§ 31-2952 — Coverage for prostate cancer screening.

(a) Each individual and group health benefits plan issued or renewed in the District of Columbia shall provide coverage for prostate cancer screening in accordance with the latest screening guidelines issued by the National Comprehensive Cancer Network, to include no less than one prostate-specific antigen test and digital rectal exam per year.

(b) The coverage provided under this section shall not be more restrictive than or separate from coverage provided from any other illness, condition, or disorder for purposes of determining deductibles, benefit year or lifetime durational limits, benefit year or lifetime dollar limits, lifetime episodes or treatment limits, copayment and coinsurance factors, and benefit year maximum for deductibles and copayments and coinsurance factors.

(c) A health insurer shall not impose on an individual receiving benefits pursuant to this section any deductible, coinsurance, copayment, or other cost-sharing requirement, except to the extent that coverage without cost-sharing would disqualify the individual from a high deductible health benefit plan, as defined in 26 U.S.C. § 223(c)(2)), from eligibility for a health savings account pursuant to 26 U.S.C. § 223.

Legislative History

Mar. 25, 2003, D.C. Law 14-233, § 3, 49 DCR 9772