ance coverage shall ensure that such plan or coverage pro-
vides coverage for— 
‘‘(1) the treatment of infertility, including non-
experimental assisted reproductive technology proce-
dures, if such plan or coverage provides coverage for 
obstetrical services; and 
‘‘(2) standard fertility preservation services 
when a medically necessary treatment may directly 
or indirectly cause iatrogenic infertility. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) the term ‘assisted reproductive technology’ 
means treatments or procedures that involve the 
handling of human egg, sperm, and embryo outside 
of the body with the intent of facilitating a preg-
nancy, including in vitro fertilization, egg, embryo, 
or sperm cryopreservation, egg or embryo donation, 
and gestational surrogacy; 
‘‘(2) the term ‘infertility’ means a disease, char-
acterized by the failure to establish a clinical preg-
nancy— 
‘‘(A) after 12 months of regular, unpro-
tected sexual intercourse; or 
‘‘(B) due to a person’s incapacity for re-
production either as an individual or with his or 
her partner, which may be determined after a 
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period of less than 12 months of regular, un-
protected sexual intercourse, or based on med-
ical, sexual and reproductive history, age, phys-
ical findings, or diagnostic testing; and 
‘‘(3) the term ‘iatrogenic infertility’ means an 
impairment of fertility due to surgery, radiation, 
chemotherapy, or other medical treatment. 
‘‘(c) REQUIRED COVERAGE.— 
‘‘(1) COVERAGE FOR INFERTILITY.—Subject to 
paragraph (3), a group health plan and a health in-
surance issuer offering group or individual health in-
surance coverage that includes coverage for obstet-
rical services shall provide coverage for treatment of 
infertility determined appropriate by the treating 
provider, including, as appropriate, ovulation induc-
tion, egg retrieval, sperm retrieval, artificial insemi-
nation, in vitro fertilization, genetic screening, 
intracytoplasmic sperm injection, and any other non- 
experimental treatment, as determined by the Sec-
retary in consultation with appropriate professional 
and patient organizations. 
‘‘(2) 
COVERAGE
FOR
IATROGENIC
INFER-
TILITY.—A group health plan and a health insur-
ance issuer offering group or individual health insur-
ance coverage shall provide coverage of fertility pres-
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ervation services for individuals who undergo medi-
cally necessary treatment that may cause iatrogenic 
infertility, as determined by the treating provider, 
including cryopreservation of gametes and other pro-
cedures, as determined by the Secretary, consistent 
with established medical practices and professional 
guidelines published by professional medical organi-
zations. 
‘‘(3) LIMITATION ON COVERAGE OF ASSISTED 
REPRODUCTIVE TECHNOLOGY.—A group health plan 
and a health insurance issuer offering group or indi-
vidual health insurance coverage shall provide cov-
erage for assisted reproductive technology as re-
quired under paragraph (1) if— 
‘‘(A) the individual is unable to bring a 
pregnancy to a live birth through minimally 
invasive infertility treatments, as determined 
appropriate by the treating provider, with con-
sideration given to participant’s, beneficiary’s, 
or enrollee’s specific diagnoses or condition for 
which coverage is available under the plan or 
coverage; and 
‘‘(B) the treatment is performed at a med-
ical facility that is in compliance with any 
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standards set by an appropriate Federal agen-
cy. 
‘‘(d) 
LIMITATION.—Cost-sharing, 
including 
deductibles and coinsurance, or other limitations for infer-
tility and services to prevent iatrogenic infertility may not 
be imposed with respect to the services required to be cov-
ered under subsection (c) to the extent that such cost- 
sharing exceeds the cost-sharing applied to similar services 
under the group health plan or health insurance coverage 
or such other limitations are different from limitations im-
posed with respect to such similar services. 
‘‘(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 be 
provided infertility treatments or fertility preserva-
tion services to which such participant, beneficiary, 
or enrollee is entitled under this section or to pro-
viders to induce such providers not to provide such 
treatments to qualified participants, beneficiaries, or 
enrollees; 
‘‘(2) prohibit a provider from discussing with a 
participant, beneficiary, or enrollee infertility treat-
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ments or fertility preservation technology or medical 
treatment options relating to this section; or 
‘‘(3) penalize or otherwise reduce or limit the 
reimbursement of a provider because such provider 
provided infertility treatments or fertility preserva-
tion services to a qualified participant, beneficiary, 
or enrollee in accordance with this section. 
‘‘(f) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require a participant, bene-
ficiary, or enrollee to undergo infertility treatments or fer-
tility preservation services. 
‘‘(g) NOTICE.—A group health plan and a health in-
surance issuer offering group or individual health insur-
ance coverage shall provide notice to each participant, ben-
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) in the next mailing made by the plan or 
issuer to the participant, beneficiary, or enrollee; 
‘‘(2) as part of any yearly informational packet 
sent to the participant, beneficiary, or enrollee; or 
‘‘(3) not later than January 1, 2024, 
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whichever is earlier. 
‘‘(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 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 
TREATMENT OF INFERTILITY AND PREVEN-
TION OF IATROGENIC INFERTILITY. 
‘‘(a) IN GENERAL.—A group health plan or a health 
insurance issuer offering group health insurance coverage 
shall ensure that such plan or coverage provides coverage 
for— 
‘‘(1) the treatment of infertility, including non-
experimental assisted reproductive technology proce-
dures, if such plan or coverage provides coverage for 
obstetrical services; and 
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‘‘(2) standard fertility preservation services 
when a medically necessary treatment may directly 
or indirectly cause iatrogenic infertility. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) the term ‘assisted reproductive technology’ 
means treatments or procedures that involve the 
handling of human egg, sperm, and embryo outside 
of the body with the intent of facilitating a preg-
nancy, including in vitro fertilization, egg, embryo, 
or sperm cryopreservation, egg or embryo donation, 
and gestational surrogacy; 
‘‘(2) the term ‘infertility’ means a disease, char-
acterized by the failure to establish a clinical preg-
nancy— 
‘‘(A) after 12 months of regular, unpro-
tected sexual intercourse; or 
‘‘(B) due to a person’s incapacity for re-
production either as an individual or with his or 
her partner, which may be determined after a 
period of less than 12 months of regular, un-
protected sexual intercourse, or based on med-
ical, sexual and reproductive history, age, phys-
ical findings, or diagnostic testing; and 
VerDate Sep 11 2014 
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‘‘(3) the term ‘iatrogenic infertility’ means an 
impairment of fertility due to surgery, radiation, 
chemotherapy, or other medical treatment. 
‘‘(c) REQUIRED COVERAGE.— 
‘‘(1) COVERAGE FOR INFERTILITY.—Subject to 
paragraph (3), a group health plan and a health in-
surance issuer offering group health insurance cov-
erage that includes coverage for obstetrical services 
shall provide coverage for treatment of infertility de-
termined appropriate by the treating provider, in-
cluding, as appropriate, ovulation induction, egg re-
trieval, sperm retrieval, artificial insemination, in 
vitro fertilization, genetic screening, intracytoplasmic 
sperm injection, and any other non-experimental 
treatment, as determined by the Secretary in con-
sultation with appropriate professional and patient 
organizations. 
‘‘(2) 
COVERAGE
FOR
IATROGENIC
INFER-
TILITY.—A group health plan and a health insur-
ance issuer offering group health insurance coverage 
shall provide coverage of fertility preservation serv-
ices for individuals who undergo medically necessary 
treatment that may cause iatrogenic infertility, as 
determined by the treating provider, including 
cryopreservation of gametes and other procedures, 
VerDate Sep 11 2014 
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as determined by the Secretary, consistent with es-
tablished medical practices and professional guide-
lines published by professional medical organiza-
tions. 
‘‘(3) LIMITATION ON COVERAGE OF ASSISTED 
REPRODUCTIVE TECHNOLOGY.—A group health plan 
and a health insurance issuer offering group health 
insurance coverage shall provide coverage for as-
sisted reproductive technology as required under 
paragraph (1) if— 
‘‘(A) the individual is unable to bring a 
pregnancy to a live birth through minimally 
invasive infertility treatments, as determined 
appropriate by the treating provider, with con-
sideration given to participant’s or beneficiary’s 
specific diagnoses or condition for which cov-
erage is available under the plan or coverage; 
and 
‘‘(B) the treatment is performed at a med-
ical facility that is in compliance with any 
standards set by an appropriate Federal agen-
cy. 
‘‘(d) 
LIMITATION.—Cost-sharing, 
including 
deductibles and coinsurance, or other limitations for infer-
tility and services to prevent iatrogenic infertility may not 
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be imposed with respect to the services required to be cov-
ered under subsection (c) to the extent that such cost- 
sharing exceeds the cost-sharing applied to similar services 
under the group health plan or health insurance coverage 
or such other limitations are different from limitations im-
posed with respect to such similar services. 
‘‘(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 be provided infer-
tility treatments or fertility preservation services to 
which such participant or beneficiary is entitled 
under this section or to providers to induce such 
providers not to provide such treatments to qualified 
participants or beneficiaries; 
‘‘(2) prohibit a provider from discussing with a 
participant or beneficiary infertility treatments or 
fertility preservation technology or medical treat-
ment options relating to this section; or 
‘‘(3) penalize or otherwise reduce or limit the 
reimbursement of a provider because such provider 
provided infertility treatments or fertility preserva-
VerDate Sep 11 2014 
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tion services to a qualified participant or beneficiary 
in accordance with this section. 
‘‘(f) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require a participant or bene-
ficiary to undergo infertility treatments or fertility preser-
vation services. 
‘‘(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-
respondence made available or distributed by the plan or 
issuer and shall be transmitted— 
‘‘(1) in the next mailing made by the plan or 
issuer to the participant or beneficiary; 
‘‘(2) as part of any yearly informational packet 
sent to the participant or beneficiary; or 
‘‘(3) not later than January 1, 2024, 
whichever is earlier. 
‘‘(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 
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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. 
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 treatment of infertility and pre-
vention of iatrogenic infertility.’’. 
(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 
TREATMENT OF INFERTILITY AND PREVEN-
TION OF IATROGENIC INFERTILITY. 
‘‘(a) IN GENERAL.—A group health plan shall ensure 
that such plan provides coverage for— 
‘‘(1) the treatment of infertility, including non-
experimental assisted reproductive technology proce-
dures, if such plan provides coverage for obstetrical 
services; and 
‘‘(2) standard fertility preservation services 
when a medically necessary treatment may directly 
or indirectly cause iatrogenic infertility. 
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‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) the term ‘assisted reproductive technology’ 
means treatments or procedures that involve the 
handling of human egg, sperm, and embryo outside 
of the body with the intent of facilitating a preg-
nancy, including in vitro fertilization, egg, embryo, 
or sperm cryopreservation, egg or embryo donation, 
and gestational surrogacy; 
‘‘(2) the term ‘infertility’ means a disease, char-
acterized by the failure to establish a clinical preg-
nancy— 
‘‘(A) after 12 months of regular, unpro-
tected sexual intercourse; or 
‘‘(B) due to a person’s incapacity for re-
production either as an individual or with his or 
her partner, which may be determined after a 
period of less than 12 months of regular, un-
protected sexual intercourse, or based on med-
ical, sexual and reproductive history, age, phys-
ical findings, or diagnostic testing; and 
‘‘(3) the term ‘iatrogenic infertility’ means an 
impairment of fertility due to surgery, radiation, 
chemotherapy, or other medical treatment. 
‘‘(c) REQUIRED COVERAGE.— 
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‘‘(1) COVERAGE FOR INFERTILITY.—Subject to 
paragraph (3), a group health plan that includes 
coverage for obstetrical services shall provide cov-
erage for treatment of infertility determined appro-
priate by the treating provider, including, as appro-
priate, ovulation induction, egg retrieval, sperm re-
trieval, artificial insemination, in vitro fertilization, 
genetic screening, intracytoplasmic sperm injection, 
and any other non-experimental treatment, as deter-
mined by the Secretary in consultation with appro-
priate professional and patient organizations. 
‘‘(2) 
COVERAGE
FOR
IATROGENIC
INFER-
TILITY.—A group health plan shall provide coverage 
of fertility preservation services for individuals who 
undergo medically necessary treatment that may 
cause iatrogenic infertility, as determined by the 
treating provider, including cryopreservation of 
gametes and other procedures, as determined by the 
Secretary, consistent with established medical prac-
tices and professional guidelines published by profes-
sional medical organizations. 
‘‘(3) LIMITATION ON COVERAGE OF ASSISTED 
REPRODUCTIVE TECHNOLOGY.—A group health plan 
shall provide coverage for assisted reproductive tech-
nology as required under paragraph (1) if— 
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‘‘(A) the individual is unable to bring a 
pregnancy to a live birth through minimally 
invasive infertility treatments, as determined 
appropriate by the treating provider, with con-
sideration given to participant’s or beneficiary’s 
specific diagnoses or condition for which cov-
erage is available under the plan; and 
‘‘(B) the treatment is performed at a med-
ical facility that is in compliance with any 
standards set by an appropriate Federal agen-
cy. 
‘‘(d) 
LIMITATION.—Cost-sharing, 
including 
deductibles and coinsurance, or other limitations for infer-
tility and services to prevent iatrogenic infertility may not 
be imposed with respect to the services required to be cov-
ered under subsection (c) to the extent that such cost- 
sharing exceeds the cost-sharing applied to similar services 
under the group health plan or such other limitations are 
different from limitations imposed with respect to such 
similar services. 
‘‘(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 be provided infer-
tility treatments or fertility preservation services to 
VerDate Sep 11 2014 
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which such participant or beneficiary is entitled 
under this section or to providers to induce such 
providers not to provide such treatments to qualified 
participants or beneficiaries; 
‘‘(2) prohibit a provider from discussing with a 
participant or beneficiary infertility treatments or 
fertility preservation technology or medical treat-
ment options relating to this section; or 
‘‘(3) penalize or otherwise reduce or limit the 
reimbursement of a provider because such provider 
provided infertility treatments or fertility preserva-
tion services to a qualified participant or beneficiary 
in accordance with this section. 
‘‘(f) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require a participant or bene-
ficiary to undergo infertility treatments or fertility preser-
vation services. 
‘‘(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— 
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SEC. 6. TREATMENT OF INFERTILITY AND PREVENTION OF 
IATROGENIC INFERTILITY 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: 
‘‘§ 1720K. Infertility treatment for veterans and 
spouses or partners of veterans. 
‘‘(a) IN GENERAL.—The Secretary shall furnish 
treatment for infertility and fertility preservation services, 
including through the use of assisted reproductive tech-
nology, to a veteran or a spouse or partner of a veteran 
if the veteran, and the spouse or partner of the veteran, 
as applicable, apply jointly for such treatment through a 
process prescribed by the Secretary for purposes of this 
section. 
‘‘(b) DEFINITIONS.—In this section, the terms ‘as-
sisted reproductive technology’ and ‘infertility’ have the 
meanings given those terms in section 2799A–11 of the 
Public Health Service Act.’’. 
(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. Infertility treatment for veterans and spouses or partners of vet-
erans.’’. 
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