I 
108TH CONGRESS 
1ST SESSION H. R. 1852
To assure equitable treatment of fertility and impotence in health care cov-
erage under group health plans, health insurance coverage, and health 
plans under the Federal employees’ health benefits program. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 29, 2003
Mr. ANDREWS introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
Education and the Workforce and Government Reform, for a period to 
be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To assure equitable treatment of fertility and impotence in 
health care coverage under group health plans, health 
insurance coverage, and health plans under the Federal 
employees’ health benefits program.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Equity in Fertility 
Coverage Act of 2003’’.
SEC. 2. EQUITY IN PROVISION OF PRESCRIPTION DRUG 
COVERAGE. 
(a) GROUP HEALTH PLANS.—
(1) PUBLIC
HEALTH
SERVICE
ACT
AMEND-
MENTS.—(A) Subpart 2 of part A of title XXVII of 
the Public Health Service Act is amended by adding 
at the end the following new section: 
‘‘SEC. 2707. EQUITY IN FERTILITY COVERAGE. 
‘‘(a) IN GENERAL.—A group health plan, and a 
health insurance issuer offering group health insurance 
coverage, that provides for coverage of impotency medica-
tions such as viagra shall also provide coverage of fertility 
treatments. 
‘‘(b) CONSTRUCTION.—Nothing in this section shall 
be construed as preventing a plan or issuer from—
‘‘(1) restricting the drugs for which benefits are 
provided under the plan or health insurance cov-
erage, or 
‘‘(2) imposing a limitation on the amount of 
benefits provided with respect to such coverage or 
the cost-sharing that may be imposed with respect to 
such coverage, 
so long as such restrictions and limitations are consistent 
with subsection (a). 
‘‘(c) NOTICE.—A group health plan under this part 
shall comply with the notice requirement under section
714(c) of the Employee Retirement Income Security Act 
of 1974 with respect to the requirements of this section 
as if such section applied to such plan.’’. 
(B) Section 2723(c) of such Act (42 U.S.C. 
300gg–23(c)) is amended by striking ‘‘section 2704’’ 
and inserting ‘‘sections 2704 and 2707’’. 
(2) ERISA AMENDMENTS.—(A) Subpart B of 
part 7 of subtitle B of title I of the Employee Re-
tirement Income Security Act of 1974 is amended by 
adding at the end the following new section: 
‘‘SEC. 714. EQUITY IN FERTILITY COVERAGE. 
‘‘(a) IN GENERAL.—A group health plan, and a 
health insurance issuer offering group health insurance 
coverage, that provides for coverage of impotency medica-
tions such as viagra shall also provide coverage of fertility 
treatments. 
‘‘(b) CONSTRUCTION.—Nothing in this section shall 
be construed as preventing a plan or issuer from—
‘‘(1) restricting the drugs for which benefits are 
provided under the plan or health insurance cov-
erage, or 
‘‘(2) imposing a limitation on the amount of 
benefits provided with respect to such coverage or 
the cost-sharing that may be imposed with respect to 
such coverage,
so long as such restrictions and limitations are consistent 
with subsection (a). 
‘‘(c) NOTICE UNDER GROUP HEALTH PLAN.—The 
imposition of the requirements of this section shall be 
treated as a material modification in the terms of the plan 
described in section 102(a)(1), for purposes of assuring 
notice of such requirements under the plan; except that 
the summary description required to be provided under the 
last sentence of section 104(b)(1) with respect to such 
modification shall be provided by not later than 60 days 
after the first day of the first plan year in which such 
requirements apply.’’. 
(B) Section 731(c) of such Act (29 U.S.C. 
1191(c)) is amended by striking ‘‘section 711’’ and 
inserting ‘‘sections 711 and 714’’. 
(C) Section 732(a) of such Act (29 U.S.C. 
1191a(a)) is amended by striking ‘‘section 711’’ and 
inserting ‘‘sections 711 and 714’’. 
(D) The table of contents in section 1 of such 
Act is amended by inserting after the item relating 
to section 713 the following new item:
‘‘Sec. 714. Equity in fertility coverage.’’.
(b) INDIVIDUAL HEALTH INSURANCE.—(1) Part B 
of title XXVII of the Public Health Service Act is amend-
ed by inserting after section 2752 the following new sec-
tion:
‘‘SEC. 2753. EQUITY IN FERTILITY COVERAGE. 
‘‘(a) IN GENERAL.—The provisions of section 2707 
(other than subsection (c)) shall apply to health insurance 
coverage offered by a health insurance issuer in the indi-
vidual market in the same manner as it applies to health 
insurance coverage offered by a health insurance issuer 
in connection with a group health plan in the small or 
large group market. 
‘‘(b) NOTICE.—A health insurance issuer under this 
part shall comply with the notice requirement under sec-
tion 714(c) of the Employee Retirement Income Security 
Act of 1974 with respect to the requirements referred to 
in subsection (a) as if such section applied to such issuer 
and such issuer were a group health plan.’’. 
(2) Section 2762(b)(2) of such Act (42 U.S.C. 
300gg–62(b)(2)) is amended by striking ‘‘section 2751’’ 
and inserting ‘‘sections 2751 and 2753’’. 
(c) FEHBP.—Section 8902 of title 5, United States 
Code, is amended by adding at the end the following the 
following new subsection: 
‘‘(p) A contract may not be made or a plan approved 
which does not comply with the requirements of section 
2753 of the Public Health Service Act.’’. 
(d) EFFECTIVE DATES.—(1) The amendments made 
by subsection (a) shall apply with respect to group health
plans for plan years beginning on or after January 1, 
2004. 
(2) The amendments made by subsection (b) shall 
apply with respect to health insurance coverage offered, 
sold, issued, renewed, in effect, or operated in the indi-
vidual market on or after January 1, 2004. 
(3) The amendment made by subsection (c) shall 
apply with respect to contracts for periods beginning on 
and after January 1, 2004. 
(e) COORDINATED REGULATIONS.—Section 104(1) of 
Health Insurance Portability and Accountability Act of 
1996 is amended by striking ‘‘this subtitle (and the 
amendments made by this subtitle and section 401)’’ and 
inserting ‘‘the provisions of part 7 of subtitle B of title 
I of the Employee Retirement Income Security Act of 
1974, and the provisions of parts A and C of title XXVII 
of the Public Health Service Act’’.
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