‘‘(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, 2020, 
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.’’. 
(b) CONFORMING AMENDMENT.—Section 2724(c) of 
the Public Health Service Act (42 U.S.C. 300gg–23(c)) 
is amended by striking ‘‘section 2704’’ and inserting ‘‘sec-
tions 2704 and 2708’’. 
(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.— 
(A) IN GENERAL.—In the case of a group 
health plan maintained pursuant to 1 or more 
collective bargaining agreements between em-
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ployee representatives and 1 or more employers 
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. 
SEC. 4. 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: 
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‘‘(p) COVERAGE FOR DIAGNOSIS AND TREATMENT 
OF INFERTILITY AND PREVENTION OF IATROGENIC IN-
FERTILITY.— 
‘‘(1) DEFINITIONS.—In this subsection, the 
terms ‘infertility’ and ‘iatrogenic infertility’ have the 
meanings given those terms in section 2729A of the 
Public Health Service Act. 
‘‘(2) REQUIRED COVERAGE.—A contract under 
this chapter shall provide, in a manner consistent 
with section 2729A of the Public Health Service 
Act— 
‘‘(A) coverage for the diagnosis and treat-
ment of infertility, including nonexperimental 
assisted reproductive technology procedures, if 
such contract covers obstetrical benefits; and 
‘‘(B) coverage for standard fertility preser-
vation services when a medically necessary 
treatment may directly or indirectly cause iatro-
genic infertility. 
‘‘(3) COST.—Coverage for the diagnosis or 
treatment of infertility and fertility preservation 
services under a health benefits plan described in 
section 8903 or 8903a may not be subject to any co-
payment or deductible greater than the copayment 
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or deductible, respectively, applicable to obstetrical 
benefits under the plan. 
‘‘(4) PREEMPTION.—Subsection (m)(1) shall 
not, with respect to a contract under this chapter, 
prevent the inclusion of any terms that, under para-
graph (2) of this subsection, are required by reason 
of section 2729A of the Public Health Service Act.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply with respect to any contract en-
tered into or renewed for a contract year beginning on 
or after the date that is 180 days after the date of enact-
ment of this Act, and any health benefits plan offered 
under such a contract. 
SEC. 5. BENEFITS FOR TREATMENT OF INFERTILITY AND 
PREVENTION OF IATROGENIC INFERTILITY 
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 infertility benefits 
‘‘(a) IN GENERAL.—Any health care plan under this 
chapter shall provide, in a manner consistent with section 
2729A of the Public Health Service Act— 
‘‘(1) coverage for the diagnosis and treatment 
of infertility, including nonexperimental assisted re-
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productive technology procedures, if such plan covers 
obstetrical benefits; and 
‘‘(2) coverage for standard fertility preservation 
services when a medically necessary treatment may 
directly or indirectly cause iatrogenic infertility. 
‘‘(b) COPAYMENT.—The Secretary of Defense shall 
establish cost-sharing requirements for the coverage of di-
agnosis and treatment of infertility and fertility preserva-
tion services described in subsection (a) that are consistent 
with the cost-sharing requirements applicable to health 
plans and health insurance coverage under section 
2729A(d) of the Public Health Service Act. 
‘‘(c) REGULATIONS.—The Secretary of Defense shall 
prescribe any regulations necessary to carry out this sec-
tion. 
‘‘(d) DEFINITIONS.—In this section, the terms ‘infer-
tility’ and ‘iatrogenic infertility’ have the meanings given 
those terms in section 2729A 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 infertility benefits.’’. 
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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: 
‘‘§ 1720J. 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 and coun-
seling through a process prescribed by the Secretary for 
purposes of this section. 
‘‘(b) INFERTILITY DEFINED.—In this section, the 
terms ‘infertility’ and ‘iatrogenic infertility’ have the 
meanings given those terms in section 2729A of the Public 
Health Service Act.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 17 of such title is amended 
by inserting after the item relating to section 1720I the 
following new item: 
‘‘1720J. Infertility treatment and counseling for veterans and spouses or part-
ners, of veterans.’’. 
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(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 1720J of title 38, United States Code, as added 
by subsection (a). 
SEC. 7. REQUIREMENT FOR STATE MEDICAID PLANS TO 
PROVIDE MEDICAL ASSISTANCE FOR TREAT-
MENT OF INFERTILITY AND PREVENTION OF 
IATROGENIC INFERTILITY. 
(a) IN GENERAL.—Section 1905 of the Social Secu-
rity Act (42 U.S.C. 1396d) is amended— 
(1) in subsection (a)(4)— 
(A) by striking ‘‘; and (D)’’ and inserting 
‘‘; (D)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘; and (E) services and 
supplies to treat infertility and prevent iatro-
genic infertility (as such terms are defined in 
section 2729A(b) of the Public Health Service 
Act) in accordance with subsection (ff)’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(ff) REQUIREMENTS
FOR COVERAGE
OF INFER-
TILITY TREATMENT AND PREVENTION OF IATROGENIC 
INFERTILITY.—For purposes of subsection (a)(4)(E), a 
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State shall ensure that the medical assistance provided 
under the State plan (or waiver of such plan) for treat-
ment of infertility and fertility preservation services com-
plies with the requirements and limitations of section 
2729A(c) 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) NO COST SHARING FOR INFERTILITY TREAT-
MENT.— 
(1) IN GENERAL.—Subsections (a)(2)(D) and 
(b)(2)(D) of section 1916 of the Social Security Act 
(42 U.S.C. 1396o(a)(2)(D)) are amended by insert-
ing ‘‘, services and supplies to treat infertility and 
provide fertility preservation services described in 
section 1905(a)(4)(E)’’ before ‘‘, or’’ each place it 
appears. 
(2) APPLICATION TO ALTERNATIVE COST SHAR-
ING.—Section 1916A(b)(3)(B)(vii) of the Social Se-
curity Act (42 U.S.C. 1396o–1(b)(3)(B)(vii)) is 
amended by inserting ‘‘and services and supplies to 
treat infertility and provide fertility preservation de-
scribed in section 1905(a)(4)(E)’’ before the period. 
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(c) PRESUMPTIVE ELIGIBILITY
FOR INFERTILITY 
TREATMENT.—Section 1920C of the Social Security Act 
(42 U.S.C. 1396r–1c) is amended— 
(1) in the section heading, by inserting ‘‘AND 
INFERTILITY TREATMENT’’ after ‘‘FAMILY PLANNING 
SERVICES’’; 
(2) in subsection (a)— 
(A) by striking ‘‘State plan’’ and inserting 
‘‘A State plan’’; 
(B) by striking ‘‘1905(a)(4)(C)’’ and in-
serting ‘‘section 1905(a)(4)(C), services and 
supplies to treat infertility and prevent iatro-
genic 
infertility 
described 
in 
section 
1905(a)(4)(E),’’; and 
(C) by inserting ‘‘or in conjunction with an 
infertility treatment service in an infertility 
treatment setting’’ before the period. 
(d) INCLUSION IN BENCHMARK COVERAGE.—Section 
1937(b) of the Social Security Act (42 U.S.C. 1396u– 
7(b)) is amended by adding at the end the following new 
paragraph: 
‘‘(8) COVERAGE OF INFERTILITY TREATMENT 
AND PREVENTION OF IATROGENIC INFERTILITY.— 
Notwithstanding the previous provisions of this sec-
tion, a State may not provide for medical assistance 
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through enrollment of an individual with benchmark 
coverage or benchmark-equivalent coverage under 
this section unless such coverage includes medical 
assistance for services and supplies to treat infer-
tility and provide fertility preservation described in 
section 1905(a)(4)(E) in accordance with such sec-
tion.’’. 
(e) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this section 
shall take effect on October 1, 2020. 
(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 1st day of the 1st cal-
endar quarter beginning after the close of the 1st 
regular session of the State legislature that ends 
after the 1-year period beginning with the date of 
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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. 
Æ 
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