(1) such regulations are in accordance with 
widely accepted and evidence-based medical stand-
ards of care for providing fertility treatment; and 
(2) the safety or health objective cannot be ad-
vanced by a different means that does not prohibit, 
limit, interfere with, or impede the rights described 
in subsection (a). 
(c) ENFORCEMENT.— 
(1) THE ATTORNEY GENERAL.— 
(A) IN GENERAL.—The Attorney General 
may commence a civil action on behalf of the 
United States against any State; an individual, 
employee, official, agency head, contractor, or-
ganization, or instrumentality acting for, or on 
behalf of, such a State; or any individual acting 
under the color of, or pursuant to, State law, 
that implements, enforces, or threatens to en-
force a limitation or requirement that prohibits, 
limits, interferes with, or impedes the statutory 
rights of an individual, a health care provider, 
a health insurance issuer, or a manufacturer 
under subsection (a). 
(B) EFFECT OF VIOLATIONS.—The court 
shall hold unlawful and set aside a limitation or 
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requirement described in subparagraph (A) if it 
is in violation of subsection (a). 
(2) PRIVATE RIGHT OF ACTION.— 
(A) IN GENERAL.—Any individual or entity 
adversely affected by an alleged violation of 
subsection (a) may commence a civil action 
against an individual, employee, official, agency 
head, contractor, organization, or instrumen-
tality acting for, or on behalf of, such a State 
that enacts, implements, or enforces a limita-
tion or requirement that prohibits, limits, inter-
feres with, or impedes the statutory rights of an 
individual, a health care provider, a health in-
surance issuer, or a manufacturer under sub-
section (a). 
(B) EFFECT OF VIOLATIONS.—The court 
shall hold unlawful and enjoin a limitation or 
requirement described in subparagraph (A) if it 
is in violation of subsection (a). 
(3) HEALTH CARE PROVIDER.— 
(A) IN GENERAL.—A health care provider 
may commence a civil action for relief on such 
provider’s own behalf, on behalf of the pro-
vider’s staff, or on behalf of the provider’s pa-
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tients who are or may be adversely affected by 
an alleged violation of subsection (a). 
(B) EFFECT OF VIOLATIONS.—The court 
shall hold unlawful and enjoin a limitation or 
requirement described in subparagraph (A) if it 
is in violation of subsection (a). 
(4) EQUITABLE RELIEF.—In any action under 
this section, the court may award appropriate equi-
table relief, including temporary, preliminary, or per-
manent injunctive relief. 
(5) COSTS.— 
(A) IN
GENERAL.—In any action under 
this section, the court shall award costs of liti-
gation, as well as reasonable attorney’s fees, to 
any prevailing plaintiff. 
(B) LIABILITY OF PLAINTIFFS.—A plain-
tiff shall not be liable to a defendant for costs 
or attorney’s fees in any non-frivolous action 
under this section unless such costs or attor-
ney’s fees are imposed by the court as part of 
sanctions for violations committed during the 
discovery process. 
(6) JURISDICTION.—The district courts of the 
United States shall have jurisdiction over pro-
ceedings under this section and shall exercise the 
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same without regard to whether the party aggrieved 
shall have exhausted any administrative or other 
remedies that may be provided for by law. 
(7) RIGHT TO REMOVE.— 
(A) IN GENERAL.—Any party shall have a 
right to remove an action brought under this 
subsection to the district court of the United 
States for the district and division embracing 
the place where such action is pending. 
(B) REVIEW.—An order remanding the 
case to the State court from which it was re-
moved under this paragraph is immediately re-
viewable by appeal or otherwise. 
(d) REGULATIONS.—Not later than 180 days after 
the date of enactment of this Act, the Secretary of Health 
and Human Services shall promulgate regulations to carry 
out this section. 
(e) RULES OF CONSTRUCTION.— 
(1) IN GENERAL.—For purposes of this title, a 
State law, or the administration, implementation, or 
enforcement of a State law, constitutes a prohibi-
tion, limitation, interference, or impediment on a 
health care provider providing, an individual receiv-
ing, a health insurance issuer covering, or a manu-
facturer marketing drugs or devices for fertility 
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treatment, provided in accordance with widely ac-
cepted and evidence-based medical standards of care, 
as described in subsection 104, if the administration, 
implementation, interpretation, or enforcement of 
such law has an effect that— 
(A) imposes requirements or limitations 
that are inconsistent with providing, receiving, 
providing health insurance coverage for, or pro-
viding drugs or devices for fertility treatment in 
accordance with widely accepted and evidence- 
based medical standards of care or that other-
wise violate the purpose and requirements of 
this Act, which may include— 
(i) requiring that a health care pro-
vider provide, and patients undertake, 
medically unnecessary procedures and serv-
ices, including tests and procedures, pro-
viding medically inaccurate information re-
garding fertility treatment, or requiring 
additional unnecessary in-person visits to a 
health care provider, that are inconsistent 
with widely accepted and evidence-based 
medical standards of care; 
(ii) imposing limitations or require-
ments concerning physical offices, clinics, 
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facilities, equipment, staffing, or hospital 
transfer arrangements of facilities where 
fertility treatment is provided, or the cre-
dentials or hospital privileges or status of 
personnel at such facilities, that are not 
consistent with widely accepted and evi-
dence-based medical standards of care; or 
(iii) limiting a health care provider’s 
right or ability to provide, or a patient’s 
right to receive, or imposing limitations 
that reduce the efficacy of, fertility treat-
ment in accordance with widely accepted 
and evidence-based medical standards of 
care, including retrieval of multiple eggs 
during oocyte retrieval; performance of in-
semination procedures, including intra-
uterine 
insemination; 
intracytoplasmic 
sperm 
injections 
to 
fertilize 
multiple 
human eggs; and cryopreservation of one 
or more eggs or embryos for fertility pres-
ervation and subsequent transfer, if deter-
mined appropriate by the health care pro-
vider and patient; 
(B) infringes, limits, or restricts the ability 
of a health care provider, patient, health insur-
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ance issuer, or manufacturer, to exercise or en-
force their statutory rights under this title on 
the basis of marital status, sex (including sex-
ual orientation and gender identity) or any 
other protected class that is covered by Federal 
law; 
(C) limits a health care provider’s or pa-
tient’s right or ability to determine the most ap-
propriate disposition of fertilized eggs or em-
bryos, including by defining a gamete or em-
bryo in such a way as to prevent the disposition 
of gametes and embryos; 
(D) limits a health care provider’s ability 
to provide, or a patient’s ability to receive, fer-
tility treatment via telemedicine, in accordance 
with widely accepted and evidence-based med-
ical standards of care; 
(E) limits or prohibits a health care pro-
vider’s ability to provide, or a patient’s ability 
to receive, fertility counseling or fertility treat-
ment based on the residency of the patient, or 
prohibits or limits the ability of any individual 
to assist or support a patient seeking fertility 
treatment; 
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(F) imposes requirements or limitations 
that compel health care providers to provide, or 
patients to receive, medically unnecessary care, 
or withhold medically necessary care, in a man-
ner that is not consistent with widely accepted 
and evidence-based medical standards of care 
for fertility treatment, including mandating the 
transfer of embryos that a health care provider 
would not reasonably expect, based on widely 
accepted and evidence-based medical standards 
of care, to lead to a healthy pregnancy or a live 
birth; 
(G) limits a health care provider’s right or 
ability to prescribe or dispense, or a patient’s 
right or ability to receive or use, medications 
for fertility treatment in accordance with widely 
accepted and evidence-based medical standards 
of care, unless such a limitation is generally ap-
plicable to the prescription, dispensing, or dis-
tribution of medications; or 
(H) limits a health care provider’s right or 
ability to perform a human sperm retrieval pro-
cedure in accordance with widely accepted and 
evidence-based medical standards of care. 
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(2) CLARIFICATION.—The descriptions of spe-
cific State laws that would violate the statutory 
rights and protections described in paragraph (1) 
shall not be construed to limit potential violations of 
the statutory rights and protections under this title 
to only the restrictions and limitations listed in 
paragraph (1), and potential violations of this title 
may result from novel State restrictions and limita-
tions that are not listed under paragraph (1). 
(3) EXCLUSION.—It shall not constitute a pro-
hibition, limitation, interference, or impediment to a 
health care provider providing, an individual receiv-
ing, a health insurance issuer covering, or a manu-
facturer marketing a drug or device for purposes of, 
fertility treatment under this title for an entity to 
act in compliance with the Food and Drug Adminis-
tration’s regulation of drugs, devices, biological 
products, human cells, tissues, or cellular or tissue- 
based products used in fertility treatment, consistent 
with widely accepted and evidence-based medical 
standards of care for fertility treatment. 
SEC. 105. APPLICABILITY AND PREEMPTION. 
(a) IN GENERAL.— 
(1) GENERAL APPLICATION.— 
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(A) EFFECT ON STATE LAW.—This title 
supersedes any State law that is inconsistent 
with the statutory rights established under this 
title and precludes the implementation of such 
a law, whether statutory, common law, or other-
wise, and whether adopted before or after the 
date of enactment of this Act. 
(B) PROHIBITION.—No State shall admin-
ister, implement, or enforce any law, rule, regu-
lation, standard, or other provision having the 
force and effect of law that conflicts with any 
provision of this title, notwithstanding any 
other provision of Federal law. 
(2) EXCLUSION.—Preemption of State law 
under paragraph (1) does not apply to— 
(A) State law regarding the resolution of 
disputes between 2 individuals with rights de-
scribed in section 104(a)(1) with respect to the 
same reproductive genetic material, such as oo-
cytes, sperm, fertilized eggs, and embryos; or 
(B) any other State law, to the extent that 
such law does not conflict with this title and 
protects an individual’s right and ability to re-
ceive fertility treatment in accordance with 
widely accepted and evidence-based medical 
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standards of care, including any such law that 
holds a health care provider accountable for not 
providing fertility treatment in accordance with 
widely accepted and evidence-based medical 
standards of care. 
(3) 
PRESERVATION
OF
FEDERAL
PUBLIC 
HEALTH AUTHORITIES.—Nothing in this title shall 
have the effect of superseding, negating, or limiting 
provisions of Federal law, including the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 301 et 
seq.) or the Public Health Service Act (42 U.S.C. 
201 et seq.), and regulations promulgated under 
such statutes, with respect to the regulation of 
drugs, devices, biological products, human cells, tis-
sues, or cellular or tissue-based products used in fer-
tility treatment. 
(4) PRESERVATION OF HIPAA RULES.—Nothing 
in this title shall have the effect of superseding, ne-
gating, or limiting the provisions of the privacy, se-
curity, and breach notification regulations in parts 
160 and 164 of title 45, Code of Federal Regula-
tions (or successor regulations). 
(5) SUBSEQUENTLY ENACTED FEDERAL LEGIS-
LATION.—Federal statutory law adopted after the 
date of the enactment of this Act is subject to this 
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title unless such law explicitly excludes such applica-
tion by reference to this title. 
(b) DEFENSE.—In any cause of action against an in-
dividual or entity who is subject to a limitation or require-
ment that violates this title, in addition to the remedies 
specified in section 104(b), this title shall also apply to, 
and may be raised as a defense by, such an individual or 
entity. 
TITLE II—VETERAN FAMILIES 
HEALTH SERVICES 
SEC. 200. SHORT TITLE. 
This title may be cited as the ‘‘Veteran Families 
Health Services Act’’. 
Subtitle A—Reproductive and Fer-
tility 
Preservation 
Assistance 
for Members of the Uniformed 
Services 
SEC. 201. DEFINITIONS. 
In this subtitle: 
(1) ACTIVE DUTY.—The term ‘‘active duty’’ has 
the meaning given that term in section 101(18) of 
title 37, United States Code. 
(2) UNIFORMED
SERVICES.—The term ‘‘uni-
formed services’’ has the meaning given that term in 
section 101(a)(5) of title 10, United States Code. 
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SEC. 202. PROVISION OF FERTILITY TREATMENT AND 
COUNSELING TO CERTAIN MEMBERS OF THE 
UNIFORMED SERVICES AND SPOUSES, PART-
NERS, AND GESTATIONAL SURROGATES OF 
SUCH MEMBERS. 
(a) FERTILITY TREATMENT AND COUNSELING.— 
(1) IN
GENERAL.—The Secretary of Defense 
shall make available fertility treatment and coun-
seling to a member of the uniformed services or a 
spouse, partner, or gestational surrogate of such a 
member. 
(2) ELIGIBILITY FOR TREATMENT AND COUN-
SELING.—Fertility treatment and counseling shall be 
furnished under paragraph (1) without regard to the 
sex, sex characteristics, gender identity, sexual ori-
entation, infertility diagnosis, or marital status of 
the member of the uniformed services or their part-
ner. 
(3) IN VITRO FERTILIZATION.—In the case of 
in vitro fertilization treatment furnished under para-
graph (1), the Secretary may furnish to an indi-
vidual under such paragraph— 
(A) not more than three completed oocyte 
retrievals; and 
(B) unlimited embryo transfers. 
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(b) PROCUREMENT OF REPRODUCTIVE GENETIC MA-
TERIAL.—If a member of the uniformed services is unable 
to provide their reproductive genetic material, such as oo-
cytes, sperm, fertilized eggs, and embryos, for purposes 
of fertility treatment under subsection (a), the Secretary 
shall, at the election of such member, allow such member 
to receive such treatment with donated reproductive ge-
netic material and pay or reimburse such member the rea-
sonable costs of procuring such material from a donor. 
(c) RULES OF CONSTRUCTION.— 
(1) IMPACT ON EXISTING AUTHORITY.—Noth-
ing in this section shall be construed to rescind the 
authority of the Secretary to provide in vitro fer-
tilization benefits pursuant to section 1074(c)(4) of 
title 10, United States Code. 
(2) SOURCING OF GESTATIONAL SURROGATE OR 
REPRODUCTIVE
GENETIC
MATERIAL.—Nothing in 
this section shall be construed to require the Sec-
retary— 
(A) to find or certify a gestational surro-
gate for a member of the uniformed services or 
to connect a gestational surrogate with such a 
member; or 
(B) to find or certify reproductive genetic 
material, such as oocytes, sperm, fertilized eggs, 
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and embryos, from a donor for a member of the 
uniformed services or to connect such a member 
with reproductive genetic material from a 
donor. 
(d) DEFINITIONS.—In this section: 
(1) FERTILITY TREATMENT.—The term ‘‘fer-
tility treatment’’ includes the following: 
(A) Preservation of human oocytes, sperm, 
or embryos for later reproductive use. 
(B) 
Artificial 
insemination, 
including 
intravaginal insemination, intracervical insemi-
nation, and intrauterine insemination. 
(C) Assisted reproductive technology, in-
cluding in vitro fertilization and other treat-
ments or procedures in which reproductive ge-
netic material, such as oocytes, sperm, fertilized 
eggs, and embryos, are handled, when clinically 
appropriate. 
(D) Genetic testing of embryos. 
(E) Medications prescribed or obtained 
over-the-counter, as indicated for fertility. 
(F) Gamete donation. 
(G) Such other information, referrals, 
treatments, procedures, medications, laboratory 
testing, technologies, and services relating to 
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fertility as the Secretary of Defense determines 
appropriate. 
(2) 
GESTATIONAL
SURROGATE.—The 
term 
‘‘gestational surrogate’’ means an individual who 
agrees to become pregnant through in vitro fertiliza-
tion under a gestational surrogacy agreement using 
gametes that are not the gametes of that individual. 
(3) PARTNER.—The term ‘‘partner’’, with re-
spect to a member of the uniformed services, means 
an individual selected by the member who agrees to 
be a parent, with the member, of a child born as a 
result of the use of any fertility treatment under this 
section. 
SEC. 203. ESTABLISHMENT OF FERTILITY PRESERVATION 
PROCEDURES AFTER AN INJURY OR ILLNESS. 
(a) IN GENERAL.—The Secretary of Defense, acting 
through the Assistant Secretary of Defense for Health Af-
fairs, shall establish procedures for the retrieval of repro-
ductive genetic material, such as oocytes, sperm, fertilized 
eggs, and embryos, as soon as medically appropriate, from 
a member of the uniformed services in cases in which the 
fertility of such member is potentially jeopardized as a re-
sult of an injury or illness incurred or aggravated while 
serving on active duty in the uniformed services in order 
to preserve the medical options of such member. 
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(b) INCLUSION OF INFORMATION IN ADVANCED DI-
RECTIVES
AND
MILITARY
TESTAMENTARY
INSTRU-
MENTS.—The Secretary of Defense shall ensure that any 
advance medical directive, as defined in section 1044c(b) 
of title 10, United States Code, or military testamentary 
instrument, as defined in section 1044d(b) of such title, 
completed by a member of the uniformed services includes 
questions about the consent of the member to fertility 
preservation procedures under subsection (a). 
(c) DISPOSAL OF REPRODUCTIVE GENETIC MATE-
RIAL.—Subject to section 204, in accordance with regula-
tions prescribed by the Secretary for purpose of this sub-
section, the Secretary shall dispose of reproductive genetic 
material retrieved from a member of the uniformed serv-
ices under subsection (a)— 
(1) with the specific consent of the member; or 
(2) if the member— 
(A) has lost the ability to consent perma-
nently, as determined by a medical professional, 
or has died; and 
(B) has not specified the use of their re-
productive genetic material in an advance direc-
tive or testamentary instrument executed by the 
member. 
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