FOURTEENTH CONGRESS OF THE REPUBLIC ) 
OF THE PHILIPPINES 
1 
First Regular Session 
1 
SEN 
S. B. No. 
Introduced by Senator Miriam Defensor Santiago 
EXPLANATORY NOTE 
The Constitution, Article 11, Section 15, provides: 
The State shall protect and promote the right to health of the people and 
instill health consciousness among them. 
A fundamental part of human experience is fulfilling the desire to reproduce. 
Unfortunately, millions of Filipino women and men are suffering from infertility. 
While recent improvements in therapy make pregnancy possible for more couples now 
than in past years, the majority of group health plans do not provide coverage for infertility 
therapy; thus, making it impossible for low and middle income families lo avail of the 
technology. 
Hence, this bill seeks to require coverage for the treatment of infertility in any group 
health plan or individual health insurance. * 
’ This bill was originally filed during the Thirteenth Congress, First Regular Session. 


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FOURTEENTH CONGRESS OF THE REPUBLIC) 
OF THE PHILIPPINES 
1 
First Regular Session 
) 
S. B. No. sENAE3 
4 2 
Introduced by Senator Miriam Defensor Santiago 
AN ACT 
REQUIRING COVERAGE FOR THE TREATMENT OF WERTILITY 
IN ANY GROUP HEALTH PLAN OR HEALTH INSURANCE 
Be it enacted by the Senate and House of Representatives of the Philippines in Congress 
assembled: 
SECTION 1. Short Title. - This Act shall be known as the “Family Bnilding Act of 
2007.” 
SECTION 2. Standards Relating to Beiteflts for Treatment of infertility. 
(A) In General. - In a case in which a group health plan and a health insurance issuer, 
offering health insurance coverage, provide coverage for obstetrical services, such plan or issuer 
shall include coverage for treatment of infertility consistent with this Section. 
(B) Infertility Defined. - For purposes of this section, the term ‘infertility’ means a 
disease or condition that results in the abnormal function o f  the reproductive system, which 
results in - 
(1) The illability to conceive after (one) 1 year of unprotected intercourse, or 
(2) The inability to carry a pregnancy to live birth. 
(C) Required Coverage. - A group health plan and a health insurance issuer, offering 
health insurance coverage shall provide coverage for treatment of infertility deemed appropriate 
by a participant or beneficiary and the treating physician. Such treatment shall include ovulation 
induction, artificial insemination, in vitro fertilization (IVF), gamete intrafallopian transfer 
(GIFT), zygote intrafallopian transfer (ZFT), intracytoplasmic sperm injection (ICSI), and any 
other treatment provided it has been deemed as ‘non-experimental’ by the Secretary of Health 
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after consultation with appropriate professional and patient organizations such as the Philippine 
Association of Medical Technologists. 
(D) Limitation on Coverage of Assisted Reproductive Technology. - 
(1) In General. - In the case of assisted reproductive technology, coverage shall 
be provided if -- 
(a) The participant or beneficiary has been unable to bring a pregnancy 
into a live birth through less costly medically appropriate infertility treatments for 
which coverage is available under the insured’s policy, plan, or contract; 
(b) The participant or beneficiary has not undergone four (4) complete 
oocyte retrievals, except that if a live birth follows a completed oocyte retrieval, 
then at least two (2) more completed oocyte retrievals shall be covered, with a 
lifetinre cap of 6 retrjevals; 
(2) Definition of Assisted Reproductive Technology. - For purposes of this 
paragraph, the term ‘assisted reproductive technology’ includes all treatments or 
procedures that involve the handling of human egg and sperm for the purpose of helping 
a woman become pregnant. Types o f  Assisted Reproductive Technology include in vitro 
fertilization, gamete intrafallopian transfer, zygote intrafallopian transfer, embryo 
cryopreservation, egg or embryo donation, and surrogate birth. 
(E) Review by the Secretary of Health. - Not later than five (5) years after the date of 
enactment of the Family Building Act, the Secretary of Health shall review the requirements for 
treatment of infertility established under paragraph (D)(l). 
(F) Limitation. - Deductibles, co-insurance, and other cost-sharing or other limitations for 
infertility therapy may not be imposed to the extent they exceed the deductibles, co-insurance, 
and limitations that are applied to similar services under the group health plan or health 
insurance coverage. 
(G) Prohibitions. - A group health plan and a health insurance issuer, offering group 
health insurance coverage, in connection with a group health p!m, may not - 
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( 1 )  Deny to a participant or beneficiruy eljgibility, or continued eligibility, to 
enroll or to renew coverage under the terms of the plan, solely for the purpose of 
avoiding the requirements oE this section; 
(2) Provide incentives, either monetary or otherwise, to a participant or 
beneficiary to encourage such participant or beneficiary not to be provided infertility 
treatments to which they are entitled under this section or to providers to induce such 
providers not to provide such measurements to qualified participants or beneficiaries; 
(3) Prohibit a provider from discussing with a participant or beneficiary infertility 
treatment techniques or medical treatment options relating to this section; or 
(4) Penalize or otherwise reduce or limit the reimbursement of a provider because 
such provider provided infertility treatments to a qualified participant or beneficiary in 
accordance with this section. 
(H) Rule of Construcfion. - Nothing in this Section shall be construed to require a 
participant or beneficiary to undergo infertility therapy. 
SECTION 3. Separability Clause. - If any provision or part hereof, is held invalid or 
unconstitutional, the remainder of the law or the provision shall remain valid and subsisting. 
SECTION 4. Repealing Clause. - Any law, presidential decree or issuance, executive 
order, letter of instruction, administrative order, rule or regulations contrary to or inconsistent 
with, the provisions of this Act is hereby repealed, modified, or amended accordingly. 
SECTION 5. ESfectivity Clause. - This Act shall talce effect fifteen (15) days after its 
publication in at least two (2) newspapers of general circulation. 
Approved, 
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