Senate Commerce Committee Statement to Senate, No. 791 — State of New Jersey (June 9, 2022)

Summary

The Senate Commerce Committee of the State of New Jersey, in a statement dated June 9, 2022, reports favorably and with committee amendments Senate Bill No. 791. As amended, health insurance carriers must cover an annual prostate cancer screening without cost sharing for men between 40 and 75 years of age. The statement says current law requires coverage only for men age 50 and over who are asymptomatic and men age 40 and over with a family history or other risk factors. Screening is defined to include a digital rectal exam, the prostate-specific antigen test and follow-up testing directed by a physician, such as urinary analysis and medical imaging. The requirement extends to the State Health Benefits Program and other State plans.

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SENATE COMMERCE COMMITTEE

STATEMENT TO

SENATE, No.
791

with
committee amendments

STATE
OF NEW JERSEY

DATED: JUNE 9,
2022

The
Senate Commerce Committee reports favorably and with committee amendments
Senate Bill No. 791.

As
amended, this bill requires health, hospital, and medical service corporations,
health maintenance organizations, and commercial group health insurers to
provide coverage for an annual prostate cancer screening without cost sharing
for men who are between 40 and 75 years of age. Under current law, these
health insurance carriers are required only to provide coverage for an annual
medically recognized diagnostic examination including, but not limited to, a digital
rectal examination and a prostate-specific antigen test for men age 50 and over
who are asymptomatic and for men age 40 and over with a family history of
prostate cancer or other prostate cancer risk factors. The bill expands the
definition of “prostate cancer screening” to mean medically viable methods for
the detection and diagnosis of prostate cancer, which includes a digital rectal
exam and the prostate-specific antigen test and associated laboratory work.
“Prostate cancer screening” shall also include subsequent follow up testing as
direct by a physician, including, but not limited to:

(1) urinary
analysis;

(2) serum
biomarkers;

(3) medical
imaging, including, but not limited to, magnetic resonance imaging.

The
bill also extends the prostate cancer screening requirements to commercial
individual health insurers, health benefits plans issued pursuant to the New
Jersey Individual Health Coverage and Small Employer Health Benefits Programs,
the State Health Benefits Program, and the School Employees’ Health Benefits
Program, which are not required to provide this coverage under current law.

COMMITTEE AMENDMENTS

The committee amended the bill to prohibit cost
sharing only for men 40 to 75 years of age.

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