‘‘(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.— 
(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.— 
VerDate Sep 11 2014 
23:50 Aug 12, 2025
Jkt 059200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H4648.IH
H4648
kjohnson on DSK7ZCZBW3PROD with $$_JOB
(A) IN GENERAL.—In the case of a group 
health plan maintained pursuant to one or more 
collective bargaining agreements between em-
ployee representatives and one or more employ-
ers ratified before the date of enactment of this 
Act, the amendments made by subsection (a) 
shall not apply to plan years beginning before 
the later of— 
(i) the date on which the last collec-
tive bargaining agreements relating to the 
plan terminates (determined without re-
gard to any extension thereof agreed to 
after the date of enactment of this Act), or 
(ii) the date occurring 6 months after 
the date of the enactment of this Act. 
(B) CLARIFICATION.—For purposes of 
subparagraph (A), any plan amendment made 
pursuant to a collective bargaining agreement 
relating to the plan which amends the plan sole-
ly to conform to any requirement added by sub-
section (a) shall not be treated as a termination 
of such collective bargaining agreement. 
VerDate Sep 11 2014 
23:50 Aug 12, 2025
Jkt 059200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H4648.IH
H4648
kjohnson on DSK7ZCZBW3PROD with $$_JOB
SEC. 3. FEDERAL EMPLOYEES HEALTH BENEFITS PRO-
GRAM. 
(a) IN GENERAL.—Section 8902 of title 5, United 
States Code, is amended by adding at the end the fol-
lowing: 
‘‘(q)(1) In this subsection, the term ‘fertility treat-
ment’ has the meaning given the term in section 2799A– 
11(b) of the Public Health Service Act. 
‘‘(2) A contract under this chapter shall provide, in 
a manner consistent with section 2799A–11 of the Public 
Health Service Act, coverage for fertility treatment, if that 
contract covers obstetrical benefits. 
‘‘(3) Coverage for fertility treatment under a health 
benefits plan described in section 8903 or 8903a may not 
be subject to any copayment or deductible greater than 
the copayment or deductible, respectively, applicable to ob-
stetrical benefits under the plan. 
‘‘(4) Subsection (m)(1) shall not, with respect to a 
contract under this chapter, prevent the inclusion of any 
terms that, under paragraph (2) of this subsection, are 
required by reason of section 2799A–11 of the Public 
Health Service Act.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply with respect to— 
(1) any contract entered into or renewed for a 
contract year beginning on or after the date that is 
VerDate Sep 11 2014 
23:50 Aug 12, 2025
Jkt 059200
PO 00000
Frm 00018
Fmt 6652
Sfmt 6201
E:\BILLS\H4648.IH
H4648
kjohnson on DSK7ZCZBW3PROD with $$_JOB
180 days after the date of enactment of this Act; 
and 
(2) any health benefits plan offered under a 
contract described in paragraph (1). 
SEC. 4. BENEFITS FOR FERTILITY TREATMENT UNDER THE 
TRICARE PROGRAM. 
(a) IN GENERAL.—Chapter 55 of title 10, United 
States Code, is amended by adding at the end the fol-
lowing new section: 
‘‘§ 1110c. Obstetrical and fertility benefits 
‘‘(a) IN GENERAL.—Any health care plan under this 
chapter shall provide, in a manner consistent with section 
2799A–11 of the Public Health Service Act, coverage for 
fertility treatment, if such plan covers obstetrical benefits. 
‘‘(b) COPAYMENT.—The Secretary of Defense shall 
establish cost-sharing requirements for the coverage of fer-
tility treatment that are consistent with the cost-sharing 
requirements applicable to health plans and health insur-
ance coverage under section 2799A–11(d) of the Public 
Health Service Act. 
‘‘(c) REGULATIONS.—The Secretary of Defense shall 
prescribe any regulations necessary to carry out this sec-
tion. 
VerDate Sep 11 2014 
23:50 Aug 12, 2025
Jkt 059200
PO 00000
Frm 00019
Fmt 6652
Sfmt 6201
E:\BILLS\H4648.IH
H4648
kjohnson on DSK7ZCZBW3PROD with $$_JOB
‘‘(d) DEFINITIONS.—In this section, the term ‘fer-
tility treatment’ has the meaning given the term in section 
2799A–11(b) of the Public Health Service Act.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 55 of such title is amended 
by adding at the end the following new item: 
‘‘1110c. Obstetrical and fertility benefits.’’. 
SEC. 5. FERTILITY TREATMENT FOR VETERANS AND 
SPOUSES OR PARTNERS OF 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: 
‘‘§ 1720M. 
Fertility 
treatment 
for 
veterans 
and 
spouses or partners of veterans 
‘‘(a) IN GENERAL.—The Secretary shall furnish fer-
tility treatment services to a veteran or a spouse or part-
ner of a veteran if the veteran, and the spouse or partner 
of the veteran, as applicable, apply jointly for such fertility 
treatment through a process prescribed by the Secretary 
for purposes of this section. 
‘‘(b) DEFINITIONS.—In this section, the term ‘fer-
tility treatment’ has the meaning given the term in section 
2799A–11(b) of the Public Health Service Act.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 17 of such title is amended 
VerDate Sep 11 2014 
23:50 Aug 12, 2025
Jkt 059200
PO 00000
Frm 00020
Fmt 6652
Sfmt 6201
E:\BILLS\H4648.IH
H4648
kjohnson on DSK7ZCZBW3PROD with $$_JOB
by inserting after the item relating to section 1720L the 
following new item: 
‘‘1720M. Fertility treatment for veterans and spouses or partners of veterans.’’. 
(c) REGULATIONS.—Not later than 18 months after 
the date of the enactment of this Act, the Secretary of 
Veterans Affairs shall prescribe regulations to carry out 
section 1720M of title 38, United States Code, as added 
by subsection (a). 
SEC. 6. REQUIREMENT FOR STATE MEDICAID PLANS TO 
PROVIDE MEDICAL ASSISTANCE FOR FER-
TILITY TREATMENT. 
(a) IN GENERAL.—Section 1905 of the Social Secu-
rity Act (42 U.S.C. 1396d) is amended— 
(1) in subsection (a)(4)(C), by inserting 
‘‘(which shall include fertility treatment provided in 
accordance with subsection (kk))’’ after ‘‘family 
planning services and supplies’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(kk) REQUIREMENTS FOR COVERAGE OF FERTILITY 
TREATMENT.—For purposes of subsection (a)(4)(C), a 
State shall ensure that the medical assistance provided 
under the State plan (or waiver of such plan) for fertility 
treatment complies with the requirements of section 
2799A–11(b) of the Public Health Service Act in the same 
manner as such requirements and limitations apply to 
VerDate Sep 11 2014 
23:50 Aug 12, 2025
Jkt 059200
PO 00000
Frm 00021
Fmt 6652
Sfmt 6201
E:\BILLS\H4648.IH
H4648
kjohnson on DSK7ZCZBW3PROD with $$_JOB
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 
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, 2026. 
(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 
VerDate Sep 11 2014 
23:50 Aug 12, 2025
Jkt 059200
PO 00000
Frm 00022
Fmt 6652
Sfmt 6201
E:\BILLS\H4648.IH
H4648
kjohnson on DSK7ZCZBW3PROD with $$_JOB
of the enactment of this section. For purposes of the 
preceding sentence, in the case of a State that has 
a 2-year legislative session, each year of the session 
is deemed to be a separate regular session of the 
State legislature. 
SEC. 7. MEDICARE COVERAGE OF FERTILITY TREATMENT. 
(a) COVERAGE.—Section 1861(s)(2) of the Social Se-
curity Act (42 U.S.C. 1395x(s)(2)) is amended— 
(1) in subparagraph (JJ), by inserting ‘‘and’’ 
after the semicolon at the end; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(KK) fertility treatment (as defined in section 
2799A–11(b) of the Public Health Service Act);’’. 
(b) PAYMENT AND WAIVER OF COINSURANCE.—Sec-
tion 1833(a)(1) of the Social Security Act (42 U.S.C. 
1395l(a)(1)) is amended— 
(1) by striking ‘‘and’’ before ‘‘(HH)’’; and 
(2) by inserting before the semicolon at the end 
the following: ‘‘, and (II) with respect to fertility 
treatment (as described in section 1861(s)(2)(KK)), 
the amount paid shall be equal to 100 percent of the 
lesser of the actual charge for the treatment or the 
amount determined under the payment basis deter-
mined under section 1848’’. 
VerDate Sep 11 2014 
23:50 Aug 12, 2025
Jkt 059200
PO 00000
Frm 00023
Fmt 6652
Sfmt 6201
E:\BILLS\H4648.IH
H4648
kjohnson on DSK7ZCZBW3PROD with $$_JOB
(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 
(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, 2026. 
Æ 
VerDate Sep 11 2014 
23:50 Aug 12, 2025
Jkt 059200
PO 00000
Frm 00024
Fmt 6652
Sfmt 6301
E:\BILLS\H4648.IH
H4648
kjohnson on DSK7ZCZBW3PROD with $$_JOB