STATE OF NEW YORK ________________________________________________________________________ 7749 2023-2024 Regular Sessions IN SENATE November 13, 2023 ___________ Introduced by Sen. KRUEGER -- read twice and ordered printed, and when printed to be committed to the Committee on Rules AN ACT to amend the family court act, the public health law, the general business law and the insurance law, in relation to surrogacy programs and agreements; and to amend the social services law, in relation to enrollment in the state health insurance exchange The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Section 581-102 of the family court act, as added by 2 section 1 of part L of chapter 56 of the laws of 2020, is amended to 3 read as follows: 4 § 581-102. Definitions. (a) "Assisted reproduction" means a method of 5 causing pregnancy other than sexual intercourse and includes but is not 6 limited to: 7 1. intrauterine or vaginal insemination; 8 2. donation of gametes; 9 3. donation of embryos; 10 4. in vitro fertilization and transfer of embryos; and 11 5. intracytoplasmic sperm injection. 12 (b) "Central assisted reproduction registry" means the registry estab- 13 lished pursuant to section twenty-five hundred ninety-nine-cc of the 14 public health law. 15 (c) "Child" means a born individual of any age whose parentage may be 16 determined under this act or other law. 17 [~~(c)~~] (d) "Compensation" means payment of any valuable consideration 18 in excess of reasonable medical and ancillary costs. 19 [~~(d)~~] (e) "Donor" means an individual who does not intend to be a 20 parent who produces gametes and provides them to another person, other 21 than the individual's spouse, for use in assisted reproduction. For 22 purposes of parts eight and ten of this article and of governing stat- 23 utes and regulations, the term "donor" means an individual who does not EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD13512-02-3

S. 7749 2 1 intend to be a parent who receives compensation for time and effort to 2 produce gametes for use in assisted reproduction by an intended parent 3 or parents who are unknown to the donor of the gametes at the time of 4 donation. The term does not include a person who is a parent under part 5 three of this article. Donor also includes an individual who had dispo- 6 sitional control of an embryo or gametes who then transfers disposi- 7 tional control and releases all present and future parental and inheri- 8 tance rights and obligations to a resulting child. 9 [~~(e)~~] (f) "Donor-conceived person or individual" means an individual 10 of any age who was conceived using assisted reproduction and donor 11 gametes that were produced by a donor who received compensation for time 12 and effort and who was unknown to the intended parent or parents at the 13 time of donation. 14 (g) "Embryo" means a cell or group of cells containing a diploid 15 complement of chromosomes or group of such cells, not a gamete or 16 gametes, that has the potential to develop into a live born human being 17 if transferred into the body of a person under conditions in which 18 gestation may be reasonably expected to occur. 19 [~~(f)~~] (h) "Embryo transfer" means all medical and laboratory proce- 20 dures that are necessary to effectuate the transfer of an embryo into 21 the uterine cavity. 22 [~~(g)~~] (i) "Gamete" means a cell containing a haploid complement of DNA 23 that has the potential to form an embryo when combined with another 24 gamete. Sperm and eggs shall be considered gametes. A human gamete used 25 or intended for reproduction may not contain nuclear DNA that has been 26 deliberately altered, or nuclear DNA from one human combined with the 27 cytoplasm or cytoplasmic DNA of another human being. 28 [~~(h)~~] (j) "Gamete donation agency agreement" means an agreement 29 between a gamete donor or an intended parent or parents and an agent, 30 gamete agency, gamete bank, fertility clinic, surrogacy program, or 31 health care provider that details the terms under which: (A) a donor 32 shall receive compensation for time and effort to produce gametes for 33 use in assisted reproduction by an intended parent or parents who is 34 unknown to the donor of the gametes at the time of donation; or (B) an 35 intended parent or parents shall receive fresh or frozen donor gametes. 36 (k) "Gamete donation matched agreement" means an agreement between a 37 gamete donor and an intended parent or parents that details the terms 38 under which a donor shall receive compensation for time and effort to 39 produce gametes for use in assisted reproduction by the intended parent 40 or parents who is unknown to the donor of the gametes at the time of 41 donation. 42 (l) "Health care practitioner" means an individual licensed or certi- 43 fied under title eight of the education law, or a similar law of another 44 state or country, acting within his or her scope of practice. 45 (m) "Identified gamete donation or identified gamete donor" means that 46 the gamete donor agrees to release identifying and medical information 47 upon request to a donor-conceived individual who was conceived using 48 their donor gametes and assisted reproduction once the donor-conceived 49 individual attains the age of eighteen, or to a legal parent or guardian 50 if the donor-conceived individual is under the age of eighteen. 51 (n) "Independent escrow agent" means someone other than the parties to 52 a surrogacy agreement and their attorneys. An independent escrow agent 53 can, but need not, be a surrogacy program, provided such surrogacy 54 program is owned [~~or managed~~] by an attorney licensed to practice law in 55 the state of New York. If such independent escrow agent is not an attor- 56 ney owned surrogacy program, it shall be [~~licensed,~~] bonded and insured.

S. 7749 3 1 [~~(i) "Surrogacy agreement" is an agreement between at least one~~ 2 ~~intended parent and a person acting as surrogate intended to result in a~~ 3 ~~live birth where the child will be the legal child of the intended~~ 4 ~~parents.~~ 5 ~~(j)~~] (o) "Informed legal consent" means that a potential gamete donor, 6 a potential person acting as surrogate, or an intended parent or parents 7 provide fully-informed legal consent in a signed written statement to 8 enter into a gamete donation matched agreement, a gamete donation agency 9 agreement, or a surrogacy agreement after completing the required 10 informed legal consent procedures under part ten of this article. 11 (p) "Informed medical consent" means that a potential gamete donor, a 12 potential person acting as surrogate, or an intended parent or parents 13 provide fully-informed medical consent in a signed written statement to 14 enter into a gamete donation matched agreement, a gamete donation agency 15 agreement, or a surrogacy agreement after completing the informed 16 medical consent procedures under part ten of this article. Informed 17 medical consent to enter into a gamete donation or surrogacy agreement 18 does not replace the medical consent that a gamete donor, a person 19 acting as surrogate, or an intended parent or parents must provide prior 20 to undergoing individual medical procedures. 21 (q) "In vitro fertilization" means the formation of a human embryo 22 outside the human body. 23 (r) "Intended parent" means an individual who manifests the intent to 24 be legally bound as the parent of a child resulting from assisted 25 reproduction or a surrogacy agreement, provided he or she meets the 26 requirements of this article. 27 (s) "Nonidentified gamete donation or nonidentified gamete donor" 28 means that the gamete donor does not agree to release identifying infor- 29 mation to a donor-conceived individual who was conceived using their 30 donor gametes and assisted reproduction, or to a legal parent or guardi- 31 an of the donor-conceived individual. A nonidentified gamete donor is 32 informed that the department may release their nonidentifying medical 33 information upon request of a donor-conceived individual upon attaining 34 eighteen years of age, or of a legal parent or guardian if the donor- 35 conceived individual is under the age of eighteen. 36 (t) "Parent" as used in this article means an individual with a 37 parent-child relationship created or recognized under this act or other 38 law. 39 (u) "Participant" means an individual who either provides a gamete 40 that is used in assisted reproduction, is an intended parent, is a 41 person acting as surrogate, or is the spouse of an intended parent or 42 person acting as surrogate. 43 (v) "Person acting as surrogate" means an adult person, not an 44 intended parent, who enters into a surrogacy agreement to bear a child 45 who will be the legal child of the intended parent or parents so long as 46 the person acting as surrogate has not provided the egg used to conceive 47 the resulting child. 48 [~~(k) "Health care practitioner" means an individual licensed or certi-~~ 49 ~~fied under title eight of the education law, or a similar law of another~~ 50 ~~state or country, acting within his or her scope of practice.~~ 51 ~~(l) "Intended parent" is an individual who manifests the intent to be~~ 52 ~~legally bound as the parent of a child resulting from assisted reprod-~~ 53 ~~uction or a surrogacy agreement provided he or she meets the require-~~ 54 ~~ments of this article.~~ 55 ~~(m) "In vitro fertilization" means the formation of a human embryo~~ 56 ~~outside the human body.~~

S. 7749 4 1 ~~(n) "Parent" as used in this article means an individual with a~~ 2 ~~parent-child relationship created or recognized under this act or other~~ 3 ~~law.~~ 4 ~~(o) "Participant" is an individual who either: provides a gamete that~~ 5 ~~is used in assisted reproduction, is an intended parent, is a person~~ 6 ~~acting as surrogate, or is the spouse of an intended parent or person~~ 7 ~~acting as surrogate.~~ 8 ~~(p)~~] (w) "Record" means information inscribed in a tangible medium or 9 stored in an electronic or other medium that is retrievable in perceiva- 10 ble form. 11 [~~(q)~~] (x) "Retrieval" means the procurement of eggs or sperm from a 12 gamete provider. 13 [~~(r)~~] (y) "Spouse" means an individual married to another, or who has 14 a legal relationship entered into under the laws of the United States or 15 of any state, local or foreign jurisdiction, which is substantially 16 equivalent to a marriage, including a civil union or domestic partner- 17 ship. 18 [~~(s)~~] (z) "State" means a state of the United States, the District of 19 Columbia, Puerto Rico, the United States Virgin Islands, or any territo- 20 ry or insular possession subject to the jurisdiction of the United 21 States. 22 [~~(t)~~] (aa) "Surrogacy agreement" means an agreement between at least 23 one intended parent and a person acting as surrogate intended to result 24 in a live birth where the child will be the legal child of the intended 25 parents. 26 (bb) "Transfer" means the placement of an embryo or gametes into the 27 body of a person with the intent to achieve pregnancy and live birth. 28 § 2. Section 581-202 of the family court act, as added by section 1 of 29 part L of chapter 56 of the laws of 2020, is amended to read as follows: 30 § 581-202. Proceeding for judgment of parentage of a child conceived 31 through assisted reproduction. (a) A proceeding for a judgment of 32 parentage with respect to a child conceived through assisted reprod- 33 uction may be commenced: 34 (1) if [~~the~~] an intended parent or child resides in New York state, in 35 the county where the intended parent resides any time after the first 36 trimester of pregnancy [~~is achieved~~] or in the county where the child 37 was born or resides; or 38 (2) if [~~the~~] neither an intended parent [~~and~~] nor the child [~~do not~~] 39 reside in New York state, up to ninety days after the birth of the child 40 in the county where the child was born. 41 (b) The petition for a judgment of parentage must be verified. 42 (c) Where [~~a petition includes the following truthful~~] the court finds 43 the following statements in the petition to be true, the court shall 44 adjudicate the intended parent or parents to be the parent or parents of 45 the child: 46 (1) a statement that an intended parent has been a resident of the 47 state for at least six months, or if an intended parent is not a New 48 York state resident, that the child will be or was born in the state 49 within ninety days of filing; and 50 (2) a statement from the gestating intended parent that the gestating 51 intended parent became pregnant as a result of assisted reproduction; 52 and 53 (3) in cases where there is a non-gestating intended parent, a state- 54 ment from the gestating intended parent and non-gestating intended 55 parent that the non-gestating intended parent consented to assisted 56 reproduction pursuant to section 581-304 of this article; and

S. 7749 5 1 (4) proof of any donor's donative intent. 2 (d) The following shall be deemed sufficient proof of a donor's dona- 3 tive intent for purposes of this section: 4 (1) in the case of [~~an anonymous~~] a nonidentified donor [or] who 5 received compensation for time and effort to produce gametes for use in 6 assisted reproduction by an intended parent or parents who were unknown 7 to the donor of the gametes at the time of donation, a signed record 8 from the gamete storage facility, fertility clinic, health care practi- 9 tioner, or other entity that collected the donor gametes, or that 10 received the donor gametes from another entity, stating or demonstrating 11 that such gametes were donated on a nonidentified basis and that the 12 gamete donor has no proprietary or parental interest in the gametes or 13 embryos. The record shall be signed by the health care practitioner or 14 by a representative of the gamete storage facility, fertility clinic, or 15 other entity: 16 (i) before a notary public, or 17 (ii) before two witnesses who are neither the intended parents nor 18 employed by the health care practitioner, gamete storage facility, 19 fertility clinic, or other entity; provided that if the record is signed 20 before two witnesses, the name, phone number, email address, and mailing 21 address of each witness must be recorded; or 22 (2) in the case of an identified donor who received compensation for 23 time and effort to produce gametes for use in assisted reproduction by 24 an intended parent or parents who were unknown to the donor of the 25 gametes at the time of donation, a signed record from the gamete donor 26 certifying that they agreed to identified gamete donation and have no 27 proprietary or parental interest in the gametes or embryos. The record 28 shall be signed: 29 (i) before a notary public, or 30 (ii) before two witnesses who are not the intended parents; provided 31 that if the record is signed before two witnesses, the name, phone 32 number, email address, and mailing address of each witness must be 33 recorded; or 34 (3) where gametes or embryos have previously been released to a gamete 35 or embryo storage facility or in the presence of a health care practi- 36 tioner, either: 37 (i) a statement or documentation from the gamete or embryo storage 38 facility or health care practitioner stating or demonstrating that such 39 gametes or embryos were [~~anonymously~~] donated on an identified or noni- 40 dentified basis, or had previously been released; or 41 (ii) clear and convincing evidence that the gamete or embryo donor 42 intended to donate gametes or embryos [~~anonymously~~] on an identified or 43 nonidentified basis, or intended to release such gametes or embryos to a 44 gamete or embryo storage facility or health care practitioner; or 45 [~~(2)~~] (4) in the case of a donation from a [~~known~~] donor who is known 46 to the intended parent or parents, either: [a.] 47 (i) a record from the gamete or embryo donor acknowledging the 48 donation and confirming that the donor has no parental or proprietary 49 interest in the gametes or embryos. The record shall be signed by the 50 gestating intended parent and the gamete or embryo donor[~~. The record~~ 51 ~~may be, but is not required to be, signed~~] or donors: 52 [~~(i)~~] (A) before a notary public, or 53 [~~(ii)~~] (B) before two witnesses who are not the intended parents; 54 provided that if the record is signed before two witnesses who are not 55 the intended parents, the name, phone number, email address, and mailing 56 address of each witness must be recorded, or

S. 7749 6 1 [~~(iii)~~] (C) before a health care practitioner; or 2 [b.] (ii) clear and convincing evidence that the gamete or embryo 3 donor agreed, prior to conception, with the gestating parent and non- 4 gestating parent, if applicable, that the donor [~~has~~] or donors have no 5 parental or proprietary interest in the gametes or embryos. 6 (e) (1) In the absence of evidence pursuant to paragraph two of this 7 subdivision, notice shall be given to the donor at least twenty days 8 prior to the date set for the proceeding to determine the existence of 9 donative intent by delivery of a copy of the petition and notice pursu- 10 ant to section three hundred eight of the civil practice law and rules. 11 Such notice shall also be given to the gestating intended parent, the 12 non-gestating intended parent, if applicable, and the gestating intended 13 parent's spouse, if applicable, each of whom shall be a necessary party. 14 Upon a showing to the court, by affidavit or otherwise, on or before the 15 date of the proceeding or within such further time as the court may 16 allow, that personal service cannot be effected at the [~~donor's~~] last 17 known address or addresses of the donor or donors, and/or the non-peti- 18 tioning intended parent, if any, with reasonable effort, notice may be 19 given, without prior court order therefore, at least twenty days prior 20 to the proceeding by registered or certified mail directed to [~~the~~ 21 ~~donor's~~] such last known address or addresses. Notice by publication 22 shall not be required to be given to [~~a donor~~] anyone entitled to notice 23 pursuant to the provisions of this section. 24 (2) Notwithstanding the above, where sperm is provided under the 25 supervision of a health care practitioner to someone other than the 26 sperm provider's intimate partner or spouse without a record of the 27 sperm provider's intent to parent notice is not required. 28 (f) In cases not covered by subdivision (c) of this section, the court 29 shall adjudicate the parentage of the child consistent with part three 30 of this article. 31 (g) Where the requirements of subdivision (c) of this section are met 32 or where the court finds the intended parent or parents to be a parent 33 under subdivision [~~(e)~~] (f) of this section, the court shall issue a 34 judgment of parentage: 35 (1) declaring, that upon the birth of the child, the intended parent 36 or parents is or are the legal parent or parents of the child; and 37 (2) ordering the intended parent or parents to assume responsibility 38 for the maintenance and support of the child immediately upon the birth 39 of the child; and 40 (3) if there is a donor or donors, ordering that [~~the~~] any donor is 41 not a parent of the child; and 42 (4) ordering that: 43 (i) Pursuant to section two hundred fifty-four of the judiciary law, 44 the clerk of the court shall transmit to the state commissioner of 45 health, or for a person born in New York city, to the commissioner of 46 health of the city of New York, on a form prescribed by the commission- 47 er, a written notification of such entry together with such other facts 48 as may assist in identifying the birth record of the person whose 49 parentage was in issue and, if such person whose parentage has been 50 determined is under eighteen years of age, the clerk shall also transmit 51 forthwith to the registry operated by the department of social services 52 pursuant to section three hundred seventy-two-c of the social services 53 law a notification of such determination; and 54 (ii) Pursuant to section forty-one hundred thirty-eight of the public 55 health law and NYC Public Health Code section 207.05 that upon receipt 56 of a judgment of parentage the local registrar where a donor-conceived

S. 7749 7 1 or surrogate-born child is born will report the parentage of the donor- 2 conceived or surrogate-born child to the appropriate department of 3 health in conformity with the court order. [~~If an~~] After the original 4 birth certificate has [~~already~~] been issued, the appropriate department 5 of health will amend the birth certificate in an expedited manner and 6 seal the [~~previously issued~~] original birth certificate [~~except that it~~ 7 ~~may be rendered~~] which shall be accessible to the [~~child~~] donor-con- 8 ceived or surrogate-born person at eighteen years of age or [~~the~~] to a 9 legal parent or [~~parents.~~] guardian if the donor-conceived or surro- 10 gate-born person is under the age of eighteen; and 11 (5) if the judgment of parentage is issued prior to the birth of the 12 child, ordering the petitioner or petitioners, within seven days of such 13 birth, to provide the court with notification thereof, together with 14 such other facts as may assist in identifying the birth record of the 15 child whose parentage was in issue. Such notification shall be in writ- 16 ing on a form to be prescribed by the chief administrator of the courts. 17 The court shall thereafter issue an amended judgment of parentage that 18 includes the child's name as it appears on the child's birth certificate 19 and the child's date of birth. 20 (h) For the purposes of this section, "original birth certificate" 21 means the unamended birth certificate that contains the information 22 required under section forty-one hundred thirty-two of the public health 23 law, including the name of the person who acted as surrogate who gave 24 birth to the child, and the name of any identified gamete donor or the 25 donor reference number of any nonidentified gamete donor whose gametes 26 were used in assisted reproduction to conceive the child. 27 § 3. Section 581-203 of the family court act, as added by section 1 of 28 part L of chapter 56 of the laws of 2020, is amended to read as follows: 29 § 581-203. Proceeding for judgment of parentage of a child conceived 30 pursuant to a surrogacy agreement. (a) The proceeding may be commenced: 31 (1) in any county where an intended parent resided any time after the 32 surrogacy agreement was executed; 33 (2) in the county where the child was born or resides; or 34 (3) in the county where the surrogate resided any time after the 35 surrogacy agreement was executed. 36 (b) The proceeding may be commenced at any time after the [~~surrogacy~~ 37 ~~agreement has been executed~~] first trimester of the surrogate pregnancy 38 and the person acting as surrogate, the spouse of the person acting as 39 surrogate, if applicable, any donor for whom there is not proof of dona- 40 tive intent as set forth in subdivision (d) of section 581-202 of this 41 part, if any, and all intended parents are necessary parties. The 42 service provisions of subdivision (e) of section 581-202 of this part 43 shall be applicable to donors entitled to notice pursuant to this 44 provision. 45 (c) The petition for a judgment of parentage must be verified and 46 include the following: 47 (1) a statement that the person acting as surrogate [~~or at least one~~ 48 of] and the intended parent or parents [~~has~~] have been [~~a resident~~] 49 residents of the state for at least six months at the time the surrogacy 50 agreement was executed and have certified that they will maintain New 51 York state residency for the duration of the surrogate pregnancy and for 52 at least one month following the birth of any children; [~~and~~] 53 (2) a certification from the attorney representing the intended parent 54 or parents and the attorney representing the person acting as surrogate 55 and the spouse of the person acting as surrogate, if applicable, that 56 the requirements of part four of this article have been met; [~~and~~]

S. 7749 8 1 (3) a statement from all parties to the surrogacy agreement that they 2 knowingly and voluntarily entered into the surrogacy agreement and that 3 the parties are jointly requesting the judgment of parentage; and 4 (4) a copy of the executed surrogacy agreement. 5 (d) Where the court finds the statements required by subdivision (c) 6 of this section to be true, the court shall issue a judgment of parent- 7 age, without additional proceedings or documentation: 8 (1) declaring, that upon the birth of the child born during the term 9 of the surrogacy agreement, the intended parent or parents are the only 10 legal parent or parents of the child; 11 (2) declaring, that upon the birth of the child born during the term 12 of the surrogacy agreement, the person acting as surrogate, and the 13 spouse of the person acting as surrogate, if [~~any~~] applicable, is not 14 [~~the~~] a legal parent of the child; 15 (3) declaring that upon the birth of the child born during the term of 16 the surrogacy agreement, [~~the donors~~] any donor, if [~~any~~] applicable, 17 [~~are~~] is not [~~the parents~~] a parent of the child; 18 (4) ordering the person acting as surrogate and the spouse of the 19 person acting as surrogate, if any, to transfer the child to the 20 intended parent or parents if this has not already occurred; 21 (5) ordering the intended parent or parents to assume responsibility 22 for the maintenance and support of the child immediately upon the birth 23 of the child; and 24 (6) ordering that: 25 (i) Pursuant to section two hundred fifty-four of the judiciary law, 26 the clerk of the court shall transmit to the state commissioner of 27 health, or for a person born in New York city, to the commissioner of 28 health of the city of New York, on a form prescribed by the commission- 29 er, a written notification of such entry together with such other facts 30 as may assist in identifying the birth record of the person whose 31 parentage was in issue and, if the person whose parentage has been 32 determined is under eighteen years of age, the clerk shall also transmit 33 to the registry operated by the department of social services pursuant 34 to section three hundred seventy-two-c of the social services law a 35 notification of the determination; and 36 (ii) Pursuant to section forty-one hundred thirty-eight of the public 37 health law and NYC Public Health Code section 207.05 that upon receipt 38 of a judgement of parentage the local registrar where a child is born 39 will report the parentage of the child to the appropriate department of 40 health in conformity with the court order. [~~If an~~] After the original 41 birth certificate has [~~already~~] been issued, the appropriate department 42 of health will amend the birth certificate in an expedited manner and 43 seal the [~~previously issued~~] original birth certificate [~~except that it~~ 44 ~~may be rendered~~] which shall be accessible to the [~~child~~] donor-con- 45 ceived or surrogate-born person at eighteen years of age or [~~the~~] to a 46 legal parent or [~~parents~~] guardian if the donor-conceived or surrogate- 47 born person is under the age of eighteen; and 48 (7) if the judgment of parentage is issued prior to the birth of the 49 child, ordering the petitioner or petitioners, within seven days of such 50 birth, to provide the court with notification thereof, together with 51 such other facts as may assist in identifying the birth record of the 52 child whose parentage was in issue. Such notification shall be in writ- 53 ing on a form to be prescribed by the chief administrator of the courts. 54 The court shall thereafter issue an amended judgment of parentage that 55 includes the child's name as it appears on the child's birth certificate 56 and the child's date of birth.

S. 7749 9 1 (e) In the event the certification required by paragraph two of subdi- 2 vision (c) of this section cannot be made because of a technical or 3 non-material deviation from the requirements of this article; the court 4 may nevertheless enforce the agreement and issue a judgment of parentage 5 if the court determines the agreement is in substantial compliance with 6 the requirements of this article. In the event that any other require- 7 ments of subdivision (c) of this section are not met, the court shall 8 determine parentage according to part four of this article. 9 (f) For the purposes of this section, "original birth certificate" 10 means the unamended birth certificate that contains the information 11 required under section forty-one hundred thirty-two of the public health 12 law, including the name of the person who acted as surrogate who gave 13 birth to the child, and the name of any identified gamete donor or the 14 donor reference number of any nonidentified gamete donor whose gametes 15 were used in assisted reproduction to conceive the child. 16 § 4. Section 581-205 of the family court act, as added by section 1 of 17 part L of chapter 56 of the laws of 2020, is amended to read as follows: 18 § 581-205. Inspection of records. (a) Court records relating to 19 proceedings under this article shall be sealed, provided, however, that 20 the office of temporary and disability assistance, a child support unit 21 of a social services district or a child support agency of another state 22 providing child support services pursuant to title IV-d of the federal 23 social security act, when a party to a related support proceeding and to 24 the extent necessary to provide child support services or for the admin- 25 istration of the program pursuant to title IV-d of the federal social 26 security act, may obtain a copy of a judgment of parentage. The parties 27 to the proceeding and the child shall have the right to inspect and make 28 copies of the entire court record, including, but not limited to, the 29 name of the person acting as surrogate and, prior to the effective date 30 of section fourteen hundred five of the general business law, the name 31 of any [~~known donors~~] identified gamete donor or the donor reference 32 number of any nonidentified gamete donor, and after the effective date 33 of section fourteen hundred five of the general business law, the name 34 of any identified gamete donor. Pursuant to section forty-one hundred 35 thirty-eight-e of the public health law, a person who is donor-conceived 36 or surrogate-born under section 581-202 or 581-203 of this part has the 37 right to obtain a certified copy of their original birth certificate. 38 Notwithstanding any other provision of law, the county clerk or the 39 clerk of the supreme, surrogate's or family court shall not display the 40 surname of the child or parties in any document, index, minutes or other 41 record available to the public. 42 (b) For the purposes of this section, "original birth certificate" 43 means the unamended birth certificate that contains the information 44 required under section forty-one hundred thirty-two of the public health 45 law, including the name of the person who acted as surrogate who gave 46 birth to the child, and the name of any identified gamete donor or the 47 donor reference number of any nonidentified gamete donor whose gametes 48 were used in assisted reproduction to conceive the child. 49 § 5. Subdivision (a) of section 581-206 of the family court act, as 50 added by section 1 of part L of chapter 56 of the laws of 2020, is 51 amended to read as follows: 52 (a) Proceedings pursuant to this article may be instituted in [~~the~~] 53 New York state supreme [or] court, family court or surrogates court. 54 § 6. The family court act is amended by adding a new section 581-207 55 to read as follows:

S. 7749 10 1 § 581-207. Certified copy of judgment of parentage. Upon issuing a 2 judgment of parentage pursuant to section 581-202 or 581-203 of this 3 part, the issuing court shall provide a certified copy of such judgment 4 to the intended parent or parents and if the judgment of parentage is 5 issued pursuant to section 581-203 of this part, to the person acting as 6 surrogate, and the spouse of the person acting as surrogate, if applica- 7 ble. 8 § 7. Subdivision (b) of section 581-303 of the family court act, as 9 added by section 1 of part L of chapter 56 of the laws of 2020, is 10 amended to read as follows: 11 (b) The court shall issue a judgment of parentage pursuant to this 12 article upon application by any [~~participant~~] person authorized to file 13 a petition pursuant to subdivision (c) of section 581-201 of this arti- 14 cle. 15 § 8. Paragraph 3 of subdivision (a) and subdivision (d) of section 16 581-306 of the family court act, as added by section 1 of part L of 17 chapter 56 of the laws of 2020, are amended to read as follows: 18 (3) where the intended parents are married, transfer of legal rights 19 and dispositional control [~~occurs only~~] becomes effective upon: (i) 20 living separate and apart pursuant to a decree or judgment of separation 21 or pursuant to a written agreement of separation subscribed by the 22 parties thereto and acknowledged or proved in the form required to enti- 23 tle a deed to be recorded; or (ii) living separate and apart at least 24 three years; or (iii) divorce; or (iv) death. 25 (d) An embryo disposition agreement [~~or advance directive~~] that is not 26 in compliance with subdivision (a) of this section may still be found to 27 be enforceable by the court after balancing the respective interests of 28 the parties except that the intended parent who divested him or herself 29 of legal rights and dispositional control may not be declared to be a 30 parent for any purpose without his or her consent. The intended parent 31 awarded legal rights and dispositional control of the embryos shall, in 32 this instance, be declared to be the only parent of the child. 33 § 9. Section 581-402 of the family court act, as added by section 1 of 34 part L of chapter 56 of the laws of 2020, is amended to read as follows: 35 § 581-402. Eligibility to enter surrogacy agreement. (a) A person 36 acting as surrogate shall be eligible to enter into an enforceable 37 surrogacy agreement under this article if the person acting as surrogate 38 has met the following requirements at the time the surrogacy agreement 39 is executed: 40 (1) the person acting as surrogate is at least twenty-one years of age 41 and less than thirty-five years of age at the time of conception; 42 (2) the person acting as surrogate has met and has certified that they 43 will continue to meet residency requirements, including: 44 (i) the person acting as surrogate is a United States citizen or a 45 lawful permanent resident [~~and, where at least one intended parent is~~ 46 ~~not~~]; 47 (ii) the person acting as surrogate has been a resident of New York 48 state for at least six months[~~, was a resident of New York state for at~~ 49 ~~least six months~~] at the time the surrogacy agreement was executed; and 50 (iii) the person acting as surrogate will maintain New York state 51 residency for the duration of the surrogate pregnancy and for at least 52 one month following the birth of any children; 53 (3) the person acting as surrogate has not provided the egg used to 54 conceive the resulting child; 55 (4) the person acting as surrogate has [~~completed~~] obtained written 56 medical clearance to undergo a surrogate pregnancy under this part after

S. 7749 11 1 completing a medical evaluation and psychological screening with [a] an 2 independent health care practitioner licensed under title eight of the 3 education law relating to the anticipated surrogate pregnancy. [~~Such~~] 4 The department shall maintain a list of independent health care provid- 5 ers. The medical evaluation shall include a screening of the medical 6 history of the potential surrogate including known health conditions 7 that may pose risks to the potential surrogate or embryo during pregnan- 8 cy and any guidelines, procedures, or protocols developed pursuant to 9 paragraph (d) of subdivision one of section twenty-five hundred ninety- 10 nine-cc of the public health law. A potential surrogate shall not 11 obtain written medical clearance to undergo a surrogate pregnancy if 12 they meet any of the disqualifying criteria under paragraph (d) of 13 subdivision one of section twenty-five hundred ninety-nine-cc of the 14 public health law; 15 (5) the person acting as surrogate must have previously delivered at 16 least one healthy live birth from an uncomplicated pregnancy that was 17 not pursuant to a surrogacy agreement, and all previous pregnancies must 18 have been without serious complications; 19 (6) the person acting as surrogate has not delivered more than a total 20 of four live children; 21 (7) the person acting as surrogate has not had any previous cesarean 22 sections; 23 (8) the person acting as surrogate has given informed medical and 24 legal consent [~~for the surrogacy after the licensed health care practi-~~ 25 ~~tioner inform them of the medical risks of surrogacy including the~~ 26 ~~possibility of multiple births, risk of medications taken for the surro-~~ 27 ~~gacy, risk of pregnancy complications, psychological and psychosocial~~ 28 ~~risks, and impacts on their personal lives;~~] to enter into the surrogacy 29 agreement after completing the informed medical and legal consent proce- 30 dures pursuant to this article; 31 [~~(6)~~] (9) the person acting as surrogate, and the spouse of the person 32 acting as surrogate, if applicable, have been represented from the 33 initiation of and throughout the contractual process and the duration of 34 the [~~contract and its execution~~] surrogacy agreement until all of the 35 acts contemplated by the surrogacy agreement have been fulfilled by 36 seperate, independent legal counsel of their own choosing who is 37 licensed to practice law in the state of New York which shall be paid 38 for by the intended parent or parents, except that a person acting as 39 surrogate who is receiving no compensation may waive the right to have 40 the intended parent or parents pay the fee for such legal counsel. Where 41 the intended parent or parents are paying for the independent legal 42 counsel of the person acting as surrogate, and the spouse of the person 43 acting as surrogate, if applicable, a separate retainer agreement shall 44 be prepared clearly stating that such legal counsel will only represent 45 the person acting as surrogate and the spouse of the person acting as 46 surrogate, if applicable, in all matters pertaining to the surrogacy 47 agreement, that such legal counsel will not offer legal advice to any 48 other parties to the surrogacy agreement, and that the attorney-client 49 relationship lies with the person acting as surrogate and the spouse of 50 the person acting as surrogate, if applicable; 51 [~~(7) the person acting as surrogate has or the surrogacy agreement~~ 52 ~~stipulates that the person acting as surrogate will obtain a comprehen-~~ 53 ~~sive~~] 54 (10) the surrogacy agreement must provide that the person acting as 55 surrogate has or will obtain a comprehensive health insurance policy 56 that takes effect prior to taking any medication or commencing treatment

S. 7749 12 1 to further embryo transfer that covers preconception care, prenatal 2 care, major medical treatments, hospitalization, and behavioral health 3 care, and the comprehensive health insurance policy has a term that 4 extends throughout the duration of the expected pregnancy and for twelve 5 months after the birth of the child, a stillbirth, a miscarriage result- 6 ing in termination of pregnancy, or termination of the pregnancy; the 7 policy shall be paid for, whether directly or through reimbursement or 8 other means, by the intended parent or parents on behalf of the person 9 acting as surrogate pursuant to the surrogacy agreement, except that a 10 person acting as surrogate who is receiving no compensation may waive 11 the right to have the intended parent or parents pay for the health 12 insurance policy. The intended parent or parents shall also pay for or 13 reimburse the person acting as surrogate for all co-payments, deduct- 14 ibles and any other out-of-pocket medical costs associated with precon- 15 ception, pregnancy, childbirth, or postnatal care, that accrue through 16 twelve months after the birth of the child, a stillbirth, a miscarriage, 17 or termination of the pregnancy. A person acting as surrogate who is 18 receiving no compensation may waive the right to have the intended 19 parent or parents make such payments or reimbursements; 20 [~~(8) the surrogacy agreement must provide that the intended parent or~~ 21 ~~parents shall procure and pay for a life insurance policy for the person~~ 22 ~~acting as surrogate that takes effect prior to taking any medication or~~ 23 ~~the commencement of medical procedures to further embryo transfer,~~ 24 ~~provides a minimum benefit of seven hundred fifty thousand dollars or~~ 25 ~~the maximum amount the person acting as surrogate qualifies for if less~~ 26 ~~than seven hundred fifty thousand dollars, and has a term that extends~~ 27 ~~throughout the duration of the expected pregnancy and for twelve months~~ 28 ~~after the birth of the child, a stillbirth, a miscarriage resulting in~~ 29 ~~termination of pregnancy, or termination of the pregnancy, with a bene-~~ 30 ~~ficiary or beneficiaries of their choosing. The policy shall be paid~~ 31 ~~for, whether directly or through reimbursement or other means, by the~~ 32 ~~intended parent or parents on behalf of the person acting as surrogate~~ 33 ~~pursuant to the surrogacy agreement, except that a person acting as~~ 34 ~~surrogate who is receiving no compensation may waive the right to have~~ 35 ~~the intended parent or parents pay for the life insurance policy~~] 36 (11) the person acting as surrogate has registered with the central 37 assisted reproduction registry; and 38 [~~(9)~~] (12) the person acting as surrogate meets all other requirements 39 deemed appropriate by the commissioner of health regarding the health of 40 the prospective surrogate. 41 (b) The intended parent or parents shall be eligible to enter into an 42 enforceable surrogacy agreement under this article if he, she or they 43 have met the following requirements at the time the surrogacy agreement 44 was executed: 45 (1) at least one intended parent must provide their gametes to create 46 the embryo that will be transferred to the person acting as surrogate, 47 unless the intended parent or parents are unable to provide their 48 gametes for medical reasons; 49 (2) the intended parent or parents have met and have certified that 50 they will continue to meet the residency requirements, including: 51 (i) at least one intended parent is a United States citizen or a 52 lawful permanent resident; and [~~was a resident~~] 53 (ii) the intended parent or parents have been residents of New York 54 state for at least six months at the time the surrogacy agreement was 55 executed; and

S. 7749 13 1 (iii) the intended parent or parents will maintain New York state 2 residency for the duration of the surrogate pregnancy and for at least 3 one month following the birth of any children; 4 (3) the intended parent or parents have given informed medical and 5 legal consent to enter into the surrogacy agreement after completing the 6 informed medical and legal consent procedures pursuant to part ten of 7 this article; 8 [~~(2)~~](4) the intended parent or parents [~~has~~] have been represented 9 [~~throughout~~] from the initiation of and throughout the contractual proc- 10 ess and the duration of the [~~contract and its execution~~] surrogacy 11 agreement until all of the acts contemplated by the surrogacy agreement 12 have been fulfilled by separate, independent legal counsel of his, her 13 or their own choosing who is licensed to practice law in the state of 14 New York; [~~and~~ 15 ~~(3) he or she is~~] (5) they are an adult person who is not in a spousal 16 relationship, or [~~adult~~] any adults who are spouses together, or any two 17 adults who are intimate partners together, except an adult in a spousal 18 relationship is eligible to enter into an enforceable surrogacy agree- 19 ment without [~~his or her~~] their spouse if: 20 (i) they are living separate and apart pursuant to a decree or judg- 21 ment of separation or pursuant to a written agreement of separation 22 subscribed by the parties thereto and acknowledged or proved in the form 23 required to entitle a deed to be recorded; or 24 (ii) they have been living separate and apart for at least three years 25 prior to execution of the surrogacy agreement; 26 (6) the intended parent or parents were not parties to another surro- 27 gacy agreement at the time the surrogacy agreement pursuant to part four 28 of this article was executed and they will not enter into another surro- 29 gacy agreement until after all of the acts contemplated by the current 30 surrogacy agreement have been fulfilled; and 31 (7) the intended parent or parents have registered with the central 32 assisted reproduction registry. 33 (c) [~~where~~] Where the spouse of an intended parent is not a required 34 party to the agreement, the spouse is not an intended parent and shall 35 not have rights or obligations to the child. 36 § 10. Section 581-403 of the family court act, as added by section 1 37 of part L of chapter 56 of the laws of 2020, is amended to read as 38 follows: 39 § 581-403. Requirements of surrogacy agreement. A surrogacy agreement 40 shall be deemed to have satisfied the requirements of this article and 41 be enforceable if it meets the following requirements: 42 (a) it shall be in a [~~signed~~] record [~~verified or executed before~~] 43 with each signature either notarized or witnessed by two [~~non-party~~ 44 ~~witnesses~~] non-parties, whose names, phone numbers, email addresses, and 45 mailing addresses shall be recorded, and signed by: 46 (1) each intended parent, and 47 (2) the person acting as surrogate, and the spouse of the person 48 acting as surrogate, if [~~any~~] applicable, unless: 49 (i) [~~the person acting as surrogate and the spouse of the person~~ 50 ~~acting as surrogate~~] they are living separate and apart pursuant to a 51 decree or judgment of separation or pursuant to a written agreement of 52 separation subscribed by the parties thereto and acknowledged or proved 53 in the form required to entitle a deed to be recorded; or 54 (ii) they have been living separate and apart for at least three years 55 prior to execution of the surrogacy agreement;

S. 7749 14 1 (b) it shall be executed prior to the person acting as surrogate 2 taking any medication or the commencement of medical procedures in the 3 furtherance of embryo transfer, [~~provided~~] and after the person acting 4 as surrogate [~~shall have~~] has provided informed medical and legal 5 consent pursuant to part ten of this article to [~~undergo such medical~~ 6 ~~treatment or medical procedures prior to executing the~~] enter into the 7 surrogacy agreement; 8 (c) it shall be executed by a person acting as surrogate [~~meeting~~] who 9 met the eligibility requirements of subdivision (a) of section 581-402 10 of this part and by the spouse of the person acting as surrogate, if 11 applicable, unless the signature of the spouse of the person acting as 12 surrogate is not required as set forth in this section; 13 (d) it shall be executed by an intended parent or parents who met the 14 eligibility requirements of subdivision (b) of section 581-402 of this 15 part; 16 (e) the person acting as surrogate and the spouse of the person acting 17 as surrogate, if applicable, and the intended parent or parents shall 18 have been represented from the initiation of and throughout the contrac- 19 tual process and the surrogacy agreement stipulates that they will 20 continue to be represented throughout the duration of the [~~contract and~~ 21 ~~its execution~~] surrogacy agreement until all of the acts contemplated by 22 the surrogacy agreement have been fulfilled by separate, independent 23 legal counsel of their own choosing, who is licensed to practice law in 24 the state of New York, to be paid for by the intended parent or parents; 25 (f) if the surrogacy agreement provides for the payment of compen- 26 sation to the person acting as surrogate, the funds for base compen- 27 sation and reasonable anticipated additional expenses shall have been 28 placed in escrow with an independent escrow agent, who consents to the 29 jurisdiction of New York courts for all proceedings related to the 30 enforcement of the escrow agreement, prior to the person acting as 31 surrogate commencing [~~with~~] any medical procedure other than medical 32 evaluations necessary to determine the person acting as surrogate's 33 eligibility; 34 (g) the person acting as surrogate has or the surrogacy agreement 35 stipulates that the person acting as surrogate has or will obtain a 36 comprehensive health insurance policy or shall obtain such policy once 37 the surrogacy agreement is executed pursuant to section fourteen hundred 38 nine of the general business law, which shall take effect prior to 39 taking any medication or commencing treatment to further embryo transfer 40 that covers preconception care, prenatal care, major medical treatments, 41 hospitalization, and behavioral health care, and the comprehensive poli- 42 cy has a term that extends throughout the duration of the expected preg- 43 nancy and for twelve months after the birth of the child, a stillbirth, 44 a miscarriage resulting in termination of pregnancy, or termination of 45 the pregnancy; the policy shall be paid for, whether directly or through 46 reimbursement or other means, by the intended parent or parents on 47 behalf of the person acting as surrogate pursuant to the surrogacy 48 agreement, except that a person acting as surrogate who is receiving no 49 compensation may waive the right to have the intended parent or parents 50 pay for the health insurance policy. The intended parent or parents 51 shall also pay for or reimburse the person acting as surrogate for all 52 co-payments, deductibles and any other out-of-pocket medical costs asso- 53 ciated with preconception, pregnancy, childbirth, or postnatal care, 54 that accrue through twelve months after the birth of the child, a still- 55 birth, a miscarriage, or termination of the pregnancy. A person acting 56 as surrogate who is receiving no compensation may waive the right to

S. 7749 15 1 have the intended parent or parents make such payments or reimburse- 2 ments; 3 (h) the surrogacy agreement must include information disclosing how 4 the intended parent or parents will cover the medical expenses of the 5 person acting as surrogate and the child. [~~If comprehensive health care~~ 6 ~~coverage is used to cover the medical expenses, the~~] The disclosure 7 shall include a review and summary of the comprehensive health care 8 policy provisions related to coverage and exclusions for the person 9 acting as surrogate's pregnancy and if an intended parent's or parents' 10 health insurance coverage of in vitro fertilization shall be used to 11 cover medical costs of assisted reproduction services rendered to the 12 person acting as surrogate pursuant to section three thousand two 13 hundred twenty-one or four thousand three hundred three of the insurance 14 law; and 15 [~~(h)~~] (i) it shall include the following information: 16 (1) the date, city and state where the surrogacy agreement was 17 executed; 18 (2) the first and last names of and contact information for the 19 intended parent or parents and of the person acting as surrogate; 20 (3) prior to the effective date of section fourteen hundred five of 21 the general business law, the first and last names of and contact infor- 22 mation for the persons from which the gametes originated, if [~~known~~] 23 identified, or the gamete donor reference number if the donation was 24 nonidentified. After the effective date of section fourteen hundred five 25 of the general business law the first and last name and contact informa- 26 tion for any gamete donor must be included. The agreement shall specify 27 whether the gametes provided were eggs, sperm, or embryos; 28 (4) the name of and contact information for the licensed and regis- 29 tered surrogacy program handling the surrogacy agreement, the independ- 30 ent escrow agent, and the fertility clinic; and 31 (5) the name of and contact information for the attorney representing 32 the person acting as surrogate, and the spouse of the person acting as 33 surrogate, if applicable, and the attorney representing the intended 34 parent or parents; and 35 [~~(i)~~] (j) the surrogacy agreement must comply with all of the follow- 36 ing terms: 37 (1) As to the person acting as surrogate and the spouse of the person 38 acting as surrogate, if applicable: 39 (i) the person acting as surrogate agrees to undergo embryo transfer 40 and attempt to carry and give birth to the child; 41 (ii) the person acting as surrogate and the spouse of the person 42 acting as surrogate, if applicable, agree to surrender custody of all 43 resulting children to the intended parent or parents immediately upon 44 birth; 45 (iii) the surrogacy agreement shall include the name of and contact 46 information for the attorney representing the person acting as surrogate 47 and, if applicable, the spouse of the person acting as surrogate; 48 (iv) the surrogacy agreement must include an acknowledgement by the 49 person acting as surrogate and the spouse of the person acting as surro- 50 gate, if applicable, that they have received a copy of the Surrogate's 51 Bill of Rights and the bill of rights of donor-conceived and surrogate- 52 born individuals from their legal counsel including an explanation of 53 each right and how to implement their rights pursuant to part ten of 54 this article; 55 (v) the surrogacy agreement must permit the person acting as surrogate 56 to make all health [~~and~~], welfare, and behavioral decisions regarding

S. 7749 16 1 themselves and their pregnancy [~~including~~]. Health and welfare decisions 2 include but are not limited to, whether to get vaccinated against the 3 Coronavirus and other illnesses, to consent to a cesarean section or 4 multiple embryo transfer, and notwithstanding any other provisions in 5 this chapter, provisions in the agreement to the contrary are void and 6 unenforceable. This article does not diminish the right of the person 7 acting as surrogate to terminate or continue a pregnancy. The surrogacy 8 agreement may not include clauses or terms that impose restrictions on 9 the behavior of the person acting as surrogate. Any such clause or term 10 is void and unenforceable; 11 (vi) the surrogacy agreement shall require the person acting as surro- 12 gate to receive surrogate screening, assisted reproduction, maternity 13 health care and delivery, and behavioral health care services from 14 health care providers licensed under title eight of the education law; 15 (vii) the surrogacy agreement shall permit the person acting as a 16 surrogate to utilize the services of a health care practitioner licensed 17 under title eight of the education law of the person's choosing; 18 [~~(vii)~~] (viii) the surrogacy agreement shall not limit the right of 19 the person acting as surrogate to terminate or continue the pregnancy or 20 reduce or retain the number of fetuses or embryos the person is carry- 21 ing; 22 [~~(viii)~~] (ix) the surrogacy agreement shall provide for [~~the right of~~] 23 the person acting as surrogate [~~, upon request,~~] to obtain a comprehen- 24 sive health insurance policy that covers behavioral health care and will 25 cover the cost of psychological counseling to address issues resulting 26 from the person's participation in the surrogacy agreement, including, 27 but not limited to, counseling following delivery[~~. The cost of that~~ 28 ~~counseling~~], and such policy shall be paid for by the intended parent or 29 parents; 30 [~~(ix)~~] (x) the surrogacy agreement must include a notice that any 31 compensation received pursuant to the agreement is taxable and may 32 affect the eligibility of the person acting as [~~surrogate's ability~~] 33 surrogate and the person acting as surrogate's spouse, if applicable, 34 for public benefits or the amount of such benefits; [~~and~~ 35 ~~(x)~~] (xi) the surrogacy agreement must provide that the intended 36 parent or parents shall procure and pay for a life insurance policy for 37 the person acting as surrogate that takes effect prior to taking any 38 medication or the commencement of medical and surgical procedures to 39 further embryo transfer, provides a minimum benefit of seven hundred 40 fifty thousand dollars or the maximum amount the person acting as surro- 41 gate qualifies for if less than seven hundred fifty thousand dollars, 42 and has a term that extends throughout the duration of the expected 43 pregnancy and for twelve months after the birth of the child, a still- 44 birth, a miscarriage resulting in termination of pregnancy, or termi- 45 nation of the pregnancy, with a beneficiary or beneficiaries of their 46 choosing. The policy shall be paid for, whether directly or through 47 reimbursement or other means, by the intended parent or parents on 48 behalf of the person acting as surrogate pursuant to the surrogacy 49 agreement, except that a person acting as surrogate who is receiving no 50 compensation may waive the right to have the intended parent or parents 51 pay for the life insurance policy; 52 (xii) the surrogacy agreement shall provide that[~~, upon the person~~ 53 ~~acting as surrogate's request,~~] the intended parent or parents [~~have or~~ 54 ~~will procure and~~] shall procure and pay for a disability insurance poli- 55 cy for the person acting as surrogate[~~; the person acting as surrogate~~ 56 ~~may designate the beneficiary of the person's choosing~~] before the

S. 7749 17 1 person acting as surrogate starts taking medication or commences medical 2 and surgical procedures to further embryo transfer; and 3 (xiii) the surrogacy agreement may not include a nondisclosure clause 4 that prohibits the person acting as surrogate from talking about the 5 surrogacy agreement, the surrogate pregnancy, or their experience acting 6 as a surrogate. Any such clause shall be void and unenforceable. 7 (2) As to the intended parent or parents: 8 (i) the intended parent or parents agree to accept custody of all 9 resulting children immediately upon birth regardless of number, gender, 10 or mental or physical condition and regardless of whether the intended 11 embryos were transferred due to a laboratory error without diminishing 12 the rights, if any, of anyone claiming to have a superior parental 13 interest in the child; and 14 (ii) the intended parent or parents agree to assume responsibility for 15 the support of all resulting children immediately upon birth; and 16 (iii) the surrogacy agreement shall include the name of and contact 17 information for the attorney representing the intended parent or 18 parents; and 19 (iv) the surrogacy agreement shall provide that the rights and obli- 20 gations of the intended parent or parents under the surrogacy agreement 21 are not assignable; and 22 (v) the intended parent or parents agree to execute a will, prior to 23 the embryo transfer, designating a guardian for all resulting children 24 and authorizing their executor to perform the intended parent's or 25 parents' obligations pursuant to the surrogacy agreement. 26 § 11. Section 581-408 of the family court act, as added by section 1 27 of part L of chapter 56 of the laws of 2020, is amended to read as 28 follows: 29 § 581-408. Absence of surrogacy agreement. Where there is no surrogacy 30 agreement, the parentage of the child will be determined based on other 31 laws of this state, taking into account the best interests of the child. 32 § 12. Section 581-409 of the family court act, as added by section 1 33 of part L of chapter 56 of the laws of 2020, is amended to read as 34 follows: 35 § 581-409. Dispute as to surrogacy agreement. (a) Any dispute which is 36 related to a surrogacy agreement other than disputes as to parentage, 37 shall be resolved by the supreme court, which shall determine the 38 respective rights and obligations of the parties[~~, in~~]. In any proceed- 39 ing initiated pursuant to this section, the court may, at its 40 discretion, authorize the use of conferencing or mediation at any point 41 in the proceedings. 42 (b) Any disputes as to parentage shall be resolved taking into account 43 the best interests of the child. 44 (c) Except as expressly provided in the surrogacy agreement, the 45 intended parent or parents and the person acting as surrogate shall be 46 entitled to all remedies available at law or equity in any dispute 47 related to the surrogacy agreement. 48 [~~(c)~~] (d) There shall be no specific performance remedy available for 49 a breach. 50 (e) In any proceeding initiated pursuant to this section, where the 51 supreme court determines that the dispute involves both contractual and 52 parentage issues, the court may order that the portion of the proceeding 53 raising parentage issues may be transferred to the family or surrogate's 54 court.

S. 7749 18 1 § 13. Subdivision (c) of section 581-502 of the family court act, as 2 added by section 1 of part L of chapter 56 of the laws of 2020, is 3 amended to read as follows: 4 (c) Compensation may not be conditioned upon the number of oocytes 5 retrieved, purported quality or genome-related traits of the gametes or 6 embryos. 7 § 14. Section 581-601 of the family court act, as added by section 1 8 of part L of chapter 56 of the laws of 2020, is amended to read as 9 follows: 10 § 581-601. Applicability. The rights enumerated in this part shall 11 apply to any person acting as surrogate [~~in this state~~] under part four 12 of this article, notwithstanding any surrogacy agreement, judgment of 13 parentage, memorandum of understanding, verbal agreement or contract to 14 the contrary. Except as otherwise provided by law, any written or verbal 15 agreement purporting to waive or limit any of the rights in this part is 16 void as against public policy. The rights enumerated in this part are 17 not exclusive, and are in addition to any other rights provided by law, 18 regulation, or a surrogacy agreement that meets the requirements of this 19 article. 20 § 15. Section 581-602 of the family court act, as added by section 1 21 of part L of chapter 56 of the laws of 2020, is amended to read as 22 follows: 23 § 581-602. Health [~~and~~], welfare, and behavioral decisions. A person 24 acting as surrogate has the same right to make all health [~~and~~], 25 welfare, and behavioral decisions regarding [~~them-self~~] themself and 26 their pregnancy, including but not limited to whether to get vaccinated 27 against the Coronavirus and other illnesses, to consent to a cesarean 28 section or multiple embryo transfer, to utilize the services of a health 29 care practitioner licensed under title eight of the education law of 30 their choosing, whether to terminate or continue the pregnancy, and 31 whether to reduce or retain the number of fetuses or embryos they are 32 carrying. A person acting as surrogate has the same right to make all 33 behavioral decisions regarding themself and their pregnancy as other 34 pregnant people in New York state. Any provisions that restrict the 35 behavior of a person acting as surrogate in a surrogacy agreement under 36 part four of this article are void and unenforceable. 37 § 16. Section 581-603 of the family court act, as added by section 1 38 of part L of chapter 56 of the laws of 2020, is amended to read as 39 follows: 40 § 581-603. Independent legal counsel. A person acting as surrogate, 41 has the right to be represented from the initiation of and throughout 42 the contractual process and the duration of the surrogacy agreement [~~and~~ 43 ~~its execution~~], until all of the acts contemplated by the surrogacy 44 agreement have been fulfilled by separate, independent legal counsel of 45 their own choosing who is licensed to practice law in the state of New 46 York, to be paid for by the intended parent or parents. 47 § 17. Section 581-604 of the family court act, as added by section 1 48 of part L of chapter 56 of the laws of 2020, is amended to read as 49 follows: 50 § 581-604. Health insurance and medical costs. A person acting as 51 surrogate has the right to have a comprehensive health insurance policy 52 that covers preconception care, prenatal care, major medical treatments, 53 hospitalization and behavioral health care for a term [~~that extends~~] 54 beginning before the person acting as surrogate takes any medication or 55 commences medical procedures to further embryo transfer and extending 56 throughout the duration of the expected pregnancy and for twelve months

S. 7749 19 1 after the birth of the child, a stillbirth, a miscarriage resulting in 2 termination of pregnancy, or termination of the pregnancy, to be paid 3 for by the intended parent or parents. The intended parent or parents 4 shall also pay for or reimburse the person acting as surrogate for all 5 co-payments, deductibles and any other out-of-pocket medical costs asso- 6 ciated with pregnancy, childbirth, or postnatal care that accrue through 7 twelve months after the birth of the child, a stillbirth, a miscarriage, 8 or the termination of the pregnancy. A person acting as a surrogate who 9 is receiving no compensation may waive the right to have the intended 10 parent or parents make such payments or reimbursements. 11 § 18. Section 581-605 of the family court act, as added by section 1 12 of part L of chapter 56 of the laws of 2020, is amended to read as 13 follows: 14 § 581-605. Counseling. A person acting as surrogate has the right to 15 [~~obtain~~] have a comprehensive health insurance policy that covers behav- 16 ioral health care and will cover the cost of psychological counseling to 17 address issues resulting from their participation in a surrogacy agree- 18 ment and such policy shall be paid for by the intended parent or 19 parents. 20 § 19. Section 581-607 of the family court act is renumbered section 21 581-608 and a new section 581-607 is added to read as follows: 22 § 581-607. Disability insurance policy. A person acting as surrogate 23 has the right to be provided a disability insurance policy prior to 24 taking any medication or commencement of medical and surgical procedures 25 to further embryo transfer, which shall be paid for by the intended 26 parent or parents. 27 § 20. Article 5-C of the family court act is amended by adding four 28 new parts 8, 9, 10 and 11 to read as follows: 29 PART 8 30 GAMETE DONATION MATCHED AGREEMENT AND 31 GAMETE DONATION AGENCY AGREEMENT 32 Section 581-801. Applicability. 33 581-802. Gamete donation matched agreement or gamete donation 34 agency agreement authorized. 35 581-803. Eligibility to enter into a gamete donation matched 36 agreement or a gamete donation agency agreement. 37 581-804. Requirements of a gamete donation matched agreement or 38 a gamete donation agency agreement. 39 581-805. Gamete donation matched agreement or gamete donation 40 agency agreement; effect of subsequent spousal 41 relationship. 42 581-806. Termination of a gamete donation matched agreement or a 43 gamete donation agency agreement. 44 581-807. Parentage under a compliant gamete donation matched 45 agreement or a compliant gamete donation agency 46 agreement. 47 581-808. Dispute as to a gamete donation matched agreement or a 48 gamete donation agency agreement. 49 § 581-801. Applicability. The provisions enumerated in this part shall 50 apply to: 51 (a) a gamete donation matched agreement between a gamete donor and an 52 intended parent or parents. The gamete donor and/or the intended parent 53 or parents is located in or is a resident of New York state; and 54 (b) a gamete donation agency agreement between: 55 (1) a gamete donor located in, or who is a resident of New York state; 56 or

S. 7749 20 1 (2) an intended parent or parents located in, or who are residents of 2 New York state that receive fresh or frozen gametes; and 3 (3) an agent, gamete agency, gamete broker, surrogacy program, fertil- 4 ity clinic, or health care provider, hereinafter referred to in this 5 part as an "entity". 6 § 581-802. Gamete donation matched agreement or gamete donation agency 7 agreement authorized. If eligible under this article to enter into a 8 gamete donation matched agreement or a gamete donation agency agreement: 9 (a) a gamete donor and an intended parent or parents may enter into a 10 gamete donation matched agreement which will be enforceable provided the 11 gamete donation matched agreement meets the requirements of this arti- 12 cle; 13 (b) a gamete donor or an intended parent or parents may enter into a 14 gamete donation agency agreement with an entity which will be enforcea- 15 ble provided the gamete donation agency agreement meets the requirements 16 of this article. 17 § 581-803. Eligibility to enter into a gamete donation matched agree- 18 ment or a gamete donation agency agreement. (a) An egg donor shall be 19 eligible to enter into an enforceable gamete donation matched agreement 20 or a gamete donation agency agreement under this article if the egg 21 donor has met all of the following requirements at the time the agree- 22 ment is executed: 23 (1) the egg donor must be at least twenty-one years of age and no more 24 than thirty years of age, unless the entity requires a maximum age that 25 is less than thirty; 26 (2) the egg donor may only enter into a gamete donation matched agree- 27 ment or a gamete donation agency agreement where the entity that 28 collects the donor's gametes and provides matching services, if applica- 29 ble, is licensed and registered by New York state; 30 (3) fewer than ten donor-conceived individuals that were conceived 31 using the donor gametes of the egg donor have been born in New York 32 state, provided that this number shall not include the egg donor's own 33 biological children; 34 (4) the egg donor has given informed medical and legal consent to 35 enter into the gamete donation matched agreement or the gamete donation 36 agency agreement after completing the informed medical and legal consent 37 procedures pursuant to part ten of this article; 38 (5) the egg donor has obtained written medical clearance to undergo 39 ovarian stimulation and oocyte retrieval after completing a medical 40 evaluation and psychological screening with independent health care 41 practitioners licensed under title eight of the education law relating 42 to the anticipated gamete donation. The department shall maintain a list 43 of independent health care providers; 44 (6) the egg donor shall not obtain written medical clearance to under- 45 go ovarian stimulation and oocyte retrieval if they have any medical 46 conditions indicated by the American college of obstetricians and gyne- 47 cologists (ACOG) that place individuals at risk of ovarian hyperstimula- 48 tion, if they have any relevant communicable disease agents and diseases 49 specified by the U.S. food and drug administration, or if they are not 50 eligible to donate gametes pursuant to regulations of the department of 51 health as set forth in 10 NYCRR 52-8.5 and 52-3.4; 52 (7) the egg donor is not eligible to enter into a gamete donation 53 matched agreement or a gamete donation agency agreement if the egg donor 54 has previously undergone ovarian stimulation six times or more, includ- 55 ing for purposes of egg freezing, or if the egg donor has experienced

S. 7749 21 1 ovarian hyperstimulation syndrome (OHSS), polycystic ovarian syndrome 2 (PCOS), or endometriosis; 3 (8) if an egg donor is entering into a gamete donation matched agree- 4 ment or a gamete donation agency agreement prior to the effective date 5 of section fourteen hundred five of the general business law, the egg 6 donor was counseled on their options regarding identity disclosure under 7 section fourteen hundred seven of the general business law and has 8 certified in a signed record whether they agree to donate gametes as an 9 identified or nonidentified gamete donor after completing the informed 10 medical and legal consent procedures pursuant to part ten of this arti- 11 cle. If an egg donor is entering into a gamete donation matched agree- 12 ment or a gamete donation agency agreement after the effective date of 13 section fourteen hundred five of the general business law, the egg donor 14 was counseled on their options regarding identity disclosure under 15 section fourteen hundred seven of the general business law and has 16 certified in a signed record that they agree to donate gametes as an 17 identified gamete donor after completing the informed medical and legal 18 consent procedures pursuant to part ten of this article; and 19 (9) the egg donor has registered with the central assisted reprod- 20 uction registry. 21 (b) A sperm donor shall be eligible to enter into an enforceable 22 gamete donation matched agreement or a gamete donation agency agreement 23 under this article if the sperm donor has met all of the following 24 requirements at the time the agreement is executed: 25 (1) a sperm donor must be at least twenty-one years of age, and no 26 more than forty years of age, unless the entity requires a maximum age 27 that is less than forty years of age; 28 (2) a sperm donor may only enter into a gamete donation matched agree- 29 ment or a gamete donation agency agreement where the entity that 30 collects the donor's gametes and provides matching services, if applica- 31 ble, is licensed and registered by New York state; 32 (3) fewer than ten donor-conceived individuals that were conceived 33 using the donor gametes of the sperm donor have been born in New York 34 state, provided that this number shall not include a sperm donor's own 35 biological children; 36 (4) a sperm donor provided informed medical and legal consent to enter 37 into the gamete donation matched agreement or the gamete donation agency 38 agreement after completing the informed medical and legal consent proce- 39 dures pursuant to part ten of this article; 40 (5) a sperm donor has obtained written medical clearance to produce 41 their gametes for use in assisted reproduction after completing a 42 medical evaluation and a psychological screening with independent health 43 care practitioners licensed under title eight of the education law 44 relating to the anticipated gamete donation. The department shall main- 45 tain a list of independent health care providers; 46 (6) a sperm donor shall not obtain written medical clearance if the 47 sperm donor has any relevant communicable disease agents and diseases 48 specified by the U.S. food and drug administration, or if they are not 49 eligible pursuant to regulations of the department of health as set 50 forth in 10 NYCRR 52-8.5 and 52-3.4; 51 (7) if a sperm donor is entering into a gamete donation matched agree- 52 ment or a gamete donation agency agreement prior to the effective date 53 of section fourteen hundred five of the general business law, the sperm 54 donor was counseled on their options regarding identity disclosure under 55 section fourteen hundred seven of the general business law and has 56 certified in a signed record whether they agree to donate gametes as an

S. 7749 22 1 identified or nonidentified gamete donor after completing the informed 2 medical and legal consent procedures pursuant to part ten of this arti- 3 cle. If a sperm donor is entering into a gamete donation matched agree- 4 ment or a gamete donation agency agreement after the effective date of 5 section fourteen hundred five of the general business law, the sperm 6 donor was counseled on their options regarding identity disclosure under 7 section fourteen hundred seven of the general business law and has 8 certified in a signed record that they agree to donate gametes as an 9 identified gamete donor after completing the informed medical and legal 10 consent procedures pursuant to part ten of this article; and 11 (8) the sperm donor registered with the central assisted reproduction 12 registry. 13 (c) An intended parent or parents shall be eligible to enter into an 14 enforceable gamete donation matched agreement or gamete donation agency 15 agreement if the intended parent or parents have met all of the follow- 16 ing requirements at the time the agreement is executed: 17 (1) the intended parent or parents have given informed medical and 18 legal consent to enter into the gamete donation matched agreement or the 19 gamete donation agency agreement after completing the informed medical 20 and legal consent procedures pursuant to part ten of this article; 21 (2) an intended parent or parents may only enter into a gamete 22 donation matched agreement or a gamete donation agency agreement where 23 the entity that collects the donor's gametes and provides matching 24 services, if applicable, is licensed and registered by New York state; 25 (3) if an intended parent or parents are entering into a gamete 26 donation matched agreement or a gamete donation agency agreement prior 27 to the effective date of section fourteen hundred five of the general 28 business law, the intended parent or parents were counseled on the 29 options regarding identity disclosure of gamete donors and information 30 that a donor-conceived person, or the parent or legal guardian, has the 31 right to obtain upon request under section fourteen hundred seven of the 32 general business law. If an intended parent or parents are entering into 33 a gamete donation matched agreement or a gamete donation agency agree- 34 ment after the the effective date of section fourteen hundred five of 35 the general business law, the intended parent or parents were counseled 36 that nonidentified donation is not permitted and on the information that 37 donor-conceived individuals, or the parent or legal guardian, has the 38 right to obtain upon request under section fourteen hundred seven of the 39 general business law. 40 § 581-804. Requirements of a gamete donation matched agreement or a 41 gamete donation agency agreement. A gamete donation matched agreement or 42 a gamete donation agency agreement shall be deemed to have satisfied the 43 requirements of this article and be enforceable if it meets all of the 44 following requirements: 45 (a) It shall be in a record signed by the gamete donor and each 46 intended parent, if applicable: 47 (1) before a notary public; or 48 (2) before two witnesses who are not parties to the agreement; 49 provided that if the record is signed before two witnesses who are not 50 the intended parents, the name, phone number, email address, and mailing 51 address of each witness must be recorded. 52 (b) It shall be executed by a gamete donor who met the eligibility 53 requirements of subdivision (a) or (b) of section 581-803 of this part; 54 (c) It shall be executed by an intended parent or parents, if applica- 55 ble, who met the eligibility requirements of subdivision (c) of section 56 581-803 of this part.

S. 7749 23 1 (d) The gamete donor was provided the option to consult with an inde- 2 pendent legal counsel of their own choosing who is licensed to practice 3 in the state of New York, to be paid for by the entity. If the gamete 4 donor opted to consult with legal counsel, they have had the consulta- 5 tion prior to executing the gamete donation matched agreement or the 6 gamete donation agency agreement. 7 (e) If an egg donor is entering into a gamete donation matched agree- 8 ment or a gamete donation agency agreement, the agreement shall be 9 executed prior to the egg donor taking any medication or commencement of 10 medical procedures in the furtherance of ovarian stimulation and oocyte 11 retrieval. 12 (f) It shall include the following information: 13 (1) the date, city, and state where the gamete donation matched agree- 14 ment or the gamete donation agency agreement was executed; 15 (2) the first and last name of and contact information for the gamete 16 donor, and whether the gametes provided are eggs, sperm, or embryos; 17 (3) the first and last name of and contact information for the 18 intended parent or parents if applicable; 19 (4) the name of and contact information for the entity that provided 20 matching services, if applicable, and collected the donor gametes; and 21 (5) the amount of compensation that the gamete donor shall receive for 22 their time and effort to produce eggs or sperm. 23 (g) The gamete donation matched agreement or the gamete donation agen- 24 cy agreement must comply with all of the following terms: 25 (1) As to the egg donor, if applicable: 26 (i) the gamete donation matched agreement or the gamete donation agen- 27 cy agreement must include signed certification by the egg donor that 28 they have completed the informed medical and legal consent procedures 29 pursuant to part ten of this article and have provided informed medical 30 and legal consent to enter into the gamete donation matched agreement or 31 gamete donation agency agreement; 32 (ii) the gamete donation matched agreement or the gamete donation 33 agency agreement must include signed certification indicating whether 34 the egg donor authorizes use of the eggs they are donating, or embryos 35 created from the donated eggs, for research at any time; 36 (iii) the gamete donation matched agreement or gamete donation agency 37 agreement must include signed certification indicating whether the egg 38 donor authorizes distribution of the eggs they are donating, or embryos 39 created from the donated eggs, to multiple intended parents in different 40 households; 41 (iv) the egg donor agrees to undergo ovarian stimulation and oocyte 42 retrieval and attempt to produce eggs for use in assisted reproduction, 43 subject to their right to cancel an egg retrieval cycle or terminate the 44 gamete donation matched agreement or gamete donation agency agreement at 45 any time; 46 (v) the egg donor has certified that they have no parental or proprie- 47 tary interest in the eggs provided under the gamete donation matched 48 agreement or gamete donation agency agreement; 49 (vi) the gamete donation matched agreement or gamete donation agency 50 agreement must provide for the right of the egg donor to exercise sole 51 discretion over decisions regarding their behavior, other than behaviors 52 that would harm their health, and to make all decisions regarding their 53 health and welfare, including the amount of time that transpires between 54 egg retrieval cycles and gamete donation matched agreements or gamete 55 donation agency agreements and whether to cancel an egg retrieval cycle

S. 7749 24 1 or terminate a gamete donation matched agreement or gamete donation 2 agency agreement at any time; 3 (vii) the gamete donation matched agreement or gamete donation agency 4 agreement must provide that the entity or the intended parent or 5 parents, if applicable, shall pay for a health insurance policy that 6 covers major medical treatment, hospitalization, and behavioral health 7 care for the egg donor, and the health insurance policy has a term that 8 begins before the egg donor starts taking any medication or commencement 9 of medical and surgical procedures in furtherance of ovarian stimulation 10 and oocyte retrieval and extends for twelve months after oocyte 11 retrieval is completed. If the egg donor does not have such a health 12 insurance policy, one may be purchased pursuant to section three hundred 13 sixty-five-p of the social services law once the gamete donation matched 14 agreement or the gamete donation agency agreement has been executed. The 15 entity or the intended parent or parents shall also pay for or reimburse 16 the egg donor for all co-payments, deductibles and any other out-of- 17 pocket medical costs associated with ovarian stimulation, oocyte 18 retrieval, and medical or psychological complications that accrue 19 through twelve months after oocyte retrieval is completed; 20 (viii) the gamete donation matched agreement or gamete donation agency 21 agreement shall provide for the egg donor to obtain a health insurance 22 policy that covers major medical treatment, hospitalization, and behav- 23 ioral health care and will cover the cost of psychological counseling to 24 address issues resulting from the donor's participation in the gamete 25 donation matched agreement or gamete donation agency agreement, includ- 26 ing, but not limited to, counseling following the gamete donation. The 27 policy shall be paid for by the entity or the intended parent or 28 parents, if applicable; 29 (ix) the gamete donation matched agreement or gamete donation agency 30 agreement may not include more than one cycle of oocyte retrieval, and 31 may not require the egg donor to sign another gamete donation matched 32 agreement or gamete donation agency agreement until a minimum of three 33 months has passed following fulfillment of the current agreement; 34 (x) the egg donor has been shown the entity's compensation list for 35 gamete donation that is made available to the general public; 36 (xi) if an egg donor is entering into a gamete donation matched agree- 37 ment or a gamete donation agency agreement prior to the effective date 38 of section fourteen hundred five of the general business law, the agree- 39 ment must include the egg donor's signed certification that they agree 40 to provide donor gametes on an identified or nonidentified basis. If an 41 egg donor is entering into a gamete donation matched agreement or gamete 42 donation agency agreement after the effective date of section fourteen 43 hundred five of the general business law, the agreement must include the 44 egg donor's signed certification that they agree to identified donation; 45 and 46 (xii) donor screening, ovarian stimulation, oocyte retrieval, and 47 other medical services that are received pursuant to the gamete donor 48 matched agreement or the gamete donor agency agreement must be provided 49 by health care providers licensed under title eight of the education 50 law. 51 (2) As to the sperm donor, if applicable: 52 (i) the gamete donation matched agreement or gamete donation agency 53 agreement must include signed certification by the sperm donor that they 54 have completed the informed medical and legal consent procedures pursu- 55 ant to part ten of this article and have provided informed medical and

S. 7749 25 1 legal consent to enter into the gamete donation matched agreement or 2 gamete donation agency agreement; 3 (ii) the sperm donor agrees to attempt to produce sperm for use in 4 assisted reproduction, subject to their right to stop donating sperm and 5 to terminate the gamete donation matched agreement or gamete donation 6 agency agreement at any time; 7 (iii) the sperm donor has certified that they have no parental or 8 proprietary interest in the sperm provided under the gamete donation 9 matched agreement or gamete donation agency agreement; 10 (iv) the gamete donation matched agreement or gamete donation agency 11 agreement must permit the sperm donor to make all health and welfare 12 decisions regarding themself, including whether to stop donating sperm 13 and to terminate a gamete donation matched agreement or a gamete 14 donation agency agreement at any time; 15 (v) the sperm donor has been shown the entity's compensation list for 16 gamete donation that is made available to the general public; 17 (vi) the gamete donation matched agreement or the gamete donation 18 agency agreement must include signed certification indicating whether 19 the sperm donor authorizes use of the sperm they are donating, or embr- 20 yos created from the donated sperm, for research at any time; 21 (vii) if a sperm donor is entering into a gamete donation matched 22 agreement or a gamete donation agency agreement prior to the effective 23 date of section fourteen hundred five of the general business law, the 24 agreement must include the sperm donor's signed certification that they 25 agree to provide donor gametes on an identified or nonidentified basis. 26 If a sperm donor is entering into a gamete donation matched agreement or 27 gamete donation agency agreement after the effective date of section 28 fourteen hundred five of the general business law, the agreement must 29 include the sperm donor's signed certification that they agree to iden- 30 tified donation; and 31 (viii) donor screening and other medical services that are required 32 under the gamete donor matched agreement or the gamete donor agency 33 agreement must be provided by health care providers licensed under title 34 eight of the education law. 35 (3) As to the intended parent or parents, if applicable: 36 (i) the gamete donation matched agreement or the gamete donation agen- 37 cy agreement must include certification by each intended parent that 38 they have completed the informed medical and legal consent procedures 39 pursuant to part ten of this article and have provided informed medical 40 and legal consent to enter into the gamete donation matched agreement or 41 the gamete donation agency agreement; and 42 (ii) the intended parent or parents agree to accept parental rights 43 and responsibility of all resulting donor-conceived children, regardless 44 of number, gender, or mental or physical condition without diminishing 45 the rights, if any, of anyone claiming to have a superior parental 46 interest in the child. 47 § 581-805. Gamete donation matched agreement or gamete donation agency 48 agreement; effect of subsequent spousal relationship. After the 49 execution of a gamete donation matched agreement or a gamete donation 50 agency agreement under this article, the subsequent separation or 51 divorce of the intended parents does not affect the rights, duties and 52 responsibilities of the intended parents as outlined in the gamete 53 donation matched agreement or gamete donation agency agreement. 54 § 581-806. Termination of a gamete donation matched agreement or a 55 gamete donation agency agreement. (a) Right to terminate. A gamete 56 donor has the right to terminate a gamete donation matched agreement or

S. 7749 26 1 a gamete donation agency agreement at any time, and an egg donor has the 2 right to cancel an egg retrieval cycle at any time. 3 (b) Termination of a gamete donation matched agreement. (1) An egg 4 donor or the intended parent or parents may terminate a gamete donation 5 matched agreement without penalty and without being required to reim- 6 burse donor screening costs after the agreement has been executed and 7 before the egg donor has started taking medication or commenced medical 8 procedures to further ovarian stimulation and oocyte retrieval. 9 (2) An egg donor may terminate the gamete donation matched agreement 10 at any time without penalty and without being required to reimburse 11 donor screening, medication, or medical procedure costs due to changing 12 their mind about donating their gametes, provided that if the egg donor 13 terminates the gamete donation matched agreement after they have started 14 taking medication or commenced medical procedures to further ovarian 15 stimulation and oocyte retrieval, the egg donor is required to return 16 any financial compensation received. The egg donor shall retain the 17 health insurance policy obtained under the terms of the agreement. 18 (3) An egg donor may terminate the gamete donation matched agreement 19 at any time without penalty and without being required to reimburse 20 donor screening, medication, or medical procedure costs due to experi- 21 encing medical complications verified by an independent health care 22 provider licensed under title eight of the education law of the egg 23 donor's choosing, provided that if the egg donor terminates the gamete 24 donation matched agreement after they have started taking medication or 25 commenced medical procedures to further ovarian stimulation and oocyte 26 retrieval, the egg donor shall receive prorated compensation for their 27 time and effort and shall retain the health insurance policy obtained 28 under the terms of the agreement. 29 (4) If the physician cancels the egg retrieval cycle or terminates the 30 gamete donation matched agreement after the egg donor has started taking 31 medication or commenced medical procedures to further ovarian stimu- 32 lation and oocyte retrieval, the egg donor shall receive prorated 33 compensation for their time and effort, which shall be paid for by the 34 entity, and the egg donor shall retain the health insurance policy 35 obtained under the terms of the agreement. 36 (5) If the intended parent or parents cancel the egg retrieval cycle 37 or terminate the gamete donation matched agreement after the egg donor 38 has started taking medication or commenced medical procedures to further 39 ovarian stimulation and oocyte retrieval, the egg donor shall receive 40 prorated compensation for their time and effort, which shall be paid for 41 by the intended parent or parents, and shall retain the health insurance 42 policy obtained under the terms of the agreement. 43 (6) A sperm donor may stop donating sperm and may terminate a gamete 44 donation matched agreement at any time without penalty and without being 45 required to reimburse donor screening costs. 46 (c) Termination of a gamete donation agency agreement between a gamete 47 donor and an entity. (1) An egg donor may terminate a gamete donation 48 agency agreement without penalty and without being required to reimburse 49 donor screening costs after the agreement has been executed and before 50 the egg donor has started taking medication or commenced medical proce- 51 dures to further ovarian stimulation and oocyte retrieval. 52 (2) An egg donor may terminate the gamete donation agency agreement at 53 any time without penalty and without being required to reimburse donor 54 screening, medication, or medical procedure costs due to changing their 55 mind about donating their gametes, provided that if the egg donor termi- 56 nates the gamete donation agency agreement after they have started

S. 7749 27 1 taking medication or commenced medical procedures to further ovarian 2 stimulation and oocyte retrieval, the egg donor is required to return 3 any financial compensation received. The egg donor shall retain the 4 health insurance policy obtained under the terms of the agreement. 5 (3) An egg donor may terminate the gamete donation agency agreement at 6 any time without penalty and without being required to reimburse donor 7 screening, medication, or medical procedure costs due to experiencing 8 medical complications verified by an independent health care provider 9 licensed under title eight of the education law of the egg donor's 10 choosing, provided that if the egg donor terminates the gamete donation 11 agency agreement after they have started taking medication or commenced 12 medical procedures to further ovarian stimulation and oocyte retrieval, 13 the egg donor shall receive a prorated compensation for their time and 14 effort, and the egg donor shall retain the health insurance policy 15 obtained under the terms of the agreement. 16 (4) If the physician cancels the egg retrieval cycle or terminates the 17 gamete donation agency agreement after the egg donor has started taking 18 medication or commenced medical procedures to further ovarian stimu- 19 lation and oocyte retrieval, the egg donor shall receive prorated 20 compensation for their time and effort, which shall be paid for by the 21 entity, and the egg donor shall retain the health insurance policy 22 obtained under the terms of the agreement. 23 (5) A sperm donor may stop donating sperm and may terminate a gamete 24 donation agency agreement at any time without penalty and without being 25 required to reimburse donor screening costs. 26 (d) Termination of a gamete donation agency agreement between an 27 intended parent or parents and an entity, where the intended parent or 28 parents are receiving fresh donor gametes. (1) If receiving fresh donor 29 eggs, the intended parent or parents may terminate a gamete donation 30 agency agreement without penalty and without being required to reimburse 31 donor screening costs after the agreement has been executed and before 32 the egg donor has started taking medication or commenced medical proce- 33 dures to further ovarian stimulation and oocyte retrieval. 34 (2) If receiving fresh donor eggs and the physician cancels the egg 35 retrieval cycle or terminates the gamete donation agency agreement, the 36 intended parent or parents may not be required to reimburse donor 37 screening costs or compensate the egg donor for time and effort. 38 (3) If receiving fresh donor eggs and the intended parent or parents 39 terminate the gamete donation agency agreement after the egg donor has 40 started taking medication or commenced medical procedures to further 41 ovarian stimulation and oocyte retrieval, the intended parent or parents 42 may not be required to reimburse donor screening costs. The egg donor 43 shall receive prorated compensation for their time and effort, which 44 shall be paid by the intended parent or parents; and 45 (4) If receiving fresh donor sperm, the intended parent or parents may 46 terminate a gamete donation agency agreement without penalty and without 47 being required to reimburse donor screening costs; and 48 (e) The amount of prorated compensation that an egg donor shall 49 receive for their time and effort under subdivisions (b), (c), and (d) 50 of this section shall be stipulated in regulations that shall be promul- 51 gated by the commissioner. 52 § 581-807. Parentage under a compliant gamete donation matched agree- 53 ment or a compliant gamete donation agency agreement. Upon the birth of 54 a child conceived by assisted reproduction under a gamete donation 55 matched agreement or a gamete donation agency agreement that complies 56 with this part, each intended parent is, by operation of law, a parent

S. 7749 28 1 of the child and the gamete donor or donors are not a parent of the 2 child. 3 § 581-808. Dispute as to a gamete donation matched agreement or a 4 gamete donation agency agreement. (a) Any dispute which is related to a 5 gamete donation matched agreement or a gamete donation agency agreement 6 shall be resolved by the supreme court of the state of New York, which 7 shall determine the respective rights and obligations of the parties. 8 (b) Except as expressly provided in the gamete donation matched agree- 9 ment, the intended parent or parents and the gamete donor shall be enti- 10 tled to all remedies available at law or equity in any dispute related 11 to the gamete donation matched agreement. 12 (c) There shall be no specific performance remedy available for a 13 breach by the gamete donor of any gamete donation matched agreement or 14 of any gamete donation agency agreement term. 15 PART 9 16 GAMETE DONOR'S BILL OF RIGHTS 17 Section 581-901. Applicability. 18 581-902. Medical records. 19 581-903. Health and welfare decisions. 20 581-904. Independent legal counsel. 21 581-905. Health insurance and medical costs. 22 581-906. Counseling. 23 581-907. Termination of a gamete donation matched agreement or a 24 gamete donation agency agreement. 25 § 581-901. Applicability. The rights enumerated in this part shall 26 apply to any gamete donor located in, or who is a resident of New York 27 state, receives compensation for time and effort to produce eggs or 28 sperm collected by a New York state licensed gamete agency, gamete bank, 29 or fertility clinic for use in assisted reproduction by an intended 30 parent or parents who are unknown to the donor of the gametes at the 31 time of donation, notwithstanding any gamete donation agreement, judg- 32 ment of parentage, memorandum of understanding, verbal agreement or 33 contract to the contrary. Except as otherwise provided by law, any writ- 34 ten or verbal agreement purporting to waive or limit any of the rights 35 in this part is void as against public policy. The rights enumerated in 36 this part are not exclusive, and are in addition to any other rights 37 provided by law, regulation, or a gamete donation matched agreement or 38 gamete donation agency agreement that meets the requirements of this 39 article. 40 § 581-902. Medical records. (a) A gamete donor has the right to choose 41 which medical records and health information they shall share with an 42 intended parent or parents or with an agent, gamete agency, surrogacy 43 program, gamete bank, fertility clinic, or health care provider that is 44 providing matching services or collecting their gametes, other than the 45 medical records and information they are required to share pursuant to 46 10 NYCRR Part 52. 47 (b) An egg donor has the right to obtain a copy of their medical and 48 clinical records related to donor screening and to each egg retrieval 49 cycle including: 50 (1) all test records including all laboratory and genetic test 51 results; 52 (2) all X-ray or imaging procedure results including sonogram images 53 and analysis; 54 (3) reports on egg and embryo quality; and

S. 7749 29 1 (4) the names of medications the egg donor has been prescribed and 2 corresponding dosages. 3 (c) A sperm donor has the right to obtain a copy of their medical and 4 clinical records related to donor screening and to each sperm donation 5 including: 6 (1) all test records including all laboratory and genetic test 7 results; and 8 (2) reports on sperm count and quality of all sperm samples. 9 § 581-903. Health and welfare decisions. (a) An egg donor has the 10 right to exercise sole discretion over decisions regarding their behav- 11 ior, other than behaviors that would harm their health, and to make all 12 health and welfare decisions regarding themselves, including but not 13 limited to, the amount of time that transpires between commencing egg 14 retrieval cycles, entering into gamete donation matched agreements or 15 gamete donation agency agreements, and whether to cancel an egg 16 retrieval cycle or terminate a gamete donation matched agreement or a 17 gamete donation agency agreement at any time. 18 (b) A sperm donor has the right to exercise sole discretion over deci- 19 sions regarding their behavior, other than behaviors that would harm 20 their health, and to make all health and welfare decisions regarding 21 themself, including the right to terminate the gamete donation matched 22 agreement or the gamete donation agency agreement at any time. 23 (c) This article does not diminish the responsibility of health care 24 providers to ensure adherence to standards of medical practice. 25 § 581-904. Independent legal counsel. Prior to executing a gamete 26 donation matched agreement or a gamete donation agency agreement, a 27 gamete donor has the right to consult with independent legal counsel of 28 their own choosing who is licensed to practice law in the state of New 29 York, to be paid for by the agent, gamete agency, surrogacy program, 30 gamete bank, fertility clinic, or health care provider. The department 31 shall maintain a list of independent legal counselors. 32 § 581-905. Health insurance and medical costs. An egg donor has the 33 right to have a health insurance policy that covers major medical treat- 34 ments, hospitalizations, and behavioral health care for a term that 35 takes effect prior to the egg donor taking any medication and commencing 36 medical procedures in furtherance of ovarian stimulation and oocyte 37 retrieval and that extends for twelve months after oocyte retrieval is 38 completed. Such policy shall be paid for by the agent, gamete agency, 39 surrogacy program, gamete bank, fertility clinic, health care provider, 40 or the intended parent or parents, if applicable, which shall also pay 41 for or reimburse the egg donor for all co-payments, deductibles and any 42 other out-of-pocket medical costs associated with ovarian stimulation, 43 oocyte retrieval, and medical or psychological complications pursuant to 44 the gamete donation matched agreement or the gamete donation agency 45 agreement. 46 § 581-906. Counseling. An egg donor has the right to have a health 47 insurance policy that covers behavioral health care and will cover the 48 cost of psychological counseling to address issues resulting from 49 participation in the gamete donation matched agreement or the gamete 50 donation agency agreement, including, but not limited to counseling 51 following the gamete donation. Such policy shall be paid for by the 52 agent, gamete agency, surrogacy program, gamete bank, fertility clinic, 53 health care provider, or the intended parent or parents, if applicable. 54 § 581-907. Termination of a gamete donation matched agreement or a 55 gamete donation agency agreement. (a) An egg donor has the right to

S. 7749 30 1 terminate a gamete donation matched agreement or a gamete donation agen- 2 cy agreement at any time. 3 (b) A sperm donor has the right to stop donating gametes and to termi- 4 nate a gamete donation matched agreement or a gamete donation agency 5 agreement at any time. An egg donor has the right to cancel an egg 6 retrieval cycle at any time. 7 PART 10 8 INFORMED CONSENT 9 Section 581-1001. Applicability. 10 581-1002. Uniform protocols for informed medical and legal 11 consent. 12 581-1003. Informed medical and legal consent procedures for a 13 potential egg donor. 14 581-1004. Informed medical and legal consent procedures for a 15 potential sperm donor. 16 581-1005. Informed medical and legal consent procedures for a 17 potential person acting as surrogate. 18 581-1006. Informed medical and legal consent procedures for an 19 intended parent or parents. 20 § 581-1001. Applicability. (a) The informed medical and legal consent 21 procedures and requirements in this section shall be administered to: 22 (1) a potential gamete donor who intends to enter into a gamete 23 donation matched agreement or gamete donation agency agreement under 24 part eight of this article to receive compensation for time and effort 25 to provide gametes for use in assisted reproduction by an intended 26 parent who is unknown to the donor of the gametes at the time of 27 donation; 28 (2) a potential person acting as surrogate who intends to enter into a 29 surrogacy agreement under part four of this article; and 30 (3) an intended parent who intends to enter into a gamete donation 31 matched agreement or a gamete donation agency agreement under part eight 32 of this article or a surrogacy agreement under part four of this arti- 33 cle. 34 (b) The informed medical and legal consent processes shall be adminis- 35 tered and documented prior to the execution of a gamete donation matched 36 agreement, or a surrogacy agreement. 37 § 581-1002. Uniform protocols for informed medical and legal consent. 38 Uniform protocols to administer informed medical and legal consent 39 procedures are established, and shall be updated, to reflect research 40 findings and current evidence-based best practices, to ensure that each 41 potential gamete donor, potential person acting as surrogate, and 42 intended parent is fully informed and able to voluntarily consent to 43 agreement provisions without being coerced or incentivized. 44 (a) The department of health, in consultation with the task force on 45 life and the law, shall develop video tutorials that provide information 46 about how gamete donation and surrogacy work in New York state, which 47 shall address applicable regulations, an overview of the informed 48 medical and legal consent processes, required medical screenings, and an 49 overview of the rights afforded to gamete donors, persons acting as 50 surrogates, intended parents, and donor-conceived and surrogate-born 51 individuals. The department shall make video tutorials available online 52 and in DVD format. Video tutorials shall be updated as necessary to 53 reflect current law, regulations, and medical best practices.

S. 7749 31 1 (b) The department of health, in consultation with the task force on 2 life and the law, shall develop and maintain a checklist of information 3 that must be reviewed with potential egg donors and requirements the 4 potential egg donor must comply with before they provide informed 5 medical and legal consent to enter into a gamete donation matched agree- 6 ment or a gamete donation agency agreement, including: 7 (1) The potential egg donor shall be informed of the following medical 8 information, which shall be provided in writing to the potential egg 9 donor and reviewed verbally with the potential egg donor: 10 (i) the results of the potential egg donor's medical and psychological 11 screenings and whether they have any health conditions that disqualify 12 them from donating gametes or that would put them at greater risk of 13 adverse health outcomes from undergoing ovarian stimulation and oocyte 14 retrieval; 15 (ii) the medications and medical and surgical procedures associated 16 with ovarian stimulation and oocyte retrieval and their potential risks 17 or side effects; and 18 (iii) the known health risks to egg donors and donor-conceived 19 persons, including disclosure that all health risks are not known due to 20 lack of data. 21 (2) The potential egg donor shall attend a counseling session regard- 22 ing issues related to gamete donation, including: 23 (i) potential psychological and emotional impacts on the potential egg 24 donor, the egg donor's current or future children and partner, if appli- 25 cable, and on any donor-conceived persons; and 26 (ii) best practices for talking with children and other family members 27 about gamete donation. 28 (3) The potential egg donor shall be informed of the following legal 29 information which shall be provided in writing to the potential egg 30 donor and reviewed verbally with the potential egg donor: 31 (i) the rights an egg donor is afforded in the gamete donor's bill of 32 rights pursuant to part nine of this article and how to implement each 33 right, and rights that are afforded donor-conceived individuals in the 34 bill of rights of donor-conceived and surrogate-born individuals pursu- 35 ant to part eleven of this article; 36 (ii) that donated eggs, or embryos created from donated eggs, could be 37 used for research at any time unless the egg donor does not authorize 38 such use of their donor gametes. The egg donor must provide signed 39 certification that indicates whether they authorize use of their donor 40 gametes for research at any time; 41 (iii) that donated eggs, or embryos created from donated eggs, could 42 be provided to intended parents from multiple households for use in 43 assisted reproduction, unless the gamete donor does not authorize such 44 distribution. The egg donor must provide signed certification that indi- 45 cates whether they authorize such distribution of their gametes; 46 (iv) the list of gamete donation compensation for providing donor 47 gametes pursuant to a gamete donation matched agreement or a gamete 48 donation agency agreement; 49 (v) the maximum number of donor-conceived persons that may be born in 50 New York state after the effective date of section fourteen hundred four 51 of the general business law using the donor gametes provided by the 52 potential egg donor, and the possibility that the gametes provided by 53 the egg donor will be used for assisted reproduction to conceive a child 54 that will be born outside of New York state, which cannot be tracked or 55 regulated by New York state;

S. 7749 32 1 (vi) that compensation received pursuant to a gamete donation matched 2 agreement or a gamete donation agency agreement is taxable and may 3 affect the eligibility of the egg donor for public benefits or the 4 amount of such benefits, including social security benefits; 5 (vii) the potential egg donor's options regarding identity disclosure 6 under section fourteen hundred seven of the general business law; 7 (viii) information about the central assisted reproduction registry, 8 including: 9 (A) the purpose of the registry; 10 (B) what personal and clinical data that is collected and how it is 11 used; 12 (C) how collected personal information is secured and kept confiden- 13 tial; 14 (D) that a gamete donor is required to register before executing a 15 gamete donation matched agreement or a gamete donation agency agreement; 16 (E) how the egg donor can voluntarily provide health information 17 updates confidentially to the registry in the future; and 18 (F) the terms of the gamete donation matched agreement or the gamete 19 donation agency agreement. 20 (c) The department of health, in consultation with the task force on 21 life and the law, shall develop and maintain a checklist of information 22 that must be reviewed with potential sperm donors and requirements the 23 potential sperm donor must comply with before they provide informed 24 medical and legal consent to enter into a gamete donation matched agree- 25 ment or a gamete donation agency agreement, including: 26 (1) The potential sperm donor must be informed of the following 27 medical information, which shall be provided in writing to the potential 28 sperm donor and reviewed verbally with the potential sperm donor: 29 (i) the results of the potential sperm donor's medical and psycholog- 30 ical screenings and whether they have any health conditions that 31 disqualify them from donating gametes; and 32 (ii) the known health risks to donor-conceived persons, including 33 disclosure that all health risks are not known due to lack of data. 34 (2) The potential sperm donor shall be provided written materials on 35 counseling topics regarding issues related to gamete donation, includ- 36 ing: 37 (i) the potential psychological and emotional impacts on the potential 38 sperm donor, the sperm donor's current or future children and partner, 39 if applicable, and any donor-conceived children; and 40 (ii) the best practices for talking with children and other family 41 members about gamete donation. 42 (3) The potential sperm donor must be informed of the following legal 43 information, which shall be provided in writing to the potential sperm 44 donor and reviewed verbally with the potential sperm donor: 45 (i) the rights a sperm donor is afforded in the gamete donor's bill of 46 rights pursuant to part nine of this article and how to implement each 47 right, and rights that are afforded donor-conceived individuals pursuant 48 to part eleven of this article; 49 (ii) the maximum number of donor-conceived persons that may be born in 50 New York state using the donor gametes provided by the potential sperm 51 donor after the effective date of section fourteen hundred eight of the 52 general business law, and the possibility that the gametes provided by 53 the sperm donor will be used for assisted reproduction to conceive a 54 child that will be born outside of New York state, which cannot be 55 tracked or regulated by New York state;

S. 7749 33 1 (iii) that donated sperm, or embryos created from donated sperm, could 2 be used for research at any time unless the sperm donor does not author- 3 ize such use of their donor gametes. The sperm donor must provide signed 4 certification that indicates whether they authorize use of their donor 5 gametes for research at any time; 6 (iv) the list of gamete donation compensation schedule for providing 7 donor gametes pursuant to a gamete donation matched agreement or a 8 gamete donation agency agreement; 9 (v) that compensation received pursuant to a gamete donation matched 10 agreement or a gamete donation agency agreement is taxable and may 11 affect the eligibility of the sperm donor for public benefits or amount 12 of such benefits, including social security benefits; 13 (vi) the potential sperm donor's options regarding identity disclosure 14 under section fourteen hundred seven of the general business law; 15 (vii) information about the central assisted reproduction registry, 16 including: 17 (A) the purpose of the registry; 18 (B) what personal and clinical data that is collected and how it is 19 used; 20 (C) how collected personal information is secured and kept confiden- 21 tial; 22 (D) that donors are required to register before executing a gamete 23 donation matched agreement or a gamete donation agency agreement; and 24 (E) how the sperm donor can voluntarily provide health information 25 updates confidentially to the registry in the future; and 26 (viii) the terms of the gamete donation matched agreement or the 27 gamete donation agency agreement. 28 (d) The department of health, in consultation with the task force on 29 life and the law, shall develop and maintain a checklist of information 30 that must be reviewed with a potential person acting as surrogate and 31 requirements the potential sperm donor must comply with before they 32 provide informed medical and legal consent to enter into a surrogacy 33 agreement, including: 34 (1) The potential person acting as surrogate must be informed of the 35 following medical information, which shall be provided in writing to the 36 potential person acting as surrogate and reviewed verbally with the 37 potential person acting as surrogate: 38 (i) the results of the potential person acting as surrogate's medical 39 and psychological screenings and whether they have any health conditions 40 that disqualify them from undergoing a surrogate pregnancy or that would 41 put them at greater risk of adverse health outcomes during a surrogate 42 pregnancy; 43 (ii) the medications and medical and surgical procedures associated 44 with surrogate pregnancy and their potential risks or side effects; 45 (iii) that in vitro fertilization procedures and prenatal and obstet- 46 ric care will be administered according to the best practices described 47 by the American College of Obstetricians and Gynecologists; 48 (iv) the medical risks of surrogate pregnancy, including: 49 (A) the possibility and risk of multiple births and preterm births, 50 which also increases the chance of a medically-necessary cesarean 51 section; 52 (B) the risks of multiple embryo transfer and disclosure that multiple 53 embryo transfer contradicts the guidelines of the American college of 54 obstetrics and gynecology; 55 (C) the risk of pregnancy complications, including preeclampsia;

S. 7749 34 1 (D) the risks of delivery by cesarean section and disclosure that 2 elective cesarean section contradicts the guidelines of the American 3 college of obstetrics and gynecology; and 4 (E) the known health risks to persons acting as surrogates and surro- 5 gate-born persons, including disclosure that all health risks are not 6 known due to lack of data. 7 (2) The potential person acting as surrogate shall attend a counseling 8 session regarding issues related to surrogacy, including: 9 (i) the potential psychological, emotional, and psychosocial risks to 10 the person acting as surrogate, their current and future children and 11 partner, and any surrogate-born persons; 12 (ii) best practices for talking to a person acting as surrogate's 13 children and other family members about surrogacy; and 14 (iii) impacts on their personal lives. 15 (3) The potential person acting as surrogate must be informed of the 16 following legal information, which shall be provided in writing to the 17 potential person acting as surrogate and reviewed verbally with the 18 potential person acting as surrogate: 19 (i) the rights a person acting as surrogate is afforded in the surro- 20 gate's bill of rights pursuant to part six of this article and how to 21 implement each right, and rights that surrogate-born individuals are 22 afforded in the bill of rights of donor-conceived and surrogate-born 23 individuals pursuant to part eleven of this article; 24 (ii) compensation received pursuant to a surrogacy agreement is taxa- 25 ble and may affect the eligibility of the person acting as surrogate and 26 the person acting as surrogate's spouse, if applicable, for public bene- 27 fits or the amount of such benefits, including social security benefits; 28 (iii) a person acting as surrogate is required by New York state law 29 to transfer parental rights immediately upon the birth of any child born 30 pursuant to a surrogacy agreement under part four of this article and 31 pursuant to section 581-203 of this article. The requirement is irrev- 32 ocable, even if the intended parent or parents are found to have been 33 convicted of criminal behavior, domestic violence, or child abuse; 34 (iv) information about the central assisted reproduction registry, 35 including: 36 (A) the purpose of the registry; 37 (B) what personal and clinical data that is collected and how it is 38 used; 39 (C) how collected personal information is secured and kept confiden- 40 tial; 41 (D) that a person acting as surrogate is required to register before 42 executing a surrogacy agreement; and 43 (E) how the person acting as surrogate can voluntarily provide health 44 information updates confidentially to the registry in the future; and 45 (v) the terms of the surrogacy agreement. 46 (e) The department of health, in consultation with the task force on 47 life and the law, shall develop and maintain a checklist of information 48 that must be reviewed with the intended parent or parents before they 49 provide informed medical and legal consent to enter into a gamete 50 donation matched agreement or a gamete donation agency agreement, 51 including: 52 (1) The intended parent or parents must be informed of the following 53 medical information, which shall be provided in writing to the intended 54 parent or parents and reviewed verbally with the intended parent or 55 parents:

S. 7749 35 1 (i) if the intended parent or parents are using donor eggs, the medi- 2 cations and medical and surgical procedures associated with ovarian 3 stimulation and oocyte retrieval and their potential risks or side 4 effects under subparagraph (ii) of paragraph one of subdivision (b) of 5 this section; 6 (ii) if the intended parent or parents are using donor eggs, known 7 health risks to egg donors and donor-conceived persons, including 8 disclosure that all health risks are not known due to lack of data under 9 subparagraph (iii) of paragraph one of subdivision (b) of this section; 10 and 11 (iii) if the intended parent or parents are using donor sperm, known 12 health risks to donor-conceived children, including disclosure that all 13 health risks are not known due to lack of data, under subparagraph (ii) 14 of paragraph one of subdivision (c) of this section. 15 (2) The intended parent or parents shall attend a counseling session 16 regarding issues related to using donor gametes to help build their 17 family, including: 18 (i) the potential psychological and emotional impacts of conceiving a 19 child using donor gametes on the intended parent or parents and any 20 current children; 21 (ii) the potential psychological and emotional impacts on donor-con- 22 ceived children and risks to the mental health of donor-conceived chil- 23 dren who are not told about being donor-conceived; and 24 (iii) the best practices for telling children they are donor-con- 25 ceived. 26 (3) The intended parent or parents must be informed of the following 27 legal information, which shall be provided in writing to the intended 28 parent or parents and reviewed verbally with the intended parent or 29 parents: 30 (i) the rights gamete donors are afforded in the gamete donor's bill 31 of rights pursuant to part nine of this article; 32 (ii) the rights donor-conceived individuals are afforded in the 33 donor-conceived and surrogate-born individual's bill of rights pursuant 34 to part eleven of this article; 35 (iii) the maximum number of donor-conceived individuals that may be 36 born in New York state that were conceived using assisted reproduction 37 and the donor gametes provided by a single gamete donor, and the possi- 38 bility that donor-conceived individuals who are conceived using gametes 39 from the same donor may be born outside of New York state, which cannot 40 be tracked or regulated by New York state; 41 (iv) if donor gametes are being used, the gamete donor's options 42 regarding identity disclosure under section fourteen hundred seven of 43 the general business law; 44 (v) information about the central assisted reproduction registry, 45 including: 46 (A) the purpose of the registry; 47 (B) what personal and clinical data that is collected and how it is 48 used; 49 (C) how collected personal information is secured and kept confiden- 50 tial; and 51 (D) how an intended parent can voluntarily provide health information 52 updates confidentially for their donor-conceived child to the registry 53 in the future; and 54 (vi) the terms of the gamete donation matched agreement or the gamete 55 donation agency agreement.

S. 7749 36 1 (f) The department of health, in consultation with the task force on 2 life and the law, shall develop and maintain a checklist of information 3 that must be reviewed with the intended parent or parents before they 4 provide informed medical and legal consent to enter into a surrogacy 5 agreement, including: 6 (1) The intended parent or parents must be informed of the following 7 medical information, which shall be provided in writing to the intended 8 parent or parents and reviewed verbally with the intended parent or 9 parents: 10 (i) if the intended parent or parents are using donor eggs, the 11 medical information under subparagraphs (i), (ii) and (iii) of paragraph 12 one of subdivision (e) of this section and if they are using donor 13 sperm, the medical information under subparagraph (iii) of paragraph one 14 of subdivision (e) of this section; 15 (ii) the medications and medical and surgical procedures associated 16 with surrogate pregnancy and their potential risks or side effects under 17 subparagraph (ii) of paragraph one of subdivision (d) of this section; 18 (iii) the medical risks of surrogate pregnancy listed under subpara- 19 graph (iv) of paragraph one of subdivision (d) of this section; and 20 (iv) the known health risks to persons acting as surrogates and surro- 21 gate-born persons, including disclosure that all health risks are not 22 known due to lack of data, under clause (E) of subparagraph (iv) of 23 paragraph one of subdivision (d) of this section. 24 (2) The intended parent or parents shall attend a counseling session 25 regarding issues related to, if applicable, using donor gametes surroga- 26 cy to help build their family, including: 27 (i) the potential psychological and emotional impacts of conceiving a 28 child using donor gametes, if applicable, and of engaging a person 29 acting as surrogate on the intended parent or parents and any current 30 children; 31 (ii) the potential psychological and emotional impacts on donor-con- 32 ceived, if applicable, and surrogate-born children and risks to the 33 mental health of children who are not told about being donor-conceived, 34 if applicable, and surrogate-born; and 35 (iii) the best practices for telling children they are donor-con- 36 ceived, if applicable, and surrogate-born. 37 (3) The intended parent or parents must be informed of the following 38 legal information, which shall be provided in writing to the intended 39 parent or parents and reviewed verbally with the intended parent or 40 parents: 41 (i) if the intended parent or parents are using donor gametes to 42 conceive the child that shall be born pursuant to a surrogacy agreement 43 under part four of this article, the legal information required under 44 paragraph three of subdivision (e) of this section; 45 (ii) the rights that a person acting as surrogate is afforded in the 46 surrogate's bills of rights pursuant to part six of this article; 47 (iii) the rights that surrogate-born individuals are afforded in the 48 bill of rights of donor-conceived and surrogate-born individuals pursu- 49 ant to part eleven of this article; 50 (iv) that the person acting as surrogate has the same right to make 51 decisions about their behavior during the surrogate pregnancy as other 52 pregnant people have in New York state. Any provisions in a surrogacy 53 agreement that restrict a surrogate's behavior are void and unenforcea- 54 ble; 55 (v) information about the central assisted reproduction registry, 56 including:

S. 7749 37 1 (A) the purpose of the registry; 2 (B) what personal and clinical data that is collected and how it is 3 used; 4 (C) how collected personal information is secured and kept confiden- 5 tial; 6 (D) that the intended parent or parents are required to register 7 before executing a surrogacy agreement; and 8 (E) how an intended parent can voluntarily provide health information 9 updates confidentially for their donor-conceived, if applicable, and 10 surrogate-born child to the registry in the future; and 11 (vii) the terms of the surrogacy agreement. 12 § 581-1003. Informed medical and legal consent procedures for a poten- 13 tial egg donor. Before a potential egg donor executes a gamete donation 14 matched agreement or a gamete donation agency agreement, all of the 15 following procedures must be completed and documented in order to 16 provide informed medical and legal consent to enter into the agreement: 17 (a) The potential egg donor shall watch the video tutorial under 18 subdivision (a) of section 581-1002 of this part and have an opportunity 19 to speak with a representative to review the information and ask ques- 20 tions about the video and the procedure. 21 (b) An independent health care provider licensed under title eight of 22 the education law shall provide the medical information required under 23 paragraph one of subdivision (b) of section 581-1002 of this part in 24 writing to the potential egg donor, and review the information with the 25 potential egg donor, and answer questions the potential egg donor may 26 have. 27 (c) The potential egg donor shall attend a counseling session with an 28 independent mental health practitioner licensed under title eight of the 29 education law who shall review the information required under paragraph 30 two of subdivision (b) of section 581-1002 of this part. The cost of the 31 counseling session shall be paid for by the agent, gamete agency, gamete 32 bank, fertility clinic, surrogacy program, or health care provider, as 33 applicable. 34 (d) A representative shall provide the legal information required 35 under paragraph three of subdivision (b) of section 581-1002 of this 36 part in writing, including a copy of the gamete donor's bill of rights 37 and the bill of rights of donor-conceived and surrogate-born individ- 38 uals, and review the information. The potential egg donor shall be 39 provided an opportunity to consult with independent legal counsel 40 licensed to practice in New York state, to be paid for by the agent, 41 gamete agency, gamete bank, fertility clinic, surrogacy program, or 42 health care provider, as applicable. 43 (e) The potential egg donor shall verify in a signed record that 44 informed medical and legal consent procedures have been completed, they 45 had an opportunity to ask questions, and they fully understand the 46 information. 47 § 581-1004. Informed medical and legal consent procedures for a poten- 48 tial sperm donor. Before a potential sperm donor executes a gamete 49 donation matched agreement or a gamete donation agency agreement, all of 50 the following procedures must be completed and documented in order to 51 provide informed medical and legal consent to enter into the agreement: 52 (a) The potential sperm donor shall watch the video tutorial under 53 subdivision (a) of section 581-1002 of this part and have an opportunity 54 to speak with a representative to review the information and ask ques- 55 tions about the video and the procedure.

S. 7749 38 1 (b) An independent health care provider licensed under title eight of 2 the education law shall provide the medical information required under 3 paragraph one of subdivision (c) of section 581-1002 of this part in 4 writing to the potential sperm donor, review the information with the 5 potential sperm donor, and answer questions the potential sperm donor 6 may have. 7 (c) The potential sperm donor shall receive the information required 8 under paragraph two of subdivision (c) of section 581-1002 of this part 9 in writing from an independent mental health practitioner licensed under 10 title eight of the education law. 11 (d) A representative shall provide the legal information required 12 under paragraph three of subdivision (c) of section 581-1002 of this 13 part in writing, including a copy of the gamete donor's bill of rights 14 and the bill of rights of donor-conceived and surrogate-born individ- 15 uals. The potential sperm donor shall be provided an opportunity to 16 consult with independent legal counsel licensed to practice in New York 17 state, to be paid for by the agent, gamete agency, gamete bank, fertili- 18 ty clinic, surrogacy program, or health care provider, as applicable. 19 (e) The potential sperm donor shall verify in a signed record that 20 informed medical and legal consent procedures have been completed, they 21 had an opportunity to ask questions, and they fully understand the 22 information. 23 § 581-1005. Informed medical and legal consent procedures for a poten- 24 tial person acting as surrogate. Before a potential person acting as 25 surrogate executes a surrogacy agreement, all of the following proce- 26 dures must be completed and documented in order to provide informed 27 medical and legal consent to enter into the surrogacy agreement: 28 (a) The potential person acting as surrogate shall watch the video 29 tutorial required under subdivision (a) of section 581-1002 of this part 30 and have an opportunity to speak with a representative to review the 31 information and ask questions about the video and surrogacy; 32 (b) An independent health care provider licensed under title eight of 33 the education law shall provide the medical information required under 34 paragraph one of subdivision (d) of section 581-1002 of this part in 35 writing to the potential person acting as surrogate, review the informa- 36 tion with the potential person acting as surrogate, and answer questions 37 the potential person acting as surrogate may have; 38 (c) The potential person acting as surrogate shall have a counseling 39 session with an independent mental health practitioner licensed under 40 title eight of the education law, who shall review the information 41 required under paragraph two of subdivision (d) of section 581-1002 of 42 this part. The cost of the counseling session shall be paid for by the 43 surrogacy program, fertility clinic, or the intended parent or parents, 44 as applicable; 45 (d) The independent legal counsel licensed to practice in New York 46 state who represents the person acting as surrogate shall provide the 47 legal information required under paragraph three of subdivision (d) of 48 section 581-1002 of this part in writing, including the surrogate's bill 49 of rights and the bill of rights of donor-conceived and surrogate-born 50 people, and review the information; 51 (e) The potential person acting as surrogate shall verify in a signed 52 record that informed medical and legal consent procedures have been 53 completed, they had an opportunity to ask questions, and they fully 54 understand the information. 55 § 581-1006. Informed medical and legal consent procedures for an 56 intended parent or parents. Before an intended parent or parents execute

S. 7749 39 1 a gamete donation matched agreement, a gamete donation agency agreement, 2 or a surrogacy agreement, the following procedures must be completed and 3 documented in order to provide informed medical and legal consent to 4 enter into the agreement: 5 (a) The intended parent or parents shall watch the video tutorial or 6 tutorials required under subdivision (a) of section 581-1002 of this 7 part and have an opportunity to speak with a representative to review 8 the information and ask questions. 9 (b) If the intended parent or parents are entering into a gamete 10 donation matched agreement or a gamete donation agency agreement, an 11 independent health care provider licensed under title eight of the 12 education law shall provide the medical information required under para- 13 graph one of subdivision (e) of section 581-1002 of this part in writing 14 to the intended parent or parents, review the information with the 15 intended parent or parents, and answer questions the intended parent or 16 parents may have. If the intended parent or parents are entering into a 17 surrogacy agreement, an independent health care provider licensed under 18 title eight of the education law shall provide the medical information 19 required under paragraph one of subdivision (f) of section 581-1002 of 20 this part in writing to the intended parent or parents, review the 21 information with the intended parent or parents, and answer questions 22 the intended parent or parents may have. 23 (c) If the intended parent or parents are entering into a gamete 24 donation matched agreement or a gamete donation agency agreement, they 25 shall attend a counseling session with an independent mental health 26 practitioner licensed under title eight of the education law, who shall 27 review the information required under paragraph (2) of subdivision (e) 28 of section 581-1002 of this part with the intended parent or parents. If 29 the intended parent or parents are entering into a surrogacy agreement, 30 they shall attend a counseling session with an independent mental health 31 practitioner licensed under title eight of the education law, who shall 32 review the information required under paragraph two of subdivision (f) 33 of section 581-1002 of this part. 34 (d) If the intended parent or parents are entering into a gamete 35 donation matched agreement or a gamete donation agency agreement, a 36 representative shall provide the legal information required under para- 37 graph three of subdivision (e) of section 581-1002 of this part in writ- 38 ing to the intended parent or parents, including the gamete donor's bill 39 of rights and the bill of rights of donor-conceived and surrogate-born 40 people, and review the information. If the intended parent or parents 41 are entering into a surrogacy agreement, the independent legal counsel 42 licensed to practice in New York state who represents them shall provide 43 the legal information required under paragraph three of subdivision (f) 44 of section 581-1002 of this part in writing to the intended parent or 45 parents, including a copy of the surrogate's bill of rights and the bill 46 of rights of donor-conceived and surrogate-born people, and review the 47 information. 48 (e) Each intended parent shall verify in writing that informed medical 49 and legal consent procedures have been completed, they had an opportu- 50 nity to ask questions, and they fully understand the information that 51 was provided. 52 PART 11 53 BILL OF RIGHTS OF DONOR-CONCEIVED AND 54 SURROGATE-BORN INDIVIDUALS

S. 7749 40 1 Section 581-1101. Applicability. 2 581-1102. Original birth certificate. 3 581-1103. Access to nonidentifying information. 4 581-1104. Access to identifying information. 5 § 581-1101. Applicability. The rights enumerated in this part shall 6 apply to any donor-conceived or surrogate-born individual who was 7 conceived by assisted reproduction pursuant to part four or part eight 8 of this article to ensure that all individuals have access to the iden- 9 tifying and medical information permitted by New York state law of 10 everyone involved in their creation. 11 § 581-1102. Original birth certificate. (a) For the purposes of this 12 section, "original birth certificate" means the unamended birth certif- 13 icate that contains the information required under section forty-one 14 hundred thirty-two of the public health law, including the name of the 15 person who acted as surrogate who gave birth to the child, and the name 16 of any identified gamete donor or the donor reference number of any 17 nonidentified gamete donor whose gametes were used in assisted reprod- 18 uction to conceive the child. 19 (b) An individual who is donor-conceived or surrogate-born pursuant to 20 part four or part eight of this article has the right to obtain upon 21 request a certified copy of their original birth certificate pursuant to 22 section forty-one hundred thirty-eight-e of the public health law, once 23 they turn eighteen years of age. 24 § 581-1103. Access to nonidentifying information. An individual who is 25 donor-conceived pursuant to part four or part eight of this article has 26 the right to obtain upon request nonidentifying medical and psycholog- 27 ical health information of any nonidentified gamete donor or once the 28 individual turns eighteen years of age, or a parent or legal guardian 29 may request the information if the donor-conceived person is under the 30 age of eighteen. 31 § 581-1104. Access to identifying information. (a) An individual who 32 is donor-conceived pursuant to part four or part eight of this article 33 has the right to obtain upon request identifying and medical and psycho- 34 logical health information of any identified gamete donor who provided 35 the donor gametes that were used for conception of the individual once 36 the donor-conceived individual turns eighteen years of age, or a parent 37 or legal guardian may request the information if the donor-conceived 38 person is under the age of eighteen. 39 (b) An individual who is conceived pursuant to part four of this arti- 40 cle has the right to obtain upon request identifying and medical and 41 psychological health information of the person who acted as surrogate 42 and gave birth to them once the surrogate-born individual turns eighteen 43 years of age, or a parent or legal guardian may request the information 44 if the surrogate-born person is under the age of eighteen. 45 § 21. Subdivision 1 of section 2599-cc of the public health law, as 46 added by section 12 of part L of chapter 56 of the laws of 2020, is 47 amended to read as follows: 48 1. The commissioner shall promulgate regulations on the practice of 49 gestational surrogacy. Such regulations shall include, but not be limit- 50 ed to: 51 (a) guidelines and procedures for obtaining fully informed consent 52 from potential persons acting as surrogates, and from intended parents 53 to enter into a surrogacy agreement under part four of article five-C of 54 the family court act, including but not limited to [~~a full disclosure of~~ 55 ~~any known or potential health risks and mental health impacts associated~~

S. 7749 41 1 ~~with acting as a surrogate~~] the procedure and requirements under part 2 ten of article five-C of the family court act; 3 (b) the development and distribution, in printed form and on the 4 department's website, of informational material relating to gestational 5 surrogacy, including but not limited to the scope of information 6 provided on the website of the Human Fertilisation & Embryology Authori- 7 ty of the United Kingdom; 8 (c) the establishment of [~~a voluntary~~] the central [~~tracking~~] assisted 9 reproduction registry of required information related to persons acting 10 as surrogates and surrogacy, as reported by surrogacy programs, fertili- 11 ty clinics, and other designated entities licensed by the department 12 pursuant to article forty-four of the general business law [~~upon the~~ 13 ~~affirmative consent of a person acting as surrogate~~]. Such registry 14 shall provide a means for gathering and maintaining accurate information 15 on the: 16 (i) identifying information of and contact information for persons 17 who act as surrogates; 18 (ii) number of times a person has acted as a surrogate; 19 [~~(ii)~~] (iii) medical history and optional self-reported health infor- 20 mation [of] updates provided by the person acting as surrogate; [~~and~~] 21 (iv) medical information and outcomes of the surrogate pregnancy and 22 birth; 23 (v) health information of children born pursuant to a surrogacy agree- 24 ment; and 25 [~~(iii)~~] (vi) other information deemed appropriate by the commissioner; 26 (d) the development of guidelines, procedures or protocols, in consul- 27 tation with the American college of obstetricians and gynecologists [~~and~~ 28 ~~the American society for reproductive medicine,~~] to assist physicians in 29 screening potential surrogates for their ability to serve as a surrogate 30 as required under [~~subdivision~~] paragraph four of subdivision (a) of 31 section 581-402 of the family court act including taking into consider- 32 ation the potential surrogates family medical history and complications 33 from prior pregnancies and known health conditions that may pose a risk 34 to the potential surrogate during pregnancy [~~and~~], including, but not 35 limited to the following criteria that would disqualify a potential 36 person acting as surrogate from entering into a surrogacy agreement 37 under part four of article five-C of the family court act: whether the 38 potential person acting as surrogate meets any of the American college 39 of obstetricians and gynecologists (ACOG) medical and mental health 40 criteria for high-risk pregnancy; 41 (e) the development of best medical practices to protect the health of 42 persons acting as surrogates and surrogate-born children, including 43 requiring that health care providers licensed under title eight of the 44 education law shall counsel persons acting as surrogates about immuniza- 45 tions in accordance with best medical practice. Immunizations shall be 46 administered only upon the request of the person acting as surrogate; 47 (f) the development of guidance to reduce conflicts of interest among 48 physicians providing health care services to the surrogate[.]; and 49 (g) procedures for a surrogacy program, assisted reproduction service 50 provider, or other entity to determine the eligibility of a potential 51 person acting as surrogate to enter into a surrogacy agreement, pursuant 52 to part four of article five-C of the family court act. 53 § 22. The public health law is amended by adding four new sections 54 2599-dd, 2599-ee, 2599-ff and 2599-gg to read as follows: 55 § 2599-dd. Gamete donation. The commissioner, in consultation with the 56 transplant council or the task force on life and the law, shall promul-

S. 7749 42 1 gate regulations on gamete donation. Such regulations shall include, but 2 not be limited to: 3 1. Guidelines and procedures for obtaining fully informed medical and 4 legal consent, including but not limited to the procedures and require- 5 ments under part ten of article five-C of the family court act, from: 6 (a) a potential gamete donor and an intended parent or parents to 7 enter into a gamete donation matched agreement; and 8 (b) a potential gamete donor or an intended parent or parents to enter 9 into a gamete donation agency agreement. 10 2. The development and distribution, in printed form and on the 11 department website, of informational material relating to gamete 12 donation, including but not limited to the scope of information provided 13 on the website of the Human Fertilisation & Embryology Authority of the 14 United Kingdom. 15 3. The establishment of the central assisted reproduction registry of 16 required information related to ova and sperm donors and gamete 17 donation, as reported by agents, gamete agencies, gamete banks, surroga- 18 cy programs, fertility clinics, and health care providers licensed by 19 the department pursuant to article forty-four of the general business 20 law. Such registry shall provide a means for gathering and maintaining 21 accurate information on: 22 (a) identifying information of and contact information for gamete 23 donors, provided that a nonidentified gamete donor upon request may be 24 listed by a reference number; 25 (b) the number of times an egg donor has undergone ovarian stimu- 26 lation, including for purposes of egg freezing; 27 (c) medical history and optional self-reported health information 28 updates provided by the gamete donor; 29 (d) health information of donor-conceived persons; 30 (e) number of donor-conceived persons born in New York state using the 31 gametes of each egg and sperm donor; and 32 (f) other information deemed appropriate by the commissioner. 33 4. The development of guidelines, procedures or protocols, in consul- 34 tation with the transplant council or the task force on life and the 35 law, to assist physicians licensed under title eight of the education 36 law when screening potential gamete donors for their ability to produce 37 gametes for use in assisted reproduction pursuant to a gamete donation 38 matched agreement or a gamete donation agency agreement pursuant to part 39 eight of article five-C of the family court act, including taking into 40 consideration the potential gamete donor's family medical history and 41 medical complications from prior cycles of ovarian stimulation and 42 oocyte retrieval and known health conditions that may pose a risk to the 43 potential gamete donor or any donor-conceived persons, including, but 44 not limited to the following criteria that would disqualify a potential 45 gamete donor from entering into a gamete donation matched agreement or a 46 gamete donation agency agreement under part eight of the family court 47 act: 48 (a) a potential egg donor has any medical conditions indicated by the 49 American college of obstetricians and gynecologists (ACOG) that place 50 individuals at risk of ovarian hyperstimulation; 51 (b) a potential egg donor has previously undergone ovarian stimulation 52 more than six times, including for purposes of egg freezing; or 53 (c) a potential egg donor has previously experienced ovarian hypersti- 54 mulation syndrome (OHSS), polycystic ovarian syndrome (PCOS), or endome- 55 triosis.

S. 7749 43 1 5. The development of best medical practices to protect the health of 2 egg donors and donor-conceived persons, including but not limited to: 3 (a) conservative low stimulation medication protocols aiming to 4 produce no more than twenty to twenty-five eggs in a single cycle in 5 compliance with best medical practice; 6 (b) an egg retrieval cycle shall be canceled, if necessary, in accord- 7 ance with best medical practice to avoid ovarian hyperstimulation 8 syndrome; and 9 (c) there shall be a minimum of three months after an egg donor under- 10 goes oocyte retrieval before the egg donor enters into a gamete donation 11 matched agreement or a gamete donation agency agreement. 12 6. Procedures for an agent, gamete agency, gamete bank, surrogacy 13 program, fertility clinic, or health care provider to determine if a 14 potential egg donor is eligible to enter into a gamete donation matched 15 agreement or a gamete donation agency agreement, under subdivision (a) 16 of section 581-803 of the family court act, including procedures to 17 verify the approximate number of donor-conceived children that have 18 already been born in New York state using assisted reproduction and the 19 gametes of the potential egg or sperm donor. 20 § 2599-ee. New York state ART, gamete donation, and gestational surro- 21 gacy program. 1. There is hereby established within the department the 22 New York state ART, gamete donation, and gestational surrogacy program, 23 hereinafter referred to as "the program". 24 2. The program shall be responsible for the following duties: 25 (a) administer the central assisted reproduction registry and process 26 requests from authorized individuals for nonidentifying medical informa- 27 tion of nonidentified gamete donors and identifying and medical informa- 28 tion of identified gamete donors and persons acting as surrogates; 29 (b) maintain copies of gamete donation matched agreements, gamete 30 donation agency agreements, and surrogacy agreements along with all 31 required records and documents in a manner that protects confidentiality 32 and privacy of information; 33 (c) develop print and electronic materials with educational informa- 34 tion, current best practices, and research findings on topics related to 35 assisted reproductive technology, gamete donation, and surrogacy; and 36 (d) develop the content and maintain a website with information and 37 resources on assisted reproduction, gamete donation, and surrogacy under 38 subdivision two of section twenty-five hundred ninety-nine-cc and subdi- 39 vision two of section twenty-five hundred ninety-nine-dd of this arti- 40 cle. 41 3. (a) The program shall perform such acts, prescribe such forms and 42 propose such rules, regulations and orders as it may deem necessary or 43 proper to fully effectuate the provisions of this article. 44 (b) The program shall have the power to promulgate any and all neces- 45 sary rules and regulations governing assisted reproduction, gamete 46 donation, and surrogacy, practices in this state. 47 4. The task force on life and the law shall act as advisory board for 48 the program. The advisory board shall consider all matters submitted to 49 it by the program, including rulemaking, advising the office and legis- 50 lature on assisted reproduction, gamete donation, and surrogacy, prac- 51 tices and issues. 52 5. The action, proceedings, authority, and orders of the office in 53 enforcing the provisions of this article and applying them to specific 54 cases shall at all times be regarded as in their nature judicial and 55 shall be treated as prima facie just and legal.

S. 7749 44 1 § 2599-ff. Central assisted reproduction registry. 1. The ova and 2 sperm donor registry and the surrogate registry shall be known collec- 3 tively as the central assisted reproduction registry. 4 2. The program shall administer the central assisted reproduction 5 registry. 6 3. The following individuals, surrogacy programs, assisted reprod- 7 uction service providers, and other entities are required to register: 8 (a) a potential person acting as surrogate who is entering into a 9 surrogacy agreement pursuant to part four of article five-C of the fami- 10 ly court act; 11 (b) a potential gamete donor entering into a gamete donation matched 12 agreement or a gamete donation agency agreement pursuant to part eight 13 of article five-C of the family court act; 14 (c) an intended parent or parents entering into a surrogacy agreement 15 pursuant to part four of article five-C of the family court act; and 16 (d) a licensed agent, gamete agency, surrogacy program, gamete bank, 17 fertility clinic, or a health care provider that provides matching or 18 recruitment services or services contemplated by a gamete donation 19 matched agreement, a gamete donation agency agreement, or a surrogacy 20 agreement; 21 4. The commissioner shall promulgate regulations on the following: 22 (a) registration procedures for the individuals, surrogacy programs, 23 assisted reproduction service providers and other entities that are 24 required to register with the central assisted reproduction registry 25 pursuant to subdivision three of this section; 26 (b) procedures for a gamete donor, a person who acted as surrogate, 27 and a donor-conceived or surrogate-born individual, or a parent or legal 28 guardian if the donor-conceived or surrogate-born person is under the 29 age of eighteen to provide optional self-reported health information 30 updates to the central assisted reproduction registry; 31 (c) procedures for a donor-conceived or a surrogate-born individual to 32 request upon attaining eighteen years of age nonidentifying medical 33 information of a nonidentified gamete donor who provided donor eggs or 34 sperm that were used for assisted reproduction for their conception 35 pursuant to part four or part eight of article five-C of the family 36 court act, or for a parent or legal guardian to request the information 37 if the donor-conceived or surrogate-born person is under the age of 38 eighteen; 39 (d) procedures for a donor-conceived or a surrogate-born individual to 40 request upon attaining eighteen years of age identifying and medical 41 information of an identified gamete donor who provided donor eggs or 42 sperm that were used for assisted reproduction for their conception 43 pursuant to part four or part eight of article five-C of the family 44 court act, or for a parent or legal guardian to request the information 45 if the donor-conceived or surrogate-born person is under the age of 46 eighteen; 47 (e) procedures for a surrogate-born individual upon attaining eighteen 48 years of age to request identifying and medical information of the 49 person who acted as surrogate and gave birth to them pursuant to part 50 four of article five-C of the family court act, or for a parent or legal 51 guardian to request the information if the surrogate-born person is 52 under the age of eighteen; and 53 (f) procedures to request nonidentifying health information from the 54 central assisted reproduction registry for purposes of public health 55 research.

S. 7749 45 1 5. The central assisted reproduction registry shall be operated by 2 employees of the department specifically designated by the commissioner. 3 Access to all records and information in the registry shall be limited 4 to such designated employees and such records and information shall be 5 kept strictly confidential except as specifically authorized by law. The 6 commissioner shall establish rules and procedures designed to keep such 7 records and information separate and apart from other records of the 8 department and kept in a manner where access to such records and infor- 9 mation is strictly limited to such designated employees and shall 10 promulgate regulations designed to effectuate the purposes of this 11 section. Notwithstanding any inconsistent provision of this chapter or 12 any other law to the contrary, the commissioner shall have access to the 13 information authorized to be released pursuant to this section contained 14 in surrogacy agreements, gamete donation agreements, and clinical data 15 maintained by the New York State ART, gamete donation, and gestational 16 surrogacy program and any agency, court or department having appropriate 17 records which will enable the commissioner to effectuate the purposes of 18 this section and may require the cooperation of such agency, court or 19 department in providing the information authorized to be released pursu- 20 ant to this section, provided, however, that the commissioner shall not 21 have access to the actual records of any agency, court or department 22 maintaining such records. 23 § 2599-gg. Gamete donation, assisted reproduction, and surrogacy 24 reporting requirements. The commissioner shall promulgate regulations on 25 gamete donation, assisted reproduction, and surrogacy reporting proce- 26 dures and requirements. Such regulations shall include, but not be 27 limited to: 28 1. Reporting requirements for surrogacy programs, assisted reprod- 29 uction service providers, health care providers, other entities that 30 provide services contemplated under part four or part eight of article 31 five-C of the family court act, and state or local departments of health 32 information and outcomes related to gamete donation, assisted reprod- 33 uction, and surrogacy to the central assisted reproduction registry, 34 including the following: 35 (a) Gamete donation data, including: 36 (i) the name, contact information, age, and sex or gender of the 37 gamete donor; 38 (ii) the donor screening results; 39 (iii) the name of any agent, gamete agency, gamete bank, surrogacy 40 program, fertility clinic, and health care practitioner that provided 41 matching services, if applicable, and that collected the donor gametes; 42 (iv) medication and oocyte retrieval protocols; 43 (v) egg retrieval cycle or sperm donation outcomes, including any 44 adverse reactions or health complications experienced by the egg donor, 45 the number and quality of oocytes retrieved, the quality of sperm 46 produced, insemination and embryo incubation protocols, and the number 47 and quality of embryos, as applicable; and 48 (vi) any resulting clinical pregnancy and donor-conceived person born. 49 (b) Surrogacy data: 50 (i) name, contact information, and age of the person acting as surro- 51 gate, and name and contact information of the intended parent or 52 parents; 53 (ii) the screening results of the person acting as surrogate; 54 (iii) the name of any surrogacy program, and fertility clinic, health 55 care provider, and other entity that provided matching services or 56 assisted reproduction services contemplated by the surrogacy agreement;

S. 7749 46 1 (iv) medication and embryo transfer protocols; 2 (v) embryo transfer cycle outcomes, including any adverse reactions or 3 health complications experienced by the person acting as surrogate, the 4 number of embryos transferred, and if clinical pregnancy was achieved; 5 (vi) the number of fetuses carried, and any health complications 6 during the surrogate pregnancy and delivery, as applicable; and 7 (vii) the number of any resulting children born and any health compli- 8 cations. 9 2. Reporting procedures and protocol to ensure confidentiality of 10 health information. 11 3. Penalties for agents, gamete agencies, surrogacy programs, gamete 12 banks, and fertility clinics, and health care practitioners licensed by 13 the department for violating reporting requirements, to include finan- 14 cial penalties and loss of licensure. 15 § 23. Subdivision (c) of section 1400 of the general business law, as 16 added by section 11 of part L of chapter 56 of the laws of 2020, is 17 amended to read as follows: 18 (c) "Surrogacy program" does not include any party to a surrogacy 19 agreement or any person licensed to practice law and representing a 20 party to the surrogacy agreement, but does include and is not limited to 21 any agency, agent, business, or individual engaged in, arranging, or 22 facilitating transactions contemplated by a surrogacy agreement, regard- 23 less of whether such agreement ultimately comports with the requirements 24 of part four of article five-C of the family court act. 25 § 24. Section 1401 of the general business law, as added by section 11 26 of part L of chapter 56 of the laws of 2020, is amended to read as 27 follows: 28 § 1401. Surrogacy programs regulated under this article. The 29 provisions of this article apply to New York state licensed and regis- 30 tered surrogacy programs arranging or facilitating transactions contem- 31 plated by a surrogacy agreement under part four of article five-C of the 32 family court act if: 33 (a) The surrogacy program does business in New York state; 34 (b) A person acting as surrogate who is party to a surrogacy agreement 35 resides in New York state during the term of the surrogacy agreement; or 36 (c) Any medical procedures under the surrogacy agreement are performed 37 in New York state. 38 § 25. Section 1402 of the general business law, as added by section 11 39 of part L of chapter 56 of the laws of 2020, is amended to read as 40 follows: 41 § 1402. Assisted reproduction service providers regulated under this 42 article. The provisions of this article apply to agents, gamete agen- 43 cies, gamete banks, fertility clinics, health care providers and other 44 entities if: 45 1. The agent, gamete agency, gamete bank, fertility clinic, health 46 care provider, or other entity does business in this state, including: 47 (a) recruiting or matching gamete donors who are located in or resi- 48 dents of New York state, or matching gamete donors with intended parents 49 who are located in or residents of New York state; or 50 (b) collecting gametes from gamete donors who are located in or resi- 51 dents of New York state; or 52 (c) distributing donor gametes to intended parents who are located in 53 or residents of New York state; or 54 2. Any health care services performed, provided or otherwise arranged 55 by the entity are performed in this state, including diagnostic, 56 medical, or surgical services associated with screening potential gamete

S. 7749 47 1 donors or in furtherance of collecting donor gametes under part four or 2 part eight of article five-C of the family court act. 3 § 26. Section 1403 of the general business law is renumbered section 4 1409 and subdivision (g), as added by section 11 of part L of chapter 56 5 of the laws of 2020, is amended to read as follows: 6 (g) Shall ensure that all potential parties to a surrogacy agreement, 7 at the time of consultation with such surrogacy program, are provided 8 with written notice of the surrogates' bill of rights enumerated in part 9 six, the gamete donor's bill of rights enumerated in part nine and the 10 bill of rights of donor-conceived and surrogate-born individuals enumer- 11 ated in part eleven of article five-C of the family court act. 12 § 27. Section 1404 of the general business law is renumbered section 13 1410 and subdivision 1, as added by section 11 of part L of chapter 56 14 of the laws of 2020, is amended to read as follows: 15 1. The department of health, in consultation with the department of 16 financial services, shall promulgate rules and regulations to implement 17 the requirements of this article regarding surrogacy programs and 18 assisted reproduction service providers in a manner that ensures the 19 safety and health of gamete [~~providers and~~], donors, persons serving as 20 surrogates, donor-conceived individuals, and surrogate-born individuals. 21 Such regulations shall: 22 (a) Require agents, gamete agencies, surrogacy programs [~~to monitor~~ 23 ~~compliance with surrogacy agreements eligibility and requirements in~~ 24 ~~state law~~], gamete banks, fertility clinics, health care practitioners 25 and other entities that recruit or match gamete donors, or that collect 26 donor gametes to make publicly available a compensation list for gamete 27 donation that is accessible to gamete donors and the general public on 28 the entity's website and in print; [~~and~~] 29 (b) Require [~~the surrogacy programs and assisted reproduction service~~ 30 ~~providers to administer informed consent procedures that comply with~~ 31 ~~regulations promulgated by the department of health under section twen-~~ 32 ~~ty-five hundred ninety-nine-cc of the public health law.~~] agents, gamete 33 agencies, surrogacy programs, gamete banks, fertility clinics, health 34 care practitioners, and other entities, to advertise and make represen- 35 tations of gamete donation pursuant to section fourteen hundred eight of 36 this part; 37 (c) Require agents, gamete agencies, surrogacy programs, gamete banks, 38 fertility clinics, health care practitioners, and other entities to 39 cover the cost of medical and psychological screening of potential 40 gamete donors. Gamete donors and intended parents may not be required to 41 cover or reimburse such screening costs; 42 (d) Require agents, gamete agencies, surrogacy programs, gamete banks, 43 fertility clinics, health care practitioners and other entities that 44 distribute donor gametes to an intended parent or parents located in or 45 who are residents of New York state for use in assisted reproduction to 46 track and report the number of donor-conceived persons born in New York 47 state using the gametes of each donor who entered into a gamete donation 48 matched agreement or a gamete donation agency agreement under part eight 49 of article five-C of the family court act to the central assisted 50 reproduction registry; 51 (e) Require surrogacy programs to monitor compliance with surrogacy 52 agreements eligibility and requirements in state law; 53 (f) Require surrogacy programs and assisted reproduction service 54 providers to administer informed medical and legal consent procedures 55 that comply with part ten of article five-C of the family court act and

S. 7749 48 1 with regulations promulgated by the department of health under section 2 twenty-five hundred ninety-nine-cc of the public health law; 3 (g) Require surrogacy programs, fertility clinics, health care practi- 4 tioners, and other entities that recruit persons acting as surrogates to 5 track and report the number of children delivered pursuant to a surroga- 6 cy agreement by each person acting as surrogate to the central assisted 7 reproduction registry; and 8 (h) Require surrogacy programs, agents, gamete agencies, gamete banks, 9 fertility clinics, health care practitioners, and other entities that 10 provide services contemplated by gamete donation matched agreements, 11 gamete donation agency agreements, and surrogacy agreements to pay an 12 annual fee which shall be determined by the commissioner of the depart- 13 ment of health that shall be used to pay for maintenance costs of the 14 central assisted reproduction registry. 15 § 28. The general business law is amended by adding six new sections 16 1403, 1404, 1405, 1406, 1407 and 1408 to read as follows: 17 § 1403. Matching service providers regulated under this article. The 18 provisions of this article shall apply to an agent, gamete agency, 19 surrogacy program, gamete bank, fertility clinic, health care practi- 20 tioner, or other assisted reproduction service providers that provides 21 matching services to potential gamete donors or intended parents located 22 in or who are residents of New York state. 23 § 1404. Limits on number of donor-conceived persons born in New York 24 state using gametes donated by each egg and sperm donor. Effective Janu- 25 ary first, two thousand twenty-six, a maximum of ten donor-conceived 26 individuals who are conceived using a single egg or sperm donor's 27 gametes may be born in New York state. This number does not include a 28 gamete donor's own biological children. 29 1. When determining the eligibility of a potential gamete donor to 30 enter into a gamete donation matched agreement or a gamete donation 31 agency agreement, an agent, gamete agency, surrogacy program, gamete 32 bank, health care practitioner, or fertility clinic, hereinafter 33 referred to as an "entity", shall follow regulations issued pursuant to 34 subdivision six of section twenty-five hundred ninety-nine-dd of the 35 public health law to determine how many donor-conceived individuals who 36 were conceived using the donor gametes of a potential egg or sperm donor 37 have been born in New York state. 38 2. If the entity determines that at least ten donor-conceived individ- 39 uals have been born in New York state, the entity shall not match the 40 potential gamete donor, collect their gametes, or distribute the donor's 41 gametes that were already collected on or after the effective date of 42 this section to an intended parent or parents located in or who are 43 residents of New York state. The potential gamete donor shall not be 44 eligible to enter into a gamete donation matched agreement or a gamete 45 donation agency agreement. 46 § 1405. Nonidentified gamete donation prohibited. Effective January 47 first, two thousand twenty-six, nonidentified gamete donation will no 48 longer be permissible in New York state. Once this section takes effect: 49 1. An individual located in or who is a resident of New York state who 50 intends to receive compensation for time and effort to produce gametes 51 for use in assisted reproduction will be required to sign a certified 52 statement that they agree to identified donation; 53 2. An agent, gamete agency, gamete bank, surrogacy program, fertility 54 clinic, or health care practitioner, hereinafter referred to as an 55 "entity", that distributes donor gametes to an intended parent or 56 parents located in or who are residents of New York state must only

S. 7749 49 1 distribute the gametes of donors who have signed a certified statement 2 agreeing to identified donation; 3 3. The entity shall inform the potential gamete donor that any donor- 4 conceived individuals will be able to obtain upon request identifying 5 and medical information of the gamete donor upon attaining eighteen 6 years of age, or the legal parent or guardian will be able to request 7 the information if the donor-conceived individual is under the age of 8 eighteen; and 9 4. If a potential gamete donor does not agree to identified donation, 10 an entity shall not match or collect gametes from the potential gamete 11 donor. 12 § 1406. Collection of identifying information and medical history and 13 determination of gamete donor eligibility. 1. For the purposes of this 14 section, the following terms shall mean: 15 (a) "identifying information" means: 16 (i) the gamete donor's full name; 17 (ii) the gamete donor's date of birth; and 18 (iii) the gamete donor's permanent address, current address, and other 19 contact information at the time of the donation. Other contact informa- 20 tion includes the gamete donor's phone number and email address; and 21 (b) "medical history" means information regarding any: 22 (i) present physical and psychological illness of the donor; 23 (ii) past physical and psychological illness of the donor; and 24 (iii) social, genetic, and family medical history pertaining to the 25 donor's health. 26 2. An agent, gamete agency, surrogacy program, gamete bank, fertility 27 clinic, or health care practitioner, hereinafter referred to as an 28 "entity", that shall collect gametes from a potential gamete donor or 29 shall match a potential gamete donor with an intended parent or parents 30 shall collect the potential donor's identifying information and medical 31 history: 32 (a) The entity shall verify the following information about each 33 potential gamete donor to determine their eligibility to enter into a 34 gamete donation matched agreement or a gamete donation agency agreement, 35 under part eight of article five-C of the family court act: 36 (i) the age of the potential gamete donor; 37 (ii) the number of times a potential egg donor has previously under- 38 gone ovarian stimulation, including to freeze their eggs; 39 (iii) following procedures promulgated pursuant to subdivision six of 40 section twenty-five hundred ninety-nine-dd of the public health law, the 41 approximate number of donor-conceived persons that were conceived pursu- 42 ant to part eight of article five-C of the family court act using the 43 donor gametes of the potential donor and have been born in New York 44 state; 45 (b) At least once every three years, the entity shall request updates 46 from the donor. The entity shall report required information and updated 47 donor information as received pursuant to section twenty-five hundred 48 ninety-nine-gg of the public health law to the central assisted reprod- 49 uction registry. 50 3. An entity that receives gametes from another entity that collected 51 the gametes shall record the name of and contact information for the 52 entity from which it received the gametes at the time of receipt and: 53 (a) The entity that collected the gametes shall provide a certified 54 statement that was signed by the gamete donor of the individual's dona- 55 tive intent. Should the entity that collected the gametes not provide 56 such certification, the entity shall certify that the gametes were

S. 7749 50 1 donated and the gamete donor does not have parental or proprietary 2 interest in the gametes; and 3 (b) The entity that collected the gametes shall provide copies of all 4 identifying information and medical and screening records of the gamete 5 donor; 6 (c) If an entity that collects donor gametes after the effective date 7 of this section of this article shall transfer the donor gametes to 8 another entity, the entity that collected the gametes shall provide a 9 certified statement that was signed by the gamete donor declaring their 10 agreement to identified gamete donation. If the entity that collected 11 the gametes does not possess such certification, it may not transfer the 12 donor gametes to another entity licensed by New York state. 13 § 1407. Gamete donor identity disclosure. 1. An agent, gamete agency, 14 gamete bank, surrogacy program, fertility clinic, health care provider, 15 or other entity that recruits or matches a potential gamete donor shall 16 counsel them on their identity disclosure options and provide the 17 following information: 18 (a) A potential donor who shall enter into a gamete donation matched 19 agreement or a gamete donation agency agreement under part eight of 20 article five-C of the family court act prior to the effective date of 21 section fourteen hundred five of this article may agree to donate 22 gametes as an identified or nonidentified gamete donor. A donor who 23 shall enter into a gamete donation matched agreement or a gamete 24 donation agency agreement under part eight of article five-C of the 25 family court act after the effective date of section fourteen hundred 26 five of this article must agree to donate gametes as an identified 27 gamete donor. The gamete donor shall certify in a written record that 28 they agree to nonidentified or identified gamete donation; and 29 (b) nonidentified gamete donors are unlikely to remain anonymous to 30 any donor-conceived persons due to DNA testing, the possibility of data 31 breaches, and unforeseen technological developments; and 32 (c) any donor-conceived person who was conceived pursuant to part four 33 or part eight of article five-C of the family court act may obtain upon 34 request nonidentifying medical information of a nonidentified gamete 35 donor or identifying and medical information of an identified gamete 36 donor upon attaining eighteen years of age, or a legal parent or guardi- 37 an may request the information if the donor-conceived person is under 38 the age of eighteen; and 39 2. If a potential gamete donor does not agree to donate their gametes 40 as an identified gamete donor after the effective date of section four- 41 teen hundred five of this article, the agent, gamete agency, surrogacy 42 program, gamete bank, fertility clinic, or health care provider shall 43 not provide matching services, enter into a gamete donation agency 44 agreement with the potential donor, or collect the potential donor's 45 gametes. 46 § 1408. Gamete donation advertising and representation. 1. Print, 47 electronic and online advertisements that promote recruitment or match- 48 ing of gamete donors who are residents of or located in New York state, 49 or matching of gamete donors with intended parents who are residents of 50 or located in New York state may not include any compensation amounts 51 other than those specified on the compensation list of the agent, gamete 52 agency, gamete bank, surrogacy program, fertility clinic, or health care 53 provider that shall be made available to the public and is posted on the 54 entity's website. 55 2. An agent, gamete bank, gamete agency, surrogacy program, fertility 56 clinic, or health care provider that provides information to an intended

S. 7749 51 1 parent or parents who are considering entering into a gamete donation 2 matched agreement or a gamete donation agency agreement shall make accu- 3 rate representations of how many donor eggs an intended parent or 4 parents might receive from one egg retrieval cycle. An entity shall 5 communicate that it is not possible to know how many donor eggs will be 6 received, and may not communicate that the number of donor eggs will be 7 more than thirty. 8 § 29. Subdivision 1 of section 4132 of the public health law, as added 9 by chapter 104 of the laws of 1971, is amended to read as follows: 10 1. The certificate of birth shall contain such information, including 11 the social security numbers of the parents, and identifying information 12 of any gamete donor and person who acted as surrogate, if a parentage 13 order was issued pursuant to section 581-202 or 581-203 of the family 14 court act, and be in such form as the commissioner may prescribe. 15 (a) If a parentage order was issued pursuant to section 581-203 of the 16 family court act, the first and last name of the person acting as surro- 17 gate who was a party to the judgment of parentage proceeding shall be 18 included on the original certificate of birth as the birth mother; and 19 (b) If a parentage order was issued pursuant to section 581-202 of the 20 family court act: 21 (i) the first and last name of any identified gamete donor shall be 22 included on the original certificate of birth as a gamete donor; and 23 (ii) a reference number for any nonidentified gamete donor shall be 24 included on the original certificate of birth as a gamete donor, 25 provided that the donor gametes were collected prior to the effective 26 date of section fourteen hundred five of the general business law; and 27 (c) If a parentage order was issued pursuant to section 581-203 of the 28 family court act and the surrogate-born person was also donor-conceived, 29 the information in paragraphs (a) and (b) of this subdivision shall be 30 included on the original certificate of birth; and 31 (d) If a parentage order is issued pursuant to section 581-202 or 32 581-203 of the family court act, an asterisk shall be placed on the 33 amended birth certificate. 34 § 30. The section heading, subdivision 1 and paragraph (a) of subdivi- 35 sion 2 of section 4138-e of the public health law, as added by chapter 36 491 of the laws of 2019, are amended to read as follows: 37 [~~Adoptee's~~] The right of adoptees, donor-conceived individuals and 38 surrogate-born individuals to a certified copy of [~~his or her~~] their 39 birth certificate. 1. The legislature hereby states its intention to 40 acknowledge, support and encourage the life-long health and well-being 41 needs of persons who have been and will be adopted, donor-conceived, and 42 surrogate-born in this state. The legislature further recognizes that 43 the denial of access to accurate and complete medical and self-identify- 44 ing data of any adopted person, donor-conceived, and surrogate-born 45 person, known and wilfully withheld by others, may result in such person 46 succumbing to preventable disease, premature death or otherwise 47 unhealthy life, is a violation of that person's human rights and is 48 contrary to the tenets of government. As such, the provisions of this 49 section seek to establish considerations under the law for adopted 50 donor-conceived, and surrogate-born persons equal to such considerations 51 permitted by law to all non-adopted non-donor conceived, and non-surro- 52 gate born persons; this section does so while providing for the privacy 53 of an adopted donor-conceived, and surrogate-born person and [~~his or~~ 54 ~~her~~] their birth. 55 (a) Notwithstanding any other provision of law, the commissioner or a 56 local registrar or any person authorized by the commissioner or a local

S. 7749 52 1 registrar, upon application, proof of identity and payment of a nominal 2 fee, shall issue certified copies of original long form line by line, 3 vault copy birth certificates, including any change attached to that 4 certificate by a birth parent or parents, and any information provided 5 to the commissioner or a local registrar pursuant to subdivision one of 6 section one hundred fourteen of the domestic relations law, to (i) an 7 adopted donor-conceived or surrogate-born person, if eighteen years of 8 age or more, or (ii) if the adopted donor-conceived or surrogate-born 9 person is deceased, the adopted person's direct line descendants, or 10 (iii) the lawful representatives of such adopted person, or lawful 11 representatives of such deceased adopted person's direct line descend- 12 ants, as the case may be. 13 § 31. Items (v) and (vii) of subparagraph (C) of paragraph 6 of 14 subsection (k) of section 3221 of the insurance law, as amended by 15 section 1 of part L of chapter 57 of the laws of 2019, are amended to 16 read as follows: 17 (v)(I) For the purposes of this paragraph, "infertility" means a 18 disease or condition characterized by the incapacity to impregnate 19 another person or to conceive, defined by (a) the failure to establish a 20 clinical pregnancy after twelve months of regular, unprotected sexual 21 intercourse or therapeutic donor insemination, or after six months of 22 regular, unprotected sexual intercourse or therapeutic donor insemina- 23 tion for a female thirty-five years of age or older; or (b) a person's 24 inability to reproduce either as a single individual or with their part- 25 ner without medical intervention; or (c) a licensed physician's or 26 osteopathic physician's findings based on a patient's medical, sexual, 27 or reproductive history, age, physical findings, or diagnostic testing. 28 Earlier evaluation and treatment may be warranted based on an individ- 29 ual's medical, sexual, or reproductive history [or], age, physical find- 30 ings, or diagnostic testing. 31 (II) For purposes of this paragraph, "iatrogenic infertility" means an 32 impairment of fertility by surgery, radiation, chemotherapy or other 33 medical treatment affecting reproductive organs or processes. 34 (vii) Every large group policy delivered or issued for delivery in 35 this state that provides medical, major medical or similar comprehen- 36 sive-type coverage shall provide coverage for three [~~cycles of~~] 37 completed oocyte retrievals and in-vitro fertilization [~~used in the~~ 38 ~~treatment of infertility~~] with unlimited embryo transfers from fresh or 39 frozen oocytes or embryos from a covered retrieval, in accordance with 40 the guidelines of the American College of Obstetricians and Gynecolo- 41 gists, using single embryo transfer (SET) when recommended and medically 42 appropriate for the treatment of infertility. Coverage may be subject to 43 annual deductibles and coinsurance, including copayments, as may be 44 deemed appropriate by the superintendent and as are consistent with 45 those established for other benefits within a given policy. [~~For~~ 46 ~~purposes of this item, a "cycle" is defined as either all treatment that~~ 47 ~~starts when: preparatory medications are administered for ovarian stimu-~~ 48 ~~lation for oocyte retrieval with the intent of undergoing in-vitro~~ 49 ~~fertilization using a fresh embryo transfer; or medications are adminis-~~ 50 ~~tered for endometrial preparation with the intent of undergoing in-vitro~~ 51 ~~fertilization using a frozen embryo transfer.~~] 52 § 32. Subparagraphs (E) and (G) of paragraph 3 of subsection (s) of 53 section 4303 of the insurance law, as amended by section 2 of part L of 54 chapter 57 of the laws of 2019, are amended to read as follows: 55 (E)(i) For the purposes of this subsection, "infertility" means a 56 disease or condition characterized by the incapacity to impregnate

S. 7749 53 1 another person or to conceive, defined by (a) the failure to establish a 2 clinical pregnancy after twelve months of regular, unprotected sexual 3 intercourse or therapeutic donor insemination, or after six months of 4 regular, unprotected sexual intercourse or therapeutic donor insemina- 5 tion for a female thirty-five years of age or older; (b) a person's 6 inability to reproduce either as a single individual or with their part- 7 ner without medical intervention; or (c) a licensed physician's or 8 osteopathic physician's findings based on a patient's medical, sexual, 9 or reproductive history, age, physical findings, or diagnostic testing. 10 Earlier evaluation and treatment may be warranted based on an individ- 11 ual's medical history or physical findings. 12 (ii) For purposes of this subsection, "iatrogenic infertility" means 13 an impairment of fertility by surgery, radiation, chemotherapy or other 14 medical treatment affecting reproductive organs or processes. 15 (G) Every large group contract that provides medical, major medical or 16 similar comprehensive-type coverage shall provide coverage for three 17 [~~cycles of~~] completed oocyte retrievals and in-vitro fertilization [~~used~~ 18 ~~in the treatment of infertility~~] with unlimited embryo transfers from 19 fresh or frozen oocytes or embryos from a covered retrieval, in accord- 20 ance with the guidelines of the American College of Obstetricians and 21 Gynecologists, using single embryo transfer (SET) when recommended and 22 medically appropriate for the treatment of infertility. Coverage may be 23 subject to annual deductibles and coinsurance, including copayments, as 24 may be deemed appropriate by the superintendent and as are consistent 25 with those established for other benefits within a given contract. [~~For~~ 26 ~~purposes of this subparagraph, a "cycle" is defined as either all treat-~~ 27 ~~ment that starts when: preparatory medications are administered for~~ 28 ~~ovarian stimulation for oocyte retrieval with the intent of undergoing~~ 29 ~~in-vitro fertilization using a fresh embryo transfer; or medications are~~ 30 ~~administered for endometrial preparation with the intent of undergoing~~ 31 ~~in-vitro fertilization using a frozen embryo transfer.~~] 32 § 33. Item (vii) of subparagraph (C) of paragraph 6 of subsection (k) 33 of section 3221 of the insurance law, as amended by section 1 of part L 34 of chapter 57 of the laws of 2019, is amended to read as follows: 35 (vii) Every large group policy delivered or issued for delivery in 36 this state that provides medical, major medical or similar comprehen- 37 sive-type coverage shall provide coverage for three cycles of in-vitro 38 fertilization used in the treatment of infertility. Coverage may be 39 subject to annual deductibles and coinsurance, including copayments, as 40 may be deemed appropriate by the superintendent and as are consistent 41 with those established for other benefits within a given policy. For 42 purposes of this item, a "cycle" is defined as either all treatment that 43 starts when: preparatory medications are administered for ovarian stimu- 44 lation for oocyte retrieval with the intent of undergoing in-vitro 45 fertilization using a fresh embryo transfer; or medications are adminis- 46 tered for endometrial preparation with the intent of undergoing in-vitro 47 fertilization using a frozen embryo transfer. A policy may not impose 48 any exclusions, limitations, or other restrictions on coverage of treat- 49 ment of infertility based on a covered individual's participation in 50 fertility services provided by or to a third party. 51 § 34. Subparagraph (G) of paragraph 3 of subsection (s) of section 52 4303 of the insurance law, as amended by section 2 of part L of chapter 53 57 of the laws of 2019, is amended to read as follows: 54 (G) Every large group contract that provides medical, major medical or 55 similar comprehensive-type coverage shall provide coverage for three 56 cycles of in-vitro fertilization used in the treatment of infertility.

S. 7749 54 1 Coverage may be subject to annual deductibles and coinsurance, including 2 copayments, as may be deemed appropriate by the superintendent and as 3 are consistent with those established for other benefits within a given 4 contract. For purposes of this subparagraph, a "cycle" is defined as 5 either all treatment that starts when: preparatory medications are 6 administered for ovarian stimulation for oocyte retrieval with the 7 intent of undergoing in-vitro fertilization using a fresh embryo trans- 8 fer; or medications are administered for endometrial preparation with 9 the intent of undergoing in-vitro fertilization using a frozen embryo 10 transfer. A policy may not impose any exclusions, limitations, or other 11 restrictions on coverage of treatment of infertility based on a covered 12 individual's participation in fertility services provided by or to a 13 third party. 14 § 35. The social services law is amended by adding a new section 365-p 15 to read as follows: 16 § 365-p. Enrollment in the state health insurance exchange; surrogacy 17 and egg donation. In addition to any triggering event that provides 18 eligibility for a special enrollment period available to individuals for 19 enrollment in a qualified health plan in the state health insurance 20 exchange established pursuant to the federal Patient Protection and 21 Affordable Care Act (P.L.111-148), the state health insurance exchange 22 shall allow for: 23 1. the enrollment of a person acting as surrogate who is a party to a 24 surrogacy agreement under part four of article five-C of the family 25 court act at any time after the surrogacy agreement has been executed. 26 Upon such enrollment, any qualified health plan in the state health 27 insurance exchange shall ensure that coverage is effective on the date 28 of application; and 29 2. the enrollment of an egg donor who is a party to a gamete donation 30 matched agreement or a gamete donation agency agreement under part eight 31 of article five-C of the family court act at any time after the gamete 32 donation matched agreement or the gamete donation agency agreement has 33 been executed. Upon such enrollment, any qualified health plan in the 34 state health insurance exchange shall ensure that coverage is effective 35 on the date of application. 36 § 36. This act shall take effect immediately.

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