[Congressional Record Volume 143, Number 82 (Thursday, June 12, 1997)]
[Senate]
[Pages S5620-S5621]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. BOXER:
  S. 902. A bill to require physicians to provide certain men with 
information concerning prostate specific antigen tests and to provide 
for programs of research on prostate cancer; to the Committee on Labor 
and Human Resources.


               the prostate testing full information act

  Mrs. BOXER. Mr. President, today, I introduce the Prostate Testing 
Full Information Act. In a series of town meetings in my State of 
California, I brought together the top prostate cancer experts in the 
State, the head of the urology branch at the National Cancer Institute, 
and prostate cancer survivors to discuss what can be done to aid in the 
fight against this disease.
  The statistics on prostate cancer are alarming. Based on current U.S. 
rates, about 19 of every 100 men born today will be diagnosed with 
prostate cancer during their lifetime, while approximately 4 of every 
100 men will die from the disease. Between 1973 and 1993, the rate of 
new cases of prostate cancer rose by 173 percent. During 1997, 
approximately 370,000 new cases will be diagnosed and more than 40,000 
men will die of prostate cancer.
  This bill will require physicians, at the time they perform a 
prostate examination on men over the age of 50, to inform the patient 
of the availability of the prostate specific antigen [PSA] test and 
other appropriate diagnostic procedures.
  In addition, the bill increases prostate cancer research funding at 
the National Institutes of Health and the Agency for Health Care Policy 
and Research.
  I urge my colleagues to join me in cosponsoring this important 
legislation.

[[Page S5621]]

  I ask unanimous consent that the text of the legislation be included 
in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 902

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Prostate Testing Full 
     Information Act''.

     SEC. 2. REQUIREMENT RELATING TO CERTAIN PHYSICIANS.

       (a) Requirement.--If a covered physician, during a physical 
     examination, examines the prostate gland of a patient, the 
     physician shall provide information to the patient concerning 
     the availability of appropriate diagnostic procedures, 
     including the prostate antigen test, if any of the following 
     conditions are present:
       (1) The patient is over 50 years of age.
       (2) The patient manifests clinical symptomatology.
       (3) The patient is at an increased risk of prostate cancer.
       (4) The provision of the information to the patient is 
     medically necessary, in the opinion of the physician.
       (b) Enforcement.--The Secretary of Health and Human 
     Services shall promulgate regulations that--
       (1) require the reporting of covered physicians that 
     violate subsection (a) to the Secretary; and
       (2) provide for the application of sanctions to enforce the 
     provisions of subsection (a).
       (c) Definition.--In this section, the term ``covered 
     physician'' means a physician as defined in section 1861(r) 
     of the Social Security Act (42 U.S.C. 1395x(r)) who has 
     received any Federal payment or assistance under any program 
     under--
       (1) the Public Health Service Act (42 U.S.C. 201 et seq.); 
     or
       (2) the Social Security Act (42 U.S.C. 301 et seq.).

     SEC. 3. AMENDMENTS TO THE EMPLOYEE RETIREMENT INCOME SECURITY 
                   ACT OF 1974.

       (a) In General.--Subpart B of part 7 of subtitle B of title 
     I of the Employee Retirement Income Security Act of 1974 (as 
     added by section 603(a) of the Newborns' and Mothers' Health 
     Protection Act of 1996 and amended by section 702(a) of the 
     Mental Health Parity Act of 1996) is amended by adding at the 
     end the following:

     ``SEC. 713. REQUIREMENT RELATING TO PROSTATE SPECIFIC ANTIGEN 
                   TEST.

       ``(a) Requirement.--If a physician, during a physical 
     examination, examines the prostate gland of a patient, the 
     physician shall provide information to the patient concerning 
     the availability of appropriate diagnostic procedures, 
     including the prostate antigen test, if any of the following 
     conditions are present:
       ``(1) The patient is over 50 years of age.
       ``(2) The patient manifests clinical symptomatology.
       ``(3) The patient is at an increased risk of prostate 
     cancer, as determined pursuant to regulations promulgated by 
     the Secretary of Health and Human Services.
       ``(4) The provision of the information to the patient is 
     medically necessary, in the opinion of the physician.
       ``(b) Prohibition on Limitation.--The provision of 
     information in accordance with subsection (a) may not be 
     prohibited under the terms of--
       ``(1) any written contract or written agreement between the 
     physician and any group health plan, any health insurance 
     issuer providing health insurance coverage in connection with 
     a group health plan, or any related party with respect to a 
     group health plan; or
       ``(2) any written statement from the plan, issuer, or 
     related party to the physician.
       ``(c) Rule of Construction.--Nothing in this section shall 
     be construed as requiring a group health plan or a health 
     insurance issuer providing health insurance coverage in 
     connection with a group health plan to provide coverage for 
     prostate specific antigen tests.
       ``(d) Definition.--In this section, the term `physician' 
     has the meaning given such term in section 1861(r) of the 
     Social Security Act (42 U.S.C. 1395x(r)).''.
       (b) Clerical Amendment.--The table of contents in section 1 
     of such Act, as amended by section 603 of the Newborns' and 
     Mothers' Health Protection Act of 1996 and section 702 of the 
     Mental Health Parity Act of 1996, is amended by inserting 
     after the item relating to section 712 the following new 
     item:

``Sec. 713. Requirement relating to prostate specific antigen test.''.

       (c) Effective Date.--The amendments made by this section 
     shall apply with respect to plan years beginning on or after 
     January 1, 1998.

     SEC. 4. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT RELATING 
                   TO THE GROUP MARKET.

       (a) In General.--Subpart 2 of part A of title XXVII of the 
     Public Health Service Act (as added by section 604(a) of the 
     Newborns' and Mothers' Health Protection Act of 1996 and 
     amended by section 703(a) of the Mental Health Parity Act of 
     1996) is amended by adding at the end the following new 
     section:

     ``SEC. 2706. REQUIREMENT RELATING TO PROSTATE SPECIFIC 
                   ANTIGEN TEST.

       ``(a) Requirement.--If a physician, during a physical 
     examination, examines the prostate gland of a patient, the 
     physician shall provide information to the patient concerning 
     the availability of appropriate diagnostic procedures, 
     including the prostate antigen test, if any of the following 
     conditions are present:
       ``(1) The patient is over 50 years of age.
       ``(2) The patient manifests clinical symptomatology.
       ``(3) The patient is at an increased risk of prostate 
     cancer, as determined pursuant to regulations promulgated by 
     the Secretary of Health and Human Services.
       ``(4) The provision of the information to the patient is 
     medically necessary, in the opinion of the physician.
       ``(b) Prohibition on Limitation.--The provision of 
     information in accordance with subsection (a) may not be 
     prohibited under the terms of--
       ``(1) any written contract or written agreement between the 
     physician and any group health plan, any health insurance 
     issuer providing health insurance coverage in connection with 
     a group health plan, or any related party with respect to a 
     group health plan; or
       ``(2) any written statement from the plan, issuer, or 
     related party to the physician.
       ``(c) Rule of Construction.--Nothing in this section shall 
     be construed as requiring a group health plan or a health 
     insurance issuer providing health insurance coverage in 
     connection with a group health plan to provide coverage for 
     prostate specific antigen tests.
       ``(d) Definition.--In this section, the term `physician' 
     has the meaning given such term in section 1861(r) of the 
     Social Security Act (42 U.S.C. 1395x(r)).''.
       (b) Effective Date.--The amendments made by this section 
     shall apply with respect to group health plans for plan years 
     beginning on or after January 1, 1998.

     SEC. 5. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT RELATING 
                   TO THE INDIVIDUAL MARKET.

       (a) In General.--Subpart 3 of part B of title XXVII of the 
     Public Health Service Act (as added by section 605(a) of the 
     Newborn's and Mother's Health Protection Act of 1996) is 
     amended by adding at the end the following new section:

     ``SEC. 2752. REQUIREMENT RELATING TO PROSTATE SPECIFIC 
                   ANTIGEN TEST.

       ``The provisions of section 2706 shall apply to health 
     insurance coverage offered by a health insurance issuer in 
     the individual market in the same manner as they apply to 
     health insurance coverage offered by a health insurance 
     issuer in connection with a group health plan in the small or 
     large group market.''.
       (b) Effective Date.--The amendment made by this section 
     shall apply with respect to health insurance coverage 
     offered, sold, issued, renewed, in effect, or operated in the 
     individual market on or after January 1, 1998.

     SEC. 6. RESEARCH AND EDUCATION REGARDING PROSTATE CANCER; 
                   CERTAIN PROGRAMS OF THE PUBLIC HEALTH SERVICE.

       (a) National Institutes of Health.--Section 417B(c) of the 
     Public Health Service Act (42 U.S.C. 286a-8(c)) is amended in 
     the first sentence by striking ``$72,000,000'' and all that 
     follows and inserting the following: ``$90,250,000 for fiscal 
     year 1998, $108,500,000 for fiscal year 1999, $126,500,000 
     for fiscal year 2000, and $145,000,000 for fiscal year 
     2001.''.
       (b) Agency for Health Care Policy and Research.--Section 
     902 of the Public Health Service Act (42 U.S.C. 299a) is 
     amended by adding at the end the following:
       ``(f) Activities Regarding Prostate Cancer.--The 
     Administrator shall, with respect to prostate cancer--
       ``(1) conduct and support research on the outcomes, 
     effectiveness, and appropriateness of health services and 
     procedures; and
       ``(2) in carrying out section 912(a), provide for the 
     development, periodic review, and updating of clinically 
     relevant guidelines, standards of quality, performance 
     measures, and medical review criteria.''.

                          ____________________