H.R. 1826: Prostate-Specific Antigen Screening for High-risk Insured Men Act
This bill aims to amend the Public Health Service Act to require group health plans and health insurance issuers to provide coverage for prostate cancer screenings without additional costs to individuals. The bill also recognizes the importance of early detection and treatment in improving survival rates for prostate cancer.
Findings
The bill provides several factual findings, including:
- Prostate cancer is the second leading cause of cancer death in men in the United States, with an estimated 34,700 deaths in 2023.
- Prostate cancer is the second most commonly diagnosed cancer in the country, with over 288,000 new cases estimated in 2023.
- The survival rate for prostate cancer is nearly 100% when diagnosed early but drops to 30% when diagnosed in late stages.
- African-American men have a higher risk of developing and dying from prostate cancer compared to White men.
- Men with a family history of prostate cancer are more likely to be diagnosed with the disease.
- The cost of treating advanced prostate cancer is significantly higher than treating early-stage cancer.
Requirement for Coverage
The bill requires group health plans and health insurance issuers offering group or individual health insurance coverage to cover preventive health services without any cost-sharing requirements. This includes evidence-based items and services recommended by the United States Preventive Services Task Force and immunizations recommended by the Advisory Committee on Immunization Practices.
Specific to prostate cancer, the bill mandates coverage for high-risk men aged 40 and over, including African-American men and those with a family history of prostate cancer. These individuals should have access to evidence-based preventive care and screenings for prostate cancer without cost-sharing.
Effective Date
The amendment made by this bill will apply to plan years beginning on or after January 1, 2024.