OHIO LEGISLATIVE SERVICE COMMISSION
Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
H.B. 550 Bill Analysis
135th General Assembly
Click here for H.B. 550’s Fiscal Note
Version: As Introduced
Primary Sponsors: Reps. Jarrells and Johnson
Effective date:
Logan Briggs, Attorney
SUMMARY
▪ Requires health benefit plans to provide coverage of preventative prostate cancer
screenings for certain men at higher risk of developing prostate cancer.
▪ Prohibits health benefit plans from imposing cost-sharing requirements on covered
screenings.
DETAILED ANALYSIS
Preventative prostate cancer screening coverage
The bill requires health plan issuers to provide coverage for all expenses associated with
prostate cancer screenings for any covered person who is male, at least 40 years old, and at high
risk of developing prostate cancer. As described below, health plan issuers must provide coverage
for at least one covered screening every 12 months.1
A health plan issuer may not impose any cost-sharing requirements for the coverage
required by the bill. Pursuant to continuing law, “cost-sharing” means the cost to a covered
person under a health benefit plan according to any copayment, coinsurance, deductible, or
other out-of-pocket expense requirement.2
The bill defines a “prostate cancer screening” as any evidence-based preventive care or
screening procedure performed for the purpose of identifying prostate cancer, including
prostate-specific antigen (PSA) tests and digital rectal examination. A PSA test is a blood test
which measures the amount of prostate-specific antigen in the bloodstream. Both normal and
cancerous cells in the prostate gland produce PSA, meaning that PSA levels are often higher in
1 R.C. 3902.64(B) and (D)(2).
2 R.C. 3902.64(C); R.C. 3902.50(C), not in the bill.
September 6, 2024
Office of Research and Drafting LSC Legislative Budget Office
individuals with prostate cancer. As such, PSA tests are considered a reliable component in
identifying and monitoring prostate cancer.3
Eligibility
Under the bill, a person is eligible for the required coverage when they are a male who is
at least 40 years of age, and who is considered to be at high risk of developing prostate cancer
based on one or both of the following factors:
1. The individual or a first-degree relative has been diagnosed with a genetic alteration or
cancer associated with increased risk of prostate cancer. The bill defines a “first-degree
relative” as a biological parent, full biological sibling, or biological child.
2. The individual has a family history of prostate cancer. This means that a first-degree
relative of the individual was diagnosed with, developed, or died as a result of prostate
cancer.4
Adoption of rules
Under the bill, the Superintendent of Insurance must adopt rules which will identify which
PSA tests must be covered by health benefit plans, and how long the interval shall be between
covered preventative prostate cancer screenings, so long as that interval is not longer than one
year. The Superintendent may require the minimum interval between covered screenings to be
less than one year.5
Applicability
The provisions of this bill apply to any health benefit plan issued, renewed, or modified in
this state on or after the bill’s effective date. It does not apply to any health benefit plan entered
into prior to that effective date unless that plan is subsequently renewed or modified. 6
Exemption from Superintendent of Insurance review
The bill exempts its cost-sharing limitations from an existing law that could prevent them
from being applied until a review by the Superintendent of Insurance has been conducted with
respect to mandated health benefits.7 Under current law, if the General Assembly enacts a
statute mandating health benefits, that statute cannot be applied to any health benefit plan until
the Superintendent of Insurance holds a hearing and determines that it can be applied fully and
equally in all respects to (1) employee benefit plans subject to regulation by the federal
3 R.C. 3902.64(A)(3); Prostate-Specific Antigen (PSA) Test, which may be accessed by conducting a
keyword “Prostate-Specific Antigen (PSA) Test” search on the National Cancer Institute’s website:
cancer.gov.
4 R.C. 3902.64(A) and (B).
5 R.C. 3902.64(D).
6 R.C. 4902.64(B) and (C).
7 R.C. 3902.63(B).
P a g e |2 H.B. 550
As Introduced
Office of Research and Drafting LSC Legislative Budget Office
“Employee Retirement Income Security Act of 1974” (ERISA),8 and (2) employee benefit plans
established or modified by the state or its political subdivisions.9 ERISA appears to preempt any
state regulation of such plans.10
Federal legislation
The bill is partially based on H.R. 1826, known as the “PSA Screening for HIM Act,”
introduced in the 118th Congress on March 28, 2023. The federal bill was subsequently referred
to the Subcommittee on Health within the House Committee on Energy and Commerce.
However, it has not yet been reported. That bill requires private health insurance plans to cover
preventive prostate cancer screenings that are not already covered under the recommendations
of the U.S. Preventive Services Task Force for men over the age of 40 and who are at high risk of
developing prostate cancer without imposing any cost-sharing requirement. In particular, “high
risk” men include Black men and men with a family history of prostate cancer.11
HISTORY
Action Date
Introduced 05-15-24
anhb0550in-135/ks
8 29 United States Code (U.S.C.) 1001.
9 R.C. 3901.71, not in the bill.
10 29 U.S.C. 1144.
11 H.R. 1826, 188th Cong. (2023).
P a g e |3 H.B. 550
As Introduced