Bill > SB19

This bill, known as the David "Mac" McElhaney and Roy S. Johnson Prostate Cancer Prevention Act, aims to eliminate out-of-pocket costs for men at high risk for prostate cancer when they undergo screening. "Cost-sharing requirements" refer to expenses like deductibles, coinsurance, or copayments that an insured person normally pays for covered services. The bill defines "men at high risk" to include African American men and men with a family history of prostate cancer or related cancers, or those who carry a genetic marker for increased risk. It also clarifies that prostate cancer screening includes a prostate-specific antigen (PSA) blood test and a digital rectal exam. Under the existing law, screening benefits were subject to the same cost-sharing as other covered benefits, but this bill amends that to state that no cost-sharing will be imposed on men over 50, and specifically exempts men over 40 who are identified as being at high risk for prostate cancer from any cost-sharing requirements for these screenings. The bill also includes provisions to prevent health insurance plans from penalizing providers who order these screenings and will become effective on October 1, 2027.

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