Veteran Families Health Services Act of 2021
Bill: S.1280 | Sponsor: Sen. Murray, Patty (D-WA)
Policy area: Armed Forces and National Security

Summary:
Veteran Families Health Services Act of 2021
This bill addresses fertility treatments, counseling, and other health-related programs for veterans and members of the Armed Forces.
Specifically, the bill requires the Department of Defense (DOD) and the Department of Veterans Affairs (VA) to provide fertility treatments and counseling to covered veterans and active duty service members or a spouse, partner, or gestational surrogate of such veteran or service member. A covered veteran or service member is a former or current member of the Armed Forces who has an infertility condition, unless it is demonstrable that the individual was completely infertile prior to serving in the Armed Forces.
In the case of in vitro fertilization treatment, DOD and the VA may not furnish more than three completed cycles or six attempted cycles, whichever occurs first.
DOD must establish procedures related to gamete retrieval and storage. Additionally, DOD must provide service members with the opportunity to cryopreserve and store their gametes prior to deployment to a combat zone or a hazardous duty assignment.
DOD and the VA must share best practices and facilitate referrals for the furnishing of fertility treatment and counseling to eligible individuals.
Fertility counseling and treatment are included within authorized VA medical services.
The VA may pay the adoption expenses (for up to three adoptions) for a covered member who is enrolled in the VA health care system.
The VA must facilitate specified reproduction and infertility research conducted collaboratively by DOD and the Department of Health and Human Services.

To improve the reproductive assistance provided by the Department of 
 Defense and the Department of Veterans Affairs to certain members of 
  the Armed Forces, veterans, and their spouses or partners, and for 
                            other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Veteran Families 
Health Services Act of 2021''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
TITLE I--REPRODUCTIVE AND FERTILITY PRESERVATION ASSISTANCE FOR MEMBERS 
                          OF THE ARMED FORCES

Sec. 101. Definitions.
Sec. 102. Provision of fertility treatment and counseling to certain 
                            members of the Armed Forces and spouses, 
                            partners, and gestational surrogates of 
                            such members.
Sec. 103. Establishment of fertility preservation procedures after an 
                            injury or illness.
Sec. 104. Cryopreservation and storage of gametes of members of the 
                            Armed Forces on active duty.
Sec. 105. Assistance with and continuity of care regarding reproductive 
                            and fertility preservation services.
Sec. 106. Coordination between Department of Defense and Department of 
                            Veterans Affairs on furnishing of fertility 
                            treatment and counseling.
      TITLE II--REPRODUCTIVE AND ADOPTION ASSISTANCE FOR VETERANS

Sec. 201. Inclusion of fertility treatment and counseling under the 
                            definition of medical services in title 38.
Sec. 202. Fertility treatment and counseling for certain veterans and 
                            spouses, partners, and gestational 
                            surrogates of such veterans.
Sec. 203. Adoption assistance for certain veterans.
Sec. 204. Assistance with and continuity of care regarding reproductive 
                            and fertility preservation services.
Sec. 205. Facilitation of reproduction and infertility research.
Sec. 206. Annual report on fertility treatment and counseling furnished 
                            by Department of Veterans Affairs.
Sec. 207. Report on timeliness and adequacy of access by veterans to 
                            fertility treatment and counseling services 
                            furnished by Department of Veterans 
                            Affairs.
Sec. 208. Regulations on furnishing of fertility treatment and 
                            counseling and adoption assistance by 
                            Department of Veterans Affairs.

TITLE I--REPRODUCTIVE AND FERTILITY PRESERVATION ASSISTANCE FOR MEMBERS 
                          OF THE ARMED FORCES

SEC. 101. DEFINITIONS.

    In this title:
            (1) Active duty.--The term ``active duty'' has the meaning 
        given that term in section 101(d)(1) of title 10, United States 
        Code.
            (2) Armed forces.--The term ``Armed Forces'' has the 
        meaning given the term ``armed forces'' in section 101(a)(4) of 
        such title.

SEC. 102. PROVISION OF FERTILITY TREATMENT AND COUNSELING TO CERTAIN 
              MEMBERS OF THE ARMED FORCES AND SPOUSES, PARTNERS, AND 
              GESTATIONAL SURROGATES OF SUCH MEMBERS.

    (a) Fertility Treatment and Counseling.--
            (1) In general.--The Secretary of Defense shall furnish 
        fertility treatment and counseling, including through the use 
        of assisted reproductive technology, to a covered member of the 
        Armed Forces or a spouse, partner, or gestational surrogate of 
        such a member.
            (2) Eligibility for treatment and counseling.--Fertility 
        treatment and counseling shall be furnished under paragraph (1) 
        without regard to the sex, gender identity, sexual orientation, 
        or marital status of the covered member of the Armed Forces.
            (3) In vitro fertilization.--In the case of in vitro 
        fertilization treatment furnished under paragraph (1), the 
        Secretary may furnish not more than three completed cycles or 
        six attempted cycles of in vitro fertilization, whichever 
        occurs first, to an individual under such paragraph.
    (b) Procurement of Gametes.--If a covered member of the Armed 
Forces is unable to provide their gametes 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 
gametes and pay or reimburse such member the reasonable costs of 
procuring gametes from a donor.
    (c) Rule of Construction.--Nothing in this section shall be 
construed to require the Secretary--
            (1) to find or certify a gestational surrogate for a 
        covered member of the Armed Forces or to connect a gestational 
        surrogate with such a member; or
            (2) to find or certify gametes from a donor for a covered 
        member of the Armed Forces or to connect such a member with 
        gametes from a donor.
    (d) Definitions.--In this section:
            (1) Assisted reproductive technology.--The term ``assisted 
        reproductive technology'' includes in vitro fertilization and 
        other fertility treatments in which both eggs and sperm are 
        handled when clinically appropriate.
            (2) Covered member of the armed forces.--The term ``covered 
        member of the Armed Forces'' means a member of the Armed Forces 
        who has an infertility condition, unless the Secretary can show 
        that the member was completely infertile before service on 
        active duty in the Armed Forces.
            (3) Fertility treatment.--The term ``fertility treatment'' 
        includes the following:
                    (A) Procedures that use assisted reproductive 
                technology.
                    (B) Sperm retrieval.
                    (C) Egg retrieval.
                    (D) Artificial insemination.
                    (E) Embryo transfer.
                    (F) Such other treatments as the Secretary of 
                Defense considers appropriate.
            (4) Infertility condition.--The term ``infertility 
        condition'' includes--
                    (A) a diagnosis of infertility; or
                    (B) the inability to conceive or safely carry a 
                pregnancy to term, including as a result of treatment 
                for another condition.
            (5) Partner.--The term ``partner'', with respect to a 
        member of the Armed Forces, means an individual selected by the 
        member who agrees to share with the member the parental 
        responsibilities with respect to any child born as a result of 
        the use of any fertility treatment under this section.

SEC. 103. 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 Affairs, shall establish 
procedures for the retrieval of gametes, as soon as medically 
appropriate, from a member of the Armed Forces in cases in which the 
fertility of such member is potentially jeopardized as a result of an 
injury or illness incurred or aggravated while serving on active duty 
in the Armed Forces in order to preserve the medical options of such 
member.
    (b) Consent for Retrieval of Gametes.--Gametes may be retrieved 
from a member of the Armed Forces under subsection (a) only--
            (1) with the specific consent of the member; or
            (2) if the member is unable to consent, if a medical 
        professional determines that--
                    (A) the future fertility of the member is 
                potentially jeopardized as a result of an injury or 
                illness described in subsection (a) or will be 
                potentially jeopardized as a result of treating such 
                injury or illness;
                    (B) the member lacks the capacity to consent to the 
                retrieval of gametes and is likely to regain such 
                capacity; and
                    (C) the retrieval of gametes under this section is 
                in the medical interest of the member.
    (c) Consent for Use of Retrieved Gametes.--Gametes retrieved from a 
member of the Armed Forces under subsection (a) may be used only--
            (1) with the specific consent of the member; or
            (2) if the member has lost the ability to consent 
        permanently, as determined by a medical professional, as 
        specified in an advance directive or testamentary instrument 
        executed by the member.
    (d) Disposal of Gametes.--In accordance with regulations prescribed 
by the Secretary for purpose of this subsection, the Secretary shall 
dispose of gametes retrieved from a member of the Armed Forces under 
subsection (a)--
            (1) with the specific consent of the member; or
            (2) if the member--
                    (A) has lost the ability to consent permanently, as 
                determined by a medical professional; and
                    (B) has not specified the use of their gametes in 
                an advance directive or testamentary instrument 
                executed by the member.

SEC. 104. CRYOPRESERVATION AND STORAGE OF GAMETES OF MEMBERS OF THE 
              ARMED FORCES ON ACTIVE DUTY.

    (a) In General.--The Secretary of Defense shall provide members of 
the Armed Forces on active duty in the Armed Forces with the 
opportunity to cryopreserve and store their gametes prior to--
            (1) deployment to a combat zone; or
            (2) a duty assignment that includes a hazardous assignment, 
        as determined by the Secretary.
    (b) Period of Time.--
            (1) In general.--The Secretary shall provide for the 
        cryopreservation and storage of gametes of any member of the 
        Armed Forces under subsection (a) in a facility of the 
        Department of Defense or of a private entity and the 
        transportation of such gametes, at no cost to the member, until 
        the date that is one year after the retirement, separation, or 
        release of the member from the Armed Forces.
            (2) Continued cryopreservation and storage.--At the end of 
        the one-year period specified in paragraph (1), the Secretary 
        shall permit an individual whose gametes were cryopreserved and 
        stored in a facility of the Department as described in that 
        paragraph to select, including pursuant to an advance medical 
        directive or military testamentary instrument completed under 
        subsection (c), one of the following options:
                    (A) To continue such cryopreservation and storage 
                in such facility with the cost of such cryopreservation 
                and storage borne by the individual.
                    (B) To transfer the gametes to a private 
                cryopreservation and storage facility selected by the 
                individual.
                    (C) To transfer the gametes to a facility of the 
                Department of Veterans Affairs if cryopreservation and 
                storage is available to the individual at such 
                facility.
            (3) Disposal of gametes.--If an individual described in 
        paragraph (2) does not make a selection under subparagraph (A), 
        (B), or (C) of such paragraph, the Secretary may dispose of the 
        gametes of the individual not earlier than the date that is 90 
        days after the end of the one-year period specified in 
        paragraph (1) with respect to the individual.
    (c) Advance Medical Directive and Military Testamentary 
Instrument.--A member of the Armed Forces who elects to cryopreserve 
and store their gametes under this section must complete an advance 
medical directive, as defined in section 1044c(b) of title 10, United 
States Code, and a military testamentary instrument, as defined in 
section 1044d(b) of such title, that explicitly specifies the use of 
their cryopreserved and stored gametes if such member dies or otherwise 
loses the capacity to consent to the use of their cryopreserved and 
stored gametes.
    (d) Agreements.--To carry out this section, the Secretary may enter 
into agreements with private entities that provide cryopreservation, 
transportation, and storage services for gametes.

SEC. 105. ASSISTANCE WITH AND CONTINUITY OF CARE REGARDING REPRODUCTIVE 
              AND FERTILITY PRESERVATION SERVICES.

    The Secretary of Defense shall ensure that employees of the 
Department of Defense assist members of the Armed Forces--
            (1) in navigating the services provided under this title;
            (2) in finding a provider that meets the needs of such 
        members with respect to such services; and
            (3) in continuing the receipt of such services without 
        interruption during a permanent change of station for such 
        members.

SEC. 106. COORDINATION BETWEEN DEPARTMENT OF DEFENSE AND DEPARTMENT OF 
              VETERANS AFFAIRS ON FURNISHING OF FERTILITY TREATMENT AND 
              COUNSELING.

    (a) In General.--The Secretary of Defense and the Secretary of 
Veterans Affairs shall share best practices and facilitate referrals, 
as they consider appropriate, on the furnishing of fertility treatment 
and counseling to individuals eligible for the receipt of such 
counseling and treatment from the Secretaries.
    (b) Memorandum of Understanding.--The Secretary of Defense and the 
Secretary of Veterans Affairs shall enter into a memorandum of 
understanding--
            (1) providing that the Secretary of Defense will ensure 
        access by the Secretary of Veterans Affairs to gametes of 
        veterans stored by the Department of Defense for purposes of 
        furnishing fertility treatment under section 1720K of title 38, 
        United States Code, as added by section 202(a); and
            (2) authorizing the Department of Veterans Affairs to 
        compensate the Department of Defense for the cryopreservation, 
        transportation, and storage of gametes of veterans under 
        section 104.

      TITLE II--REPRODUCTIVE AND ADOPTION ASSISTANCE FOR VETERANS

SEC. 201. INCLUSION OF FERTILITY TREATMENT AND COUNSELING UNDER THE 
              DEFINITION OF MEDICAL SERVICES IN TITLE 38.

    Section 1701(6) of title 38, United States Code, is amended by 
adding at the end the following new subparagraph:
                    ``(I) Fertility treatment and counseling, including 
                treatment using assisted reproductive technology.''.

SEC. 202. FERTILITY TREATMENT AND COUNSELING FOR CERTAIN VETERANS AND 
              SPOUSES, PARTNERS, AND GESTATIONAL SURROGATES OF SUCH 
              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:
``Sec. 1720K. Fertility treatment and counseling for certain veterans 
              and spouses, partners, and gestational surrogates of such 
              veterans
    ``(a) In General.--(1) The Secretary shall furnish fertility 
treatment and counseling, including through the use of assisted 
reproductive technology, to a covered veteran or a spouse, partner, or 
gestational surrogate of a covered veteran if the veteran, and the 
spouse, partner, or gestational surrogate of the veteran, as 
applicable, apply jointly for such treatment and counseling through a 
process prescribed by the Secretary.
    ``(2) Fertility treatment and counseling shall be furnished under 
paragraph (1) without regard to the sex, gender identity, sexual 
orientation, or marital status of the covered veteran.
    ``(3) In the case of in vitro fertilization treatment furnished 
under paragraph (1), the Secretary may furnish not more than three 
completed cycles or six attempted cycles of in vitro fertilization, 
whichever occurs first, to an individual under such paragraph.
    ``(b) Procurement of Gametes.--If a covered veteran is unable to 
provide their gametes for purposes of fertility treatment under 
subsection (a), the Secretary shall, at the election of such member, 
allow such veteran to receive such treatment with donated gametes and 
pay or reimburse such veteran the reasonable costs of procuring gametes 
from a donor.
    ``(c) Coordination of Care for Other Individuals.--In the case of a 
veteran or a spouse, partner, or gestational surrogate of a veteran not 
described in subsection (a) who is seeking fertility treatment and 
counseling, the Secretary may coordinate fertility treatment and 
counseling for such veteran, spouse, partner, or gestational surrogate.
    ``(d) Outreach and Training.--The Secretary shall carry out an 
outreach and training program to ensure veterans and health care 
providers of the Department are aware of--
            ``(1) the availability of and eligibility requirements for 
        fertility treatment and counseling under this section; and
            ``(2) any changes to fertility treatment and counseling 
        covered under this section.
    ``(e) Rule of Construction.--Nothing in this section shall be 
construed to require the Secretary--
            ``(1) to find or certify a gestational surrogate for a 
        covered veteran or to connect a gestational surrogate with a 
        covered veteran; or
            ``(2) to furnish maternity care to a covered veteran or 
        spouse, partner, or gestational surrogate of a covered veteran 
        in addition to what is otherwise required by law.
    ``(f) Definitions.--In this section:
            ``(1) The term `assisted reproductive technology' includes 
        in vitro fertilization and other fertility treatments in which 
        both eggs and sperm are handled when clinically appropriate.
            ``(2) The term `covered veteran' means a veteran who--
                    ``(A) has an infertility condition, unless the 
                Secretary can show that the veteran was completely 
                infertile before service in the active military, naval, 
                or air service; and
                    ``(B) is enrolled in the system of annual patient 
                enrollment established under section 1705(a) of this 
                title.
            ``(3) The term `fertility treatment' includes the 
        following:
                    ``(A) Procedures that use assisted reproductive 
                technology.
                    ``(B) Sperm retrieval.
                    ``(C) Egg retrieval.
                    ``(D) Artificial insemination.
                    ``(E) Embryo transfer.
                    ``(F) Such other treatments as the Secretary 
                considers appropriate.
            ``(4) The term `infertility condition' includes--
                    ``(A) a diagnosis of infertility; or
                    ``(B) the inability to conceive or safely carry a 
                pregnancy to term, including as a result of treatment 
                for another condition.
            ``(5) The term `partner', with respect to a veteran, means 
        an individual selected by the veteran who agrees to share with 
        the veteran the parental responsibilities with respect to any 
        child born as a result of the use of any fertility treatment 
        under this section.''.
    (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 section 1720J the following new item:

``1720K. Fertility treatment and counseling for certain veterans and 
                            spouses, partners, and gestational 
                            surrogates of such veterans.''.

SEC. 203. ADOPTION ASSISTANCE FOR CERTAIN VETERANS.

    (a) In General.--Subchapter VIII of chapter 17 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 1789. Adoption assistance
    ``(a) In General.--The Secretary may pay an amount, not to exceed 
the limitation amount, to assist a covered veteran in the adoption of 
one or more children, without regard to the sex, gender identity, 
sexual orientation, or marital status of the covered veteran.
    ``(b) Limitation Amount.--For purposes of this section, the 
limitation amount is the amount equal to the cost the Department would 
incur by paying the expenses of three adoptions by covered veterans, as 
determined by the Secretary.
    ``(c) Covered Veteran Defined.--In this section, the term `covered 
veteran' has the meaning given that term in section 1720K(f) of this 
title.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
subchapter VIII of chapter 17 of such title is amended by inserting 
after the item relating to section 1788 the following new item:

``1789. Adoption assistance.''.

SEC. 204. ASSISTANCE WITH AND CONTINUITY OF CARE REGARDING REPRODUCTIVE 
              AND FERTILITY PRESERVATION SERVICES.

    The Secretary of Veterans Affairs shall ensure that employees of 
the Department of Veterans Affairs assist veterans--
            (1) in navigating the services provided under this title 
        and the amendments made by this title;
            (2) in finding a provider that meets the needs of such 
        veterans with respect to such services; and
            (3) in continuing the receipt of such services without 
        interruption if such veterans move to a different geographic 
        location.

SEC. 205. FACILITATION OF REPRODUCTION AND INFERTILITY RESEARCH.

    (a) In General.--Subchapter II of chapter 73 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 7330D. Facilitation of reproduction and infertility research
    ``(a) Facilitation of Research Required.--The Secretary shall 
facilitate research conducted collaboratively by the Secretary of 
Defense and the Secretary of Health and Human Services to improve the 
ability of the Department of Veterans Affairs to meet the long-term 
reproductive health care needs of veterans who have a genitourinary 
service-connected disability or a condition that was incurred or 
aggravated in line of duty in the active military, naval, or air 
service, such as a spinal cord injury, military sexual trauma, or a 
mental health condition, that affects the ability of the veteran to 
reproduce.
    ``(b) Dissemination of Information.--The Secretary shall ensure 
that information produced by the research facilitated under this 
section that may be useful for other activities of the Veterans Health 
Administration is disseminated throughout the Veterans Health 
Administration.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
subchapter II of chapter 73 of such title is amended by inserting after 
the item relating to section 7330C the following new item:

``7330D. Facilitation of reproduction and infertility research.''.
    (c) Report.--
            (1) In general.--Not later than three years after the date 
        of the enactment of this Act, the Secretary of Veterans Affairs 
        shall submit to Congress a report on the research activities 
        conducted by the Secretary under section 7330D of title 38, 
        United States Code, as added by subsection (a).
            (2) Elements.--The report submitted under paragraph (1) 
        shall include demographic data on veterans included in the 
        research conducted under section 7330D of title 38, United 
        States Code, as added by subsection (a), disaggregated by age, 
        race, ethnicity, sex, gender identity, sexual orientation, 
        marital status, type of disability (if applicable), and 
        geographic location of such veterans.

SEC. 206. ANNUAL REPORT ON FERTILITY TREATMENT AND COUNSELING FURNISHED 
              BY DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Not later than one year after the date of the 
enactment of this Act, and not less frequently than annually 
thereafter, the Secretary of Veterans Affairs shall submit to the 
Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives a report on the 
fertility treatment and counseling furnished by the Department of 
Veterans Affairs, including through non-Department providers, during 
the year preceding the submittal of the report.
    (b) Elements.--Each report submitted under subsection (a) shall 
include, for the period covered by the report, the following:
            (1) The number of veterans who were diagnosed with clinical 
        infertility, disaggregated by age, race, ethnicity, sex, gender 
        identity, sexual orientation, marital status, type of 
        disability (if applicable), geographic location, era of 
        military service, and, to the extent possible to determine, the 
        cause of infertility of such veterans.
            (2) The number of veterans who received fertility treatment 
        or counseling furnished by the Department of Veterans Affairs, 
        including through non-Department providers, disaggregated by 
        age, race, ethnicity, sex, gender identity, sexual orientation, 
        marital status, type of disability (if applicable), geographic 
        location, era of military service, and, to the extent possible 
        to determine, the cause of infertility of such veterans.
            (3) The number of veterans who self-reported difficulty 
        becoming pregnant or successfully carrying a pregnancy to term 
        to a health care provider of the Department or a non-Department 
        provider, disaggregated by age, race, ethnicity, sex, gender 
        identity, sexual orientation, marital status, type of 
        disability (if applicable), and geographic location of such 
        veterans.
            (4) The number of veterans who were exposed to hazardous 
        chemical or biological agents during service in the Armed 
        Forces who--
                    (A) received a clinical diagnosis of infertility; 
                or
                    (B) self-reported difficulty becoming pregnant or 
                successfully carrying a pregnancy to term.
            (5) The number of spouses, partners, and gestational 
        surrogates of veterans who received fertility treatment or 
        counseling furnished by the Department, including through non-
        Department providers.
            (6) The cost to the Department of furnishing fertility 
        treatment and counseling, including through non-Department 
        providers, disaggregated by cost of services and 
        administration.
            (7) The average cost to the Department per recipient of 
        fertility treatment and counseling.
            (8) In cases in which the Department furnished fertility 
        treatment through the use of assisted reproductive technology, 
        including through non-Department providers, the average number 
        of cycles per person furnished, disaggregated by type of 
        treatment.
            (9) A description of how fertility treatment and counseling 
        services of the Department, including those services provided 
        through non-Department providers, are coordinated with similar 
        services of the Department of Defense, including the average 
        wait time for veterans to transfer from the health system of 
        the Department of Defense to the Veterans Health 
        Administration.
    (c) Definitions.--In this section, the terms ``assisted 
reproductive technology'' and ``partner'' have the meanings given those 
terms in section 1720K(f) of title 38, United States Code, as added by 
section 202(a).

SEC. 207. REPORT ON TIMELINESS AND ADEQUACY OF ACCESS BY VETERANS TO 
              FERTILITY TREATMENT AND COUNSELING SERVICES FURNISHED BY 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Not later than 180 days after the date of the 
enactment of this Act, and not less frequently than every 180 days 
thereafter, the Secretary of Veterans Affairs shall submit to Congress 
a report containing data on the timeliness and adequacy of access by 
veterans to fertility treatment and counseling services furnished by 
the Department of Veterans Affairs, including through non-Department 
providers.
    (b) Elements.--Each report submitted under subsection (a) shall 
include, for the period covered by the report, the following:
            (1) The average number of days from when a veteran first 
        seeks fertility treatment to when a referral for such treatment 
        is made and the average number of days from when such referral 
        is made to when an appointment for such treatment occurs, 
        disaggregated by facility of the Department or non-Department 
        provider.
            (2) The average number of days from when a veteran first 
        seeks fertility counseling to when a referral for such 
        counseling is made and the average number of days from when 
        such referral is made to when an appointment for such 
        counseling occurs, disaggregated by facility of the Department 
        or non-Department provider.
            (3) The number of available providers of the Department and 
        non-Department providers for fertility treatment and counseling 
        in each State or territory, disaggregated by facility.
            (4) The average number of days it takes for the Secretary 
        to pay claims for fertility treatment and counseling services 
        from non-Department providers under section 1703D of title 38, 
        United States Code.

SEC. 208. REGULATIONS ON FURNISHING OF FERTILITY TREATMENT AND 
              COUNSELING AND ADOPTION ASSISTANCE BY DEPARTMENT OF 
              VETERANS AFFAIRS.

    Not later than 18 months after the date of the enactment of this 
Act, the Secretary of Veterans Affairs shall prescribe regulations--
            (1) to carry out section 1720K of title 38, United States 
        Code, as added by section 202(a); and
            (2) to carry out section 1789 of such title, as added by 
        section 203(a).
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