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AUA ADVOCACY Prostate-Specific Antigen Coverage for Prostate Cancer Screening by the Oregon Health Plan
By: Brian Duty, MD, Oregon Health & Science University, Portland | Posted on: 18 Mar 2024
On January 18, 2024, the Health Evidence Review Commission, which is part of the Oregon Health Authority, approved a recommendation to ensure coverage of PSA screening for all Oregonians, regardless of their risk factor.
Before this vote, all major insurance providers in the state covered PSA screening. However, the Oregon Health Plan (OHP) did not cover the cost of screening because of the “C” recommendation from the United States Preventive Services Task Force. Though the OHP did make a coverage exception for individuals with lower urinary tract symptoms, those at increased risk of prostate cancer—like Black men and men with a family history of prostate cancer—were not covered by the state plan. Based on this discrepancy, I, as the chair of the AUA State Advocacy Committee (SAC) and member of the Oregon Value-based Benefits Subcommittee (VbBS), requested that VbBS review the coverage policy.
As the VbBS is responsible for making evidence-based recommendations to the Health Evidence Review Commission regarding OHP coverage, the AUA submitted joint written testimony with the Oregon Urological Society. Additionally, Dr Sudhir Isharwal, president of the Oregon Urological Society, provided public testimony during the VbBS committee meeting.
The AUA’s SAC considers promoting access to prostate cancer screening, diagnostic methods, and treatment as one of its top legislative priorities. The diligent efforts of AUA members have led to the passage of similar policies or legislation in New York, Maryland, and Rhode Island. Unfortunately, a similar bill passed by the California State Legislature in 2023 was vetoed by Governor Newsome.
The success of these and other efforts is why the SAC is developing a new “grasstops” program. This program will provide support and teaching aids for establishing relationships with local elected officials. That way, AUA members will be positioned to influence, comment, or testify on policies related to our priorities when the opportunity arises—as I had the opportunity to do in Oregon. If you are interested in being notified when this program goes live, please get in touch with the AUA State Advocacy Manager, Joshua Webster, at JWebster@AUAnet.org.
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