I 118th CONGRESS 1st Session H. R. 544 IN THE HOUSE OF REPRESENTATIVES January 26, 2023 Ms. Brownley introduced the following bill; which was referred to the Committee on Veterans' Affairs A BILL To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to provide coverage for infertility treatment and standard fertility preservation services, and for other purposes.

1. Short title This Act may be cited as the Veterans Infertility Treatment Act of 2023 . 2. Infertility treatments for veterans (a) Authority Chapter 17 of title 38, United States Code, is amended by inserting after section 1720J the following new section (and conforming the table of sections at the beginning of such chapter accordingly): 1720K. Infertility treatment and standard fertility preservation services (a) Treatment and services (1) In furnishing medical services under this chapter, at the election of a covered individual and subject to paragraph (4), the Secretary shall furnish to the covered individual infertility treatments (including through the use of assisted reproductive technology), standard fertility preservation services, or both. (2) In the case of in vitro fertilization treatment furnished under paragraph (1), the Secretary may furnish to a covered individual under such paragraph not more than three completed in vitro fertilization cycles that result in live birth or 10 attempted in vitro fertilization cycles, whichever occurs first. (3) The Secretary may furnish in vitro fertilization treatment under paragraph (1) using donated gametes or embryos. (4) The Secretary may not furnish to a covered individual an in vitro fertilization cycle or other treatment or service under paragraph (1) unless the Secretary receives consent for such cycle, treatment, or service from each of the following: (A) The covered individual. (B) If the covered individual is a partner of a covered veteran, the covered veteran. (C) If applicable, the third-party donor. (b) Rule of construction Nothing in this section shall be construed to require the Secretary to furnish maternity care to a covered individual, in addition to what is otherwise required by section 1786 of this title or other provisions of law. (c) Relationship to State law The legal status, custody, future use, donation, disposition, or destruction, of gametes or embryos relating to treatment or services furnished under this section shall be determined in accordance with the law of the State in which the gametes or embryos are located. (d) Payments for beneficiary travel for partners For purposes of paying travel expenses under section 111 of this title for treatment or services furnished under this section to a partner of a covered veteran, the Secretary shall deem the partner to be a veteran receiving treatment or care under this chapter. (e) Definitions In this section: (1) The term assisted reproductive technology includes in vitro fertilization and other infertility treatments. (2) The term covered individual means a covered veteran or a partner of a covered veteran. (3) The term covered veteran means a veteran who is enrolled in the system of annual patient enrollment established under section 1705(a) of this title and— (A) has infertility; or (B) is at risk of having infertility, as determined by a licensed physician based on— (i) the medical, sexual, and reproductive history, age, physical findings, or diagnostic testing, or a combination thereof, of the veteran; or (ii) any planned medication therapy, surgery, radiation, chemotherapy, or other medical treatment. (4) The term infertility means a disease, condition, or status characterized by— (A) the inability of a person to reproduce either as an individual or with the partner of the individual; or (B) the failure to conceive a pregnancy or to carry a pregnancy to live birth after one year of regular, unprotected sexual intercourse. (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 infertility treatment under this section. (6) The term standard fertility preservation service includes the procurement, cryopreservation, and storage of gametes and embryos. . (b) Applicability; regulations (1) Applicability Except as provided by paragraph (3)(A), section 1720K of title 38, United States Code, as added by subsection (a), shall apply with respect to infertility treatment and standard fertility preservation services furnished by the Secretary of Veterans Affairs beginning on the date on which the Secretary prescribes regulations under paragraph (2). (2) Regulations Not later than one year after the date of the enactment of this Act, the Secretary shall prescribe regulations to carry out section 1720K of title 38, United States Code, as added by subsection (a). (3) Interim policies (A) Continuity of services Except as provided by subparagraph (B), an individual who on the day before the date on which the Secretary prescribes regulations under paragraph (2) is receiving counseling and treatment furnished by the Secretary pursuant to existing infertility authority may elect to— (i) continue receiving such counseling and services pursuant to the existing infertility authority, subject to the limitations of that authority; or (ii) begin receiving such counseling and services pursuant to section 1720K of title 38, United States Code, as added by subsection (a), subject to the limitations of that section that shall be applied in a manner that recognizes such counseling and services previously furnished under the existing infertility authority. (B) Expansion of services During the period beginning 180 days after the date of the enactment of this Act and ending on the date on which the Secretary prescribes regulations under paragraph (2), the Secretary shall ensure that counseling and treatment furnished pursuant to existing infertility authority include the following elements: (i) The Secretary may furnish such counseling and treatment to the partner of a veteran covered by such provision without regard to whether the partner and veteran are married. (ii) The Secretary may furnish such counseling and treatment using donated gametes or embryos. (4) Definitions In this subsection: (A) The term existing infertility authority means section 234(a)(1) of the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2022 (division J of Public Law 117–103 ; 136 Stat. 556), or other provisions of law administered by the Secretary of Veterans Affairs enacted before the date of the enactment of this Act that provide authority to the Secretary to furnish fertility counseling and treatment. (B) The term partner has the meaning given that term in section 1720K of title 38, United States Code, as added by subsection (a).