without contraception or to carry a pregnancy 
to a live birth; or 
‘‘(ii) the presence of a demonstrated condi-
tion determined by 2 physicians (at least 1 of 
whom specializes in infertility) to cause infer-
tility; and 
‘‘(B) the term ‘nonexperimental assisted repro-
ductive technology procedure’ means in vitro fer-
tilization, gamete intrafallopian transfer, zygote 
intrafallopian transfer, and any other clinical treat-
ment or procedure the safety and efficacy of which 
are recognized by the American Society for Repro-
ductive Medicine, the American College of Obstetri-
cians and Gynecologists, or any other similar nation-
ally-recognized organization, or a Federal agency de-
scribed in paragraph (2)(B)(iii). 
‘‘(6) The Office shall prescribe any regulations nec-
essary to carry out this subsection.’’. 
(b) DEFENSE HEALTH CARE PLANS.—(1) Chapter 
55 of title 10, United States Code, is amended by adding 
at the end the following new section:
‘‘§ 1110a. Obstetrical and infertility benefits 
‘‘(a)(1) Any health care plan under this chapter 
which provides obstetrical benefits shall also provide cov-
erage for the diagnosis and treatment of infertility, includ-
ing nonexperimental assisted reproductive technology pro-
cedures. 
‘‘(2) Under this subsection—
‘‘(A) coverage for the diagnosis or treatment of 
infertility may not be subject to any copayment or 
deductible greater than applies with respect to ob-
stetrical benefits under the plan involved; and 
‘‘(B) coverage for a procedure described in 
paragraph (5)(B) shall, in the case of any individual, 
be required only if—
‘‘(i) such individual has been unable to 
carry a pregnancy to live birth through less 
costly, medically appropriate infertility treat-
ments for which such individual has coverage 
under this chapter; 
‘‘(ii) the procedure (including any retrieval 
incident thereto) is performed at medical facili-
ties that conform to the standards of the Amer-
ican Society for Reproductive Medicine, the So-
ciety for Assisted Reproductive Technology, the 
American College of Obstetricians and Gyne-
cologists, or any other similar nationally-recog-
nized organization, or a Federal agency that 
promulgates standards for infertility proce-
dures; and
‘‘(iii) if the services of a laboratory are re-
quired, such laboratory is accredited by the Col-
lege of American Pathologists’ Reproductive 
Laboratory Accreditation Program or any other 
similar nationally-recognized program, or a 
Federal agency performing a similar function. 
‘‘(3)(A) Except as provided in subparagraph (B) or 
(C)—
‘‘(i) coverage for a procedure described in para-
graph (5)(B) may be provided only if the individual 
involved has not already undergone 4 attempts to 
achieve a live birth using any such procedures; and 
‘‘(ii) coverage for an oocyte retrieval may be 
provided only if the individual involved has not al-
ready undergone 4 complete oocyte retrievals. 
‘‘(B) For purposes of clause (i) of subparagraph 
(A)—
‘‘(i) if a live birth results from the third at-
tempt (using a procedure described in paragraph 
(5)(B)), such clause shall be applied by substituting 
‘5’ for ‘4’; and 
‘‘(ii) if a live birth results from the fourth at-
tempt (using a procedure described in paragraph 
(5)(B)), such clause shall be applied by substituting 
‘6’ for the otherwise applicable lifetime maximum.
‘‘(C) For purposes of clause (ii) of subparagraph 
(A)—
‘‘(i) if a live birth results from the third oocyte 
retrieval, such clause shall be applied by substituting 
‘5’ for ‘4’; and 
‘‘(ii) if a live birth results from the fourth oo-
cyte retrieval, such clause shall be applied by sub-
stituting ‘6’ for the otherwise applicable lifetime 
maximum. 
‘‘(4) In no event shall this subsection be considered 
to permit or require coverage—
‘‘(A) if, or to the extent that, the health bene-
fits plan objects to such coverage on the basis of re-
ligious beliefs; or 
‘‘(B) in connection with any procedure or treat-
ment, unless rendered by a physician or at the direc-
tion or request of a physician. 
‘‘(5) For purposes of this subsection—
‘‘(A) the term ‘infertility’ means—
‘‘(i) the inability to conceive a pregnancy 
after 12 months of regular sexual relations 
without contraception or to carry a pregnancy 
to a live birth; or 
‘‘(ii) the presence of a demonstrated condi-
tion determined by 2 physicians (at least 1 of
whom specializes in infertility) to cause infer-
tility; and 
‘‘(B) the term ‘nonexperimental assisted repro-
ductive technology procedure’ means in vitro fer-
tilization, gamete intrafallopian transfer, zygote 
intrafallopian transfer, and any other clinical treat-
ment or procedure the safety and efficacy of which 
are recognized by the American Society for Repro-
ductive Medicine, the American College of Obstetri-
cians and Gynecologists, or any other similar nation-
ally-recognized organization, or a Federal agency de-
scribed in paragraph (2)(B)(iii). 
‘‘(b) The Secretary of Defense shall prescribe any 
regulations necessary to carry out this section.’’.
(2) The table of sections at the beginning of such 
chapter is amended by adding at the end the following 
new item:
‘‘1110a. Obstetrical and infertility benefits.’’.
SEC. 2. EFFECTIVE DATE. 
The amendments made by this Act shall apply with 
respect to contracts entered into or renewed for any year 
beginning after the end of the 6-month period beginning 
on the date of enactment of this Act.
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