HB 33: Require insurance coverage for certain prostate cancer screening
The bill aims to enact a new section in the revised code that requires health insurers to cover preventive screenings for certain men at high-risk for developing prostate cancer. This includes prostate-specific antigen tests and digital rectal examinations. The bill applies to men aged 40 or older who have a family history of prostate cancer or a genetic alteration associated with increased risk. The requirement includes coverage for expenses associated with prostate cancer screenings, and health benefit plans must provide this coverage without imposing a cost-sharing requirement. The bill also allows for rules to be adopted by the superintendent of insurance to specify the types of prostate-specific antigen tests and the interval between screenings.
| Feb. 05, 2025 | Referred to committee: Insurance |
| Feb. 03, 2025 | Introduced |
As Introduced
36th General Assembly
Regular Session H. B. No. 33
Representatives Jarrells, Johnson
Cosponsors: Representatives Williams, Denson, McNally, Upchurch, Cockley, Brennan, Brewer, Russo, Sigrist, Synenberg, White, E., Mohamed, Rogers, Thomas, C., Schmidt
A B I L L
To enact section 3902.66 of the Revised Code to 1
require health insurers to cover preventive 2
screenings for certain men at high-risk for 3
developing prostate cancer. 4
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That section 3902.66 of the Revised Code be 5
enacted to read as follows: 6
Sec. 3902.66. (A) As used in this section:
(1) "Family history of prostate cancer" means that a 8
first-degree relative of a covered person was diagnosed with, 9
developed, or died as a result of prostate cancer. 10
(2) "First-degree relative" means a biological parent, 11
full biological sibling, or biological child. 12
(3) "Prostate cancer screening" means any evidence-based 13
preventive care or screening procedure performed for the purpose 14
of identifying prostate cancer, including prostate-specific 15
antigen tests and digital rectal examination. 16
H. B. No. 33 As Introduced
(B) Notwithstanding section 3901.71 of the Revised Code, a 17
health benefit plan issued, renewed, or modified in this state 18
on or after the effective date of this section shall provide 19
coverage for all expenses associated with prostate cancer 20
screenings for covered persons who are male, at least forty 21
years of age, and are at high risk of developing prostate cancer 22
based on one or both of the following factors: 23
(1) Diagnosis of the covered person or a first-degree 24
relative with a genetic alteration or cancer associated with 25
increased risk of prostate cancer; 26
(2) A family history of prostate cancer. 27
(C) Subject to division (E) of this section, no health 28
benefit plan issued, renewed, or modified in this state on or 29
after the effective date of this section shall impose a cost- 30
sharing requirement for the coverage required by division (B) of 31
this section. 32
(D) The superintendent of insurance shall adopt rules in 33
accordance with Chapter 119. of the Revised Code for the 34
purposes of implementing and administering this section, 35
including rules that specify both of the following: 36
(1) The types of prostate-specific antigen tests for which 37
coverage is required by this section; 38
(2) The interval between prostate cancer screenings 39
covered in accordance with this section, which shall not be 40
greater than one year. 41
(E) If, under federal law, the application of the 42
requirement in division (C) of this section would result in 43
health savings account ineligibility under 26 U.S.C. 223, then 44
the requirement of division (C) of this section applies for 45
H. B. No. 33 As Introduced
health savings account-qualified high deductible health plans 46
with respect to the deductible of such a plan after the enrollee 47
has satisfied the minimum deductible under 26 U.S.C. 223. 48