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<dc:title>118 S2801 IS: Veteran Families Health Services Act of 2023</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2023-09-14</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">II</distribution-code><congress>118th CONGRESS</congress><session>1st Session</session><legis-num>S. 2801</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20230914">September 14, 2023</action-date><action-desc><sponsor name-id="S229">Mrs. Murray</sponsor> (for herself, <cosponsor name-id="S386">Ms. Duckworth</cosponsor>, <cosponsor name-id="S408">Mr. Hickenlooper</cosponsor>, <cosponsor name-id="S337">Mr. Coons</cosponsor>, <cosponsor name-id="S366">Ms. Warren</cosponsor>, <cosponsor name-id="S313">Mr. Sanders</cosponsor>, <cosponsor name-id="S311">Ms. Klobuchar</cosponsor>, <cosponsor name-id="S341">Mr. Blumenthal</cosponsor>, <cosponsor name-id="S415">Mr. Warnock</cosponsor>, <cosponsor name-id="S316">Mr. Whitehouse</cosponsor>, <cosponsor name-id="S247">Mr. Wyden</cosponsor>, <cosponsor name-id="S324">Mrs. Shaheen</cosponsor>, <cosponsor name-id="S364">Mr. Murphy</cosponsor>, <cosponsor name-id="S221">Mrs. Feinstein</cosponsor>, <cosponsor name-id="S307">Mr. Brown</cosponsor>, <cosponsor name-id="S362">Mr. Kaine</cosponsor>, <cosponsor name-id="S413">Mr. Padilla</cosponsor>, <cosponsor name-id="S253">Mr. Durbin</cosponsor>, and <cosponsor name-id="S359">Mr. Heinrich</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSVA00">Committee on Veterans' Affairs</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>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.</official-title></form><legis-body style="OLC" display-enacting-clause="yes-display-enacting-clause" id="HA43902C93C9D4EE6B55629B5DA16835C"><section commented="no" display-inline="no-display-inline" section-type="section-one" id="S1"><enum>1.</enum><header display-inline="yes-display-inline">Short title; table of contents</header><subsection commented="no" display-inline="no-display-inline" id="id65122B47233C458AA8F08EA1E9AB07BC"><enum>(a)</enum><header display-inline="yes-display-inline">Short title</header><text display-inline="yes-display-inline">This Act may be cited as the <quote><short-title>Veteran Families Health Services Act of 2023</short-title></quote>.</text></subsection><subsection commented="no" display-inline="no-display-inline" id="id662C61DE7ED940058CE3FC9E04C5E188"><enum>(b)</enum><header display-inline="yes-display-inline">Table of contents</header><text display-inline="yes-display-inline">The table of contents for this Act is as follows:</text><toc><toc-entry level="section" idref="S1">Sec. 1. Short title; table of contents.</toc-entry><toc-entry level="title" idref="id019790046DCD41D8B92277CB2567C3DC">TITLE I—Reproductive and fertility preservation assistance for members of the Armed Forces</toc-entry><toc-entry level="section" idref="idEDE914049BAD48AFAC2C9D23527FC811">Sec. 101. Definitions.</toc-entry><toc-entry level="section" idref="id26471FB10A1C403090FA39106CC25087">Sec. 102. Provision of fertility treatment and counseling to certain members of the Armed Forces and spouses, partners, and gestational surrogates of such members.</toc-entry><toc-entry level="section" idref="id281d3d4383154f3fb7ef0567c270356f">Sec. 103. Establishment of fertility preservation procedures after an injury or illness.</toc-entry><toc-entry level="section" idref="id64f1868ef4504aebace3704eda4d1091">Sec. 104. Cryopreservation and storage of reproductive genetic material of members of the Armed Forces on active duty.</toc-entry><toc-entry level="section" idref="id81B91D5E434548E0B663924F52690884">Sec. 105. Assistance with and continuity of care regarding reproductive and fertility preservation services.</toc-entry><toc-entry level="section" idref="id7C634326437D4E2FAF3CC304D4C7124A">Sec. 106. Coordination between Department of Defense and Department of Veterans Affairs on furnishing of fertility treatment and counseling.</toc-entry><toc-entry level="title" idref="id9F13673B7E724487BDD39E8EAD60B148">TITLE II—Reproductive and adoption assistance for veterans</toc-entry><toc-entry level="section" idref="id78B4CAA5748B46758449CA134E4D693D">Sec. 201. Inclusion of fertility treatment and counseling under the definition of medical services in title 38.</toc-entry><toc-entry level="section" idref="id1509ADED17894214A21BB69300402750">Sec. 202. Fertility treatment and counseling for certain veterans and spouses, partners, and gestational surrogates of such veterans.</toc-entry><toc-entry level="section" idref="id6ACD60DBFD29432B9FC171B394209CD2">Sec. 203. Adoption assistance for certain veterans.</toc-entry><toc-entry level="section" idref="id439DBEF6842A4F8996F4C1CD21596DE8">Sec. 204. Assistance with and continuity of care regarding reproductive and fertility preservation services.</toc-entry><toc-entry level="section" idref="id8468CB06F5084B78B604B4D3D8342AE7">Sec. 205. Facilitation of reproduction and infertility research.</toc-entry><toc-entry level="section" idref="id73DFF111D4FF4CDCBB859B1D504A5792">Sec. 206. Regulations on furnishing of fertility treatment and counseling and adoption assistance by Department of Veterans Affairs.</toc-entry></toc></subsection></section><title commented="no" level-type="subsequent" id="id019790046DCD41D8B92277CB2567C3DC" style="OLC"><enum>I</enum><header display-inline="yes-display-inline">Reproductive and fertility preservation assistance for members of the Armed Forces</header><section section-type="subsequent-section" id="idEDE914049BAD48AFAC2C9D23527FC811"><enum>101.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title:</text><paragraph id="idC126D6F04AC84166BE45BDF191AFF03B"><enum>(1)</enum><header>Active duty</header><text>The term <term>active duty</term> has the meaning given that term in section 101(d)(1) of title 10, United States Code.</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id55C55EBB010E4E5C96E75A730137AEEA"><enum>(2)</enum><header>Armed Forces</header><text>The term <term>Armed Forces</term> has the meaning given the term <term>armed forces</term> in section 101(a)(4) of such title.</text></paragraph></section><section commented="no" display-inline="no-display-inline" id="id26471FB10A1C403090FA39106CC25087"><enum>102.</enum><header display-inline="yes-display-inline">Provision of fertility treatment and counseling to certain members of the Armed Forces and spouses, partners, and gestational surrogates of such members</header><subsection commented="no" display-inline="no-display-inline" id="id33958A758B4B4691ACAC5BCD1BF9BA95"><enum>(a)</enum><header display-inline="yes-display-inline">Fertility treatment and counseling</header><paragraph commented="no" display-inline="no-display-inline" id="idF2CCFDF27FC84CEB9F626B9BB63EC1A7"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">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.</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id7F4679FF93444F418B5C7DFA1CF1E278"><enum>(2)</enum><header display-inline="yes-display-inline">Eligibility for treatment and counseling</header><text display-inline="yes-display-inline">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.</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idFAEC4781B5D34036A9F0F0A1FF13AC8E"><enum>(3)</enum><header display-inline="yes-display-inline">In vitro fertilization</header><text display-inline="yes-display-inline">In the case of in vitro fertilization treatment furnished under paragraph (1), the Secretary may furnish to an individual under such paragraph—</text><subparagraph commented="no" display-inline="no-display-inline" id="idbfaddb1d1af64213a519a40efd5e1520"><enum>(A)</enum><text display-inline="yes-display-inline">not more than three completed oocyte retrievals; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idc4f0da91117e46d4bee774d738de9a75"><enum>(B)</enum><text display-inline="yes-display-inline">unlimited embryo transfers in accordance with the guidelines of the American Society for Reproductive Medicine.</text></subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idA9A2EBDE25DC4C8BBDB3A924F83B9E1C"><enum>(b)</enum><header display-inline="yes-display-inline">Procurement of reproductive genetic material</header><text display-inline="yes-display-inline">If a covered member of the Armed Forces is unable to provide their reproductive genetic material 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 genetic material and pay or reimburse such member the reasonable costs of procuring such material from a donor.</text></subsection><subsection commented="no" display-inline="no-display-inline" id="id885836365b7b40a3ba93acc36b4da621"><enum>(c)</enum><header display-inline="yes-display-inline">Rule of construction</header><text display-inline="yes-display-inline">Nothing in this section shall be construed to require the Secretary—</text><paragraph commented="no" display-inline="no-display-inline" id="id438fe7c4cd6f48a2966ab89e18ed93d9"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idfbf117fb89074e578ecf9978844c198a"><enum>(2)</enum><text display-inline="yes-display-inline">to find or certify reproductive genetic material from a donor for a covered member of the Armed Forces or to connect such a member with reproductive genetic material from a donor.</text></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idb72cd9d67972467caf073586d5ac7ff1"><enum>(d)</enum><header display-inline="yes-display-inline">Definitions</header><text display-inline="yes-display-inline">In this section:</text><paragraph commented="no" display-inline="no-display-inline" id="id5845C2088DA1424FB053AFA0A0BF9A38"><enum>(1)</enum><header display-inline="yes-display-inline">Assisted reproductive technology</header><text display-inline="yes-display-inline">The term <term>assisted reproductive technology</term> includes in vitro fertilization and other fertility treatments in which both eggs and sperm are handled when clinically appropriate.</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idAE7203B7DE1146A2965648F2812281CE"><enum>(2)</enum><header>Covered member of the Armed Forces</header><text>The term <term>covered member of the Armed Forces</term> 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.</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id0FEEFD3D6E844B5A92ABD29896ADD027"><enum>(3)</enum><header display-inline="yes-display-inline">Fertility treatment</header><text display-inline="yes-display-inline">The term <term>fertility treatment</term> includes the following:</text><subparagraph commented="no" display-inline="no-display-inline" id="id1d37cd1a3f0045448d94ee0bd1edd18c"><enum>(A)</enum><text display-inline="yes-display-inline">Procedures that use assisted reproductive technology.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id140db4dadb744ed8ba3abf07ded0cea0"><enum>(B)</enum><text display-inline="yes-display-inline">Sperm retrieval.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id5640b521294e4414a208a7a7322864d1"><enum>(C)</enum><text display-inline="yes-display-inline">Egg retrieval.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id6b70dbe31255441fbccf2310c5de14fa"><enum>(D)</enum><text display-inline="yes-display-inline">Artificial insemination.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id9e19c1ebe78f453ca238613de8c2e258"><enum>(E)</enum><text display-inline="yes-display-inline">Transfer of reproductive genetic material.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id7aa3b9171cd0402c96274f3ceae45df1"><enum>(F)</enum><text>Medications as prescribed or necessary for fertility.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idE6BE8AE7347949958A3EDD4597262035"><enum>(G)</enum><text display-inline="yes-display-inline">Such other treatments as the Secretary of Defense considers appropriate.</text></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idC86393B9BFBA484C9B10D1E3F198E107"><enum>(4)</enum><header>Infertility condition</header><text>The term <term>infertility condition</term> includes—</text><subparagraph commented="no" display-inline="no-display-inline" id="idA3B5AD9FE5FA444CA86562224C1E5D24"><enum>(A)</enum><text>a diagnosis of infertility; or</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idA8F68591B8EE42B290F287BB7FCC6A95"><enum>(B)</enum><text>the inability to reproduce or safely carry a pregnancy to term, including as a result of treatment for another condition.</text></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id0BE2C0515A0C4E46BA972A5E57415D38"><enum>(5)</enum><header display-inline="yes-display-inline">Partner</header><text display-inline="yes-display-inline">The term <term>partner</term>, 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.</text></paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="id281d3d4383154f3fb7ef0567c270356f"><enum>103.</enum><header display-inline="yes-display-inline">Establishment of fertility preservation procedures after an injury or illness</header><subsection commented="no" display-inline="no-display-inline" id="id7d217376b14c49aea46343a0cfff6e02"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The Secretary of Defense, acting through the Assistant Secretary of Defense for Health Affairs, shall establish procedures for the retrieval of reproductive genetic material, 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.</text></subsection><subsection commented="no" display-inline="no-display-inline" id="id9dc5c8e23fcf46caa2e106159a112279"><enum>(b)</enum><header display-inline="yes-display-inline">Consent for retrieval of reproductive genetic material</header><text display-inline="yes-display-inline">Reproductive genetic material may be retrieved from a member of the Armed Forces under subsection (a) only—</text><paragraph commented="no" display-inline="no-display-inline" id="id55be8271d52f47e99e52a2cdfd3a4938"><enum>(1)</enum><text display-inline="yes-display-inline">with the specific consent of the member; or</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id58d1ad776f5c4c88885a5e21881d1c7e"><enum>(2)</enum><text display-inline="yes-display-inline">if the member is unable to consent, if a medical professional determines that—</text><subparagraph commented="no" display-inline="no-display-inline" id="ida055af432af04888bc1130b8b0ed0495"><enum>(A)</enum><text display-inline="yes-display-inline">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;</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id350eb15ccc4a480b913bd59cd8a2a3cb"><enum>(B)</enum><text display-inline="yes-display-inline">the member lacks the capacity to consent to the retrieval of reproductive genetic material and is likely to regain such capacity; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id39d82adabc74425b87fa0bbe19d5b0aa"><enum>(C)</enum><text display-inline="yes-display-inline">the retrieval of reproductive genetic material under this section is in the medical interest of the member.</text></subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idf2c053aef57b48b4aedd420b482d9eed"><enum>(c)</enum><header display-inline="yes-display-inline">Consent for use of retrieved reproductive genetic material</header><text display-inline="yes-display-inline">Reproductive genetic material retrieved from a member of the Armed Forces under subsection (a) may be used only—</text><paragraph commented="no" display-inline="no-display-inline" id="idBA42F935D28A47A29CDB1285CC596B04"><enum>(1)</enum><text display-inline="yes-display-inline">with the specific consent of the member; or</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id1535C42C6B0F4BEAAB02F7937DCCBD97"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idfeac293742074bdfb411e379d2bde370"><enum>(d)</enum><header display-inline="yes-display-inline">Disposal of reproductive genetic material</header><text display-inline="yes-display-inline">In accordance with regulations prescribed by the Secretary for purpose of this subsection, the Secretary shall dispose of reproductive genetic material retrieved from a member of the Armed Forces under subsection (a)—</text><paragraph commented="no" display-inline="no-display-inline" id="ida072411c306b413289babe2ad0a0c1f2"><enum>(1)</enum><text display-inline="yes-display-inline">with the specific consent of the member; or</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idfa97cd2213a64c249f15813804f5888b"><enum>(2)</enum><text display-inline="yes-display-inline">if the member—</text><subparagraph commented="no" display-inline="no-display-inline" id="id2588C52936A84A54BEF89C0414709B99"><enum>(A)</enum><text display-inline="yes-display-inline">has lost the ability to consent permanently, as determined by a medical professional; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id42EBF04B83F94EFF91A1C2DFEBD77709"><enum>(B)</enum><text display-inline="yes-display-inline">has not specified the use of their reproductive genetic material in an advance directive or testamentary instrument executed by the member.</text></subparagraph></paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="id64f1868ef4504aebace3704eda4d1091"><enum>104.</enum><header display-inline="yes-display-inline">Cryopreservation and storage of reproductive genetic material of members of the Armed Forces on active duty</header><subsection commented="no" display-inline="no-display-inline" id="idb30b67bdf2f649a888e3cf6ad5e523a3"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">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 reproductive genetic material prior to—</text><paragraph commented="no" display-inline="no-display-inline" id="id13B7204E49ED404BAB709D8B38303683"><enum>(1)</enum><text display-inline="yes-display-inline">deployment to a combat zone; or</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idB5BE3B9EA51548318AB07768A41A0DC9"><enum>(2)</enum><text>a duty assignment that includes a hazardous assignment, including—</text><subparagraph commented="no" display-inline="no-display-inline" id="id08e22d4a4959440698cbf18956e7e773"><enum>(A)</enum><text display-inline="yes-display-inline">assignments resulting in exposure to perfluoroalkyl or polyfluoroalkyl substances; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id4f8c558238b64afbbca1f9efad05536c"><enum>(B)</enum><text display-inline="yes-display-inline">such other assignments as determined by the Secretary.</text></subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="ide9ec65ee092e41daba67308fce6fe21b"><enum>(b)</enum><header display-inline="yes-display-inline">Period of time</header><paragraph commented="no" display-inline="no-display-inline" id="id451C9AA1DB0E4A1B9CAE4E01170F9EA6"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The Secretary shall provide for the cryopreservation and storage of reproductive genetic material 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 material, 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.</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idc32ec8027cea4fa2bcd42b6375023470"><enum>(2)</enum><header display-inline="yes-display-inline">Continued cryopreservation and storage</header><text display-inline="yes-display-inline">At the end of the one-year period specified in paragraph (1), the Secretary shall permit an individual whose reproductive genetic material was 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:</text><subparagraph commented="no" display-inline="no-display-inline" id="idb0f846a1d5a444ffbdf424668081adcb"><enum>(A)</enum><text display-inline="yes-display-inline">To continue such cryopreservation and storage in such facility with the cost of such cryopreservation and storage borne by the individual.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id7bbdb2eeeb044de1be619f153ab8ba5f"><enum>(B)</enum><text display-inline="yes-display-inline">To transfer the material to a private cryopreservation and storage facility selected by the individual.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id51a4cff3d75246c78656d0cea160a8fc"><enum>(C)</enum><text display-inline="yes-display-inline">To transfer the material to a facility of the Department of Veterans Affairs if cryopreservation and storage is available to the individual at such facility.</text></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idC05DDFEB98AC41F99814C9C5E024873E"><enum>(3)</enum><header display-inline="yes-display-inline">Disposal of reproductive genetic material</header><text display-inline="yes-display-inline">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 reproductive genetic material 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.</text></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id2ffe45bff1744b8e8d550f56ec7fbe08"><enum>(c)</enum><header display-inline="yes-display-inline">Advance medical directive and military testamentary instrument</header><text display-inline="yes-display-inline">A member of the Armed Forces who elects to cryopreserve and store their reproductive genetic material 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 reproductive genetic material if such member dies or otherwise loses the capacity to consent to the use of their cryopreserved and stored reproductive genetic material.</text></subsection><subsection commented="no" display-inline="no-display-inline" id="idefa56aeb5ef141e4a67d4a22de639698"><enum>(d)</enum><header display-inline="yes-display-inline">Agreements</header><text display-inline="yes-display-inline">To carry out this section, the Secretary may enter into agreements with private entities that provide cryopreservation, transportation, and storage services for reproductive genetic material.</text></subsection></section><section commented="no" display-inline="no-display-inline" id="id81B91D5E434548E0B663924F52690884"><enum>105.</enum><header>Assistance with and continuity of care regarding reproductive and fertility preservation services</header><text display-inline="no-display-inline">The Secretary of Defense shall ensure that employees of the Department of Defense assist members of the Armed Forces—</text><paragraph commented="no" display-inline="no-display-inline" id="id34A735B1BA5E43C392A0A87CD510752E"><enum>(1)</enum><text display-inline="yes-display-inline">in navigating the services provided under this title;</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idE47E41277467488189F301563C046D68"><enum>(2)</enum><text display-inline="yes-display-inline">in finding a provider that meets the needs of such members with respect to such services; and</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id0CD619687B4C4B738E1FFFF59E52BD13"><enum>(3)</enum><text display-inline="yes-display-inline">in continuing the receipt of such services without interruption during a permanent change of station for such members.</text></paragraph></section><section commented="no" display-inline="no-display-inline" id="id7C634326437D4E2FAF3CC304D4C7124A"><enum>106.</enum><header display-inline="yes-display-inline">Coordination between Department of Defense and Department of Veterans Affairs on furnishing of fertility treatment and counseling</header><subsection commented="no" display-inline="no-display-inline" id="id42C1EA527BF54B3BB9CCF37DF0B3A2BA"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">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.</text></subsection><subsection commented="no" display-inline="no-display-inline" id="id7e82f6a4b81b41e79d5acbc9cabb2375"><enum>(b)</enum><header display-inline="yes-display-inline">Memorandum of understanding</header><text display-inline="yes-display-inline">The Secretary of Defense and the Secretary of Veterans Affairs shall enter into a memorandum of understanding—</text><paragraph commented="no" display-inline="no-display-inline" id="id733F834575F44B539488CC22D1533AA7"><enum>(1)</enum><text display-inline="yes-display-inline">providing that the Secretary of Defense will ensure access by the Secretary of Veterans Affairs to reproductive genetic material 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</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id385306E95DA945A38EE1DB26C31A3EE6"><enum>(2)</enum><text display-inline="yes-display-inline">authorizing the Department of Veterans Affairs to compensate the Department of Defense for the cryopreservation, transportation, and storage of reproductive genetic material of veterans under section 104.</text></paragraph></subsection></section></title><title commented="no" level-type="subsequent" id="id9F13673B7E724487BDD39E8EAD60B148" style="OLC"><enum>II</enum><header display-inline="yes-display-inline">Reproductive and adoption assistance for veterans</header><section commented="no" display-inline="no-display-inline" section-type="subsequent-section" id="id78B4CAA5748B46758449CA134E4D693D"><enum>201.</enum><header display-inline="yes-display-inline">Inclusion of fertility treatment and counseling under the definition of medical services in title 38</header><text display-inline="no-display-inline">Section 1701(6) of title 38, United States Code, is amended by adding at the end the following new subparagraph:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id6A7659FE27B54B7DABA4F0343924738D"><subparagraph commented="no" display-inline="no-display-inline" id="id08E14C8AD6D445FF8FB979F63059148A"><enum>(J)</enum><text display-inline="yes-display-inline">Fertility treatment and counseling, including treatment using assisted reproductive technology.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></section><section commented="no" display-inline="no-display-inline" section-type="subsequent-section" id="id1509ADED17894214A21BB69300402750"><enum>202.</enum><header display-inline="yes-display-inline">Fertility treatment and counseling for certain veterans and spouses, partners, and gestational surrogates of such veterans</header><subsection commented="no" display-inline="no-display-inline" id="id094377B7D22043039490A8B357DE7ABF"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subchapter II of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/17">chapter 17</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text><quoted-block style="USC" display-inline="no-display-inline" id="id1CAA020EA3AC41AEBB44839EB63669B3"><section commented="no" display-inline="no-display-inline" section-type="subsequent-section" id="id0521BE72D3154EABA85D8398A84F08C7"><enum>1720K.</enum><header display-inline="yes-display-inline">Fertility treatment and counseling for certain veterans and spouses, partners, and gestational surrogates of such veterans</header><subsection commented="no" display-inline="no-display-inline" id="idAE55961C3C6640F9B4E9A74FC770DC2F"><enum>(a)</enum><header display-inline="yes-display-inline">Requirement</header><paragraph commented="no" display-inline="no-display-inline" id="idb13b04f0fc10400b9fa78b547d991a42"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Notwithstanding any other provision of law, the Secretary shall furnish fertility treatment and counseling, including through the use of assisted reproductive technology, to a covered veteran and the spouse, partner, or gestational surrogate of the veteran if the veteran, and the spouse, partner, or gestational surrogate of the veteran, as applicable, each provide informed consent for such treatment and counseling, including for each cycle of treatment authorized under this section, through a process prescribed by the Secretary.</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id4114443D931147E6B495E7F014735243"><enum>(2)</enum><header>Provision of treatment and counseling</header><text display-inline="yes-display-inline">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.</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idE2F0AFD4A41E425FA563A52121860542"><enum>(3)</enum><header display-inline="yes-display-inline">In vitro fertilization</header><text display-inline="yes-display-inline">In the case of in vitro fertilization treatment furnished under paragraph (1), the Secretary may furnish to an individual under such paragraph—</text><subparagraph commented="no" display-inline="no-display-inline" id="idAC2D5997F00D47FA8E92B2892002E40D"><enum>(A)</enum><text display-inline="yes-display-inline">not more than three completed oocyte retrievals; and</text></subparagraph><subparagraph id="id3D32CBCAA5A04A44B956A44979929AD0" commented="no" display-inline="no-display-inline"><enum>(B)</enum><text display-inline="yes-display-inline">unlimited embryo transfers in accordance with the guidelines of the American Society for Reproductive Medicine. </text></subparagraph></paragraph></subsection><subsection id="id97e576682bea4236b057120c288a1972"><enum>(b)</enum><header>Procurement of reproductive genetic material</header><text>If a covered veteran is unable to provide their reproductive genetic material 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 reproductive genetic material and pay or reimburse such veteran the reasonable costs of procuring such material from a donor. </text></subsection><subsection id="idd6834ffc7b474558bc3df3cd5571576e"><enum>(c)</enum><header>Outreach and training</header><text>The Secretary shall carry out an outreach and training program to ensure veterans and health care providers of the Department are aware of—</text><paragraph id="id62BAC9809CE0403F8412335EA613718A"><enum>(1)</enum><text>the availability of and eligibility requirements for fertility treatment and counseling under this section; and</text></paragraph><paragraph id="id17A3EB21D58B4340B87D6BD969213666"><enum>(2)</enum><text>any changes to fertility treatment and counseling covered under this section. </text></paragraph></subsection><subsection id="id8a7da40f8aec499baca5e2239f56b65b"><enum>(d)</enum><header>Ownership, use, disposition, or destruction of reproductive genetic material</header><paragraph commented="no" display-inline="no-display-inline" id="id3de7f43897e54573aec6d5e922ffb976"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Issues or disputes regarding ownership of reproductive genetic material, future use of such material, disposition of such material, or destruction of such material shall be the sole responsibility of the covered veteran, the spouse, partner, or gestational surrogate of the veteran, and the private facility storing such material.</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id55e98354f59745b1b81171943ca799fb"><enum>(2)</enum><header>Role of Department</header><text display-inline="yes-display-inline">The role of the Department under this section is limited to furnishing the treatment and counseling required under this section when requested by a covered veteran. </text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idb6677a9d935f40128e9f2a109762fea0"><enum>(3)</enum><header>Ownership and custody of reproductive genetic material</header><text display-inline="yes-display-inline">The Department will not have ownership or custody of any reproductive genetic material obtained pursuant to treatment under this section and will not be involved in the ultimate disposition of such material or disputes between or among any parties with respect to such material. </text></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id5FDE1CC88E164A1F947B2F77C6C3989C"><enum>(e)</enum><header display-inline="yes-display-inline">Rule of construction</header><text display-inline="yes-display-inline">Nothing in this section shall be construed to require the Secretary—</text><paragraph commented="no" display-inline="no-display-inline" id="idD9D811D0D01C44A2A5EA276F30EE87AD"><enum>(1)</enum><text display-inline="yes-display-inline">to find or certify a gestational surrogate for a covered veteran or to connect a gestational surrogate with a covered veteran; or</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idC53B1D4A582E4CB89D9F9A2825CD07EA"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id978B141C12F54B048A6DD0AFC8D15A58"><enum>(f)</enum><header display-inline="yes-display-inline">Definitions</header><text display-inline="yes-display-inline">In this section:</text><paragraph commented="no" display-inline="no-display-inline" id="id0DDF635435FA47659713F67F83D60CF9"><enum>(1)</enum><text display-inline="yes-display-inline">The term <term>assisted reproductive technology</term> includes in vitro fertilization and other fertility treatments in which both eggs and sperm are handled when clinically appropriate.</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id6DCC40857C9443AE80D6041F195DE4A7"><enum>(2)</enum><text>The term <term>covered veteran</term> means a veteran who—</text><subparagraph commented="no" display-inline="no-display-inline" id="id77289D06726441F08BEEE84EA2AE381B"><enum>(A)</enum><text>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</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id47191A6E95964AAAB0A5AC5862900D87"><enum>(B)</enum><text>is enrolled in the system of annual patient enrollment established under section 1705(a) of this title.</text></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id96EE8A0220EC4A579E969D5412D1C7B9"><enum>(3)</enum><text display-inline="yes-display-inline">The term <term>fertility treatment</term> includes the following:</text><subparagraph commented="no" display-inline="no-display-inline" id="id8FD036687C234ECA9FF624C1DFBD6B97"><enum>(A)</enum><text display-inline="yes-display-inline">Procedures that use assisted reproductive technology.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id85E3A9C3FF564AEE9318D6664033AF83"><enum>(B)</enum><text display-inline="yes-display-inline">Sperm retrieval.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id6E2BA28392BF40179C717E8B35837F0E"><enum>(C)</enum><text display-inline="yes-display-inline">Egg retrieval.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id3352F9C0AE2A458DAFC65DF38CD0C0FB"><enum>(D)</enum><text display-inline="yes-display-inline">Artificial insemination.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id911CFAC55639474889BEF1A6000D321B"><enum>(E)</enum><text display-inline="yes-display-inline">Transfer of reproductive genetic material.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id460857EC01FC42C38DED7DD0917A82E8"><enum>(F)</enum><text>Medications as prescribed or necessary for fertility.</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idE70E04B1C97F4509B0D2193C3C8A2307"><enum>(G)</enum><text display-inline="yes-display-inline">Such other treatments as the Secretary considers appropriate.</text></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id1ac752317f8f434e95fad34f4ba44b51"><enum>(4)</enum><text>The term <term>gestational surrogate</term> means an individual who carries a fetus through pregnancy and gives birth to a baby for another individual or couple.</text></paragraph><paragraph id="id453b7af1965e4604bf9a5727f24e5728"><enum>(5)</enum><text>The term <term>infertility condition</term> includes—</text><subparagraph id="idb75760d213fc40259c2245e1c933c390"><enum>(A)</enum><text>a diagnosis of infertility; or</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idF3006112C3944260827BAC19643038D6"><enum>(B)</enum><text>the inability to reproduce or safely carry a pregnancy to term, including as a result of treatment for another condition.</text></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id8466B005211A4112BD999D023D1E3E6E"><enum>(6)</enum><text display-inline="yes-display-inline">The term <term>partner</term>, with respect to a covered veteran, means an individual—</text><subparagraph id="id6ad9892590a848a99abf484ff44d927e"><enum>(A)</enum><text>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; and</text></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idd1fde46bf4cf4f849d7c83eedbdc3144"><enum>(B)</enum><text display-inline="yes-display-inline">whom the veteran certifies to the Department is the partner of the veteran and therefore, based on that certification, is eligible for treatment and counseling under this section.</text></subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection commented="no" display-inline="no-display-inline" id="idF054790C106D42CABE29B8685E8E84A4"><enum>(b)</enum><header display-inline="yes-display-inline">Clerical amendment</header><text display-inline="yes-display-inline">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:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id31BE213166CB4D008701047966E9BBB2"><toc><toc-entry bold="off" level="section">1720K. Fertility treatment and counseling for certain veterans and spouses, partners, and gestational surrogates of such veterans.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section><section commented="no" display-inline="no-display-inline" section-type="subsequent-section" id="id6ACD60DBFD29432B9FC171B394209CD2"><enum>203.</enum><header display-inline="yes-display-inline">Adoption assistance for certain veterans</header><subsection commented="no" display-inline="no-display-inline" id="id6F65FEF3F7144079883009AE49A2594E"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subchapter VIII of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/17">chapter 17</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text><quoted-block style="USC" display-inline="no-display-inline" id="id674A57DE72EC4F259A4DF0F8B51FBC6F"><section commented="no" display-inline="no-display-inline" section-type="subsequent-section" id="idF41E94922DF64227BEB93D25ADA7BFDD"><enum>1790.</enum><header display-inline="yes-display-inline">Adoption assistance</header><subsection commented="no" display-inline="no-display-inline" id="idED6E50C6FAF748F5825EB1878A0DA02D"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">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.</text></subsection><subsection commented="no" display-inline="no-display-inline" id="id1F9C9E2B9D02495EA48D22CF733D5FC0"><enum>(b)</enum><header display-inline="yes-display-inline">Limitation amount</header><text display-inline="yes-display-inline">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.</text></subsection><subsection commented="no" display-inline="no-display-inline" id="idBD4D01C8FA2B46B4B2D3B580914A846F"><enum>(c)</enum><header>Covered veteran defined</header><text display-inline="yes-display-inline">In this section, the term <term>covered veteran</term> has the meaning given that term in section 1720K(f) of this title.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection commented="no" display-inline="no-display-inline" id="idBB331172BE064CF59188761B56C2557C"><enum>(b)</enum><header display-inline="yes-display-inline">Clerical amendment</header><text display-inline="yes-display-inline">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 1789 the following new item:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idDBAF82C49A7E4452B6A7B63155E92C12"><toc><toc-entry bold="off" level="section">1790. Adoption assistance.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section><section commented="no" display-inline="no-display-inline" id="id439DBEF6842A4F8996F4C1CD21596DE8"><enum>204.</enum><header>Assistance with and continuity of care regarding reproductive and fertility preservation services</header><text display-inline="no-display-inline">The Secretary of Veterans Affairs shall ensure that employees of the Department of Veterans Affairs assist veterans—</text><paragraph commented="no" display-inline="no-display-inline" id="idAC6476418DDD49768AF72605AF1848FB"><enum>(1)</enum><text display-inline="yes-display-inline">in navigating the services provided under this title and the amendments made by this title;</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idFF4AB088A18840A89967F2B9EB34B201"><enum>(2)</enum><text display-inline="yes-display-inline">in finding a provider that meets the needs of such veterans with respect to such services; and</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id7F376E6175D04E728792F852BB3BFE3B"><enum>(3)</enum><text display-inline="yes-display-inline">in continuing the receipt of such services without interruption if such veterans move to a different geographic location.</text></paragraph></section><section commented="no" display-inline="no-display-inline" id="id8468CB06F5084B78B604B4D3D8342AE7"><enum>205.</enum><header display-inline="yes-display-inline">Facilitation of reproduction and infertility research</header><subsection commented="no" display-inline="no-display-inline" id="idEE00B00FD9BC4C3194BA60F49D7C25F2"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subchapter II of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/73">chapter 73</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text><quoted-block style="USC" display-inline="no-display-inline" id="idAA734714B7624AD1AB204F0D44D51CFF"><section commented="no" display-inline="no-display-inline" section-type="subsequent-section" id="idF082EB83C8C74962A9920F9CA0568FF9"><enum>7330E.</enum><header display-inline="yes-display-inline">Facilitation of reproduction and infertility research</header><subsection commented="no" display-inline="no-display-inline" id="idBC5CC118B82447DDAE11BDC081A95996"><enum>(a)</enum><header display-inline="yes-display-inline">Facilitation of research required</header><text display-inline="yes-display-inline">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.</text></subsection><subsection commented="no" display-inline="no-display-inline" id="id1AD09987835B4ACDA19BBD46042AF96D"><enum>(b)</enum><header display-inline="yes-display-inline">Dissemination of information</header><text display-inline="yes-display-inline">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.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection commented="no" display-inline="no-display-inline" id="id547977DBD0064C7F84AA0F12A804B528"><enum>(b)</enum><header display-inline="yes-display-inline">Clerical amendment</header><text display-inline="yes-display-inline">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 7330D the following new item:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id05EB53B7D06F47D8935A8F65CE4B8384"><toc><toc-entry bold="off" level="section">7330E. Facilitation of reproduction and infertility research.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section><section commented="no" display-inline="no-display-inline" id="id73DFF111D4FF4CDCBB859B1D504A5792"><enum>206.</enum><header display-inline="yes-display-inline">Regulations on furnishing of fertility treatment and counseling and adoption assistance by Department of Veterans Affairs</header><text display-inline="no-display-inline">Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall prescribe regulations—</text><paragraph commented="no" display-inline="no-display-inline" id="id9E1A6DB3A68E4290A9ED93A5289A116E"><enum>(1)</enum><text display-inline="yes-display-inline">to carry out section 1720K of title 38, United States Code, as added by section 202(a); and</text></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idCB0A863F1B9A496CB0D6235FA77BFB01"><enum>(2)</enum><text display-inline="yes-display-inline">to carry out section 1790 of such title, as added by section 203(a). </text></paragraph></section></title></legis-body></bill> 

