RS S.B. 258 75(R) BILL ANALYSIS INSURANCE S.B. 258 By: Ellis (McCall) 5-15-97 Committee Report (Unamended) BACKGROUND Currently, Texas law does not require certain health benefit plans to provide coverage of tests for the detection of prostate cancer. Approximately 18,000 cases of prostate cancer were recorded in Texas in 1996. Illness due to prostate cancer costs the nation $5 billion each year, yet its screening costs are relatively low. Treatment of prostate cancer at an early stage costs approximately one-third of the cost of treating the cancer at a later stage. This bill requires health benefit plans to provide coverage of tests for the detection of prostate cancer. PURPOSE As proposed, S.B. 258 requires coverage under certain health benefit plans of tests for the detection of prostate cancer. RULEMAKING AUTHORITY Rulemaking authority is granted to the commissioner of insurance in SECTION 1 (Article 21.53F(5), Insurance Code) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Chapter 21E, Insurance Code, by adding Article 21.53F, as follows: Art. 21.53F. COVERAGE OF CERTAIN TESTS FOR DETECTION OF PROSTATE CANCER Sec. 1. DEFINITION. Defines "health benefit plan." Sec. 2. SCOPE OF ARTICLE. Sets forth the health benefit plans to which this article does and does not apply. Sec. 3. REQUIRED COVERAGE FOR CERTAIN TESTS FOR THE DETECTION OF PROSTATE CANCER. Requires a health benefit plan that provides benefits for diagnostic medical procedures to provide coverage for each male enrolled in the plan for expenses incurred in conducting an annual medically recognized diagnostic examination for the detection of prostate cancer. Sets forth items the minimum benefits provided under Subsection (a) must include: physical exam for detection of prostate cancer, and a prostate specific antigen test used for detection. Sec. 4. NOTICE. Requires each health benefit plan to provide written notice to each person enrolled in the plan regarding the coverage required by this article. Requires the notice to be provided in accordance with rules adopted by the commissioner of insurance (commissioner). Sec. 5. RULES. Requires the commissioner to adopt rules as necessary to administer this article. SECTION 2. Effective date: September 1, 1997. Makes application of this Act prospective to January 1, 1998. SECTION 3. Emergency clause.