THIRTEENTH CONGE 
OF THE REPUBLIC ) 
) 
First Regular Session 
1 
1 Introduc 
I 
d by Senator Miriam Defensor Santiago 
EXPLANATORY NOTE 
I 
The Constitution, 
e 2, Section 15, prc 
protect and pron 
consciousness am( 
human experienci 
ino women and me 
While recent improv 
now than in past years, the 
infertility therapy; thus, m 
of the technology. 
Hence, this bill se 
group health plan or indiv 
ealth insurance. 
l " .  
ies: 
: the right to health of the 
ithem. 
3 fulfilling the desire to reproduce. 
re suffering from infertility. 
pregnancy possible for more couples 
n plans do not provide coverage for 
' and middle income families to avail 
r the treatment of infertility in any 


THIRTEENTH C O N G E  
OF THE REPUBLIC ) 
1 
JUL 27 pis :i?z 
First Regular Session 
1 
Introdu d by Senator Miriam Defensor Santiago 
t 
COVERAGE FOR THE 
PLAN OR HEALTH INSURANCE 
Congress assembled 
SECTION 2. Stan 
relating to bene$ts for treatment of inferti1ig.- 
a case in which a group health plan and a health insurance 
e coverage, provide coverage for obstetrical services, such 
onsistent with this section) coverage for treatment of 
issuer, offering health in 
plan or issuer shall i 
infertility. 
INED - For purposes of this section, the term 
ndition that results in the abnormal function of 
'infertility' means a 
the reproductive sys 
(one) 1 year of unprotected intercourse, 
(B) the inability to c 
a pregnancy to live birth. 
(3) 
REQUIRED 
insurance issuer, offering 
treatment of infertility dee 
treating physician. ~ Such 
insemination, in vibo fe 
GE - A group health plan and a health 
ance coverage shall provide coverage for 
iate by a participant or beneficiary and the 
all include ovulation induction, artificial 
), gamete intrafallopian transfer (GIFT), 
! 
! 
zygote intrafallopian transfer 
IFT), intracytoplasmic sperm injection (ICSI), and 


any other treatment provi 
Secretary of Health after 
organizations such as the 
it has been deemed as ‘non-experimental’ by the 
sultation with appropriate professional and patient 
pine Association of Medical Technologists. 
COVERAGE OF ASSISTED REPRODUCTIVE 
TECHNOLOGY- 
- In the case of assisted reproductive 
(i) the participant or beneficiary has been unable to 
ive birth through less costly 
lity treatments for which 
cover 
birth 
I 
(2) mo 
a lifeti, 
(B) 
DEFD 
TECI-INOLOGY - 
reproductive techno1 
involve the handling i 
woman become preg 
include in vitro fe 
intrafallopian transfer 
and surrogate birth. 
(5) REVIEW BY TH 
(5) years after the date of en: 
Health, shall review the requi 
paragraphs (1) and (2). 
e is available under the insured’s policy, plan, or 
[ii) the participant or beneficiary has not undergone 
) complete oocyte retrievals, except that if a live 
llows a completed oocyte retrieval, then at least two 
e completed oocyte retrievals shall be covered, with 
Le cap of 6 retrievals; 
TION 
OF 
ASISSTED 
REPRODUCTIVE 
‘or purposes of this paragraph, the term ‘assisted 
gy’ includes all treatments or procedures that 
F human egg and sperm for the purpose of helping a 
ant. Types of Assisted Reproductive Technology 
ilization, gamete intrafallopian transfer, zygote 
embryo cryopreservation, egg or embryo donation, 
SECRETARY OF HEALTH - Not later than five 
:tment of the Family Building Act, the Secretary of 
ements for treatment of infertility established under 


. .  
(6) LIMITATION 
other limitations for infer 
exceed the deductibles, cc 
services under the group ht 
(7) PROHIBITIOb 
offering group health insw 
may not - 
'' 
(A) deny t 
eligibility, to enrol 
solely for the purpo 
(B) providi 
participant lor bene1 
to be provided infe 
section or'to prov 
measurements to q L  
(C) prohik 
beneficiary infertili 
relating to this secti 
(D) penaliz 
, 
I 
I 
provider because su 
qualified participant o 
(8) 
RULE OF CIIi 
construed to require a particip 
SECTION 3. Separac 
invalid or unconstitutional, tl 
and subsisting. 
Deductibles, co-insurance, and other cost-sharing or 
ty therapy may not be imposed to the extent they 
lsurance, and limitations that are applied to similar 
th plan or health insurance coverage. 
-A group health plan and a health insurance issuer , 
ce coverage, in connection with a group health plan, 
a participant or beneficiary eligibility, or continued 
3r to renew coverage under the terms of the plan, 
of avoiding the requirements of this section; 
incentives (either monetary or otherwise) to a 
iary to encourage such participant or beneficiary not 
lity treatments to which they are entitled under this 
:rs to induce such providers not to provide such 
Ified participants or beneficiaries; 
provider from discussing with a participant or 
reatment techniques or medical treatment options 
sr 
otherwise reduce or limit the reimbursement of a 
1 provider provided infertility treatments to a 
beneficiary in accordance with this section. 
TRUCTION - Nothing in this section shall be 
at or beneficiary to undergo infertility therapy. 
!ify Clause. - If any provisions, or part hereof, is held 
remainder of the law or the provision shall remain valid 


SECTION 4. Rep 
executive order, letter of i 
or inconsistent with, the p 
accordingly. 
ng Clause. - Any law, presidential decree or issuance, 
ction, administrative order, rule or regulations contrary to 
ions of this Act is hereby repealed, modified, or amended 
SECTION 5. Effecti 
its publication in at least twc 
Approved. 
Fn 1893 
Clause. - This Act shall take effect fifteen (15) days after 
) newspapers of general circulation.