| 1 | A bill to be entitled |
| 2 | An act relating to health insurance; requiring health |
| 3 | benefit plans, as defined, to offer coverage for prostate |
| 4 | cancer early detection screening for certain men; |
| 5 | providing an effective date. |
| 6 |
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| 7 | Be It Enacted by the Legislature of the State of Florida: |
| 8 |
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| 9 | Section 1. (1)(a) A health benefit plan that is offered, |
| 10 | issued, or renewed in this state on or after January 1, 2007, |
| 11 | which provides coverage to men age 40 or older must offer |
| 12 | coverage for annual screening for prostate cancer for such men, |
| 13 | according to the prostate cancer early detection guidelines of |
| 14 | the National Comprehensive Cancer Network. The coverage may not |
| 15 | be subject to plan deductibles. |
| 16 | (b) The prostate cancer screening coverage shall consist, |
| 17 | at a minimum, of the following tests: |
| 18 | 1. A prostate-specific antigen blood test. |
| 19 | 2. A digital rectal examination. |
| 20 | (c) If a medical practitioner recommends that an insured, |
| 21 | a subscriber, or an enrollee undergo a prostate-specific antigen |
| 22 | blood test, coverage may not be denied because that person |
| 23 | previously had a digital rectal exam and the exam results were |
| 24 | negative. |
| 25 | (2) The benefits required by this section do not limit |
| 26 | diagnostic benefits otherwise allowable under a health benefit |
| 27 | plan. |
| 28 | (3) As used in this section, the term "health benefit |
| 29 | plan" means group hospital or medical insurance coverage, a not- |
| 30 | for-profit hospital or medical service or indemnity plan, a |
| 31 | prepaid health plan, a health maintenance organization plan, a |
| 32 | preferred provider organization plan, a state or municipal |
| 33 | employee health insurance plan, a program funded under Title XIX |
| 34 | of the Social Security Act or other publicly funded program, a |
| 35 | Multiple Employer Welfare Arrangement, or an employee self- |
| 36 | insured plan, except as exempt under federal ERISA provisions. |
| 37 | The term does not include short-term, accident, fixed indemnity, |
| 38 | or specified disease policies, disability income contracts, |
| 39 | limited benefit or credit disability insurance, workers' |
| 40 | compensation insurance, automobile medical payment insurance, or |
| 41 | insurance under which benefits are payable without regard to |
| 42 | fault and which is required by law to be included in a liability |
| 43 | insurance policy or equivalent self-insurance. |
| 44 | Section 2. This act shall take effect January 1, 2007. |