Prostate-Specific Antigen Screening for High-risk Insured Men Act or the PSA Screening for HIM Act
This bill requires group health insurance plans to cover preventive prostate cancer screenings that are not already covered under the recommendations of the U.S. Preventive Services Task Force for men with a family history of prostate cancer, without imposing any cost-sharing requirement.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5200 Introduced in House (IH)]
<DOC>
116th CONGRESS
1st Session
H. R. 5200
To amend title XXVII of the Public Health Service Act to require group
health plans and health insurance issuers offering group or individual
health insurance coverage to provide coverage for prostate cancer
screenings without the imposition of cost-sharing requirements, and for
other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 20, 2019
Mr. Rush (for himself, Mr. Bucshon, Mr. Babin, Mrs. Brooks of Indiana,
Mr. Carson of Indiana, Ms. Judy Chu of California, Mr. Cohen, Mr. Dunn,
Mr. King of New York, Mr. Meeks, Mr. Murphy of North Carolina, Mr.
Payne, Mr. David P. Roe of Tennessee, Mr. David Scott of Georgia, Ms.
Sewell of Alabama, and Mr. Williams) introduced the following bill;
which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend title XXVII of the Public Health Service Act to require group
health plans and health insurance issuers offering group or individual
health insurance coverage to provide coverage for prostate cancer
screenings without the imposition of cost-sharing requirements, and for
other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Prostate-Specific Antigen Screening
for High-risk Insured Men Act'' or the ``PSA Screening for HIM Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Prostate cancer is the second leading cause of cancer
death in men in the United States with 1 in 41 men dying from
prostate cancer and more than 31,600 men estimated to die from
prostate cancer in 2019.
(2) Prostate cancer is the second most commonly diagnosed
cancer in the Nation with 1 in 9 men being diagnosed in their
lifetimes, 3.1 million men in the United States living with a
diagnosis, and over 174,000 men estimated to be diagnosed in
2019.
(3) The survival rate for prostate cancer diagnosed in
early stage is near 100 percent but prostate cancer diagnosed
in late stage has only a 30-percent survival rate.
(4) There are few, if any, symptoms of prostate cancer
before it reaches late stage.
(5) African-American men have a disproportionately higher
rate of prostate cancer and are 70 percent more likely to be
diagnosed with prostate cancer than White men, with 1 in 6
African-American men developing prostate cancer in their
lifetimes.
(6) African-American men are 2.3 times more likely to die
from prostate cancer than White men.
(7) Men with a father or brother with prostate cancer are
more than twice as likely to be diagnosed with prostate cancer
than men without a family history.
(8) The common clinical definition for men at high-risk of
prostate cancer includes African-American men and men with a
family history.
(9) Most of the major cancer and urological societies
recommend beginning screening discussions earlier for African-
American men and those with a family history of prostate
cancer.
(10) The United States Preventive Services Task Force has
encouraged research on screening African-American men,
including whether to screen African-American men at younger
ages, and has identified this research as a high-priority
cancer research gap.
(11) Barriers to screening should be minimized for high-
risk men in order to catch asymptomatic prostate cancer before
it metastasizes and the survival rate is dramatically reduced.
(12) The cost of treating metastatic prostate cancer in the
United States health care system is hundreds of millions of
dollars more annually than the cost of treating localized,
early-stage cancer.
SEC. 3. REQUIREMENT FOR GROUP HEALTH PLANS AND HEALTH INSURANCE ISSUERS
OFFERING GROUP OR INDIVIDUAL HEALTH INSURANCE COVERAGE TO
PROVIDE COVERAGE FOR PROSTATE CANCER SCREENINGS WITHOUT
IMPOSITION OF COST-SHARING REQUIREMENTS.
(a) In General.--Subsection (a) of section 2713 of the Public
Health Service Act (42 U.S.C. 300gg-13) is amended to read as follows:
``(a) Coverage of Preventive Health Services.--
``(1) In general.--A group health plan and a health
insurance issuer offering group or individual health insurance
coverage shall, at a minimum, provide coverage for and shall
not impose any cost-sharing requirements for--
``(A) evidence-based items or services that have in
effect a rating of `A' or `B' in the current
recommendations of the United States Preventive
Services Task Force;
``(B) immunizations that have in effect a
recommendation from the Advisory Committee on
Immunization Practices of the Centers for Disease
Control and Prevention with respect to the individual
involved;
``(C) with respect to infants, children, and
adolescents, evidence-informed preventive care and
screenings provided for in the comprehensive guidelines
supported by the Health Resources and Services
Administration;
``(D) with respect to women, such additional
preventive care and screenings not described in
subparagraph (A) as provided for in comprehensive
guidelines supported by the Health Resources and
Services Administration for purposes of this
subparagraph; and
``(E) with respect to men who are at high risk of
developing prostate cancer (including African-American
men and men with a family history of prostate cancer
(as defined in paragraph (2))), such additional
preventive care and screenings not described in
subparagraph (A) for prostate cancer.
``(2) Men with a family history of prostate cancer
defined.--For purposes of paragraph (1)(E), the term `men with
a family history of prostate cancer' means men who have a
first-degree relative--
``(A) who was diagnosed with metastatic prostate
cancer;
``(B) who developed metastatic prostate cancer; or
``(C) whose death was a result of prostate cancer.
``(3) Clarification regarding breast cancer screening,
mammography, and prevention recommendations.--For the purposes
of this Act, and for the purposes of any other provision of
law, the current recommendations of the United States
Preventive Service Task Force regarding breast cancer
screening, mammography, and prevention shall be considered the
most current other than those issued in or around November
2009.
``(4) Rule of construction.--Nothing in this subsection
shall be construed to prohibit a plan or issuer from providing
coverage for services in addition to those recommended by the
United States Preventive Services Task Force or to deny
coverage for services that are not recommended by such Task
Force.''.
(b) Effective Date.--The amendment made by subsection (a) shall
apply with respect to plan years beginning on or after January 1, 2021.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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