text: SECTION 1. SHORT TITLE; FINDINGS.
  
      (a) Short Title.--This Act may be cited as the ``Post-Prostate 
  Cancer Treatment Equity Act of 2007''.
      (b) Findings.--Congress finds the following:
              (1) Prostate cancer will strike about one in six men during 
          their lifetime.
              (2) Many of these men will have a prostatectomy and about 
          half of those will experience significant complications.
              (3) For some 6,000 of these men annually reconstructive 
          prosthetic urology surgery is their only option to address 
          these complications.
              (4) Medicare covers reconstructive prosthetic urology 
          surgery, as does two-third of private health benefits coverage. 
          However, about one-third of private health benefits coverage 
          does not cover this surgery.
              (5) To address a similar concern with respect to breast 
          cancer, Congress enacted the Women's Health and Cancer Rights 
          Act of 1998 that requires private health benefits coverage to 
          provide coverage for reconstructive surgery following 
          mastectomies.
              (6) Men should have a right to access to reconstructive 
          surgery following a prostatectomy just as women have the right 
          to access to reconstructive surgery following a mastectomy.
  
  SEC. 2. AMENDMENTS TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 
                1974.
  
      (a) In General.--Subpart B of part 7 of subtitle B of title I of 
  the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et 
  seq.) is amended by adding at the end the following new section:
  
  ``SEC. 714. REQUIRED COVERAGE FOR RECONSTRUCTIVE PROSTHETIC UROLOGY 
                SURGERY FOLLOWING PROSTATE CANCER TREATMENT.
  
      ``(a) In General.--A group health plan, and a health insurance 
  issuer providing health insurance coverage in connection with a group 
  health plan, that provides medical and surgical benefits with respect 
  to prostate cancer treatment shall provide, in a case of a participant 
  or beneficiary who is receiving benefits in connection with such 
  prostate cancer treatment, coverage for--
              ``(1) all stages of reconstructive prosthetic urology 
          surgery; and
              ``(2) prostheses and physical complications of 
          prostatectomy;
  in a manner determined in consultation with the attending physician and 
  the patient. Such coverage may be subject to annual deductibles and 
  coinsurance provisions as may be deemed appropriate and as are 
  consistent with those established for other benefits under the plan or 
  coverage. Written notice of the availability of such coverage shall be 
  delivered to the participant upon enrollment and annually thereafter.
      ``(b) Notice.--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 earlier.
      ``(c) Prohibitions.--A group health plan, and a health insurance 
  issuer offering group health insurance coverage in connection with a 
  group health plan, may not--
              ``(1) deny to a patient eligibility or continued 
          eligibility, to enroll or to renew coverage under the terms of 
          the plan, solely for the purposes of avoiding the requirements 
          of this section; and
              ``(2) penalize or otherwise reduce or limit the 
          reimbursement of an attending provider, or provide incentives 
          (monetary or otherwise) to an attending provider, to induce 
          such provider to provide care to an individual participant or 
          beneficiary in a manner inconsistent with this section.
      ``(d) Rule of Construction.--Nothing in this section shall be 
  construed to prevent a group health plan or a health insurance issuer 
  offering group health insurance coverage from negotiating the level and 
  type of reimbursement with a provider for care provided in accordance 
  with this section.
      ``(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 
          reconstructive prosthetic urology surgery otherwise required in 
          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) Clerical Amendment.--The table of contents in section 1 of the 
  Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 note) 
  is amended by inserting after the item relating to section 713 the 
  following new item:
  
  ``Sec. 714. Required coverage for reconstructive prosthetic urology 
                              surgery following prostate cancer 
                              treatment.''.
      (c) Effective Dates.--
              (1) In general.--The amendments made by this section shall 
          apply with respect to plan years beginning on or after the 
          first day of the sixth month beginning after the date of the 
          enactment of this Act.
              (2) Special rule for collective bargaining agreements.--In 
          the case of a group health plan maintained pursuant to 1 or 
          more collective bargaining agreements between employee 
          representative and 1 or more employers, any plan amendment made 
          pursuant to a collective bargaining agreement relating to the 
          plan which amends the plan solely to conform to any requirement 
          added by this section shall not be treated as a termination of 
          such collective bargaining agreement.
  
  SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.
  
      (a) Group Market.--Subpart 2 of part A of title XXVII of the Public 
  Health Service Act (42 U.S.C. 300gg-4 et seq.) is amended by adding at 
  the end the following new section:
  
  ``SEC. 2707. REQUIRED COVERAGE FOR RECONSTRUCTIVE PROSTHETIC UROLOGY 
                SURGERY FOLLOWING PROSTATE CANCER TREATMENT.
  
      ``The provisions of section 714 of the Employee Retirement Income 
  Security Act of 1974 shall apply to group health plans, and health 
  insurance issuers providing health insurance coverage in connection 
  with group health plans, as if included in this subpart.''.
      (b) Individual Market.--Subpart 3 of part B of title XXVII of the 
  Public Health Service Act (42 U.S.C. 300gg-51 et seq.) is amended by 
  adding at the end the following new section:
  
  ``SEC. 2753. REQUIRED COVERAGE FOR RECONSTRUCTIVE PROSTHETIC UROLOGY 
                SURGERY FOLLOWING PROSTATE CANCER TREATMENT.
  
      ``The provisions of section 2707 of the title shall apply to health 
  insurance coverage offered by a health insurance issuer in the 
  individual market in the same manner as they apply to health insurance 
  coverage offered by a health insurance issuer in connection with a 
  group health plan in the small or large group market.''.
      (c) Effective Dates.--
              (1) Group plans.--
                      (A) In general.--The amendment made by subsection 
                  (a) shall apply to group health plans for plan years 
                  beginning on or after the first day of the sixth month 
                  beginning after the date of the enactment of this Act.
                      (B) Special rule for collective bargaining 
                  agreement.--In the case of a group health plan 
                  maintained pursuant to 1 or more collective bargaining 
                  agreements between employee representatives and 1 or 
                  more employers, any plan amendment made pursuant to a 
                  collective bargaining agreement relating to the plan 
                  which amends the plan solely to conform to any 
                  requirement added by the amendment made by subsection 
                  (a) shall not be treated as a termination of such 
                  collective bargaining agreement.
              (2) Individual plans.--The amendment 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 the first day of the sixth month beginning 
          after the date of the enactment of this Act.
target: Post-Prostate Cancer Treatment Equity Act of 2007 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) and the Public Health Service Act to require a group health plan that provides medical and surgical benefits with respect to prostate cancer treatment to provide coverage for: (1) all stages of reconstructive prosthetic urology surgery; and (2) prostheses and physical complications of prostatectomy. Requires plans to provide notice of the coverage.
  
  Prohibits a group health plan from: (1) denying to a patient eligibility or continued eligibility solely to avoid the requirements of this Act; or (2) penalizing or otherwise reducing or limiting the reimbursement of a provider or providing incentives to induce such provider to provide care to a participant or beneficiary in a manner inconsistent with this Act.
  
  Applies such requirements to coverage offered in the individual market.
feat_title: To amend the Public Health Service Act and Employee Retirement Income Security Act of 1974 to require that group and individual health insurance coverage and group health plans provide coverage for reconstructive prosthetic urology surgery if they provide coverage for prostate cancer treatment.