I

104TH CONGRESS

1ST SESSION H. R. 780

To amend title XIX of the Social Security Act to provide for coverage

of prostate cancer screening tests under the medicaid program.

IN THE HOUSE OF REPRESENTATIVES

FEBRUARY 1, 1995

Mrs. VUCANOVICH introduced the following bill; which was referred to the

Committee on Commerce

A BILL

To amend title XIX of the Social Security Act to provide

for coverage of prostate cancer screening tests under

the medicaid program.

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

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Medicaid Prostate

5 Cancer Screening Act of 1995’’.

6 SEC. 2. FINDINGS.

7 Congress finds the following:

8 (1) Prostate cancer is the second leading cause

9 of cancer death among men.
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1 (2) An estimated 244,000 new cases of prostate

2 cancer in the United States are expected during

3 1995.

4 (3) An estimated 40,400 men are expected to

5 die of prostate cancer during 1995.

6 (4) The incidence of prostate cancer increases

7 with age and over 80 percent of all prostate cancers

8 are diagnosed in men over age 65.

9 (5) Early detection of prostate cancer is the

10 best way to control its growth and treat the tumors.

11 (6) Survival rates for prostate cancer have

12 steadily improved from 50 percent to 80 percent in

13 the past 30 years largely due to increases in the

14 early detection of the disease.

15 (7) The American Cancer Society and other

16 health organizations recommend an annual digital

17 rectal examination for men starting at age 40 and

18 an annual prostate-specific antigen blood test start19 ing at age 50.

20 (8) Lower-income men are often unable to af21 ford recommended cancer screening.

22 (9) Many lower-income men receive health care

23 benefits under the medicaid program.
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1 SEC. 3. COVERAGE OF PROSTATE CANCER SCREENING

2 TESTS UNDER MEDICAID.

3 (a) IN GENERAL.—Section 1905(a) of the Social Se4 curity Act (42 U.S.C. 1396d(a)) is amended—

5 (1) by striking ‘‘and’’ at the end of paragraph

6 (24);

7 (2) by redesignating paragraph (25) as para8 graph (26); and

9 (3) by inserting after paragraph (24) the fol10 lowing new paragraph:

11 ‘‘(25) prostate cancer screening tests (as de12 fined in subsection (t)); and’’.

13 (b) DEFINITION.—Section 1905 of such Act (42

14 U.S.C. 1396d) is amended by adding at the end the follow15 ing new subsection:

16 ‘‘(t) The term ‘prostate cancer screening test’ means

17 a test that consists of a digital rectal examination or a

18 prostate-specific antigen blood test (or both) provided for

19 the purpose of early detection of prostate cancer to a man

20 over 40 years of age who has not had such a test during

21 the preceding year.’’.

22 (c) MAKING COVERAGE MANDATORY.—Section

23 1902(a)(10)(A) of such Act (42 U.S.C. 1396a(a)(10)(A))

24 is amended by striking ‘‘(17) and (21)’’ and inserting

25 ‘‘(17), (21) and (25)’’.
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1 (d) 100 PERCENT FEDERAL MATCH FOR TESTS.—

2 Section 1905(b) of such Act (42 U.S.C. 1396d(b)) is

3 amended by adding at the end the following: ‘‘Notwith4 standing the first sentence of this subsection, the Federal

5 medical assistance percentage shall be 100 percent with

6 respect to amounts expended for medical assistance con7 sisting of prostate cancer screening tests (as defined in

8 subsection (t)).’’.

9 (e) CONFORMING AMENDMENTS.—(1) Section

10 1902(a)(10)(C)(iv) (42 U.S.C. 1396a(a)(10)(C)(iv)) is

11 amended—

12 (A) by striking ‘‘(5) and (17)’’ and inserting

13 ‘‘(5), (17), and (25)’’; and

14 (B) by striking ‘‘through (21)’’ and inserting

15 ‘‘through (25)’’.

16 (2) Section 1902(j) (42 U.S.C. 1396a(j)) is amended

17 by striking ‘‘through (22)’’ and inserting ‘‘through (26)’’.

18 (f) EFFECTIVE DATE.—(1) Except as provided in

19 paragraph (2), the amendments made by this section shall

20 apply to prostate cancer screening tests performed on or

21 after January 1, 1996, without regard to whether or not

22 final regulations to carry out such amendments have been

23 promulgated by such date.

24 (2) In the case of a State plan for medical assistance

25 under title XIX of the Social Security Act which the Sec-
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1 retary of Health and Human Services determines requires

2 State legislation (other than legislation appropriating

3 funds) in order for the plan to meet the additional require4 ment imposed by the amendments made by this section,

5 the State plan shall not be regarded as failing to comply

6 with the requirements of such title solely on the basis of

7 its failure to meet this additional requirement before the

8 first day of the first calendar quarter beginning after the

9 close of the first regular session of the State legislature

10 that begins after the date of the enactment of this Act.

11 For purposes of the previous sentence, in the case of a

12 State that has a 2-year legislative session, each year of

13 such session shall be deemed to be a separate regular ses14 sion of the State legislature.

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