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 Caro-
lina, 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 Com-
merce 
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 cov-
erage 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 Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Prostate-Specific Anti-
gen 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 41 men dying from prostate cancer and more 
than 31,600 men estimated to die from prostate 
cancer in 2019. 
(2) Prostate cancer is the second most com-
monly diagnosed cancer in the Nation with 1 in 9 
men being diagnosed in their lifetimes, 3.1 million 
men in the United States living with a diagnosis, 
and over 174,000 men estimated to be diagnosed in 
2019. 
(3) The survival rate for prostate cancer diag-
nosed in early stage is near 100 percent but prostate 
cancer diagnosed in late stage has only a 30-percent 
survival rate. 
(4) There are few, if any, symptoms of prostate 
cancer before it reaches late stage. 
(5) African-American men have a disproportion-
ately higher rate of prostate cancer and are 70 per-
cent more likely to be diagnosed with prostate can-
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cer than White men, with 1 in 6 African-American 
men developing prostate cancer in their lifetimes. 
(6) African-American men are 2.3 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 his-
tory. 
(8) The common clinical definition for men at 
high-risk of prostate cancer includes African-Amer-
ican men and men with a family history. 
(9) Most of the major cancer and urological so-
cieties 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 re-
search gap. 
(11) Barriers to screening should be minimized 
for high-risk men in order to catch asymptomatic 
prostate cancer before it metastasizes and the sur-
vival rate is dramatically reduced. 
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(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 
REQUIRE-
MENTS. 
(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 SERV-
ICES.— 
‘‘(1) IN GENERAL.—A group health plan and a 
health insurance issuer offering group or individual 
health insurance coverage shall, at a minimum, pro-
vide coverage for and shall not impose any cost-shar-
ing requirements for— 
‘‘(A) evidence-based items or services that 
have in effect a rating of ‘A’ or ‘B’ in the cur-
rent recommendations of the United States Pre-
ventive Services Task Force; 
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‘‘(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 comprehen-
sive guidelines supported by the Health Re-
sources and Services Administration; 
‘‘(D) with respect to women, such addi-
tional preventive care and screenings not de-
scribed 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 at high 
risk of developing prostate cancer (including Af-
rican-American men and men with a family his-
tory of prostate cancer (as defined in paragraph 
(2))), such additional preventive care and 
screenings not described in subparagraph (A) 
for prostate cancer. 
‘‘(2) MEN WITH A FAMILY HISTORY OF PROS-
TATE
CANCER
DEFINED.—For purposes of para-
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graph (1)(E), the term ‘men with a family history 
of prostate cancer’ means men who have a first-de-
gree relative— 
‘‘(A) who was diagnosed with metastatic 
prostate cancer; 
‘‘(B) who developed metastatic prostate 
cancer; or 
‘‘(C) whose death was a result of prostate 
cancer. 
‘‘(3) CLARIFICATION REGARDING BREAST CAN-
CER 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 can-
cer 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 ad-
dition 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.’’. 
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(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply with respect to plan years begin-
ning on or after January 1, 2021. 
Æ 
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