I 
112TH CONGRESS 
2D SESSION 
H. R. 4470 
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 19, 2012 
Ms. WATERS (for herself, Ms. LEE of California, Mrs. CHRISTENSEN, and Ms. 
BORDALLO) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
Ways and Means, Education and the Workforce, and Oversight and Gov-
ernment 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 Re-
tirement Income Security Act of 1974, the Internal Rev-
enue 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 screen-
ing. 
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 
‘‘Routine HIV Screening Coverage Act of 2012’’. 
(b) FINDINGS.—Congress finds the following: 
(1) HIV/AIDS continues to infect and kill thou-
sands of Americans, more than 30 years after the 
first cases were reported. 
(2) It has been estimated that approximately 
1.7 million Americans have been infected with HIV 
since the beginning of the epidemic and over 
600,000 of them have died. 
(3) The HIV/AIDS epidemic has disproportion-
ately impacted African-Americans, Latino-Ameri-
cans, and other racial and ethnic minorities. 
(4) It has been estimated that 20 percent of 
those infected with HIV in the United States do not 
know they are infected. 
(5) The Centers for Disease Control and Pre-
vention has determined that increasing the propor-
tion of people who know their HIV status is an es-
sential component of comprehensive HIV/AIDS 
treatment and prevention efforts and that early di-
agnosis is critical in order for people with HIV/ 
AIDS to receive life-extending therapy. 
(6) The Centers for Disease Control and Pre-
vention recommends routine HIV screening in health 
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care settings for all patients aged 13–64, regardless 
of risk. 
(7) Some health plans do not cover routine HIV 
screening, but only cover HIV tests for patients with 
known or perceived risk factors for HIV/AIDS and 
patients who demonstrate symptoms of AIDS. 
(8) Not all individuals who have been infected 
with HIV fall into high-risk categories or dem-
onstrate symptoms of AIDS. 
(9) If health plans covered routine HIV 
screenings, health providers would be more likely to 
recommend routine HIV screening for their patients. 
(10) Section 2713 of the Public Health Service 
Act (42 U.S.C. 300gg–13), as amended by section 
1001 of the Patient Protection and Affordable Care 
Act (Public Law 111–148), requires that health 
plans cover preventive health services without impos-
ing cost sharing requirements. 
(11) Routine HIV screening is a preventive 
health service. 
(12) Requiring health plans to cover routine 
HIV screening as a preventive health service without 
imposing cost sharing requirements could play a 
critical role in preventing the spread of HIV and al-
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lowing infected individuals to receive effective treat-
ment. 
SEC. 2. COVERAGE FOR ROUTINE HIV SCREENING UNDER 
GROUP HEALTH PLANS, HEALTH INSURANCE 
COVERAGE, AND FEHBP. 
(a) GROUP HEALTH PLANS.— 
(1) PUBLIC
HEALTH
SERVICE
ACT
AMEND-
MENTS.—Subpart II of part A of title XXVII of the 
Public Health Service Act is amended by inserting 
the following new section after section 2719A: 
‘‘SEC. 2719B. COVERAGE FOR ROUTINE HIV SCREENING. 
‘‘(a) IN GENERAL.—A group health plan and a health 
insurance issuer offering group or individual health insur-
ance coverage— 
‘‘(1) shall provide coverage for routine HIV 
screening; and 
‘‘(2) shall not impose terms and conditions (in-
cluding cost sharing requirements) with respect to 
such screening that are less favorable for a partici-
pant or beneficiary than the terms and conditions 
applicable to items and services described in section 
2713(a). 
‘‘(b) PROHIBITIONS.—A group health plan and a 
health insurance issuer offering group or individual health 
insurance coverage shall not— 
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‘‘(c) RULES OF CONSTRUCTION.—Nothing in this 
section shall be construed to require an individual who is 
a participant or beneficiary of a group health plan or 
health insurance coverage to undergo HIV screening. 
‘‘(d) 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 insur-
ance coverage that requires coverage of at least the cov-
erage of HIV screening otherwise required under this sec-
tion.’’. 
(2) INCLUSION OF NOTICE IN UNIFORM COV-
ERAGE DOCUMENTS.—Section 2715(b)(3)(B) of the 
Public Health Service Act (42 U.S.C. 300gg–15) is 
amended— 
(A) in clause (i), by striking ‘‘and’’ at the 
end; 
(B) by redesignating clause (ii) as clause 
(iii); and 
(C) by inserting after clause (i) the fol-
lowing: 
‘‘(ii) the coverage for routine HIV 
screening required under section 2719B; 
and’’. 
(3) 
ROUTINE
HIV
SCREENING
DEFINED 
THROUGH
CONSULTATION
PROCESS.—Section 
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2791(d) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(22) ROUTINE
HIV
SCREENING.—The term 
‘routine HIV screening’ shall have the meaning 
given such term by the Secretary. In defining such 
term, the Secretary shall consult with the Office of 
National AIDS Policy, the Centers for Disease Con-
trol and Prevention, health care professionals with 
expertise in HIV treatment and prevention, advo-
cates for people living with HIV, and other qualified 
individuals.’’. 
(4) CONFORMING AMENDMENTS.— 
(A) ERISA.—Section 715(a)(1) of the 
Employee Retirement Income Security Act of 
1974 (29 U.S.C. 1185d(a)(1)) is amended by 
inserting ‘‘and the Routine HIV Screening Cov-
erage Act of 2012’’ after ‘‘Patient Protection 
and Affordable Care Act’’. 
(B) IRC.—Section 9815(a)(1) of the Inter-
nal Revenue Code of 1986 is amended by in-
serting ‘‘and the Routine HIV Screening Cov-
erage Act of 2012’’ after ‘‘Patient Protection 
and Affordable Care Act’’. 
(b) APPLICATION UNDER FEDERAL EMPLOYEES 
HEALTH BENEFITS PROGRAM (FEHBP).—Section 8902 
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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 
2719B of the Public Health Service Act.’’. 
(c) EFFECTIVE DATE.—This section and the amend-
ments made by this section shall be effective for plan years 
beginning on or after the date that is 1 year after the 
date of the enactment of this Act. 
Æ 
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