[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 822 Introduced in House (IH)]
110th CONGRESS
1st Session
H. R. 822
To amend the Public Health Service Act, the Employee Retirement Income
Security Act of 1974, the Internal Revenue Code of 1986, and title 5,
United States Code, to require individual and group health insurance
coverage and group health plans and Federal employees health benefit
plans to provide coverage for routine HIV/AIDS screening.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 5, 2007
Ms. Waters (for herself, Ms. Lee, Mrs. Christensen, Mr. Stark, Ms.
Carson, and Mr. Towns) introduced the following bill; which was
referred to the Committee on Energy and Commerce, and in addition to
the Committees on Education and Labor, Ways and Means, and Oversight
and Government Reform, for a period to be subsequently determined by
the Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend the Public Health Service Act, the Employee Retirement Income
Security Act of 1974, the Internal Revenue Code of 1986, and title 5,
United States Code, to require individual and group health insurance
coverage and group health plans and Federal employees health benefit
plans to provide coverage for routine HIV/AIDS screening.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; FINDINGS.
(a) Short Title.--This Act may be cited as the ``Routine HIV/AIDS
Screening Coverage Act of 2007''.
(b) Findings.--Congress finds the following:
(1) HIV/AIDS continues to infect and kill thousands of
Americans, 25 years after the first cases were reported.
(2) It has been estimated that at least 1.6 million
Americans have been infected by HIV/AIDS since the beginning of
the epidemic and over 500,000 of them have died.
(3) The HIV/AIDS epidemic has disproportionately impacted
African Americans and Hispanic Americans and its impact on
women is growing.
(4) It has been estimated that between 24 and 27 percent of
those infected with HIV/AIDS in the United States do not know
they are infected.
(5) Not all individuals who have been infected with HIV/
AIDS demonstrate clinical indications or fall into high risk
categories.
(6) The Centers for Disease Control and Prevention has
determined that increasing the proportion of people who know
their HIV/AIDS status is an essential component of
comprehensive HIV/AIDS treatment and prevention efforts and
that early diagnosis is critical in order for people with HIV/
AIDS to receive life-extending therapy.
(7) On September 21, 2006, the Centers for Disease Control
and Prevention released new guidelines that recommend routine
HIV/AIDS screening in health care settings for all patients
aged 13-64, regardless of risk.
(8) Standard health insurance plans generally cover HIV/
AIDS screening when there are clinical indications of infection
or when there are known risk factors present.
(9) Requiring health insurance plans to cover routine HIV/
AIDS screening could play a critical role in preventing the
spread of HIV/AIDS and allowing infected individuals to receive
effective treatment.
SEC. 2. COVERAGE FOR ROUTINE HIV/AIDS SCREENING UNDER GROUP HEALTH
PLANS, INDIVIDUAL HEALTH INSURANCE COVERAGE, AND FEHBP.
(a) Group Health Plans.--
(1) Public health service act amendments.--Subpart 2 of
part A of title XXVII of the Public Health Service Act is
amended by adding at the end the following new section:
``SEC. 2707. COVERAGE FOR ROUTINE HIV/AIDS SCREENING.
``(a) Coverage.--A group health plan, and a health insurance issuer
offering group health insurance coverage, shall provide coverage for
routine HIV/AIDS screening under terms and conditions that are no less
favorable than the terms and conditions applicable to other routine
health screenings.
``(b) Prohibitions.--A group health plan, and a health insurance
issuer offering group health insurance coverage, shall not--
``(1) deny to an individual eligibility, or continued
eligibility, to enroll or to renew coverage under the terms of
the plan, solely for the purpose of avoiding the requirements
of this section;
``(2) deny coverage for routine HIV/AIDS screening on the
basis that there are no known risk factors present, or the
screening is not clinically indicated, medically necessary, or
pursuant to a referral, consent, or recommendation by any
health care provider;
``(3) provide monetary payments, rebates, or other benefits
to individuals to encourage such individuals to accept less
than the minimum protections available under this section;
``(4) penalize or otherwise reduce or limit the
reimbursement of a provider because such provider provided care
to an individual participant or beneficiary in accordance with
this section;
``(5) provide incentives (monetary or otherwise) to a
provider to induce such provider to provide care to an
individual participant or beneficiary in a manner inconsistent
with this section; or
``(6) deny to an individual participant or beneficiary
continued eligibility to enroll or to renew coverage under the
terms of the plan, solely because of the results of an HIV/AIDS
test or other HIV/AIDS screening procedure for the individual
or any other individual.
``(c) Rules of Construction.--Nothing in this section shall be
construed--
``(1) to require an individual who is a participant or
beneficiary to undergo HIV/AIDS screening; or
``(2) as preventing a group health plan or issuer from
imposing deductibles, coinsurance, or other cost-sharing in
relation to HIV/AIDS screening, except that such deductibles,
coinsurance or other cost-sharing may not be greater than the
deductibles, coinsurance, or other cost-sharing imposed on
other routine health screenings.
``(d) Notice.--A group health plan under this part shall comply
with the notice requirement under section 714(d) of the Employee
Retirement Income Security Act of 1974 with respect to the requirements
of this section as if such section applied to such plan.
``(e) Preemption.--Nothing in this section shall be construed to
preempt any State law in effect on the date of enactment of this
section with respect to health insurance coverage that requires
coverage of at least the coverage of HIV/AIDS screening otherwise
required under this section.''.
(2) ERISA amendments.--(A) Subpart B of part 7 of subtitle
B of title I of the Employee Retirement Income Security Act of
1974 is amended by adding at the end the following new section:
``SEC. 714. COVERAGE FOR ROUTINE HIV/AIDS SCREENING.
``(a) Coverage.--A group health plan, and a health insurance issuer
offering group health insurance coverage, shall provide coverage for
routine HIV/AIDS screening under terms and conditions that are no less
favorable than the terms and conditions applicable to other routine
health screenings.
``(b) Prohibitions.--A group health plan, and a health insurance
issuer offering group health insurance coverage, shall not--
``(1) deny to an individual eligibility, or continued
eligibility, to enroll or to renew coverage under the terms of
the plan, solely for the purpose of avoiding the requirements
of this section;
``(2) deny coverage for routine HIV/AIDS screening on the
basis that there are no known risk factors present, or the
screening is not clinically indicated, medically necessary, or
pursuant to a referral, consent, or recommendation by any
health care provider;
``(3) provide monetary payments, rebates, or other benefits
to individuals to encourage such individuals to accept less
than the minimum protections available under this section;
``(4) penalize or otherwise reduce or limit the
reimbursement of a provider because such provider provided care
to an individual participant or beneficiary in accordance with
this section;
``(5) provide incentives (monetary or otherwise) to a
provider to induce such provider to provide care to an
individual participant or beneficiary in a manner inconsistent
with this section; or
``(6) deny to an individual participant or beneficiary
continued eligibility to enroll or to renew coverage under the
terms of the plan, solely because of the results of an HIV/AIDS
test or other HIV/AIDS screening procedure for the individual
or any other individual.
``(c) Rules of Construction.--Nothing in this section shall be
construed--
``(1) to require an individual who is a participant or
beneficiary to undergo HIV/AIDS screening; or
``(2) as preventing a group health plan or issuer from
imposing deductibles, coinsurance, or other cost-sharing in
relation to HIV/AIDS screening, except that such deductibles,
coinsurance or other cost-sharing may not be greater than the
deductibles, coinsurance, or other cost-sharing imposed on
other routine health screenings.
``(d) Notice Under Group Health Plan.--A group health plan, and a
health insurance issuer providing health insurance coverage in
connection with a group health plan, shall provide notice to each
participant and beneficiary under such plan regarding the coverage
required by this section in accordance with regulations promulgated by
the Secretary. Such notice shall be in writing and prominently
positioned in any literature or correspondence made available or
distributed by the plan or issuer and shall be transmitted--
``(1) in the next mailing made by the plan or issuer to the
participant or beneficiary;
``(2) as part of any yearly informational packet sent to
the participant or beneficiary; or
``(3) not later than January 1, 2008;
whichever is earliest.
``(e) Preemption, Relation to State Laws.--
``(1) In general.--Nothing in this section shall be
construed to preempt any State law in effect on the date of
enactment of this section with respect to health insurance
coverage that requires coverage of at least the coverage of
HIV/AIDS screening otherwise required under this section.
``(2) ERISA.--Nothing in this section shall be construed to
affect or modify the provisions of section 514 with respect to
group health plans.''.
(B) Section 732(a) of such Act (29 U.S.C. 1191a(a)) is
amended by striking ``section 711'' and inserting ``sections
711 and 714''.
(C) The table of contents in section 1 of such Act is
amended by inserting after the item relating to section 713 the
following new item:
``Sec. 714. Coverage for routine HIV/AIDS screening.''.
(3) Internal revenue code amendments.--(A) Subchapter B of
chapter 100 of the Internal Revenue Code of 1986 is amended by
inserting after section 9812 the following:
``SEC. 9813. COVERAGE FOR ROUTINE HIV/AIDS SCREENING.
``(a) Coverage.--A group health plan shall provide coverage for
routine HIV/AIDS screening under terms and conditions that are no less
favorable than the terms and conditions applicable to other routine
health screenings.
``(b) Prohibitions.--A group health plan shall not--
``(1) deny to an individual eligibility, or continued
eligibility, to enroll or to renew coverage under the terms of
the plan, solely for the purpose of avoiding the requirements
of this section;
``(2) deny coverage for routine HIV/AIDS screening on the
basis that there are no known risk factors present, or the
screening is not clinically indicated, medically necessary, or
pursuant to a referral, consent, or recommendation by any
health care provider;
``(3) provide monetary payments, rebates, or other benefits
to individuals to encourage such individuals to accept less
than the minimum protections available under this section;
``(4) penalize or otherwise reduce or limit the
reimbursement of a provider because such provider provided care
to an individual participant or beneficiary in accordance with
this section;
``(5) provide incentives (monetary or otherwise) to a
provider to induce such provider to provide care to an
individual participant or beneficiary in a manner inconsistent
with this section; or
``(6) deny to an individual participant or beneficiary
continued eligibility to enroll or to renew coverage under the
terms of the plan, solely because of the results of an HIV/AIDS
test or other HIV/AIDS screening procedure for the individual
or any other individual.
``(c) Rules of Construction.--Nothing in this section shall be
construed--
``(1) to require an individual who is a participant or
beneficiary to undergo HIV/AIDS screening; or
``(2) as preventing a group health plan or issuer from
imposing deductibles, coinsurance, or other cost-sharing in
relation to HIV/AIDS screening, except that such deductibles,
coinsurance or other cost-sharing may not be greater than the
deductibles, coinsurance, or other cost-sharing imposed on
other routine health screenings.''.
(B) The table of sections of such subchapter is amended by
inserting after the item relating to section 9812 the following
new item:
``Sec. 9813. Coverage for routine HIV/AIDS screening.''.
(C) Section 4980D(d)(1) of such Code is amended by striking
``section 9811'' and inserting ``sections 9811 and 9813''.
(b) Application to Individual Health Insurance Coverage.--(1) Part
B of title XXVII of the Public Health Service Act is amended by
inserting after section 2752 the following new section:
``SEC. 2753. COVERAGE FOR ROUTINE HIV/AIDS SCREENING.
``(a) In General.--The provisions of section 2707 (other than
subsection (d)) shall apply to health insurance coverage offered by a
health insurance issuer in the individual market in the same manner as
it applies 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) Notice.--A health insurance issuer under this part shall
comply with the notice requirement under section 714(d) of the Employee
Retirement Income Security Act of 1974 with respect to the requirements
referred to in subsection (a) as if such section applied to such issuer
and such issuer were a group health plan.''.
(2) Section 2762(b)(2) of such Act (42 U.S.C. 300gg-62(b)(2)) is
amended by striking ``section 2751'' and inserting ``sections 2751 and
2753''.
(c) Application Under Federal Employees Health Benefits Program
(FEHBP).--Section 8902 of title 5, United States Code, is amended by
adding at the end the following new subsection:
``(p) A contract may not be made or a plan approved which does not
comply with the requirements of section 2707 of the Public Health
Service Act.''.
(d) Effective Dates.--(1) The amendments made by subsections (a)
and (c) apply with respect to group health plans and health benefit
plans for plan years beginning on or after January 1, 2008.
(2) The amendments made by subsection (b) 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, 2008.
(e) Coordination of Administration.--The Secretary of Labor, the
Secretary of Health and Human Services, and the Secretary of the
Treasury shall ensure, through the execution of an interagency
memorandum of understanding among such Secretaries, that--
(1) regulations, rulings, and interpretations issued by
such Secretaries relating to the same matter over which two or
more such Secretaries have responsibility under the provisions
of this section (and the amendments made thereby) are
administered so as to have the same effect at all times; and
(2) coordination of policies relating to enforcing the same
requirements through such Secretaries in order to have a
coordinated enforcement strategy that avoids duplication of
enforcement efforts and assigns priorities in enforcement.
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