SEC. 204. CRYOPRESERVATION AND STORAGE OF REPRO-
DUCTIVE GENETIC MATERIAL OF MEMBERS 
OF THE UNIFORMED SERVICES ON ACTIVE 
DUTY. 
(a) IN GENERAL.—The Secretary of Defense shall 
provide members of the uniformed services on active duty 
in the uniformed services with the opportunity to 
cryopreserve and store their reproductive genetic material, 
such as oocytes, sperm, fertilized eggs, and embryos, prior 
to— 
(1) deployment to a combat zone; or 
(2) a duty assignment that includes a haz-
ardous assignment, including— 
(A) assignments resulting in exposure to 
perfluoroalkyl or polyfluoroalkyl substances; 
and 
(B) such other assignments as determined 
by the Secretary. 
(b) PERIOD OF TIME.— 
(1) IN GENERAL.—The Secretary shall provide 
for the cryopreservation and storage of reproductive 
genetic material of any member of the uniformed 
services under subsection (a) in a facility of the De-
partment of Defense or of a private entity and the 
transportation of such material, at no cost to the 
member, until the date that is one year after the re-
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tirement, separation, or release of the member from 
the uniformed services. 
(2) 
CONTINUED
CRYOPRESERVATION
AND 
STORAGE.—At the end of the one-year period speci-
fied in paragraph (1), the Secretary shall permit an 
individual whose reproductive genetic material was 
cryopreserved and stored as described in that para-
graph to select, including pursuant to an advance 
medical directive or military testamentary instru-
ment completed under subsection (c), one of the fol-
lowing options: 
(A) To continue such cryopreservation and 
storage in such facility with the cost of such 
cryopreservation and storage borne by the indi-
vidual. 
(B) To transfer the material to a private 
cryopreservation and storage facility selected by 
the individual. 
(C) To transfer the material to a facility of 
the 
Department 
of 
Veterans 
Affairs 
if 
cryopreservation and storage is available to the 
individual at such facility and the individual is 
eligible for such services. 
(3) DISPOSAL OF REPRODUCTIVE GENETIC MA-
TERIAL.— 
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(A) NO SELECTION.—If an individual de-
scribed in paragraph (2) does not make a selec-
tion under subparagraph (A), (B), or (C) of 
such paragraph, the Secretary may dispose of 
the reproductive genetic material of the indi-
vidual not earlier than the date that is 90 days 
after the end of the one-year period specified in 
paragraph (1) with respect to the individual. 
(B) ELECTION
BY
INDIVIDUAL.—At the 
election of an individual described in paragraph 
(2), the Secretary may dispose of the reproduc-
tive genetic material of the individual. 
(c) ADVANCE MEDICAL DIRECTIVE AND MILITARY 
TESTAMENTARY INSTRUMENT.—A member of the uni-
formed services who elects to cryopreserve and store their 
reproductive genetic material under this section must com-
plete an advance medical directive, as defined in section 
1044c(b) of title 10, United States Code, and a military 
testamentary instrument, as defined in section 1044d(b) 
of such title, that explicitly specifies the use of their 
cryopreserved and stored reproductive genetic material if 
such member dies or otherwise loses the capacity to con-
sent to the use of their cryopreserved and stored reproduc-
tive genetic material. 
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(d) AGREEMENTS.—To carry out this section, the 
Secretary may enter into agreements with private entities 
that provide cryopreservation, transportation, and storage 
services for reproductive genetic material. 
SEC. 205. ASSISTANCE WITH AND CONTINUITY OF CARE RE-
GARDING REPRODUCTIVE AND FERTILITY 
PRESERVATION SERVICES. 
The Secretary of Defense shall ensure that employees 
of the Department of Defense assist members of the uni-
formed services— 
(1) in navigating the services provided under 
this subtitle; 
(2) in finding a provider that meets the needs 
of such members with respect to such services; and 
(3) in continuing the receipt of such services 
without interruption during a permanent change of 
station for such members. 
SEC. 206. COORDINATION BETWEEN DEPARTMENT OF DE-
FENSE AND DEPARTMENT OF VETERANS AF-
FAIRS ON FURNISHING OF FERTILITY TREAT-
MENT AND COUNSELING. 
(a) IN GENERAL.—The Secretary of Defense and the 
Secretary of Veterans Affairs shall share best practices 
and facilitate referrals, as they consider appropriate, on 
the furnishing of fertility treatment and counseling to in-
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dividuals eligible for the receipt of such counseling and 
treatment from the Secretaries. 
(b) MEMORANDUM OF UNDERSTANDING.—The Sec-
retary of Defense and the Secretary of Veterans Affairs 
shall enter into a memorandum of understanding— 
(1) providing that the Secretary of Defense will 
ensure access by the Secretary of Veterans Affairs 
to reproductive genetic material, such as oocytes, 
sperm, fertilized eggs, and embryos, of veterans 
stored by the Department of Defense for purposes of 
furnishing fertility treatment under section 1720K 
of title 38, United States Code, as added by section 
212(a); and 
(2) authorizing the Department of Veterans Af-
fairs to compensate the Department of Defense for 
the cryopreservation, transportation, and storage of 
reproductive genetic material of veterans under sec-
tion 204(b)(2)(A). 
SEC. 207. REGULATIONS. 
Not later than two years after the date of the enact-
ment of this Act, the Secretary of Defense shall prescribe 
regulations to carry out this subtitle. 
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Subtitle B—Reproductive 
Assistance for Veterans 
SEC. 211. INCLUSION OF FERTILITY TREATMENT AND 
COUNSELING UNDER THE DEFINITION OF 
MEDICAL SERVICES IN TITLE 38. 
Section 1701(6) of title 38, United States Code, is 
amended by adding at the end the following new subpara-
graph: 
‘‘(J) Fertility treatment and counseling 
under section 1720K of this title.’’. 
SEC. 212. FERTILITY TREATMENT AND COUNSELING FOR 
CERTAIN VETERANS AND SPOUSES, PART-
NERS, AND GESTATIONAL SURROGATES OF 
SUCH VETERANS. 
(a) IN GENERAL.—Subchapter II of chapter 17 of 
title 38, United States Code, is amended by adding at the 
end the following new section: 
‘‘§ 1720K. Fertility treatment and counseling for cer-
tain veterans and spouses, partners, and 
gestational surrogates of such veterans 
‘‘(a) REQUIREMENT.— 
‘‘(1) IN GENERAL.—Notwithstanding any other 
provision of law, including the surrogacy laws of any 
State, the Secretary shall furnish fertility treatment 
and counseling for the benefit of a covered veteran 
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to the veteran and the spouse, partner, gamete 
donor, or gestational surrogate of the veteran if the 
veteran, and the spouse, partner, gamete donor, or 
gestational surrogate of the veteran, as applicable, 
each provide informed consent for such treatment 
and counseling, including for each cycle of treatment 
authorized under this section, through a process pre-
scribed by the Secretary. 
‘‘(2) PROVISION
OF
TREATMENT
AND
COUN-
SELING.—Fertility treatment and counseling shall be 
furnished under paragraph (1) without regard to the 
sex, sexual characteristics, gender identity, sexual 
orientation, infertility diagnosis, or marital status of 
the covered veteran or their partner. 
‘‘(3) IN VITRO FERTILIZATION.—In the case of 
in vitro fertilization treatment furnished under para-
graph (1), the Secretary may furnish to an indi-
vidual under such paragraph— 
‘‘(A) not more than three completed oocyte 
retrievals; and 
‘‘(B) unlimited embryo transfers. 
‘‘(4) COPAYMENT.—The Secretary shall only 
furnish fertility treatment and counseling under 
paragraph (1) to a covered veteran who is required 
to pay to the United States a copayment amount as 
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a condition for the receipt of hospital care, medical 
services, or medications under this chapter if the 
covered veteran agrees to pay such applicable copay-
ment amount to the United States for such treat-
ment and counseling. 
‘‘(b) PROCUREMENT
OF REPRODUCTIVE GENETIC 
MATERIAL.— 
‘‘(1) IN GENERAL.—If a covered veteran is un-
able to provide their reproductive genetic material 
for purposes of fertility treatment under subsection 
(a), the Secretary shall, at the election of such vet-
eran— 
‘‘(A) allow such veteran to receive such 
treatment with donated reproductive genetic 
material, if the donor provides informed consent 
for use of such material; and 
‘‘(B) pay or reimburse the veteran, donor, 
or a party acting on behalf of the donor the 
reasonable costs of procuring such material 
from the donor. 
‘‘(2) OTHER
EXPENSES.—The Secretary may 
pay or reimburse a covered veteran a reasonable 
amount for personal travel and incidental expenses 
associated with procuring material from a donor 
under paragraph (1). 
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‘‘(c) OUTREACH
AND TRAINING.—The Secretary 
shall carry out an outreach and training program to en-
sure veterans and health care providers of the Department 
are aware of— 
‘‘(1) the availability of and eligibility require-
ments for fertility treatment and counseling under 
this section; and 
‘‘(2) any changes to fertility treatment and 
counseling covered under this section. 
‘‘(d) OWNERSHIP, USE, OR DISPOSITION OF REPRO-
DUCTIVE GENETIC MATERIAL.— 
‘‘(1) IN GENERAL.—Issues or disputes regard-
ing ownership of reproductive genetic material or fu-
ture use or disposition of such material shall be the 
sole responsibility of the covered veteran, the spouse, 
partner, or gestational surrogate of the veteran, as 
applicable, and the private facility storing such ma-
terial. 
‘‘(2) AGREEMENT
REGARDING
DONATED
RE-
PRODUCTIVE GENETIC MATERIAL.—As a condition 
of the use of donated gametes or embryos under this 
section, the third-party donor and a provider of fer-
tility treatment that has entered into a contract or 
agreement with the Secretary to provide such treat-
ment under this section are required to enter into an 
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arrangement or agreement governing the terms of 
the donation, to include ultimate disposition of any 
remaining gametes or embryos once a covered vet-
eran has exhausted the fertility treatment available 
under this section, unless the veteran or the spouse 
or partner of the veteran has agreed to assume li-
ability for the continued preservation of any remain-
ing gametes or embryos and the Department is not 
party to the arrangement or agreement for such con-
tinued preservation. 
‘‘(3) ROLE OF DEPARTMENT.—The role of the 
Secretary under this section is limited to furnishing 
the treatment and counseling required under this 
section when requested by a covered veteran and de-
termined necessary by the Secretary. 
‘‘(4) OWNERSHIP AND CUSTODY OF REPRODUC-
TIVE GENETIC MATERIAL.—The Secretary will not 
have ownership or custody of any reproductive ge-
netic material obtained pursuant to treatment under 
this section and will not be involved in the ultimate 
disposition of such material or disputes between or 
among any parties with respect to such material. 
‘‘(e) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require the Secretary— 
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‘‘(1) to find or certify a gestational surrogate 
for a covered veteran or to connect a gestational sur-
rogate with a covered veteran; or 
‘‘(2) to furnish maternity care to a covered vet-
eran or spouse, partner, or gestational surrogate of 
a covered veteran beyond what is otherwise required 
or authorized by law. 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) The term ‘covered veteran’ means a vet-
eran who is enrolled in the system of annual patient 
enrollment established under section 1705(a) of this 
title. 
‘‘(2) The term ‘fertility treatment’ includes the 
following: 
‘‘(A) Preservation of human oocytes, 
sperm, or embryos for later reproductive use. 
‘‘(B) Artificial insemination, including 
intravaginal insemination, intracervical insemi-
nation, and intrauterine insemination. 
‘‘(C) Assisted reproductive technology, in-
cluding in vitro fertilization and other treat-
ments or procedures in which reproductive ge-
netic material, such as oocytes, sperm, fertilized 
eggs, and embryos, are handled, when clinically 
appropriate. 
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‘‘(D) Genetic testing of embryos. 
‘‘(E) Medications prescribed or obtained 
over-the-counter, as indicated for fertility. 
‘‘(F) Gamete donation. 
‘‘(G) Such other information, referrals, 
treatments, procedures, medications, laboratory 
testing, technologies, and services relating to 
fertility as the Secretary determines appro-
priate. 
‘‘(3) The term ‘gestational surrogate’ means an 
individual who agrees to become pregnant through in 
vitro fertilization under a gestational surrogacy 
agreement using gametes that are not the gametes 
of that individual. 
‘‘(4) The term ‘partner’, with respect to a cov-
ered veteran, means an individual selected by the 
veteran who agrees to be a parent, with the veteran, 
of a child born as a result of the use of any fertility 
treatment under this section.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of subchapter II of chapter 17 of such 
title is amended by inserting after the item relating to sec-
tion 1720J the following new item: 
‘‘1720K. Fertility treatment and counseling for certain veterans and spouses, 
partners, and gestational surrogates of such veterans.’’. 
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(c) SUNSET OF EXISTING AUTHORITY.—The author-
ity under section 234 of the Military Construction, Vet-
erans Affairs, and Related Agencies Appropriations Act, 
2024 (division A of Public Law 118–42), or any similar 
authority subsequently enacted by law, shall cease on the 
effective date of regulations prescribed to carry out section 
1720K of title 38, United States Code, as added by sub-
section (a). 
SEC. 213. ASSISTANCE WITH AND CONTINUITY OF CARE RE-
GARDING REPRODUCTIVE AND FERTILITY 
PRESERVATION SERVICES. 
The Secretary of Veterans Affairs shall ensure that 
employees of the Department of Veterans Affairs assist 
veterans— 
(1) in navigating the services provided under 
this subtitle and the amendments made by this sub-
title; 
(2) in finding a provider that meets the needs 
of such veterans with respect to such services; and 
(3) in continuing the receipt of such services 
without interruption if such veterans move to a dif-
ferent geographic location. 
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SEC. 214. COORDINATION OF REPRODUCTION AND FER-
TILITY RESEARCH FOR VETERANS. 
(a) IN GENERAL.—Subchapter II of chapter 73 of 
title 38, United States Code, is amended by adding at the 
end the following new section: 
‘‘§ 7330E. Coordination of reproduction and fertility 
research for veterans 
‘‘(a) COORDINATION OF RESEARCH REQUIRED.—The 
Secretary shall coordinate with the Secretary of Defense 
and the Secretary of Health and Human Services to con-
duct research to improve the ability of the Department 
of Veterans Affairs to meet the long-term reproductive 
health care needs of veterans who have a condition that 
affects the ability of the individual to reproduce. 
‘‘(b) DISSEMINATION OF INFORMATION.—The Sec-
retary shall ensure that information produced by the re-
search under this section that may be useful for other ac-
tivities of the Department is disseminated throughout the 
Department.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of subchapter II of chapter 73 of such 
title is amended by inserting after the item relating to sec-
tion 7330D the following new item: 
‘‘7330E. Coordination of reproduction and fertility research for veterans.’’. 
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TITLE 
III—ACCESS 
TO 
FER-
TILITY 
TREATMENT 
AND 
CARE 
SEC. 301. SHORT TITLE. 
This title may be cited as the ‘‘Access to Fertility 
Treatment and Care Act’’. 
SEC. 302. STANDARDS RELATING TO BENEFITS FOR FER-
TILITY TREATMENT. 
(a) IN GENERAL.— 
(1) PHSA.—Part D of title XXVII of the Pub-
lic Health Service Act (42 U.S.C. 300gg–111 et 
seq.) is amended by adding at the end the following: 
‘‘SEC. 2799A–11. STANDARDS RELATING TO BENEFITS FOR 
FERTILITY TREATMENT. 
‘‘(a) IN GENERAL.—A group health plan or a health 
insurance issuer offering group or individual health insur-
ance coverage shall provide coverage for fertility treat-
ment, if such plan or coverage provides coverage for ob-
stetrical services. 
‘‘(b) DEFINITION.—In this section, the term ‘fertility 
treatment’ includes the following: 
‘‘(1) Preservation of human oocytes, sperm, or 
embryos for later reproductive use. 
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‘‘(2) 
Artificial 
insemination, 
including 
intravaginal insemination, intracervical insemination, 
and intrauterine insemination. 
‘‘(3) Assisted reproductive technology, including 
in vitro fertilization and other treatments or proce-
dures in which reproductive genetic material, such as 
oocytes, sperm, fertilized eggs, and embryos, are 
handled, when clinically appropriate. 
‘‘(4) Genetic testing of embryos. 
‘‘(5) Medications prescribed or obtained over- 
the-counter, as indicated for fertility. 
‘‘(6) Gamete donation. 
‘‘(7) Such other information, referrals, treat-
ments, procedures, medications, laboratory testing, 
technologies, and services relating to fertility as the 
Secretary determines appropriate. 
‘‘(c) REQUIRED COVERAGE.—A group health plan 
and a health insurance issuer offering group or individual 
health insurance coverage that includes coverage for ob-
stetrical services shall provide coverage for fertility treat-
ment determined appropriate by the health care provider, 
regardless of whether the participant, beneficiary, or en-
rollee receiving such treatment has been diagnosed with 
infertility as defined by the American Society for Repro-
ductive Medicine, if the treatment is performed at, or pre-
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scribed by, a medical facility that is in compliance with 
relevant standards set by an appropriate Federal agency. 
‘‘(d) 
LIMITATION.—Cost-sharing, 
including 
deductibles and coinsurance, or other limitations for fer-
tility treatment may not be imposed with respect to the 
services required to be covered under subsection (c) to the 
extent that such cost-sharing exceeds the cost-sharing ap-
plied to other medical services under the group health plan 
or health insurance coverage or such other limitations are 
different from limitations imposed with respect to such 
medical services, except where such limitation is more fa-
vorable with respect to fertility treatment. The Secretary 
shall promulgate interim final regulations to carry out this 
subsection, notwithstanding the notice and comment re-
quirements of section 553 of title 5, United States Code. 
‘‘(e) PROHIBITIONS.—A group health plan and a 
health insurance issuer offering group or individual health 
insurance coverage may not— 
‘‘(1) provide incentives (monetary or otherwise) 
to a participant, beneficiary, or enrollee to encourage 
such participant, beneficiary, or enrollee not to seek 
or obtain fertility treatment to which such partici-
pant, beneficiary, or enrollee is entitled under this 
section or to providers to induce such providers not 
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eficiary, and enrollee under such plan or coverage regard-
ing the coverage required by this section in accordance 
with regulations promulgated by the Secretary. Such no-
tice shall be in writing and prominently positioned in any 
literature or correspondence made available or distributed 
by the plan or issuer and shall be transmitted— 
‘‘(1) not later than the earlier of— 
‘‘(A) in the first standard mailing made by 
the plan or issuer to the participant, bene-
ficiary, or enrollee following the effective date of 
such regulations; 
‘‘(B) as part of any yearly informational 
packet sent to the participant, beneficiary, or 
enrollee; or 
‘‘(C) January 1, 2026; 
‘‘(2) in the case of a participant, beneficiary, or 
enrollee not enrolled in the plan or coverage on the 
date of transmission under paragraph (1), upon ini-
tial enrollment of such participant, beneficiary, or 
enrollee; and 
‘‘(3) on an annual basis after the transmission 
under paragraph (1) or (2). 
‘‘(h) LEVEL
AND TYPE
OF REIMBURSEMENTS.— 
Nothing in this section shall be construed to prevent a 
group health plan or a health insurance issuer offering 
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group or individual health insurance coverage from negoti-
ating the level and type of reimbursement with a provider 
for care provided in accordance with this section.’’. 
(2) ERISA.— 
(A) IN GENERAL.—Subpart B of part 7 of 
subtitle B of title I of the Employee Retirement 
Income Security Act of 1974 (29 U.S.C. 1185 
et seq.) is amended by adding at the end the 
following: 
‘‘SEC. 726. STANDARDS RELATING TO BENEFITS FOR FER-
TILITY TREATMENT. 
‘‘(a) IN GENERAL.—A group health plan or a health 
insurance issuer offering group health insurance coverage 
shall provide coverage for fertility treatment, if such plan 
or coverage provides coverage for obstetrical services. 
‘‘(b) DEFINITION.—In this section, the term ‘fertility 
treatment’ includes the following: 
‘‘(1) Preservation of human oocytes, sperm, or 
embryos for later reproductive use. 
‘‘(2) 
Artificial 
insemination, 
including 
intravaginal insemination, intracervical insemination, 
and intrauterine insemination. 
‘‘(3) Assisted reproductive technology, including 
in vitro fertilization and other treatments or proce-
dures in which reproductive genetic material, such as 
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oocytes, sperm, fertilized eggs, and embryos, are 
handled, when clinically appropriate. 
‘‘(4) Genetic testing of embryos. 
‘‘(5) Medications prescribed or obtained over- 
the-counter, as indicated for fertility. 
‘‘(6) Gamete donation. 
‘‘(7) Such other information, referrals, treat-
ments, procedures, medications, laboratory testing, 
technologies, and services relating to fertility as the 
Secretary of Health and Human Services determines 
appropriate. 
‘‘(c) REQUIRED COVERAGE.—A group health plan 
and a health insurance issuer offering group health insur-
ance coverage that includes coverage for obstetrical serv-
ices shall provide coverage for fertility treatment deter-
mined appropriate by the health care provider, regardless 
of whether the participant or beneficiary receiving such 
treatment has been diagnosed with infertility as defined 
by the American Society for Reproductive Medicine, if the 
treatment is performed at, or prescribed by, a medical fa-
cility that is in compliance with relevant standards set by 
an appropriate Federal agency. 
‘‘(d) 
LIMITATION.—Cost-sharing, 
including 
deductibles and coinsurance, or other limitations for fer-
tility treatment may not be imposed with respect to the 
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services required to be covered under subsection (c) to the 
extent that such cost-sharing exceeds the cost-sharing ap-
plied to other medical services under the group health plan 
or health insurance coverage or such other limitations are 
different from limitations imposed with respect to such 
medical services, except where such limitation is more fa-
vorable with respect to fertility treatment. The Secretary 
shall promulgate interim final regulations to carry out this 
subsection, notwithstanding the notice and comment re-
quirements of section 553 of title 5, United States Code. 
‘‘(e) PROHIBITIONS.—A group health plan and a 
health insurance issuer offering group health insurance 
coverage may not— 
‘‘(1) provide incentives (monetary or otherwise) 
to a participant or beneficiary to encourage such 
participant or beneficiary not to seek or obtain fer-
tility treatment to which such participant or bene-
ficiary is entitled under this section or to providers 
to induce such providers not to provide medically ap-
propriate fertility treatments to participants or bene-
ficiaries; 
‘‘(2) prohibit a provider from discussing with a 
participant or beneficiary fertility treatment relating 
to this section; 
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‘‘(3) penalize or otherwise reduce or limit the 
reimbursement of a provider because such provider 
provided fertility treatment to a qualified participant 
or beneficiary in accordance with this section; or 
‘‘(4) on the ground prohibited under title VI of 
the Civil Rights Act of 1964 (42 U.S.C. 2000d et 
seq.), title IX of the Education Amendments of 1972 
(20 U.S.C. 1681 et seq.), the Age Discrimination 
Act of 1975 (42 U.S.C. 6101 et seq.), section 504 
of the Rehabilitation Act of 1973 (29 U.S.C. 794), 
or section 1557 of the Patient Protection and Af-
fordable Care Act (42 U.S.C. 18116), exclude any 
individual from coverage in accordance with this sec-
tion, or discriminate against any individual with re-
spect to such coverage. 
‘‘(f) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require a participant or bene-
ficiary to undergo fertility treatment. 
‘‘(g) NOTICE.—A group health plan and a health in-
surance issuer offering group health insurance coverage 
shall provide notice to each participant and beneficiary 
under such plan or coverage regarding the coverage re-
quired by this section in accordance with regulations pro-
mulgated by the Secretary. Such notice shall be in writing 
and prominently positioned in any literature or cor-
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respondence made available or distributed by the plan or 
issuer and shall be transmitted— 
‘‘(1) not later than the earlier of— 
‘‘(A) in the first standard mailing made by 
the plan or issuer to the participant or bene-
ficiary following the effective date of such regu-
lations; 
‘‘(B) as part of any yearly informational 
packet sent to the participant or beneficiary; or 
‘‘(C) January 1, 2026; 
‘‘(2) in the case of a participant or beneficiary 
not enrolled in the plan or coverage on the date of 
transmission under paragraph (1), upon initial en-
rollment of such participant or beneficiary; and 
‘‘(3) on an annual basis after the transmission 
under paragraph (1) or (2). 
‘‘(h) LEVEL
AND TYPE
OF REIMBURSEMENTS.— 
Nothing in this section shall be construed to prevent a 
group health plan or a health insurance issuer offering 
group health insurance coverage from negotiating the level 
and type of reimbursement with a provider for care pro-
vided in accordance with this section.’’. 
(B) CLERICAL AMENDMENT.—The table of 
contents in section 1 of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C. 
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1001 et seq.) is amended by inserting after the 
item relating to section 725 the following new 
item: 
‘‘Sec. 726. Standards relating to benefits for fertility treatment.’’. 
(3) IRC.— 
(A) IN GENERAL.—Subchapter B of chap-
ter 100 of the Internal Revenue Code of 1986 
is amended by adding at the end the following: 
‘‘SEC. 9826. STANDARDS RELATING TO BENEFITS FOR FER-
TILITY TREATMENT. 
‘‘(a) IN GENERAL.—A group health plan shall pro-
vide coverage for fertility treatment, if such plan provides 
coverage for obstetrical services. 
‘‘(b) DEFINITION.—In this section, the term ‘fertility 
treatment’ includes the following: 
‘‘(1) Preservation of human oocytes, sperm, or 
embryos for later reproductive use. 
‘‘(2) 
Artificial 
insemination, 
including 
intravaginal insemination, intracervical insemination, 
and intrauterine insemination. 
‘‘(3) Assisted reproductive technology, including 
in vitro fertilization and other treatments or proce-
dures in which reproductive genetic material, such as 
oocytes, sperm, fertilized eggs, and embryos, are 
handled, when clinically appropriate. 
‘‘(4) Genetic testing of embryos. 
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‘‘(5) Medications prescribed or obtained over- 
the-counter, as indicated for fertility. 
‘‘(6) Gamete donation. 
‘‘(7) Such other information, referrals, treat-
ments, procedures, medications, laboratory testing, 
technologies, and services relating to fertility as the 
Secretary of Health and Human Services determines 
appropriate. 
‘‘(c) REQUIRED COVERAGE.—A group health plan 
that includes coverage for obstetrical services shall provide 
coverage for fertility treatment determined appropriate by 
the health care provider, regardless of whether the partici-
pant or beneficiary receiving such treatment has been di-
agnosed with infertility as defined by the American Society 
for Reproductive Medicine, if the treatment is performed 
at, or prescribed by, a medical facility that is in compli-
ance with relevant standards set by an appropriate Fed-
eral agency. 
‘‘(d) 
LIMITATION.—Cost-sharing, 
including 
deductibles and coinsurance, or other limitations for fer-
tility treatment may not be imposed with respect to the 
services required to be covered under subsection (c) to the 
extent that such cost-sharing exceeds the cost-sharing ap-
plied to other medical services under the group health plan 
or health insurance coverage or such other limitations are 
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different from limitations imposed with respect to such 
medical services, except where such limitation is more fa-
vorable with respect to fertility treatment. The Secretary 
shall promulgate interim final regulations to carry out this 
subsection, notwithstanding the notice and comment re-
quirements of section 553 of title 5, United States Code. 
‘‘(e) PROHIBITIONS.—A group health plan may not— 
‘‘(1) provide incentives (monetary or otherwise) 
to a participant or beneficiary to encourage such 
participant or beneficiary not to seek or obtain fer-
tility treatment to which such participant or bene-
ficiary is entitled under this section or to providers 
to induce such providers not to provide medically ap-
propriate fertility treatments to participants or bene-
ficiaries; 
‘‘(2) prohibit a provider from discussing with a 
participant or beneficiary fertility treatment relating 
to this section; 
‘‘(3) penalize or otherwise reduce or limit the 
reimbursement of a provider because such provider 
provided fertility treatment to a qualified participant 
or beneficiary in accordance with this section; or 
‘‘(4) on the ground prohibited under title VI of 
the Civil Rights Act of 1964 (42 U.S.C. 2000d et 
seq.), title IX of the Education Amendments of 1972 
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(20 U.S.C. 1681 et seq.), the Age Discrimination 
Act of 1975 (42 U.S.C. 6101 et seq.), section 504 
of the Rehabilitation Act of 1973 (29 U.S.C. 794), 
or section 1557 of the Patient Protection and Af-
fordable Care Act (42 U.S.C. 18116), exclude any 
individual from coverage in accordance with this sec-
tion, or discriminate against any individual with re-
spect to such coverage. 
‘‘(f) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require a participant or bene-
ficiary to undergo fertility treatment. 
‘‘(g) NOTICE.—A group health plan shall provide no-
tice to each participant and beneficiary under such plan 
regarding the coverage required by this section in accord-
ance with regulations promulgated by the Secretary. Such 
notice shall be in writing and prominently positioned in 
any literature or correspondence made available or distrib-
uted by the plan and shall be transmitted— 
‘‘(1) not later than the earlier of— 
‘‘(A) in the first standard mailing made by 
the plan to the participant or beneficiary fol-
lowing the effective date of such regulations; 
‘‘(B) as part of any yearly informational 
packet sent to the participant or beneficiary; or 
‘‘(C) January 1, 2026; 
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‘‘(2) in the case of a participant or beneficiary 
not enrolled in the plan on the date of transmission 
under paragraph (1), upon initial enrollment of such 
participant or beneficiary; and 
‘‘(3) on an annual basis after the transmission 
under paragraph (1) or (2). 
‘‘(h) LEVEL
AND TYPE
OF REIMBURSEMENTS.— 
Nothing in this section shall be construed to prevent a 
group health plan from negotiating the level and type of 
reimbursement with a provider for care provided in ac-
cordance with this section.’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections for subchapter B of chapter 100 of the 
Internal Revenue Code of 1986 is amended by 
adding at the end the following new item: 
‘‘Sec. 9826. Standards relating to benefits for fertility treatment.’’. 
(b) CONFORMING AMENDMENTS.— 
(1) PHSA.—Section 2724(c) of the Public 
Health Service Act (42 U.S.C. 300gg–23(c)) is 
amended by striking ‘‘section 2704’’ and inserting 
‘‘sections 2704 and 2799A–11’’. 
(2) ERISA.—Section 731(c) of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 
1191(c)) is amended by striking ‘‘section 711’’ and 
inserting ‘‘sections 711 and 726’’. 
(c) EFFECTIVE DATES.— 
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(1) IN GENERAL.—The amendments made by 
subsections (a) and (b) shall apply for plan years be-
ginning on or after the date that is 6 months after 
the date of enactment of this Act. 
(2) COLLECTIVE BARGAINING EXCEPTION.— 
(A) IN GENERAL.—In the case of a group 
health plan maintained pursuant to one or more 
collective bargaining agreements between em-
ployee representatives and one or more employ-
ers ratified before the date of enactment of this 
Act, the amendments made by subsection (a) 
shall not apply to plan years beginning before 
the later of— 
(i) the date on which the last collec-
tive bargaining agreements relating to the 
plan terminates (determined without re-
gard to any extension thereof agreed to 
after the date of enactment of this Act), or 
(ii) the date occurring 6 months after 
the date of the enactment of this Act. 
(B) CLARIFICATION.—For purposes of 
subparagraph (A), any plan amendment made 
pursuant to a collective bargaining agreement 
relating to the plan which amends the plan sole-
ly to conform to any requirement added by sub-
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section (a) shall not be treated as a termination 
of such collective bargaining agreement. 
SEC. 303. REQUIREMENT FOR STATE MEDICAID PLANS TO 
PROVIDE MEDICAL ASSISTANCE FOR FER-
TILITY TREATMENT. 
(a) IN GENERAL.—Section 1905 of the Social Secu-
rity Act (42 U.S.C. 1396d) is amended— 
(1) in subsection (a)(4)(C), by inserting 
‘‘(which shall include fertility treatment provided in 
accordance with subsection (kk))’’ after ‘‘family 
planning services and supplies’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(kk) REQUIREMENTS FOR COVERAGE OF FERTILITY 
TREATMENT.—For purposes of subsection (a)(4)(C), a 
State shall ensure that the medical assistance provided 
under the State plan (or waiver of such plan) for fertility 
treatment complies with the requirements of section 
2799A–11(b) of the Public Health Service Act in the same 
manner as such requirements and limitations apply to 
health insurance coverage offered by a group health plan 
or health insurance issuer.’’. 
(b) TECHNICAL AMENDMENT.—Section 1903(a)(5) 
of the Social Security Act (42 U.S.C. 1396b(a)(5)) is 
amended 
by 
inserting 
‘‘described 
in 
section 
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1905(a)(4)(C)’’ after ‘‘family planning services and sup-
plies’’. 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this section 
shall take effect on October 1, 2025. 
(2) DELAY PERMITTED IF STATE LEGISLATION 
REQUIRED.—In the case of a State plan approved 
under title XIX of the Social Security Act which the 
Secretary of Health and Human Services determines 
requires State legislation (other than legislation ap-
propriating funds) in order for the plan to meet the 
additional requirement imposed by this section, the 
State plan shall not be regarded as failing to comply 
with the requirements of such title solely on the 
basis of the failure of the plan to meet such addi-
tional requirement before the first day of the first 
calendar quarter beginning after the close of the 
first regular session of the State legislature that 
ends after the 1-year period beginning with the date 
of the enactment of this section. For purposes of the 
preceding sentence, in the case of a State that has 
a 2-year legislative session, each year of the session 
is deemed to be a separate regular session of the 
State legislature. 
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SEC. 304. MEDICARE COVERAGE OF FERTILITY TREAT-
MENT. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)) is amended— 
(1) in subparagraph (JJ), by inserting ‘‘and’’ 
after the semicolon at the end; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(KK) fertility treatment (as defined in section 
2799A–11(b) of the Public Health Service Act);’’. 
(b) PAYMENT AND WAIVER OF COINSURANCE.—Sec-
tion 1833(a)(1) of the Social Security Act (42 U.S.C. 
1395l(a)(1)) is amended— 
(1) by striking ‘‘and’’ before ‘‘(HH)’’; and 
(2) by inserting before the semicolon at the end 
the following: ‘‘, and (II) with respect to fertility 
treatment (as described in section 1861(s)(2)(KK)), 
the amount paid shall be equal to 100 percent of the 
lesser of the actual charge for the treatment or the 
amount determined under the payment basis deter-
mined under section 1848’’. 
(c) WAIVER OF APPLICATION OF DEDUCTIBLE.—The 
first sentence of section 1833(b) of the Social Security Act 
(42 U.S.C. 1395l(b)) is amended— 
(1) by striking ‘‘, and (13)’’ and inserting 
‘‘(13)’’; and 
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(2) by striking ‘‘1861(n)..’’ and inserting 
‘‘1861(n), and (14) such deductible shall not apply 
with respect to fertility treatment (as described in 
section 1861(s)(2)(KK)).’’. 
(d) PAYMENT UNDER PHYSICIAN FEE SCHEDULE.— 
Section 1848(j)(3) of the Social Security Act (42 U.S.C. 
1395w–4(j)(3)) is amended by inserting ‘‘(2)(KK),’’ after 
‘‘risk assessment),’’. 
(e) CONFORMING AMENDMENT REGARDING COV-
ERAGE.—Section 1862(a)(1)(A) of the Social Security Act 
(42 U.S.C. 1395y(a)(1)(A)) is amended— 
(1) by striking ‘‘or additional’’ and inserting ‘‘, 
additional’’; and 
(2) by inserting ‘‘, or fertility treatment (as de-
scribed 
in 
section 
1861(s)(2)(KK))’’ 
after 
‘‘1861(ddd)(1))’’. 
(f) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
January 1, 2025. 
TITLE IV—FAMILY BUILDING 
FEHB FAIRNESS 
SEC. 401. SHORT TITLE. 
This title may be cited as the ‘‘Family Building 
FEHB Fairness Act’’. 
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SEC. 402. FERTILITY TREATMENT BENEFITS. 
(a) IN GENERAL.—Section 8904 of title 5, United 
States Code, is amended— 
(1) in subsection (a)— 
(A) in paragraph (1), by adding at the end 
the following: 
‘‘(G) Fertility treatment benefits.’’; and 
(B) in paragraph (2)— 
(i) by redesignating subparagraph (F) 
as subparagraph (G); and 
(ii) by inserting after subparagraph 
(E) the following: 
‘‘(F) Fertility treatment benefits.’’; and 
(2) by adding at the end the following: 
‘‘(c) In this section, the term ‘fertility treatment’ in-
cludes the following: 
‘‘(1) Preservation of human oocytes, sperm, or 
embryos for later reproductive use. 
‘‘(2) 
Artificial 
insemination, 
including 
intravaginal insemination, intracervical insemination, 
and intrauterine insemination. 
‘‘(3) Assisted reproductive technology, including 
in vitro fertilization and other treatments or proce-
dures in which reproductive genetic material, such as 
oocytes, sperm, fertilized eggs, and embryos, are 
handled, when clinically appropriate. 
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‘‘(4) Genetic testing of embryos. 
‘‘(5) Medications prescribed or obtained over- 
the-counter, as indicated for fertility. 
‘‘(6) Gamete donation. 
‘‘(7) Such other information, referrals, treat-
ments, procedures, medications, laboratory services, 
technologies, and services relating to fertility as the 
Director of the Office of Personnel Management, in 
coordination with the Secretary of Health and 
Human Services, determines appropriate.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on the date that is 1 year 
after the date of enactment of this Act. 
Æ 
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