Requires mandatory coverage for annual prostate cancer screening for men age 40 and older by insurers, mutual benefit societies, and health maintenance organizations. (SD1)

A BILL FOR AN ACT

SECTION 1. The legislature finds that prostate cancer is the most common form of cancer, other than skin cancer, among men in the United States, and it is second only to lung cancer as a cause of cancer-related death among men. The American Cancer Society estimates that, in 2003, about 220,900 new cases of prostate cancer were diagnosed and about 28,900 men died of the disease. About seventy per cent of all diagnosed prostate cancers are found in men aged sixty-five years or older. Over the past twenty years, the survival rate for prostate cancer has increased from sixty-seven per cent to ninety-seven per cent.

In Hawaii, approximately seven hundred cases of invasive prostate cancer are diagnosed each year. Another one hundred men die from the disease annually. Among males in all ethnic groups except Hawaiian, prostate cancer is the leading type of cancer diagnosed. It is the second leading cause of cancer deaths among Caucasians, Chinese, and Filipino men in Hawaii. Prostate cancer accounts for about twenty-seven per cent of the cancer incidence and ten per cent of the cancer deaths among males in Hawaii.

The two most common tests used by physicians to detect prostate cancer are the digital rectal examination and the prostate-specific antigen test. The prostate-specific antigen test is a blood test that measures the prostate-specific antigen enzyme.

SECTION 2. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to article 10A to be appropriately designated and to read as follows:

"§431:10A-   Mandatory prostate cancer screening; notice. (a) Any other law to the contrary notwithstanding, each employer group health policy, contract, plan, or agreement issued or renewed in this State after December 31, 2006, that provides coverage to male policyholders forty years of age and older, shall provide, not as an employer option and not as a deductible, annual screening for the early detection of prostate cancer in accordance with the prostate cancer early detection guidelines of other health care organizations including, but not limited to the National Comprehensive Cancer Network, the American Cancer Society, the Centers for Disease Control, and the U.S. Preventive Services Task Force for the policyholder and individuals covered under the policy, contract, plan, or agreement. The coverage provided shall in no way diminish or limit diagnostic benefits otherwise provided.

(b) The prostate cancer screening shall consist of, at a minimum, both of the following tests, regardless if either one test shows a negative result:

(1) A prostate-specific antigen blood test; and

(2) A digital rectal examination.

(c) Every insurer shall provide notice to its policyholders regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to policyholders and shall be transmitted to policyholders within calendar year 2006 when annual information is made available to policyholders, or in any other mailing to policyholders, but in no case later than December 31, 2006."

SECTION 3. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§432-   Mandatory prostate cancer screening; notice. (a) Any other law to the contrary notwithstanding, each individual and group hospital or medical service plan, policy, contract, or agreement issued or renewed in this State after December 31, 2006, that provides coverage to male members forty years of age and older, shall provide, not as an employer option and not as a deductible, annual screening for the early detection of prostate cancer in accordance with the prostate cancer early detection guidelines of other health care organizations including, but not limited to the National Comprehensive Cancer Network, the American Cancer Society, the Centers for Disease Control, and the U.S. Preventive Services Task Force for the member and individuals covered under the policy, contract, plan, or agreement.

(b) The prostate cancer screening shall consist of, at a minimum, both of the following tests, regardless if either one test shows a negative result:

(1) A prostate-specific antigen blood test; and

(2) A digital rectal examination.

(c) Every mutual benefit society shall provide notice to its members regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to members and shall be transmitted to members within calendar year 2006 when annual information is made available to members, or in any other mailing to members, but in no case later than December 31, 2006."

SECTION 4. Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:

"§432D-23 Required provisions and benefits. Notwithstanding any provision of law to the contrary, each policy, contract, plan, or agreement issued in the State after January 1, 1995, by health maintenance organizations pursuant to this chapter, shall include benefits provided in sections 431:10-212, 431:10 A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, [and] 431:10A-121, and 431:10A-  , and chapter 431M."

SECTION 5. The benefit to be provided by health maintenance organizations corresponding to the benefit provided under section 431:10A-   , Hawaii Revised Statutes, as contained in the amendment to section 432D-23, Hawaii Revised Statutes, in section 4 of this Act, shall take effect for all policies, contracts, plans, or agreements issued in the State after December 31, 2006.

SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 7. This Act shall take effect upon its approval.