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.