119-hr1300

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1300 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 1300

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

 February 13, 2025

 Mr. Dunn of Florida (for himself, Ms. Clarke of New York, Mr. Murphy, 
 and Mr. Carter of Louisiana) 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 44 men dying from 
 prostate cancer and more than 35,700 men estimated to die from 
 prostate cancer in 2025.

    (2) Prostate cancer is the second most commonly diagnosed 
 cancer in the Nation with 1 in 8 men being diagnosed in their 
 lifetimes, 3.3 million men in the United States living with a 
 diagnosis, and over 310,000 men estimated to be diagnosed in 
 2025.

    (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 37 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 2.1 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 age 40 and over 
 and 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 evidence-based 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 prostate cancer;
 ``
        (B) who developed prostate cancer;
 ``
            (C) whose death was a result of prostate cancer;
 ``
            (D) who have been diagnosed with a cancer known 
 to be associated with increased risk of prostate 
 cancer; or
 ``
        (E) who has a genetic alteration known to be 
 associated with increased risk 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, 2026.
 <all>