HB 373: Insurance; annual prostate cancer screenings for certain men; require major medical coverage

Currently Georgia law does not specifically require health insurance plans to cover prostate cancer screenings. House Bill 373 adds a new section to Georgia's insurance code requiring 'health benefit policies,' meaning most individual and group major medical plans sold in the state, to cover annual prostate cancer screenings for men defined as high risk. The bill defines high risk to include men aged 40 to 49 with a family history of prostate cancer, all men 50 and older, and any other men a physician determines to be at risk. It also defines what counts as a family history, including relatives diagnosed with, who died from, or who carry genetic markers linked to prostate cancer. Required screenings must include both a digital rectal examination and a prostate-specific antigen (PSA) blood test. The law would take effect as soon as the Governor signs it and would apply to insurance policies issued or renewed on or after January 1, 2026.

• Adds a new Code section (O.C.G.A. § 33-24-59.34) requiring major medical health insurance policies to cover annual prostate cancer screenings for high-risk men.
• Defines 'high risk' to include men 40-49 with a family history of prostate cancer, all men 50 and older, and other men a physician identifies as at risk.
• Defines 'family history' to cover first-degree relatives diagnosed with, killed by, or genetically linked to prostate cancer.
• Specifies the required screening must include both a digital rectal exam and a prostate-specific antigen (PSA) test.
• Applies the requirement to insurance policies issued, delivered, or renewed on or after January 1, 2026.

Men insured under individual or group major medical health plans in Georgia, especially those 50 and older or with a family history of prostate cancer, along with the health insurance companies, HMOs, and other insurers that must provide this coverage under Georgia law.

Men who fall into the bill's high-risk categories would no longer have to pay out of pocket for annual prostate cancer screenings, since insurers would be required to cover both the rectal exam and PSA test. This could make early detection more accessible for men most likely to develop the disease.

• Section 1 adds new Code section 33-24-59.34, defining 'health benefit policy' broadly to include most individual and group major medical insurance products sold in Georgia.
• Section 1 defines 'men with a family history of prostate cancer' based on a first-degree relative's diagnosis, death, related cancer diagnosis, or genetic risk marker.
• Section 1 defines 'men with a high risk for prostate cancer' as those 40-49 with a family history, all men 50 and older, or others identified by a physician.
• Section 1 requires covered screenings to include both a digital rectal examination and a prostate-specific antigen test.
• Section 2 sets the effective date as upon the Governor's approval (or becoming law without it) and applies the requirement to policies issued or renewed on or after January 1, 2026.

1. 2025-03-03Senate Read and Referred (Senate)
2. 2025-02-28House Passed/Adopted By Substitute (House)
3. 2025-02-28House Third Readers (House)
4. 2025-02-26House Committee Favorably Reported By Substitute (House)
5. 2025-02-12House Second Readers (House)
6. 2025-02-11House First Readers (House)
7. 2025-02-10House Hopper (House)

• Lydia Glaize (D, HD-67)Primary sponsor
• Mark Newton (R, HD-127)
• Sharon Cooper (R, HD-45)
• Billy Mitchell (D, HD-88)
• Miriam Paris (D, HD-142)
• Spencer Frye (D, HD-122)

1. PassedHouse voteFebruary 28, 2025

   164 yea, 1 nay (5 not voting, 10 excused)

   PASSAGE: House Vote #120

• prostate cancer screening
• health insurance coverage
• men's health
• cancer prevention