By Ms. Wilkerson, a petition (accompanied by bill,
Senate, No. 2189) of Dianne Wilkerson for legislation to
provide for greater insurance coverage of prostate cancer
exams. Health Care Financing.
|
By Ms. Wilkerson, a petition (accompanied by bill,
Senate, No. 2189) of Dianne Wilkerson for legislation to
provide for greater insurance coverage of prostate cancer
exams. Health Care Financing.
|
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
SECTION 1. Chapter 175 of
the General Laws as appearing in the 2000 Official Edition, is hereby amended
by inserting after section 47S the following section:
Section 47T. Any individual policy of accident and sickness insurance issued
pursuant to section 108 which provides hospital expense and surgical expense
insurance and any group blanket policy of accident and sickness insurance
issued pursuant to section 110 which provides hospital expense and surgical
expense insurance, delivered, issued or renewed by agreement between the
insurer and the policyholder, within or without the commonwealth, shall provide
benefits for individuals and group members having a principal place of
employment within the commonwealth for the expenses incurred in conducting
a medically recognized screening examination. For purposes of this section, a
screening examination shall include a digital rectal exam and a blood test
called the prostate-specific antigen or PSA
test or the most reliable, medically recognized screening test available:
(1) for men aged 50 and older who have been counseled by their physician about
the potential risks of prostate cancer, benefits of early detection, and
treatment of prostate cancer;
(2) when used for the purpose of guiding patient management in monitoring the
response to prostate cancer treatment;
(3) when used for staging in determining the need for a bone scan in patients
with prostate cancer, or
(4) when used for male patients 40 and older who are a high risk for prostate
cancer and have been counseled by their physician about the risks and benefits
of prostate cancer screening, including men who are African American or who
have a significant family history of prostate cancer, as determined by the
treating physician.
The benefits provided in this section shall be subject to the same terms and
conditions as for any other medical condition covered by said individual or
group blanket policy.
SECTION 2. Chapter 176A of the General Laws, as so
appearing, is hereby amended by inserting after section 8S the following
section:
Section 8T. Any contract between a subscriber and the corporation under an
individual or group hospital service plan which provides hospital expense and
surgical expense insurance, delivered, issued or renewed by agreement between
the insurer and the policyholder, within or without the commonwealth, shall
provide benefits for residents of the commonwealth and all group members having
a principal place of employment within the commonwealth for the expenses
incurred in conducting a medically recognized screening examination. For
purposes of this section, a screening examination shall include a digital
rectal exam and a blood test called the prostate-specific antigen or PSA test or the most reliable, medically
recognized screening test available:
(1) for men aged 50 and older who have been counseled by their physician about
the potential risks of prostate cancer, benefits of early detection, and
treatment of prostate cancer;
(2) when used for the purpose of guiding patient management in monitoring the
response to prostate cancer treatment;
(3) when used for staging in determining the need for a bone scan in patients
with prostate cancer; or
(4) when used for male patients 40 and older who are a high risk for prostate
cancer and have been counseled by their physician about the risks and benefits
of prostate cancer screening, including men who are African American or who
have a significant family history of prostate cancer, as determined by the
treating physician.
The benefits provided in this section shall be subject to the same terms and
conditions as for any other medical condition covered by said individual or
group blanket policy.
SECTION 3.
Chapter 176B of the General Laws, as so appearing, is amended by inserting
after section 4Q the following section:
Section 4R. Any subscription certificate under an individual or group medical
service agreement which provides hospital expense and surgical expense
insurance, delivered, issued or renewed by agreement between the insurer and
the policyholder, within or without the commonwealth, shall provide benefits
for residents of the commonwealth and to all group members having a principal
place of employment within the commonwealth for the expenses incurred in
conducting a medically recognized screening examination. For purposes of this
section, a screening examination shall include a digital rectal exam and a
blood test called the prostate-specific antigen or PSA test or the most reliable, medically
recognized screening test available:
(1) for men aged 50 and older who have been counseled by their physician about
the potential risks of prostate cancer, benefits of early detection, and
treatment of prostate cancer;
(2) when used for the purpose of guiding patient management in monitoring the
response to prostate cancer treatment;
(3) when used for staging in determining the need for a bone scan in patients
with prostate cancer; or
(4) when used for male patients 40 and older who are a high risk for prostate
cancer and have been counseled by their physician about the risks and benefits
of prostate cancer screening, including men who are African American or who
have a significant family history of prostate cancer, as determined by the
treating physician.
The benefits provided in this section shall be subject to the same terms and
conditions as for any other medical condition covered by said individual or
group blanket policy.
SECTION 4. Chapter
176G, as so appearing, is hereby amended by inserting after section 4I the
following section:
Section 4J. Any individual or group health maintenance contract, which provides
hospital expense and surgical expense insurance, delivered, issued or renewed
by agreement between the insurer and the policyholder, within or without the
commonwealth, shall provide benefits for residents of the commonwealth and to
all group members having a principal place of employment within the
commonwealth for the expenses incurred in conducting a medically recognized
screening examination. For purposes of this section, a screening examination
shall include a digital rectal exam and a blood test called the
prostate-specific antigen or PSA
test or the most reliable, medically recognized screening test available:
(1) for men aged 50 and older who have been counseled by their physician about
the potential risks of prostate cancer, benefits of early detection, and
treatment of prostate cancer;
(2) when used for the purpose of guiding patient management in monitoring the
response to prostate cancer treatment;
(3) when used for staging in determining the need for a bone scan in patients
with prostate cancer, or
(4) when used for male patients 40 and older who are a high risk for prostate
cancer and have been counseled by their physician about the risks and benefits
of prostate cancer screening, including men who are African American or who
have a significant family history of prostate cancer, as determined by the
treating physician.
The benefits provided in this section shall be subject to the same terms and
conditions as for any other medical condition covered by said individual or
group blanket policy
