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[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2137 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 2137

To amend the Public Health Service Act, the Employee Retirement Income 
 Security Act of 1974, the Internal Revenue Code of 1986, and title 5, 
 United States Code, to require individual and group health insurance 
 coverage and group health plans and Federal employees health benefit 
          plans to provide coverage for routine HIV screening.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             April 28, 2009

   Ms. Waters (for herself, Mr. Stark, Mrs. Christensen, Ms. Lee of 
  California, Mr. Meeks of New York, and Mr. Frank of Massachusetts) 
 introduced the following bill; which was referred to the Committee on 
Energy and Commerce, and in addition to the Committees on Education and 
   Labor, Ways and Means, and Oversight and Government Reform, for a 
 period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL

 
To amend the Public Health Service Act, the Employee Retirement Income 
 Security Act of 1974, the Internal Revenue Code of 1986, and title 5, 
 United States Code, to require individual and group health insurance 
 coverage and group health plans and Federal employees health benefit 
          plans to provide coverage for routine HIV screening.

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

SECTION 1. SHORT TITLE; FINDINGS.

    (a) Short Title.--This Act may be cited as the ``Routine HIV 
Screening Coverage Act of 2009''.
    (b) Findings.--Congress finds the following:
            (1) HIV/AIDS continues to infect and kill thousands of 
        Americans, 25 years after the first cases were reported.
            (2) It has been estimated that at least 1.6 million 
        Americans have been infected with HIV since the beginning of 
        the epidemic and over 500,000 of them have died.
            (3) The HIV/AIDS epidemic has disproportionately impacted 
        African-Americans and Hispanic-Americans and its impact on 
        women is growing.
            (4) It has been estimated that almost one quarter of those 
        infected with HIV in the United States do not know they are 
        infected.
            (5) Not all individuals who have been infected with HIV 
        demonstrate clinical indications or fall into high risk 
        categories.
            (6) The Centers for Disease Control and Prevention has 
        determined that increasing the proportion of people who know 
        their HIV status is an essential component of comprehensive 
        HIV/AIDS treatment and prevention efforts and that early 
        diagnosis is critical in order for people with HIV/AIDS to 
        receive life-extending therapy.
            (7) On September 21, 2006, the Centers for Disease Control 
        and Prevention released new guidelines that recommend routine 
        HIV screening in health care settings for all patients aged 13-
        64, regardless of risk.
            (8) Standard health insurance plans generally cover HIV 
        screening when there are clinical indications of infection or 
        when there are known risk factors present.
            (9) Requiring health insurance plans to cover routine HIV 
        screening could play a critical role in preventing the spread 
        of HIV/AIDS and allowing infected individuals to receive 
        effective treatment.

SEC. 2. COVERAGE FOR ROUTINE HIV SCREENING UNDER GROUP HEALTH PLANS, 
              INDIVIDUAL HEALTH INSURANCE COVERAGE, AND FEHBP.

    (a) Group Health Plans.--
            (1) Public health service act amendments.--Subpart 2 of 
        part A of title XXVII of the Public Health Service Act is 
        amended by adding at the end the following new section:

``SEC. 2708. COVERAGE FOR ROUTINE HIV SCREENING.

    ``(a) Coverage.--A group health plan, and a health insurance issuer 
offering group health insurance coverage, shall provide coverage for 
routine HIV screening under terms and conditions that are no less 
favorable than the terms and conditions applicable to other routine 
health screenings.
    ``(b) Prohibitions.--A group health plan, and a health insurance 
issuer offering group health insurance coverage, shall not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan, solely for the purpose of avoiding the requirements 
        of this section;
            ``(2) deny coverage for routine HIV screening on the basis 
        that there are no known risk factors present, or the screening 
        is not clinically indicated, medically necessary, or pursuant 
        to a referral, consent, or recommendation by any health care 
        provider;
            ``(3) provide monetary payments, rebates, or other benefits 
        to individuals to encourage such individuals to accept less 
        than the minimum protections available under this section;
            ``(4) penalize or otherwise reduce or limit the 
        reimbursement of a provider because such provider provided care 
        to an individual participant or beneficiary in accordance with 
        this section;
            ``(5) provide incentives (monetary or otherwise) to a 
        provider to induce such provider to provide care to an 
        individual participant or beneficiary in a manner inconsistent 
        with this section; or
            ``(6) deny to an individual participant or beneficiary 
        continued eligibility to enroll or to renew coverage under the 
        terms of the plan, solely because of the results of an HIV test 
        or other HIV screening procedure for the individual or any 
        other individual.
    ``(c) Rules of Construction.--Nothing in this section shall be 
construed--
            ``(1) to require an individual who is a participant or 
        beneficiary to undergo HIV screening; or
            ``(2) as preventing a group health plan or issuer from 
        imposing deductibles, coinsurance, or other cost-sharing in 
        relation to HIV screening, except that such deductibles, 
        coinsurance or other cost-sharing may not be greater than the 
        deductibles, coinsurance, or other cost-sharing imposed on 
        other routine health screenings.
    ``(d) Notice.--A group health plan under this part shall comply 
with the notice requirement under section 715(d) of the Employee 
Retirement Income Security Act of 1974 with respect to the requirements 
of this section as if such section applied to such plan.
    ``(e) Preemption.--Nothing in this section shall be construed to 
preempt any State law in effect on the date of enactment of this 
section with respect to health insurance coverage that requires 
coverage of at least the coverage of HIV screening otherwise required 
under this section.''.
            (2) ERISA amendments.--(A) Subpart B of part 7 of subtitle 
        B of title I of the Employee Retirement Income Security Act of 
        1974 is amended by adding at the end the following new section:

``SEC. 715. COVERAGE FOR ROUTINE HIV SCREENING.

    ``(a) Coverage.--A group health plan, and a health insurance issuer 
offering group health insurance coverage, shall provide coverage for 
routine HIV screening under terms and conditions that are no less 
favorable than the terms and conditions applicable to other routine 
health screenings.
    ``(b) Prohibitions.--A group health plan, and a health insurance 
issuer offering group health insurance coverage, shall not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan, solely for the purpose of avoiding the requirements 
        of this section;
            ``(2) deny coverage for routine HIV screening on the basis 
        that there are no known risk factors present, or the screening 
        is not clinically indicated, medically necessary, or pursuant 
        to a referral, consent, or recommendation by any health care 
        provider;
            ``(3) provide monetary payments, rebates, or other benefits 
        to individuals to encourage such individuals to accept less 
        than the minimum protections available under this section;
            ``(4) penalize or otherwise reduce or limit the 
        reimbursement of a provider because such provider provided care 
        to an individual participant or beneficiary in accordance with 
        this section;
            ``(5) provide incentives (monetary or otherwise) to a 
        provider to induce such provider to provide care to an 
        individual participant or beneficiary in a manner inconsistent 
        with this section; or
            ``(6) deny to an individual participant or beneficiary 
        continued eligibility to enroll or to renew coverage under the 
        terms of the plan, solely because of the results of an HIV test 
        or other HIV screening procedure for the individual or any 
        other individual.
    ``(c) Rules of Construction.--Nothing in this section shall be 
construed--
            ``(1) to require an individual who is a participant or 
        beneficiary to undergo HIV screening; or
            ``(2) as preventing a group health plan or issuer from 
        imposing deductibles, coinsurance, or other cost-sharing in 
        relation to HIV screening, except that such deductibles, 
        coinsurance or other cost-sharing may not be greater than the 
        deductibles, coinsurance, or other cost-sharing imposed on 
        other routine health screenings.
    ``(d) Notice Under Group Health Plan.--A group health plan, and a 
health insurance issuer providing health insurance coverage in 
connection with a group health plan, shall provide notice to each 
participant and beneficiary under such plan regarding the coverage 
required by this section in accordance with regulations promulgated by 
the Secretary. Such notice shall be in writing and prominently 
positioned in any literature or correspondence made available or 
distributed by the plan or issuer and shall be transmitted--
            ``(1) in the next mailing made by the plan or issuer to the 
        participant or beneficiary;
            ``(2) as part of any yearly informational packet sent to 
        the participant or beneficiary; or
            ``(3) not later than January 1, 2010;
whichever is earliest.
    ``(e) Preemption, Relation to State Laws.--
            ``(1) In general.--Nothing in this section shall be 
        construed to preempt any State law in effect on the date of 
        enactment of this section with respect to health insurance 
        coverage that requires coverage of at least the coverage of HIV 
        screening otherwise required under this section.
            ``(2) ERISA.--Nothing in this section shall be construed to 
        affect or modify the provisions of section 514 with respect to 
        group health plans.''.
            (B) Section 732(a) of such Act (29 U.S.C. 1191a(a)) is 
        amended by striking ``section 711'' and inserting ``sections 
        711 and 715''.
            (C) The table of contents in section 1 of such Act is 
        amended by inserting after the item relating to section 714 the 
        following new item:

``Sec. 715. Coverage for routine HIV screening.''.
            (3) Internal revenue code amendments.--(A) Subchapter B of 
        chapter 100 of the Internal Revenue Code of 1986 is amended by 
        inserting after section 9813 the following:

``SEC. 9814. COVERAGE FOR ROUTINE HIV SCREENING.

    ``(a) Coverage.--A group health plan shall provide coverage for 
routine HIV screening under terms and conditions that are no less 
favorable than the terms and conditions applicable to other routine 
health screenings.
    ``(b) Prohibitions.--A group health plan shall not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan, solely for the purpose of avoiding the requirements 
        of this section;
            ``(2) deny coverage for routine HIV screening on the basis 
        that there are no known risk factors present, or the screening 
        is not clinically indicated, medically necessary, or pursuant 
        to a referral, consent, or recommendation by any health care 
        provider;
            ``(3) provide monetary payments, rebates, or other benefits 
        to individuals to encourage such individuals to accept less 
        than the minimum protections available under this section;
            ``(4) penalize or otherwise reduce or limit the 
        reimbursement of a provider because such provider provided care 
        to an individual participant or beneficiary in accordance with 
        this section;
            ``(5) provide incentives (monetary or otherwise) to a 
        provider to induce such provider to provide care to an 
        individual participant or beneficiary in a manner inconsistent 
        with this section; or
            ``(6) deny to an individual participant or beneficiary 
        continued eligibility to enroll or to renew coverage under the 
        terms of the plan, solely because of the results of an HIV test 
        or other HIV screening procedure for the individual or any 
        other individual.
    ``(c) Rules of Construction.--Nothing in this section shall be 
construed--
            ``(1) to require an individual who is a participant or 
        beneficiary to undergo HIV screening; or
            ``(2) as preventing a group health plan or issuer from 
        imposing deductibles, coinsurance, or other cost-sharing in 
        relation to HIV screening, except that such deductibles, 
        coinsurance or other cost-sharing may not be greater than the 
        deductibles, coinsurance, or other cost-sharing imposed on 
        other routine health screenings.''.
            (B) The table of sections of such subchapter is amended by 
        inserting after the item relating to section 9813 the following 
        new item:

``Sec. 9814. Coverage for routine HIV screening.''.
            (C) Section 4980D(d)(1) of such Code is amended by striking 
        ``section 9811'' and inserting ``sections 9811 and 9814''.
    (b) Application to Individual Health Insurance Coverage.--(1) Part 
B of title XXVII of the Public Health Service Act is amended by 
inserting after section 2753 the following new section:

``SEC. 2754. COVERAGE FOR ROUTINE HIV SCREENING.

    ``(a) In General.--The provisions of section 2708 (other than 
subsection (d)) shall apply to health insurance coverage offered by a 
health insurance issuer in the individual market in the same manner as 
it applies to health insurance coverage offered by a health insurance 
issuer in connection with a group health plan in the small or large 
group market.
    ``(b) Notice.--A health insurance issuer under this part shall 
comply with the notice requirement under section 715(d) of the Employee 
Retirement Income Security Act of 1974 with respect to the requirements 
referred to in subsection (a) as if such section applied to such issuer 
and such issuer were a group health plan.''.
    (2) Section 2762(b)(2) of such Act (42 U.S.C. 300gg-62(b)(2)) is 
amended by striking ``section 2751'' and inserting ``sections 2751 and 
2754''.
    (c) Application Under Federal Employees Health Benefits Program 
(FEHBP).--Section 8902 of title 5, United States Code, is amended by 
adding at the end the following new subsection:
    ``(p) A contract may not be made or a plan approved which does not 
comply with the requirements of section 2708 of the Public Health 
Service Act.''.
    (d) Effective Dates.--(1) The amendments made by subsections (a) 
and (c) apply with respect to group health plans and health benefit 
plans for plan years beginning on or after January 1, 2010.
    (2) The amendments made by subsection (b) shall apply with respect 
to health insurance coverage offered, sold, issued, renewed, in effect, 
or operated in the individual market on or after January 1, 2010.
    (e) Coordination of Administration.--The Secretary of Labor, the 
Secretary of Health and Human Services, and the Secretary of the 
Treasury shall ensure, through the execution of an interagency 
memorandum of understanding among such Secretaries, that--
            (1) regulations, rulings, and interpretations issued by 
        such Secretaries relating to the same matter over which two or 
        more such Secretaries have responsibility under the provisions 
        of this section (and the amendments made thereby) are 
        administered so as to have the same effect at all times; and
            (2) coordination of policies relating to enforcing the same 
        requirements through such Secretaries in order to have a 
        coordinated enforcement strategy that avoids duplication of 
        enforcement efforts and assigns priorities in enforcement.
                                 <all>
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