I 
110TH CONGRESS 
1ST SESSION H. R. 1903 
To amend the Public Health Service Act and Employee Retirement Income 
Security Act of 1974 to require that group and individual health insur-
ance coverage and group health plans provide coverage for reconstructive 
prosthetic urology surgery if they provide coverage for prostate cancer 
treatment. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 17, 2007 
Mr. TOWNS introduced the following bill; which was referred to the Committee 
on Energy and Commerce, and in addition to the Committee on Edu-
cation and Labor, 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 and Employee Re-
tirement Income Security Act of 1974 to require that 
group and individual health insurance coverage and 
group health plans provide coverage for reconstructive 
prosthetic urology surgery if they provide coverage for 
prostate cancer treatment. 
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; FINDINGS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Post-Prostate Cancer Treatment Equity Act of 2007’’. 
(b) FINDINGS.—Congress finds the following: 
(1) Prostate cancer will strike about one in six 
men during their lifetime. 
(2) Many of these men will have a prostatec-
tomy and about half of those will experience signifi-
cant complications. 
(3) For some 6,000 of these men annually re-
constructive prosthetic urology surgery is their only 
option to address these complications. 
(4) Medicare covers reconstructive prosthetic 
urology surgery, as does two-third of private health 
benefits coverage. However, about one-third of pri-
vate health benefits coverage does not cover this sur-
gery. 
(5) To address a similar concern with respect to 
breast cancer, Congress enacted the Women’s 
Health and Cancer Rights Act of 1998 that requires 
private health benefits coverage to provide coverage 
for reconstructive surgery following mastectomies. 
(6) Men should have a right to access to recon-
structive surgery following a prostatectomy just as 
women have the right to access to reconstructive 
surgery following a mastectomy. 
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SEC. 2. AMENDMENTS TO THE EMPLOYEE RETIREMENT IN-
COME SECURITY ACT OF 1974. 
(a) IN GENERAL.—Subpart B of part 7 of subtitle 
B of title I of the Employee Retirement Income Security 
Act of 1974 (29 U.S.C. 1185 et seq.) is amended by add-
ing at the end the following new section: 
‘‘SEC. 714. REQUIRED COVERAGE FOR RECONSTRUCTIVE 
PROSTHETIC 
UROLOGY 
SURGERY 
FOL-
LOWING PROSTATE CANCER TREATMENT. 
‘‘(a) IN GENERAL.—A group health plan, and a 
health insurance issuer providing health insurance cov-
erage in connection with a group health plan, that provides 
medical and surgical benefits with respect to prostate can-
cer treatment shall provide, in a case of a participant or 
beneficiary who is receiving benefits in connection with 
such prostate cancer treatment, coverage for— 
‘‘(1) all stages of reconstructive prosthetic urol-
ogy surgery; and 
‘‘(2) prostheses and physical complications of 
prostatectomy; 
in a manner determined in consultation with the attending 
physician and the patient. Such coverage may be subject 
to annual deductibles and coinsurance provisions as may 
be deemed appropriate and as are consistent with those 
established for other benefits under the plan or coverage. 
Written notice of the availability of such coverage shall 
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be delivered to the participant upon enrollment and annu-
ally thereafter. 
‘‘(b) NOTICE.—A group health plan, and a health in-
surance issuer providing health insurance coverage in con-
nection with a group health plan shall provide notice to 
each participant and beneficiary under such plan regard-
ing the coverage required by this section in accordance 
with regulations promulgated by the Secretary. Such no-
tice 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, 2008; 
whichever is earlier. 
‘‘(c) PROHIBITIONS.—A group health plan, and a 
health insurance issuer offering group health insurance 
coverage in connection with a group health plan, may 
not— 
‘‘(1) deny to a patient eligibility or continued 
eligibility, to enroll or to renew coverage under the 
terms of the plan, solely for the purposes of avoiding 
the requirements of this section; and 
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‘‘(2) penalize or otherwise reduce or limit the 
reimbursement of an attending provider, or provide 
incentives (monetary or otherwise) to an attending 
provider, to induce such provider to provide care to 
an individual participant or beneficiary in a manner 
inconsistent with this section. 
‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to prevent a group health plan or 
a health insurance issuer offering group health insurance 
coverage from negotiating the level and type of reimburse-
ment with a provider for care provided in accordance with 
this section. 
‘‘(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 reconstructive prosthetic 
urology surgery otherwise required in this section. 
‘‘(2) ERISA.—Nothing in this section shall be 
construed to affect or modify the provisions of sec-
tion 514 with respect to group health plans.’’. 
(b) CLERICAL AMENDMENT.—The table of contents 
in section 1 of the Employee Retirement Income Security 
Act of 1974 (29 U.S.C. 1001 note) is amended by insert-
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ing after the item relating to section 713 the following 
new item: 
‘‘Sec. 714. Required coverage for reconstructive prosthetic urology surgery fol-
lowing prostate cancer treatment.’’. 
(c) EFFECTIVE DATES.— 
(1) IN GENERAL.—The amendments made by 
this section shall apply with respect to plan years be-
ginning on or after the first day of the sixth month 
beginning after the date of the enactment of this 
Act. 
(2) SPECIAL
RULE
FOR
COLLECTIVE
BAR-
GAINING
AGREEMENTS.—In the case of a group 
health plan maintained pursuant to 1 or more collec-
tive bargaining agreements between employee rep-
resentative and 1 or more employers, any plan 
amendment made pursuant to a collective bargaining 
agreement relating to the plan which amends the 
plan solely to conform to any requirement added by 
this section shall not be treated as a termination of 
such collective bargaining agreement. 
SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE 
ACT. 
(a) GROUP MARKET.—Subpart 2 of part A of title 
XXVII of the Public Health Service Act (42 U.S.C. 
300gg-4 et seq.) is amended by adding at the end the fol-
lowing new section: 
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‘‘SEC. 2707. REQUIRED COVERAGE FOR RECONSTRUCTIVE 
PROSTHETIC 
UROLOGY 
SURGERY 
FOL-
LOWING PROSTATE CANCER TREATMENT. 
‘‘The provisions of section 714 of the Employee Re-
tirement Income Security Act of 1974 shall apply to group 
health plans, and health insurance issuers providing health 
insurance coverage in connection with group health plans, 
as if included in this subpart.’’. 
(b) INDIVIDUAL MARKET.—Subpart 3 of part B of 
title XXVII of the Public Health Service Act (42 U.S.C. 
300gg–51 et seq.) is amended by adding at the end the 
following new section: 
‘‘SEC. 2753. REQUIRED COVERAGE FOR RECONSTRUCTIVE 
PROSTHETIC 
UROLOGY 
SURGERY 
FOL-
LOWING PROSTATE CANCER TREATMENT. 
‘‘The provisions of section 2707 of the title shall 
apply to health insurance coverage offered by a health in-
surance issuer in the individual market in the same man-
ner as they apply to health insurance coverage offered by 
a health insurance issuer in connection with a group 
health plan in the small or large group market.’’. 
(c) EFFECTIVE DATES.— 
(1) GROUP PLANS.— 
(A) IN GENERAL.—The amendment made 
by subsection (a) shall apply to group health 
plans for plan years beginning on or after the 
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first day of the sixth month beginning after the 
date of the enactment of this Act. 
(B) SPECIAL RULE FOR COLLECTIVE BAR-
GAINING AGREEMENT.—In the case of a group 
health plan maintained pursuant to 1 or more 
collective bargaining agreements between em-
ployee representatives and 1 or more employers, 
any plan amendment made pursuant to a collec-
tive bargaining agreement relating to the plan 
which amends the plan solely to conform to any 
requirement added by the amendment made by 
subsection (a) shall not be treated as a termi-
nation of such collective bargaining agreement. 
(2) INDIVIDUAL PLANS.—The amendment 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 the first day of the sixth month beginning after 
the date of the enactment of this Act. 
Æ 
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