Excepted Fertility Benefits

A Canadian physician and clinic owner supports the proposed Excepted Fertility Benefits framework but requests that it explicitly include restorative reproductive medicine (RRM). The commenter argues that including RRM would improve patient access to root-cause treatments for reproductive pathology and reduce the need for patients to seek care internationally.

The Ethics and Public Policy Center (EPPC) supports the proposed rule but argues that the "excepted fertility benefits" must be strictly limited to the treatment of diagnosed medical pathologies rather than "social infertility." They propose specific definitions, enforcement mechanisms, and ethical safeguards to ensure the benefits remain similar to limited-scope dental and vision plans.

The Maryland Family Institute supports the proposed "Excepted Fertility Benefits" category but argues that the rule must be guided by specific ethical principles. They advocate for defining infertility as a medical condition, prioritizing natural reproductive health, excluding assisted reproductive technologies (ART) until federal safeguards are in place, and protecting the rights of embryos.

Timothy Jakubisin, representing the nonprofit clinic Veranova Health, expresses strong support for the proposed rule on Excepted Fertility Benefits. He argues that the rule will improve funding for Restorative Reproductive Medicine (RRM) training, address male factor infertility, provide employers with more discretion, and ensure adequate CPT reimbursement for RRM services.

The commenter writes in strong support of the proposed rule to establish excepted fertility benefits, emphasizing that fertility care should focus on diagnosing and treating the root causes of infertility (restorative reproductive medicine) rather than just bypassing them through IVF. They argue for a pathology-based definition of infertility and request that the final rule explicitly include and prioritize restorative care options.

The International Institute for Restorative Reproductive Medicine (IIRRM) supports the proposed rule to create a new category of Excepted Fertility Benefits. They argue that the final rule should explicitly recognize restorative reproductive medicine (RRM) as an eligible benefit category to improve patient choice, expand access in rural areas, and provide a lower-cost alternative to IVF.

Dr. Monica Minjeur, Founder and CEO of Radiant Clinic, supports broadening the scope of covered fertility benefits to include restorative reproductive medicine (RRM) and its associated diagnostic and treatment strategies. She also advocates for specific modifications to the rule, such as lower lifetime caps for small businesses, simplified enrollment pathways, and updated definitions for infertility.

The Women's Reproductive Health Foundation (WRHF) supports the proposed rule but requests that it expressly recognize and include restorative reproductive medicine (RRM) as a covered approach to infertility care. They argue that RRM is a medically sound, evidence-based approach that prioritizes identifying and treating underlying causes of infertility.

The Fertility Providers Alliance (FPA), a non-profit business association representing fertility care providers, supports the proposed rule to expand access to fertility benefits. They recommend defining benefits by clinically appropriate cycles of care rather than dollar caps, ensuring the rule doesn't displace existing state mandates, and establishing a clear scope of covered services that includes both diagnostic and assisted reproductive technologies.

Grindr, a private-sector employer, supports the proposed rule establishing "excepted fertility benefits" to expand access to family-formation services. The company argues for specific modifications to the rule, including adopting a modern medical definition of infertility, expressly including third-party reproduction (like surrogacy and donor gametes), and decoupling coverage for partners and gestational carriers from their own independent enrollment status.