I 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Prostate-Specific Anti3 gen Screening for High-risk Insured Men Act’’ or the 

4 ‘‘PSA Screening for HIM Act’’. 

5 SEC. 2. FINDINGS. 

6 Congress finds the following: 

7 (1) Prostate cancer is the second leading cause 

8 of cancer death in men in the United States with 1 

9 in 41 men dying from prostate cancer and more 

10 than 31,600 men estimated to die from prostate 

11 cancer in 2019. 

12 (2) Prostate cancer is the second most com13 monly diagnosed cancer in the Nation with 1 in 9 

14 men being diagnosed in their lifetimes, 3.1 million 

15 men in the United States living with a diagnosis, 

16 and over 174,000 men estimated to be diagnosed in 

17 2019. 

18 (3) The survival rate for prostate cancer diag19 nosed in early stage is near 100 percent but prostate 

20 cancer diagnosed in late stage has only a 30-percent 

21 survival rate. 

22 (4) There are few, if any, symptoms of prostate 

23 cancer before it reaches late stage. 

24 (5) African-American men have a disproportion25 ately higher rate of prostate cancer and are 70 per26 cent more likely to be diagnosed with prostate canVerDate Sep 11 2014 23:09 Nov 29, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5200.IH H5200

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1 cer than White men, with 1 in 6 African-American 

2 men developing prostate cancer in their lifetimes. 

3 (6) African-American men are 2.3 times more 

4 likely to die from prostate cancer than White men. 

5 (7) Men with a father or brother with prostate 

6 cancer are more than twice as likely to be diagnosed 

7 with prostate cancer than men without a family his8 tory. 

9 (8) The common clinical definition for men at 

10 high-risk of prostate cancer includes African-Amer11 ican men and men with a family history. 

12 (9) Most of the major cancer and urological so13 cieties recommend beginning screening discussions 

14 earlier for African-American men and those with a 

15 family history of prostate cancer. 

16 (10) The United States Preventive Services 

17 Task Force has encouraged research on screening 

18 African-American men, including whether to screen 

19 African-American men at younger ages, and has 

20 identified this research as a high-priority cancer re21 search gap. 

22 (11) Barriers to screening should be minimized 

23 for high-risk men in order to catch asymptomatic 

24 prostate cancer before it metastasizes and the sur25 vival rate is dramatically reduced. 


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1 (12) The cost of treating metastatic prostate 

2 cancer in the United States health care system is 

3 hundreds of millions of dollars more annually than 

4 the cost of treating localized, early-stage cancer. 

5 SEC. 3. REQUIREMENT FOR GROUP HEALTH PLANS AND 

6 HEALTH INSURANCE ISSUERS OFFERING 

7 GROUP OR INDIVIDUAL HEALTH INSURANCE 

8 COVERAGE TO PROVIDE COVERAGE FOR 

9 PROSTATE CANCER SCREENINGS WITHOUT 

10 IMPOSITION OF COST-SHARING REQUIRE11 MENTS. 

12 (a) IN GENERAL.—Subsection (a) of section 2713 of 

13 the Public Health Service Act (42 U.S.C. 300gg–13) is 

14 amended to read as follows: 

15 ‘‘(a) COVERAGE OF PREVENTIVE HEALTH SERV16 ICES.— 

17 ‘‘(1) IN GENERAL.—A group health plan and a 

18 health insurance issuer offering group or individual 

19 health insurance coverage shall, at a minimum, pro20 vide coverage for and shall not impose any cost-shar21 ing requirements for— 

22 ‘‘(A) evidence-based items or services that 

23 have in effect a rating of ‘A’ or ‘B’ in the cur24 rent recommendations of the United States Pre25 ventive Services Task Force; 


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1 ‘‘(B) immunizations that have in effect a 

2 recommendation from the Advisory Committee 

3 on Immunization Practices of the Centers for 

4 Disease Control and Prevention with respect to 

5 the individual involved; 

6 ‘‘(C) with respect to infants, children, and 

7 adolescents, evidence-informed preventive care 

8 and screenings provided for in the comprehen9 sive guidelines supported by the Health Re10 sources and Services Administration; 

11 ‘‘(D) with respect to women, such addi12 tional preventive care and screenings not de13 scribed in subparagraph (A) as provided for in 

14 comprehensive guidelines supported by the 

15 Health Resources and Services Administration 

16 for purposes of this subparagraph; and 

17 ‘‘(E) with respect to men who are at high 

18 risk of developing prostate cancer (including Af19 rican-American men and men with a family his20 tory of prostate cancer (as defined in paragraph 

21 (2))), such additional preventive care and 

22 screenings not described in subparagraph (A) 

23 for prostate cancer. 

24 ‘‘(2) MEN WITH A FAMILY HISTORY OF PROS25 TATE CANCER DEFINED.—For purposes of paraVerDate Sep 11 2014 21:50 Dec 02, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5200.IH H5200

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1 graph (1)(E), the term ‘men with a family history 

2 of prostate cancer’ means men who have a first-de3 gree relative— 

4 ‘‘(A) who was diagnosed with metastatic 

5 prostate cancer; 

6 ‘‘(B) who developed metastatic prostate 

7 cancer; or 

8 ‘‘(C) whose death was a result of prostate 

9 cancer. 

10 ‘‘(3) CLARIFICATION REGARDING BREAST CAN11 CER SCREENING, MAMMOGRAPHY, AND PREVENTION

12 RECOMMENDATIONS.—For the purposes of this Act, 

13 and for the purposes of any other provision of law, 

14 the current recommendations of the United States 

15 Preventive Service Task Force regarding breast can16 cer screening, mammography, and prevention shall 

17 be considered the most current other than those 

18 issued in or around November 2009. 

19 ‘‘(4) RULE OF CONSTRUCTION.—Nothing in 

20 this subsection shall be construed to prohibit a plan 

21 or issuer from providing coverage for services in ad22 dition to those recommended by the United States 

23 Preventive Services Task Force or to deny coverage 

24 for services that are not recommended by such Task 

25 Force.’’. 


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1 (b) EFFECTIVE DATE.—The amendment made by 

2 subsection (a) shall apply with respect to plan years begin3 ning on or after January 1, 2021. 

Æ 


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