‘‘(i) if a live birth results from the third at25 tempt (using a procedure described in paragraph 
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1 (5)(B)), such clause shall be applied by substituting 

2 ‘5’ for ‘4’; and 

3 ‘‘(ii) if a live birth results from the fourth at4 tempt (using a procedure described in paragraph 

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

6 ‘6’ for the otherwise applicable lifetime maximum. 

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

8 (A)— 

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

10 retrieval, such clause shall be applied by substituting 

11 ‘5’ for ‘4’; and 

12 ‘‘(ii) if a live birth results from the fourth oo13 cyte retrieval, such clause shall be applied by sub14 stituting ‘6’ for the otherwise applicable lifetime 

15 maximum. 

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

17 to permit or require coverage— 

18 ‘‘(A) if, or to the extent that, the health bene19 fits plan objects to such coverage on the basis of re20 ligious beliefs; or 

21 ‘‘(B) in connection with any procedure or treat22 ment, unless rendered by a physician or at the direc23 tion or request of a physician. 

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

25 ‘‘(A) the term ‘infertility’ means— 
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1 ‘‘(i) the inability to conceive a pregnancy 

2 after 12 months of regular sexual relations 

3 without contraception or to carry a pregnancy 

4 to a live birth; or 

5 ‘‘(ii) the presence of a demonstrated condi6 tion determined by 2 physicians (at least 1 of 

7 whom specializes in infertility) to cause infer8 tility; and 

9 ‘‘(B) the term ‘nonexperimental assisted repro10 ductive technology procedure’ means in vitro fer11 tilization, gamete intrafallopian transfer, zygote 

12 intrafallopian transfer, and any other clinical treat13 ment or procedure the safety and efficacy of which 

14 are recognized by the American Society for Repro15 ductive Medicine, the American College of Obstetri16 cians and Gynecologists, or any other similar nation17 ally-recognized organization, or a Federal agency de18 scribed in paragraph (2)(B)(iii). 

19 ‘‘(6) The Office shall prescribe any regulations nec20 essary to carry out this subsection.’’. 

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

22 55 of title 10, United States Code, is amended by adding 

23 at the end the following new section: 
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1 ‘‘§ 1110a. Obstetrical and infertility benefits 

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

3 which provides obstetrical benefits shall also provide cov4 erage for the diagnosis and treatment of infertility, includ5 ing nonexperimental assisted reproductive technology pro6 cedures. 

7 ‘‘(2) Under this subsection— 

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

9 infertility may not be subject to any copayment or 

10 deductible greater than applies with respect to ob11 stetrical benefits under the plan involved; and 

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

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

14 be required only if— 

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

16 carry a pregnancy to live birth through less 

17 costly, medically appropriate infertility treat18 ments for which such individual has coverage 

19 under this chapter; 

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

21 incident thereto) is performed at medical facili22 ties that conform to the standards of the Amer23 ican Society for Reproductive Medicine, the So24 ciety for Assisted Reproductive Technology, the 

25 American College of Obstetricians and Gyne26 cologists, or any other similar nationally-recog-
7 

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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 
8 

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

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

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

20 chapter is amended by adding at the end the following 

21 new item: 

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

22 SEC. 3. EFFECTIVE DATE. 

23 The amendments made by this Act shall apply with 

24 respect to contracts entered into or renewed for any year 
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1 beginning after the end of the 6-month period beginning 

2 on the date of enactment of this Act. 

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