Bill being drafted on prostate cancer

By Cy Ryan

Tuesday, Aug. 19, 2008 | 11:08 a.m.

CARSON CITY – At the 2007 session of the Nevada Legislature, state Sen. Bob Coffin sponsored a bill to require health insurance and health care plans to provide coverage for annual screenings for prostate cancer for men.

Insurance lobbyists fought the bill but it finally gained passage 11-10 in the Senate, only to die in the Assembly.

In a twist of fate, Coffin learned he had prostate cancer several months ago and underwent surgery two weeks ago.

“They got it all,” he said referring to the cancer.

Now, Coffin says he’s requested a bill be drafted for the 2009 Legislature to require annual prostate-specific antigen testing.

“This is all very ironic,” says Coffin.

A report by the state Health Division shows there were 7,569 resident prostate cancer cases from 2001 to 2004. And of the 2,351 men who were surveyed during that period 80.7 percent said they had a PSA test or a digital rectal exam to detect signs of prostate cancer.

The median age at diagnosis of prostate cancer was 68 years old and the median age at time of death was 78. There were 995 resident deaths from 2000-2004 due to prostate cancer.

The prostate cancer rate in Nevada was lower than the national average during that period. There were 152.8 cases per 100,000 men in Nevada compared to 167.9 cases nationally.

The 2007 bill would have required insurance policies to provide for annual cancer screening both by a blood test and a digital rectal examination. It would have prohibited insurance companies from charging a deductible or co-insurance.

The annual screening would apply to men 40 and older or men 35 and older who have a high risk of developing prostate cancer. High risk was defined as a man whose family had a history of prostate cancer, an African-American man or if he fit in the national or state guidelines.

Coffin’s bill didn’t pass. But part of his legislation was included in a bill by Senate Minority Leader Dina Titus that required insurance companies to provide vaccine for prevention of cervical cancer for women.

That bill, signed into law, required insurance companies that cover medical care for prostate cancer must include for examinations without prior approval. But there wasn’t the mandatory annual examination allowed and a deductible could still be charged.

Insurance lobbyists objected to the mandatory language in Coffin’s bill that required the testing be done to Nevada standards rather than national standards. Clinical examinations are changing, they argued so physicians should not be restricted on how they test. In addition they opposed the provision that a deductible could not be imposed.

Fred Hillerby, who represents Renown Health in Reno, said he would have to look at Coffin’s bill when it’s introduced. But he said these tests are permitted now in insurance policies and “everyone pays for them.”

If Coffin wants to set up a new payment system, “that may be problematic,” said Hillerby whose company has hospitals, an insurance company and other businesses. Every time a new system is started it costs more, said Hillerby.

Hillerby said the tests are typically part of a panel of examinations and he did not know how the prostate cancer test would be singled out for no-deductible.

“We’ll see what it (the Coffin bill) does,’’ said Hillerby who is also a member of the Nevada Association of Health Plans.

The health division study showed the one-year survival rate for prostate cancer in Nevada was 95.7 percent during the 2000-2004 period. And the five year survival rate was 89.6 percent during the same period.

Cy Ryan may be reached at (775) 687-5032 or [email protected].