The new policies allow anyone who has service-connected infertility to use either department’s program, lifting previous requirements that only married, heterosexual couples using their own sperm and eggs could participate.

Now, eligible troops and veterans can access IVF regardless of their martial status or sexual orientation, and they may use donor eggs or sperm ― changing a policy that previously discriminated against those whose infertility affected their ability to produce gametes.

The reforms were spurred on by a lawsuit filed in August by the Yale Law School and the National Organization for Women’s New York chapter.

“We are grateful to the Defense Department and overjoyed for the service members who, through this policy change, will now be able to access the reproductive healthcare so desperately needed in order to build their families,” Sonia Ossorio, executive director of NOW-NYC, said in a statement Monday.

DOD unveiled its new rules Friday, undoing restrictions that limited Tricare coverage of IVF to married couples only.

“We continue to identify ways to lean forward as much as we can in support of equity of access to reproductive health care for our service members,” Kimberly Lahm, who directors oversight of the Pentagon’s health affairs office, said in a statement Monday.

Veterans Affairs followed suit shortly thereafter, amending their policies to include married, same-sex couples and unmarried veterans in their IVF program. Officials there said they expect to begin enrolling newly eligible individuals in IVF programs in coming weeks.

“Raising a family is a wonderful thing, and I’m proud that VA is helping more veterans to have that opportunity,” VA Secretary Denis McDonough said in a statement. “This expansion of care has long been a priority for us, and we are working urgently to make sure that unmarried veterans and veterans in same-sex marriages will have access to IVF in every part of the country as soon as possible.”

But the moves don’t address everything in the original lawsuit, which seeks to open IVF access to all troops and veterans, regardless of whether their fertility issues were caused by illness or injury suffered while serving.

“This is substantial progress,” Donovan Bendana, a Yale Law School student representing NOW-NYC and member of the Reproductive Rights and Justice Project, said in a Monday release. “But the onerous requirement of linking infertility to a specific service injury will deny many service members the opportunity to build a family. This is especially arbitrary in light of the military’s decades-long disinterest in studying women’s health, including the impact of service on fertility.”

NOW-NYC intends to continue with the lawsuit, according to the release, seeking to remove all barriers to IVF for troops and veterans using federal health benefits.

During the two weeks that Defense Secretary Lloyd Austin spent in the hospital early this year, officials have emphasized that there was never a gap in the chain of command.

But when Austin went to Capitol Hill on Thursday to answer for his lack of transparency with his staff or the president, an open question remained regarding how neither the secretary nor anyone on his staff thought it was imperative to notify the White House that the defense secretary was in the hospital until three days in.

Twice during two hours of testimony before the House Armed Services Committee, Austin expressed accountability for the lack of notification, but added that he expected his staff would have taken care of it for him, as he didn’t have a phone from the time he got into an ambulance the night of Jan. 1.

“In terms of the hospitalization … I was the patient,” Austin told Rep. Lisa McClain, R-Mich. “And so my expectation is that the organization informed the right agencies, and so on.”

Earlier, Austin told Rep. Elise Stefanik, R-N.Y., that, “in my case, I know I would expect that my organization would do the right things to notify senior leaders, if I am the patient in the hospital.”

It was the first time Austin laid any blame for the events, other than previously admitting that he “didn’t get this right.”

Austin has said he never told anyone not to inform the chain of command, amid questions that he was attempting to keep his hospitalization a secret.

Austin has admitted that he chose not to inform anyone of his initial prostate cancer diagnosis or the Dec. 22 procedure to treat it, complications which landed him in the hospital on Jan. 1.

Previously, the Pentagon’s timeline has noted that Austin’s security team informed a military aide, who informed his chief of staff that he had gone to Walter Reed National Military Medical Center, and that ― while the chairman of the Joint Chiefs, the Pentagon’s press secretary and others were informed on Jan. 2 ― the chief of staff waited until Jan. 4 to inform the president and Congress.

The reason provided by the Pentagon for this lag was that Kelly Magsamen, Austin’s chief of staff, was out with the flu on Jan. 2 and Jan. 3, and waited to notify until she was back at work.

A review released Monday included more details, though it did not mention Magsumen specifically, instead stating that multiple members of Austin’s staff hesitated to make any notifications because they were concerned about “medical privacy laws” and a lack of written guidance for how to handle this specific situation.

The review’s recommendations do include more written guidelines, but there is also a requirement to explain to staff what is expected of them in these situations and what the privacy considerations actually are.

Lawmakers were incensed that neither Austin nor his staff notified the president or Congress in a timely manner, regardless of whether there was a written instruction somewhere that compelled them to do it.

“I do however think it was an extreme lack of leadership at some level, and I hope we identify that and there are consequences,” Rep. Trent Kelly, R-Miss., told Austin.

Multiple Republican lawmakers called for “consequences,” though those are unlikely to come. As a presidential appointee, Austin can only be fired by President Joe Biden, who has previously said he accepts Austin’s explanation and is not considering his removal.

In the course of one of those relationships, Laura M. DeSimone also misused government communications equipment to carry on the affair, while also using her position to advocate for a promotion for the subordinate, the investigation found.

“Ms. DeSimone added that the relationship was consensual and did not affect or interfere with her job in any way,” according to the report. “Ms. DeSimone told us that she did not think anyone at the MDA knew about her relationship with Subordinate 1.”

But witnesses the IG interviewed said they were well aware of the affair, and got the impression that DeSimone favored the woman over her coworkers.

The relationship lasted years, DeSimone told investigators, while she was her direct supervisor. She failed to report her relationship to her manager and to recuse herself from proceedings that could have given the impression of favoritism toward the subordinate, the report found, including advocating for a promotion for her.

Two calls to the DOD hotline in early 2021 sparked the investigation, one alleging an inappropriate relationship with a subordinate and another alleging sexual harassment against a different subordinate. The IG did not find any evidence of the second claim, but in interviewing 23 witness and reviewing millions of pieces of communication, found that DeSimone had engaged in inappropriate relationships.

DeSimone admitted to the IG that she’d had an affair with one subordinate between 2018 and 2022 while working at MDA, and another from 2005 to 2007 while serving at Naval Surface Warfare Center Dahlgren Division in Virginia. She denied, however, that she had been involved in efforts to promote the MDA subordinate.

The report also found that DeSimone used her government cell phone to carry on the affair, to the tune of more than 2,000 text messages and more than 580 phone calls from August 2018 to October 2020. While they did have a working relationship, the IG found that 61% of their communications happened on nights and weekends outside of working hours.

The IG recommended “appropriate action” for DeSimone, which its director, Air Force Lt. Gen. Heath Collins, is considering.

“Missile Defense Agency leadership is reviewing the findings of the IG report and will then decide what actions, if any, are appropriate to take,” Navy Cmdr. Timothy Gorman, a Pentagon spokesman, told Military Times on Thursday.

The report also recommends implementing a Defense Department policy for self-reporting intimate relationships at the office.

Austin’s most recent issue is not expected to affect his prostate cancer prognosis, his doctors said in a release Monday, and he is expected to be able to resume his normal duties on Tuesday.

“The current bladder issue is not expected to change his anticipated full recovery,” Dr. John Maddox, Walter Reed’s trauma director, and Dr. Gregory Chestnut, Walter Reed’s head of prostate disease research, said in a joint statement. “His cancer prognosis remains excellent.”

Deputy Defense Secretary Kathleen Hicks has been acting defense secretary since late Sunday afternoon, Air Force Maj. Gen. Pat Ryder, a Pentagon spokesman, told reporters Monday. Hicks was notified of Austin’s move to Walter Reed at the same time as White House and congressional officials, Ryder said.

Ryder did not say whether Austin’s “bladder issue” is related to the urinary tract infection that sent him to Walter Reed for two weeks earlier this year, a complication from a prostate cancer procedure completed Dec. 22.

Austin has canceled an upcoming trip to Europe, for which he was scheduled to leave Tuesday. He plans to participate remotely in a Ukraine Defense Contact Group meeting on Wednesday, Ryder said, but will be replaced by Celeste Wallander, assistant defense secretary for international security affairs, if he is not well enough to join.

Austin will be represented by NATO Ambassador Julie Smith on Thursday at a NATO ministerial meeting in Brussels, Belgium.

Before his hospitalization, Austin received a copy of a Pentagon review into his January hospitalization and recommendations for a new notification policy for senior government officials in the event of a defense secretary’s incapacitation.

Austin has handled his latest hospitalization with much more transparency than his previous stays at Walter Reed, during which time only a few members of his staff knew why he had temporarily passed duties to Hicks.

Ryder could not specify when Austin will sign off on the review or when the Pentagon will be able to share details publicly.

“Our aim is to try to provide as much information about the review to you, when we can,” he said.

The report, spurred by a spring 2018 IG hotline call, found “severe and systemic” problems with the unit’s internal controls on medication and a practice of using aliases to provide free care to White House staff, as well as a complete lack of oversight from the military health system.

“Dr. [X] asked if I could hook up this person with some Provigil as a parting gift for leaving the White House,” one witness told the IG, referring to an anti-sleepiness medication. “And at the time, the corpsmen and the medics … it was okay for us to dispense Provigil and Ambien without having a provider present. I’m not sure if it was okay as far as, like, what’s medically allowed. But in the unit, it was authorized for us to do that kind of stuff.”

The most recent review covered all executive medicine clinics in the Washington, D.C. area, which serve government officials including cabinet secretaries, Supreme Court justices, members of Congress and senior military officers.

The White House was the only unit found to be flouting regulations and operating without oversight, to include dispensing pills ― including narcotics like oxycodone and morphine ― directly rather than sending patients to a pharmacy.

These prescriptions were often handed out without verifying the staff member’s eligibility to access the White House medical unit, the report found.

And in some cases, staff generated aliases for White House staff so that they could receive specialty care or surgery at military facilities.

“Alias medical accounts provide alternate demographic data, such as name, date of birth, social security number, and military affiliation, in the electronic medical record,” a witness told the inspector general.

Witnesses told the IG that they believed the unit served the entire White House staff, despite regulations clearly stating that only beneficiaries of the military health system, including are covered.

The report includes two straightforward recommendations for the assistant defense secretary for health affairs, whose office agreed that the White House medical unit will get new, clear policies on requiring and determining patient eligibility and that the office will develop an oversight plan to review the unit’s practices going forward.

The hotline call that prompted the investigation report released this month came in the same time period as a dozen complaints about the unit, then run by now-retired Navy Rear Adm. Ronny Jackson, a current member of the U.S. House of Representatives who at the time had just been floated as a Trump administration nominee for Department of Veterans Affairs secretary.

Jackson is not named in the most recent IG report, which cites a “senior military medical officer” as in charge.

A report published in 2021 found that Jackson fostered a toxic command climate and drank while on duty throughout his time assigned to the White House during the Trump, Obama and second Bush administrations.

Jackson told Military Times in 2021 that the IG complaints were retaliation for his support of President Trump

The Defense Department has decided to lift previous regulations that only covered in-vitro fertilization for legally married couples using their own sperm and eggs, according to a Dec. 26 court filing in the New York state lawsuit.

A new policy is due out next month that will allow single troops, unmarried couples and any service members using donor sperm or eggs to have their treatment covered, according to a release from Yale Law School, which filed the suit on behalf of National Organization for Women – New York City in August.

Under the revised policy, service members in any relationship status can have IVF covered. They can also use donor sperm or eggs, where previously TRICARE would only cover IVF if the couple seeking treatments provided their own cells, excluding anyone who cannot produce viable sperm or eggs.

“We applaud the Department of Defense for working to expand access to fertility treatments for service members … But this is only the first step,” Sonia Ossorio, NOW-NYC’s executive director, said in a statement. “We will continue to challenge DoD and VA to remove all discriminatory barriers so that each and every service member and veteran who needs this reproductive care can access it.”

Though the government’s filing says that DoD expects to field a new IVF policy in February, the Pentagon was not able to confirm that timeline by Military Times’ deadline on Wednesday.

The Department of Veterans Affairs, also named in the lawsuit, has agreed to review its policies, according to the court filing, which currently only covers heterosexual married couples for such treatment.

The ongoing lawsuit also takes aim at a policy dictating that troops and veterans seeking fertility treatments can only have them covered if their infertility is considered service-linked. Examples include certain chemical exposures or injuries to reproductive organs.

And that coverage only applies to service members experiencing infertility but who can still safely carry a pregnancy, as IVF in conjunction with a gestational carrier, more commonly referred to as a surrogate, is not covered.

“Service members who delay child-rearing and need IVF because of basic demands of military life, like deployments and permanent changes of station, are ineligible for care,” Briana Thompson, a law student intern in the Veterans Legal Services Clinic at Yale Law School and former Air Force officer, said in the Wednesday release. “These stringent requirements are unlawful, out of step with IVF benefits provided to other federal employees, and antithetical to the centrality of the military family to readiness.”

But a DOD Inspector General review of more than 100,000 government purchase card transactions made from March 2020 to January 2022 reveals that roughly $54 million in purchases didn’t align with COVID-19 necessities.

That is nearly 40% of the $242 million spent on such needs, according to the IG report.

Another $52 million, in purchases wasn’t properly documented, and the IG was unable to verify what the cardholders actually bought.

“The audit determined that DOD [government purchase card] program officials did not conduct the required oversight to identify and correct improper or unsupported purchases by cardholders for the DOD’s response to COVID-19,” Robert Storch, the Pentagon’s inspector general, said in a Jan. 17 release accompanying the report.

The White House’s declaration of a national emergency freed up millions of dollars to be spent on pandemic response, but the IG’s report concluded that a large chunk of what DOD spent during that time was paid for with emergency funds despite the purchases having nothing to do with the pandemic.

In one example, an Army cardholder spent $2,000 on a plumber to investigate a sinkhole, then coded the purchase as “COVID-19.” The official who then signed off on the expense didn’t correct the coding.

In another, an Air Force cardholder spent $540 on internet service. When questioned, the command blamed “oversight error and high turnover rate at the location,” according to the report.

The erroneously coded transactions weren’t corrected, according to the report, because the officials charged with reviewing transactions didn’t do their jobs, despite existing guidelines requiring such reviews within 60 days.

“Addressing these issues is crucial to maintaining accountability, transparency, and the effective use of taxpayer resources in the response to COVID-19 and any future pandemics,” Storch said in the release.

When asked about their review practices, the Army said there was confusion about the requirements, the Navy gave conflicting versions of their practices and the Air Force said they aren’t required to document or report up the results of their reviews.

The head of Defense Pricing and Contracting agreed that $52 million had gone undocumented, but denied that the other $53 million was improperly spent.

“However, we concluded that the expenditure of funds were not necessary or reasonable for the intended and reported purpose (DoD’s COVID-19 response) and, therefore, met the definition of a questioned cost,” according to the report, adding that the official provide a response to the IG addressing the issue directly.

The IG recommended that the Government Purchase Card program not only “re-emphasize” the importance of documenting payment, but also create a process that will at least semiannually review purchases made in the name of a contingency operation, as well as create new oversight rules for the program in general.

As of the report’s release, Defense Pricing and Contracting has agreed to the recommendations, but hasn’t completed them.

The overall conduct of William Lietzau created a toxic work environment, the IG report said, as he not only reportedly harassed the subordinate, but created the perception within the office that he favored her and that the two were having an affair. Lietzau, however, will face no consequences, as he retired in October after a nearly 40-year career that included time as a Marine Corps infantry officer, a judge advocate and a civilian intelligence official.

“As I have said several times under oath, although I foolishly made myself vulnerable to some of these allegations, I did not commit any of the offenses alleged against me in this report,” Lietzau told Military Times on Wednesday. “The report recounts a false narrative and omits countless facts that do not support that narrative.”

The inspector general investigation began in spring 2021 with an anonymous complaint to the IG hotline about Lietzau’s reported sexual harassment of a member of his staff, along with a host of other infractions. The staff member had documented nearly two years of harassment, including text messages, recorded phone calls and multiple memorandums for record during particularly troubling incidents.

The first of those incidents occurred when, after a weekly staff check-in call in Lietzau’s hotel room as the two were traveling on business, Lietzau climbed on top of the subordinate, according to the report. Both parties told investigators she made clear she was not interested in an intimate relationship.

Lietzau’s written statements and interview statements explain that he thought the subordinate had been coming onto him for months, based on her behavior and how she dressed in the office, and that the temptation of her being in his hotel room was too much to overcome.

Witnesses interviewed recalled Lietzau repeatedly looking the woman up and down in front of others in the office, and recounted multiple disclosures from her that Lietzau made her uncomfortable to the point that she was avoiding being alone with him at work.

“He acknowledged his behavior when he told her, ‘And if you want to hear me say — and I crossed the line anyway and I shouldn’t have, sure. I’ll say that and take full responsibility. I have no excuses for that,’” according to the report. “He further demonstrated his awareness that his harassment contributed to the workplace perception that he was having an affair with her.”

The staff member described the encounter as traumatic, and while she tried to move on and continue a more normal working relationship with Lietzau, she realized a year later, after he confessed his love for her, that the situation could not be remedied.

The investigation also found evidence of his repeated disparagement of women, including one such incident during a promotion ceremony for the staff member, when he quipped that she must be extraordinary because he otherwise wouldn’t have picked her over a man.

An IG search of his emails turned up additional sexist comments.

“Although her official claim is that she has a higher pain threshold because she has been through childbirth—total bulls**t, but commonly used by the weaker gender,” he wrote in an email responding to someone asking about his wife’s health.

In another email from a colleague who had received a mentoring request from a man with a name Lietzau deemed feminine, Lietzau responded, “Mentor him to change his name to be more aligned with being a he….”

Emails also showed that Lietzau violated the Privacy Act when he disclosed security clearance status information while trying to help his brother and sister-in-law get jobs with the federal government.

The search then uncovered emails Lietzau sent rating and reviewing the 2020 presidential election candidates, describing Donald Trump as “narcissistic” and Joe Biden as “corrupt,” messages that violated DOD policy on political activities while serving in an official capacity.

Lietzau told Military Times “it is disingenuous to claim that an email from my office computer was an attempt to use my official position to influence the election without mentioning that it was sent to my children on a Sunday during the single week that I connected that computer to my home network because I had COVID.”

However, during the investigation, Lietzau admitted to sending emails with his political opinions to two subordinates as well.

The IG also found that he asked his subordinates to help him coordinate extracurricular activities with the International Christian Concern, a request against policies on subordinate duties.

And finally, Lietzau admitted to drinking alcohol, and encouraging subordinates to drink, in the office without required written authorization. Lietzau insisted that he was the authorizer, and so he did not need to make a formal request to have it approved.

Overall, Lietzau’s interviews with the IG and rebuttals to the findings reflect either a different recollection of events or no memory of them as they were revealed.

“The substantiation of false allegations does not benefit the cause of ending sexual harassment or any other worthy government purpose,” Lietzau said. “I have fully accepted responsibility for mistakes I made, but I will not admit to false allegations found in this report.”

Last fall, as four of the five Defense Department services and the Joint Chiefs of Staff prepared to welcome new leaders, a Republican senator from Alabama, Tommy Tuberville, was six months into his hold on senior military confirmations in protest of a Pentagon policy that allows paid leave and covers travel for reproductive health care access for service members.

It took until Nov. 2 for all four services and the Joint Chiefs to have new leadership confirmed, all of whom have been vice chiefs performing the role of two four-stars for weeks to months.

For the Army, Gen. Randy George was confirmed as the service’s chief of staff.

“The Army is doing a great job meeting all of our requirements globally,” George told Military Times in September. “I want us to continually look at how we get better at managing home station training, [operational tempo], and transformation so units have the appropriate time to meet their requirements and get the time they need to rest, refit, and stay connected with their families.”

On the Navy side, Adm. Lisa Franchetti’s confirmation made her the first woman to serve as chief of naval operations.

“The work of our Navy continues undisrupted and unabated,” she wrote in a message to the fleet as she awaited confirmation. “During this leadership transition, our core identity as sailors remains unchanged. We are forged by the sea and connected to each other through our core values of honor, courage, and commitment.”

Air Force Gen. David Allvin, meanwhile, took over the service’s chief of staff post from Gen. CQ Brown, who was named the chairman of the Joint Chiefs of Staff.

“My wife, Gina, and I are humbled by this opportunity, and we are eager to continue to serve our Air Force, our airmen and their families,” Allvin said in a statement after his promotion.

Marine Corps Gen. Eric Smith spent more than two months as his service’s acting commandant, receiving his official promotion in late September. Another month would elapse before his vice commandant was confirmed, a time during which Smith suffered a heart attack.

“Nobody should feel bad for me,” he told reporters Sept. 6. “I make plenty of money, and nobody usually yells at me, so that’s good. But it is not a sustainable thing when the last thing you do is flip your computer off at 11:30 at night and you’re getting up at 5 o’clock in the morning.”