,,ii #aah? ,,congress #a/ ,session ,s4 #bhba ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,septemb] #ad1 #bjbc,mr4 ,book] 7= himself & ,mr4 ,boozman7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ,a ,,bill ,to am5d title ,,xxvii ( ! ,public ,heal? ,s]vice ,act to require gr\p heal? plans & heal? insurance issu]s (f]+ gr\p or individual heal? insurance cov]age to provide cov]age = pro/ate canc] scre5+s )\t ! imposition ( co/-%>+ requirem5ts1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,pro/ate-,specific ,antig5 ,scre5+ = ,high-risk ,insur$ ,m5 ,act or ! ,,psa ,scre5+ = ,,him ,act4 #b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,pro/ate canc] is ! second lead+ cause ( canc] dea? 9 m5 9 ! ,unit$ ,/ates ) #a 9 #da m5 dy+ f pro/ate canc] & m ?an #cd1gjj m5 e/imat$ to die f pro/ate canc] 9 #bjbc4 7#b7 ,pro/ate canc] is ! second mo/ commonly diagnos$ canc] 9 ! ,nation ) #a 9 #h m5 be+ diagnos$ 9 _! lifetimes1 #c4a million m5 9 ! ,unit$ ,/ates liv+ ) a diagnosis1 & ov] #bhh1jjj m5 e/imat$ to be diagnos$ 9 #bjbc4 7#c7 ,! survival rate = pro/ate canc] diagnos$ 9 e>ly /age is ne> #ajj p]c5t b pro/ate canc] diagnos$ 9 late /age has only a #cj-p]c5t survival rate4 7#d7 ,!re are few1 if any1 symptoms ( pro/ate canc] be=e x rea*es late /age4 7#e7 ,african-,am]ican m5 h a disproportionately high] rate ( pro/ate canc] & are #gj p]c5t m likely to be diagnos$ ) pro/ate canc] ?an ,:ite m51 ) #a 9 #f ,african-,am]ican m5 develop+ pro/ate canc] 9 _! lifetimes4 7#f7 ,african-,am]ican m5 are #b4a times m likely to die f pro/ate canc] ?an ,:ite m54 7#g7 ,m5 ) a fa!r or bro!r ) pro/ate canc] are m ?an twice z likely to be diagnos$ ) pro/ate canc] ?an m5 )\t a family hi/ory4 7#h7 ,! common cl9ical def9ition = m5 at high-risk ( pro/ate canc] includes ,african-,am]ican m5 & m5 ) a family hi/ory4 7#i7 ,mo/ ( ! major canc] & urological societies recomm5d beg9n+ scre5+ discussions e>li] = ,african-,am]ican m5 & ^? ) a family hi/ory ( pro/ate canc]4 7#aj7 ,! ,unit$ ,/ates ,prev5tive ,s]vices ,task ,=ce has enc\rag$ rese>* on scre5+ ,african-,am]ican m51 includ+ :e!r to scre5 ,african-,am]ican m5 at y\ng] ages1 & has id5tifi$ ?is rese>* z a high-priority canc] rese>* gap4 7#aa7 ,b>ri]s to scre5+ %\ld be m9imiz$ = high-risk m5 9 ord] to cat* asymptomatic pro/ate canc] be=e x meta/asizes & ! survival rate is dramatically r$uc$4 7#ab7 ,! co/ ( treat+ meta/atic pro/ate canc] 9 ! ,unit$ ,/ates heal? c>e sy/em is hundr$s ( millions ( doll>s m annually ?an ! co/ ( treat+ localiz$1 e>ly-/age canc]4 #c4 ,requirem5t = gr\p heal? plans & heal? insurance issu]s (f]+ gr\p or individual heal? insurance cov]age to provide cov]age = pro/ate canc] scre5+s )\t imposition ( co/-%>+ requirem5ts 7a7 ,9 g5]al ,section #bgac7;a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#ac7;a77 is am5d$-- 7#a7 by /rik+ p>agraph 7#e72 7#b7 by r$esignat+ p>agraphs 7#a7 ?r\gh 7#d7 z subp>agraphs 7,a7 ?r\gh 7,d71 respectively1 & adju/+ ! m>g9s accord+ly2 7#c7 by /rik+ 7a7 ,9 g5]al--,a gr\p heal? & ins]t+ ! foll[+3 7a7 ,cov]age ( prev5tive heal? s]vices 7#a7 ,9 g5]al ,a gr\p heal? 2 7#d7 9 subp>agraph 7,b71 z s r$esignat$1 by /rik+ 2 & & ins]t+ a semicolon2 7#e7 9 subp>agraph 7,c71 z s r$esignat$1 by /rik+ ! p]iod & ins]t+ a semicolon2 7#f7 9 subp>agraph 7,d71 z s r$esignat$-- 7,a7 by /rik+ p>agraph 7#a7 & ins]t+ subp>agraph 7,a72 & 7,b7 by /rik+ ! p]iod & ins]t+ 2 &2 7#g7 by ins]t+ aft] subp>agraph 7,d71 z s r$esignat$1 ! foll[+3 7,e7 ) respect to m5 :o are age #dj & ov] & are at high risk ( develop+ pro/ate canc] 7includ+ ,african-,am]ican m5 & m5 ) a family hi/ory ( pro/ate canc] 7z def9$ 9 p>agraph 7#b7771 su* additional evid5ce-bas$ prev5tive c>e & scre5+s n describ$ 9 subp>agraph 7,a7 = pro/ate canc]4 2 & 7#h7 by /rik+ ! flu% text at ! end & ins]t+ ! foll[+3 7#b7 ,m5 ) a family hi/ory ( pro/ate canc] def9$ ,= purposes ( p>agraph 7#a77;,e71 ! t]m m5 ) a family hi/ory ( pro/ate canc] means m5 :o h a fir/-degree relative-- 7,a7 :o 0 diagnos$ ) pro/ate canc]2 7,b7 :o develop$ pro/ate canc]2 7,c7 ^: dea? 0 a result ( pro/ate canc]2 7,d7 :o h be5 diagnos$ ) a canc] kn[n to be associat$ ) increas$ risk ( pro/ate canc]2 or 7,e7 :o has a g5etic alt]ation kn[n to be associat$ ) increas$ risk ( pro/ate canc]4 7#c7 ,cl>ification reg>d+ brea/ canc] scre5+1 mammography1 & prev5tion recomm5dations ,= ! purposes ( ?is ,act1 & = ! purposes ( any o!r provision ( law1 ! curr5t recomm5dations ( ! ,unit$ ,/ates ,prev5tive ,s]vice ,task ,=ce reg>d+ brea/ canc] scre5+1 mammography1 & prev5tion %all be consid]$ ! mo/ curr5t o!r ?an ^? issu$ 9 or ar\nd ,novemb] #bjji4 7#d7 ,rule ( con/ruction ,no?+ 9 ?is subsection %all be con/ru$ to prohibit a plan or issu] f provid+ cov]age = s]vices 9 addition to ^? recomm5d$ by ! ,unit$ ,/ates ,prev5tive ,s]vices ,task ,=ce or to d5y cov]age = s]vices t are n recomm5d$ by su* ,task ,=ce4 4 7b7 ,effective date ,! am5dm5ts made by subsection 7a7 %all apply ) respect to plan ye>s beg9n+ on or aft] ,janu>y #a1 #bjbd4