II 

117TH CONGRESS 

2D SESSION S. 5295 

To address the health of cancer survivors and unmet needs that survivors 

face through the entire continuum of care from diagnosis through active 

treatment and posttreatment, in order to improve survivorship, treatment, 

transition to recovery and beyond, quality of life and palliative care, 

and long-term health outcomes, including by developing a minimum 

standard of care for cancer survivorship, irrespective of the type of 

cancer, a survivor’s background, or forthcoming survivorship needs, and 

for other purposes. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 19, 2022 

Ms. KLOBUCHAR (for herself and Mr. CARDIN) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To address the health of cancer survivors and unmet needs 

that survivors face through the entire continuum of care 

from diagnosis through active treatment and 

posttreatment, in order to improve survivorship, treatment, transition to recovery and beyond, quality of life 

and palliative care, and long-term health outcomes, including by developing a minimum standard of care for 

cancer survivorship, irrespective of the type of cancer, 

a survivor’s background, or forthcoming survivorship 

needs, and for other purposes. 


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1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Comprehensive Cancer Survivorship Act’’. 

6 (b) TABLE OF CONTENTS.—The table of contents of 

7 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 

Sec. 3. Definitions. 

Sec. 4. Coverage of cancer care planning and coordination services. 

Sec. 5. Survivorship transition tools. 

Sec. 6. Alternative payment model. 

Sec. 7. Survivorship navigation. 

Sec. 8. Survivorship care demonstration program. 

Sec. 9. Cancer survivor workforce assistance grants. 

Sec. 10. Comprehensive cancer survivorship program. 

Sec. 11. Adult cancer survivorship study. 

Sec. 12. Survivorship progress report. 

Sec. 13. Promoting State innovations to ease transitions to the primary care 

setting for children with cancer. 

Sec. 14. Childhood cancer demonstration model and standard of care. 

Sec. 15. Medicaid coverage of fertility preservation services for cancer patients. 

8 SEC. 2. FINDINGS. 

9 Congress finds the following: 

10 (1) A cancer survivor is any individual with a 

11 history of cancer, from the time of diagnosis through 

12 the rest of their life, across the continuum of care. 

13 (2) Today, there are approximately 18,000,000 

14 Americans who are cancer survivors, and the num15 ber of survivors is projected to reach 26,000,000 by 

16 2040. Therefore, there is a great need to be able to 

17 provide ways to sustain the care needed and to offer 

18 those living with, through, and beyond cancer a safe, 


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1 supportive, and accommodating environment where 

2 such individuals can engage in physical and social 

3 support activities to sustain optimal quality of life. 

4 (3) Cancer survivors face difficult emotional, 

5 psychological, neurological, financial, and other 

6 physical challenges that persist beyond diagnosis and 

7 treatment, often arising months and years after ac8 tive cancer treatment ends. 

9 (4) Cancer survivors have unique needs and 

10 must manage short- and long-term effects of their 

11 treatment, as well as regular screenings for cancer 

12 recurrence or new cancers. 

13 (5) Cancer survivors of racial and ethnic diver14 sity have disproportionately lower health-related, 

15 quality-of-life scores compared to non-Hispanic 

16 White cancer survivors. 

17 (6) Cancer survivors living in rural areas have 

18 less access to services and have poorer outcomes 

19 than survivors in metropolitan areas. 

20 (7) Children, adolescent, and young adult can21 cer survivors are particularly susceptible to long22 term consequences from treatment, and up to 80 

23 percent have a severe, disabling, life-threatening, or 

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1 tices in this area would improve treatment, quality 

2 of life, and long-term health outcomes. 

3 (8) Clinical trials have shown that cancer survi4 vorship programs help cancer survivors meet or ex5 ceed the recommended amount of physical activity, 

6 significantly increasing their cardiovascular health 

7 and overall quality of life and decreasing their can8 cer-related fatigue. 

9 (9) Survivorship care refers to the medical or 

10 psychosocial care of an individual who has completed 

11 their primary treatment for cancer, or of an indi12 vidual who is undergoing maintenance or intermit13 tent medical treatment or maintenance psychosocial 

14 care for cancer, or of an individual living with meta15 static disease under continuous medical or psycho16 social treatment. 

17 (10) Despite the National Cancer Institute and 

18 other professional organizations’ definition of a can19 cer survivor beginning on the day of a cancer diag20 nosis, there is little agreement among clinicians, re21 searchers, and insurance companies on what services 

22 are included in ‘‘survivorship care’’ and the point at 

23 which ‘‘survivorship care’’ begins. 

24 (11) Cancer survivors, their families, their care25 givers, and their providers face many difficulties unVerDate Sep 11 2014 22:51 Jan 03, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S5295.IS S5295

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1 derstanding and coordinating the transition from 

2 specialty to primary care, and for this reason com3 munication and treatment are often fragmented and 

4 inconsistent. 

5 (12) To avoid additional health-related or finan6 cial hardships to cancer survivors and their families, 

7 comprehensive and forward-thinking cancer survivor8 ship studies and programs across Federal agencies 

9 are required to engage in a coordinated effort to im10 prove health outcomes and quality of life of sur11 vivors. 

12 SEC. 3. DEFINITIONS. 

13 In this Act: 

14 (1) CANCER SURVIVOR.—The term ‘‘cancer sur15 vivor’’ means anyone who remains alive from the 

16 time of a cancer diagnosis. 

17 (2) CAREGIVER.—The term ‘‘caregiver’’ means 

18 a family member, friend, or other person who cares 

19 for an older person or adult with a chronic or dis20 abling condition, including cancer. 

21 (3) PATIENT EXPERIENCE DATA.—The term 

22 ‘‘patient experience data’’ means patient experiences, 

23 perspectives, needs, and priorities related to— 

24 (A) the symptoms of the patient’s condi25 tions and the natural history of such conditions; 


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1 (B) the impact of the conditions on the pa2 tient’s functioning and quality of life; 

3 (C) the patient’s experience with treat4 ments; 

5 (D) input on which outcomes are impor6 tant to the patient; 

7 (E) patient preferences for outcomes and 

8 treatments; and 

9 (F) the relative importance of any issues 

10 as defined by patients. 

11 (4) PSYCHOSOCIAL EFFECTS.—The term ‘‘psy12 chosocial effects’’— 

13 (A) means the psychological, behavioral, 

14 emotional, and social effects of a disease, such 

15 as cancer, and its treatment; and 

16 (B) in the case of such effects of cancer, 

17 includes changes in how a patient thinks, their 

18 feelings, moods, beliefs, ways of coping, and re19 lationships with family, friends, and coworkers. 

20 (5) PSYCHOSOCIAL CARE.—The term ‘‘psycho21 social care’’ means psychological and social services 

22 and interventions that enable survivors, patients, 

23 their families, and health care providers to optimize 

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1 ness and its consequences so as to promote better 

2 health and well-being. 

3 (6) SECRETARY.—Except as otherwise speci4 fied, the term ‘‘Secretary’’ means the Secretary of 

5 Health and Human Services. 

6 (7) SURVIVORSHIP.—The term ‘‘survivorship’’ 

7 means the period from the time of cancer diagnosis 

8 until the end of life, including any portions of such 

9 period during which interventions are necessary to 

10 address— 

11 (A) the physical, mental, emotional, social, 

12 and financial effects of cancer that begin at di13 agnosis and continue through treatment and be14 yond; and 

15 (B) issues related to follow-up care (includ16 ing regular health and wellness checkups), late 

17 and long-term effects of treatment, screening 

18 for cancer recurrence and new cancers, and 

19 quality of life. 

20 (8) SURVIVORSHIP CARE PLAN.—The term 

21 ‘‘survivorship care plan’’— 

22 (A) means an individualized care plan for 

23 patients who have been treated for cancer; and 

24 (B) includes a treatment summary and any 

25 follow-up care guidelines in such plan that— 


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1 (i) are for monitoring and maintain2 ing the patient’s medical and psychosocial 

3 health and well-being; and 

4 (ii) are meant to be a transition and 

5 communication tool for the survivor, their 

6 family, their caregiver, and all their health 

7 care providers. 

8 (9) SURVIVORSHIP NAVIGATION.—The term 

9 ‘‘survivorship navigation’’ means a service that— 

10 (A) helps patients overcome health care 

11 system and social determinants of health bar12 riers; and 

13 (B) provides patients with timely access to 

14 high-quality medical, physical, and psychosocial 

15 care from their cancer diagnosis through all 

16 phases of their cancer experience. 

17 (10) TREATMENT SUMMARY.—The term ‘‘treat18 ment summary’’ means a detailed summary of a pa19 tient’s disease, the types of treatment the patient re20 ceived, members of the patient’s care team, and any 

21 side effects or other problems, including psychosocial 

22 effects, caused by treatment. 


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1 SEC. 4. COVERAGE OF CANCER CARE PLANNING AND CO2 ORDINATION SERVICES. 

3 (a) IN GENERAL.—Section 1861 of the Social Secu4 rity Act (42 U.S.C. 1395x) is amended— 

5 (1) in subsection (s)(2)— 

6 (A) by striking ‘‘and’’ at the end of sub7 paragraph (GG); 

8 (B) by adding ‘‘and’’ at the end of sub9 paragraph (HH); and 

10 (C) by adding at the end the following new 

11 subparagraph: 

12 ‘‘(II) cancer care planning and coordination 

13 services (as defined in subsection (lll))’’; and 

14 (2) by adding at the end the following new sub15 section: 

16 ‘‘Cancer Care Planning and Coordination Services 

17 ‘‘(lll)(1) The term ‘cancer care planning and coordi18 nation services’ means, with respect to an individual who 

19 is diagnosed with cancer, the development of a treatment 

20 plan by a physician, physician assistant, or nurse practi21 tioner that— 

22 ‘‘(A) includes each component of the Institute 

23 of Medicine Care Management Plan (as described in 

24 the article entitled ‘Delivering High-Quality Cancer 

25 Care: Charting a New Course for a System in Crisis’ 

26 published by the Institute of Medicine); 


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1 ‘‘(B) is furnished in written form or electroni2 cally, at the visit of such individual with such physi3 cian, physician assistant, or nurse practitioner, or as 

4 soon after the date of the visit as practicable; 

5 ‘‘(C) is furnished, to the greatest extent prac6 ticable, in a form that appropriate takes into ac7 count cultural and linguistic needs of the individual 

8 in order to make the plan accessible to the indi9 vidual. 

10 ‘‘(2) The Secretary shall establish frequencies at 

11 which services described in paragraph (1) may be fur12 nished, provided that such services may be furnished with 

13 respect to an individual— 

14 ‘‘(A) at the time such individual is diagnosed 

15 with cancer for purposes of planning treatment; 

16 ‘‘(B) if there is a change in the condition of 

17 such individual or such individual’s treatment pref18 erences; 

19 ‘‘(C) at the end of active treatment and begin20 ning of survivorship care; and 

21 ‘‘(D) if there is a recurrence of such cancer.’’. 

22 (b) PAYMENT UNDER PHYSICIAN FEE SCHEDULE.— 

23 (1) IN GENERAL.—Section 1848(j)(3) of the 

24 Social Security Act (42 U.S.C. 1395w–4(j)(3)) is 


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1 amended by inserting ‘‘(2)(II),’’ after ‘‘health risk 

2 assessment),’’. 

3 (2) INITIAL RATES.—Unless the Secretary oth4 erwise provides, the payment rate specified under 

5 the physician fee schedule under the amendment 

6 made by paragraph (1) for cancer care planning and 

7 coordination services shall be the same payment rate 

8 as provided for transitional care management serv9 ices (as defined in CPT code 99496). 

10 (c) EFFECTIVE DATE.—The amendments made by 

11 this section shall apply to services furnished on or after 

12 the first day of the first calendar year that begins after 

13 the date of the enactment of this Act. 

14 SEC. 5. SURVIVORSHIP TRANSITION TOOLS. 

15 (a) IN GENERAL.—The head of the Office of the Na16 tional Coordinator for Health Information Technology, in 

17 collaboration with Director of the Agency for Healthcare 

18 Research and Quality, shall— 

19 (1) evaluate existing models for survivorship 

20 care plans, as they relate to both adults and chil21 dren, through engagement with professional soci22 eties, payors, patient advocacy organizations, com23 munity-based organizations, electronic health record 

24 vendors, and other stakeholders; 


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1 (2) evaluate other existing tools for developing 

2 survivorship care plans, such as— 

3 (A) survivorship guidelines of the National 

4 Comprehensive Cancer Network and the Amer5 ican Society of Clinical Oncology; or 

6 (B) tools such as Passport for Care; 

7 (3) collaborate with the Office for Civil Rights 

8 of the Department of Health and Human Services to 

9 evaluate the privacy and security implications of— 

10 (A) consolidating treatment history and 

11 survivorship guidelines into a personalized sur12 vivorship care plan, as described in paragraph 

13 (4); and 

14 (B) patient use of computer or mobile 

15 phone-based application programs described in 

16 paragraph (4)(B); and 

17 (4) taking into consideration the results of eval18 uation under paragraphs (1) and (2)— 

19 (A) not later than 12 months after the 

20 date of enactment of this Act, publish informa21 tion resources for cancer patients and providers 

22 on strategies for consolidating treatment history 

23 and survivorship guidelines into a personalized 

24 survivorship care plan to guide survivorship 

25 monitoring and follow-up care; and 


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1 (B) include in such information resources 

2 recommendations about possible patient use of 

3 application programs (‘‘apps’’) to develop per4 sonalized survivorship care plans. 

5 (b) DEFINITION.—In this section, the term ‘‘elec6 tronic health record’’ means an electronic record of health7 related information on an individual that is created, gath8 ered, managed, and consulted by authorized health care 

9 clinicians and staff. 

10 SEC. 6. ALTERNATIVE PAYMENT MODEL. 

11 Not later than 18 months after the date of the enact12 ment of this Act, the Secretary shall submit to Congress 

13 a report containing a description of an alternative pay14 ment model for payment under title XVIII and title XIX 

15 of the Social Security Act (42 U.S.C. 1395 et seq., 1396 

16 et seq.) for items and services relating to cancer survivor17 ship care. The report shall include the following: 

18 (1) A description of what event would trigger 

19 an individual’s entry into such a model (such as the 

20 end of the individual’s active cancer treatment, the 

21 beginning of the individual’s need for supportive 

22 care during active treatment, or another event). 

23 (2) The length of the individual’s participation 

24 under such model, including a description of any 

25 ability to extend such participation. 


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1 (3) In the case that such model is based on an 

2 episode of care, the appropriate length of the survi3 vorship episode of care and whether additional epi4 sodes may be triggered, if necessary. 

5 (4) Strategies to ensure that any episode of 

6 care under such a model begins with the develop7 ment and dissemination of a survivorship care plan 

8 for the transition from active cancer treatment to 

9 follow-up care to the individual and all relevant 

10 health care providers. 

11 (5) A description of any bundled payment pack12 ages that will be used under such model. 

13 (6) A specification of any follow up or new 

14 screening under such model for unmet needs of indi15 viduals participating in such model. 

16 (7) How consistent, shared decisionmaking will 

17 be promoted under such model so that individuals 

18 are given the knowledge needed for self-management 

19 between episodes of care. 

20 (8) A specification of which types of health care 

21 providers may furnish items and services under such 

22 model, including genetic counselors and mental 

23 health professionals. 

24 (9) Strategies for applying evidence-based risk 

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1 alized care pathways that match the level of care 

2 needed to the relative risks and needs of the sur3 vivor. 

4 (10) Strategies for coordination of care between 

5 such providers, such as between specialists and pri6 mary care providers, and how principal responsibility 

7 will be assigned for an episode of care. 

8 (11) Strategies for addressing social deter9 minants of health through such model. 

10 (12) A description of how such model will pro11 mote— 

12 (A) prevention, early detection surveillance, 

13 and treatment for individuals continuing to re14 ceive systemic therapy after the end of active 

15 cancer treatment; 

16 (B) such individuals’ understanding of, 

17 and access to, treatment; 

18 (C) survivorship research; and 

19 (D) the continuing health of cancer sur20 vivors. 

21 (13) An analysis of how different forms and 

22 stages of cancer may require the development of dif23 ferent survivorship plans and alternative payment 

24 models based on varying episodes of care. 


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1 (14) A plan for testing any alternative payment 

2 model described in the report, including the timing 

3 of such testing, an analysis of the impact of such 

4 testing, any barriers to implementing such testing, 

5 and any other recommendations determined appro6 priate by the Secretary. 

7 SEC. 7. SURVIVORSHIP NAVIGATION. 

8 (a) REVIEW OF PROGRAMS AND NAVIGATION

9 STUDY.— 

10 (1) IN GENERAL.—Not later than 18 months 

11 after the date of enactment of this Act, the Sec12 retary shall— 

13 (A) complete a review of previous and cur14 rent cancer survivorship navigation programs, 

15 including any applicable standards of care such 

16 as those of the Professional Oncology Naviga17 tion Task Force, and the Academy of Oncology 

18 Nurse & Patient Navigators, the Oncology 

19 Nursing Society; and 

20 (B) submit a report to the Congress on the 

21 results of such review. 

22 (2) CONSIDERATIONS.—In carrying out sub23 section (a), the Secretary shall take into consider24 ation each of the following: 


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1 (A) How cancer survivorship navigation 

2 program services might be provided from diag3 nosis across the continuum of care through sur4 vivorship, taking into consideration— 

5 (i) the type of navigation services that 

6 are most effective for survivors at the time 

7 of diagnosis; and 

8 (ii) the type of navigation services 

9 that are most useful for survivors who are 

10 managing the late and long-term effects of 

11 cancer and cancer treatment. 

12 (B) How navigation services might evolve 

13 over the continuum of care and how to encour14 age a dynamic navigation system. 

15 (C) Training needs for navigators. 

16 (D) Comparison and delineation of naviga17 tion services provided by lay and professional 

18 navigators. 

19 (E) Evaluation of optimal strategies for of20 fering survivors navigation services and encour21 aging their utilization of such services. 

22 (F) Defining— 

23 (i) the continuum of care during 

24 which services are provided; and 


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1 (ii) the nature of services for a long2 term survivor. 

3 (G) The location of navigation services 

4 (such as whether such services should be pro5 vided as part of oncology practices or outside of 

6 oncology practices). 

7 (H) Federal financing for navigation serv8 ices (such as whether to finance such services 

9 through a grant program funded through an10 nual discretionary appropriations). 

11 (I) Alternative delivery and payment mod12 els for cancer survivorship navigation services, 

13 including consideration of— 

14 (i) an episode-of-care model for pro15 viding cancer survivorship navigation serv16 ices, or a patient-focused navigation benefit 

17 that survivors could utilize in different set18 tings, with the navigation services meeting 

19 standards set by the Secretary; and 

20 (ii) services funded through the Medi21 care and Medicaid programs. 

22 (J) Resources and the role of patient advo23 cacy organizations and peer support networks 

24 in cancer survivorship navigation services. 


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1 (b) DEMONSTRATION PROGRAM FOR NAVIGATION

2 SERVICES FOR CANCER SURVIVORS.— 

3 (1) IN GENERAL.—The Secretary shall carry 

4 out a demonstration program consisting of awarding 

5 grants to eligible entities to provide navigation serv6 ices to cancer survivors. 

7 (2) TIMING.—The Secretary shall initiate the 

8 demonstration program under this subsection not 

9 later than 12 months after completing the review as 

10 required under subsection (a)(1)(A). 

11 (3) ELIGIBLE ENTITIES.—To be eligible to re12 ceive a grant under this subsection, an entity shall— 

13 (A) have staff and expertise to provide 

14 navigation services; and 

15 (B) be— 

16 (i) a community-based organization; 

17 (ii) a patient-centered education and 

18 service organization; 

19 (iii) a nonprofit patient or cancer ad20 vocacy organization; 

21 (iv) a community cancer provider; 

22 (v) a cancer center; 

23 (vi) a hospital; 

24 (vii) a community health center; or 


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1 (viii) another type of entity as the 

2 Secretary determines appropriate. 

3 (4) USE OF FUNDS.—A recipient of a grant 

4 under this section shall use the grant to provide 

5 navigation services to cancer survivors, including 

6 by— 

7 (A) offering navigation services from diag8 nosis through the continuum of care, including 

9 long-term survivorship, or offering navigation 

10 services from the end of active treatment with 

11 an emphasis on facilitating the transition from 

12 active treatment to long-term survivorship care 

13 and throughout survivorship; 

14 (B) in a timely manner, assisting cancer 

15 survivors to navigate cancer treatment and fol16 low-up services, such as screenings, risk assess17 ment, mitigation, health promotion activities, 

18 providing health information and education, 

19 coaching, and support; 

20 (C) addressing cancer care disparities in 

21 the design and delivery of services; 

22 (D) ensuring coordination with the sur23 vivor’s health care providers; 


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1 (E) following evidence-based survivorship 

2 care guidelines in the design and delivery of 

3 survivorship services; 

4 (F) ensuring the delivery of culturally ap5 propriate services and materials; and 

6 (G) assisting cancer survivors to meet and 

7 overcome barriers to treatment and follow-up 

8 services, such as any such barriers relating to 

9 food insecurity, housing, transportation, labor, 

10 access to broadband connectivity, the avail11 ability of telehealth, or child care, with empha12 sis placed on high-risk populations. 

13 SEC. 8. SURVIVORSHIP CARE DEMONSTRATION PROGRAM. 

14 (a) IN GENERAL.—The Secretary shall carry out a 

15 demonstration program for a period of 5 years consisting 

16 of awarding grants to improve the quality of cancer survi17 vorship care. 

18 (b) TIMING.—The Secretary shall initiate the dem19 onstration program under this section not later than 1 

20 year after the date of enactment of this Act. 

21 (c) DEMONSTRATION SITES.—The Secretary shall 

22 ensure that grants are awarded under this section to im23 prove the quality of cancer survivorship care at a wide di24 versity of sites, including— 


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1 (1) in urban, suburban, rural, and Tribal areas; 

2 and 

3 (2) cancer care sites including cancer centers, 

4 academic health centers, federally qualified health 

5 centers, rural health clinics, physician offices, Tribal 

6 organizations, community-based health care pro7 viders, and health care providers serving medically 

8 underserved areas. 

9 (d) AREAS OF FOCUS UNDER THE DEMONSTRATION

10 PROGRAM.—The demonstration program under this sec11 tion shall be designed to ensure the development of a vari12 ety of models for survivorship care that will permit evalua13 tion of a variety of care strategies, including— 

14 (1) utilization of navigators to assist survivors 

15 in obtaining survivorship care; 

16 (2) employment of risk-stratification to better 

17 determine the nature and intensity of services that 

18 survivors require; 

19 (3) transitions of care from cancer care pro20 viders to primary care providers, through transition21 of-care models that involve collaboration between 

22 cancer care specialists and primary care providers; 

23 (4) the training needs of primary care providers 

24 to be better equipped to work with survivors in pri25 mary care settings; 


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1 (5) utilization of survivorship care plans to fa2 cilitate coordination of survivorship care; 

3 (6) experimentation with providing cancer sur4 vivorship care at home; 

5 (7) use of information technology to plan and 

6 coordinate care to improve the consistent identifica7 tion, collection, and measurement of all forms of pa8 tient experience data, including patient-reported out9 comes of patient-reported symptoms and quality-of10 life measures; and 

11 (8) expansion of existing successful models of 

12 survivorship care. 

13 (e) EVALUATION OF DEMONSTRATION PROGRAM.— 

14 The Secretary shall— 

15 (1) develop a plan for evaluating the projects 

16 that are conducted as part of the demonstration pro17 gram under this section; and 

18 (2) not later than 18 months after the end of 

19 the 5-year demonstration program, complete such 

20 evaluation and submit a report to the Congress on 

21 the results of such evaluation. 

22 SEC. 9. CANCER SURVIVOR WORKFORCE ASSISTANCE 

23 GRANTS. 

24 (a) IN GENERAL.—The Secretary of Labor, in con25 sultation with the Secretary of Health and Human ServVerDate Sep 11 2014 22:51 Jan 03, 2023 Jkt 039200 PO 00000 Frm 00023 Fmt 6652 Sfmt 6201 E:\BILLS\S5295.IS S5295

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1 ices, shall carry out a program to award grants to non2 profit organizations and other entities to provide edu3 cation and targeted assistance— 

4 (1) to eligible cancer survivors facing barriers 

5 to employment, including those who remain in the 

6 workforce during treatment, those who reduce work7 ing hours while in treatment, and those who reenter 

8 the workforce after a treatment-related departure; 

9 and 

10 (2) to the families and caregivers of such eligi11 ble cancer survivors. 

12 (b) PROGRAM COMPONENTS.—The program under 

13 this section shall include the following: 

14 (1) Assistance, career and training services, and 

15 supportive services for eligible cancer survivors who 

16 stay in the workforce during treatment, and for their 

17 families and caregivers, including— 

18 (A) transportation assistance; 

19 (B) childcare assistance; 

20 (C) nutritional assistance; 

21 (D) physical activity assistance; 

22 (E) psychosocial assistance; 

23 (F) financial assistance during a period of 

24 medical leave; and 

25 (G) other similar assistance. 


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1 (2) Assistance and education for eligible cancer 

2 survivors who leave the workforce during treatment, 

3 and for their families and caregivers, including— 

4 (A) financial assistance during a period of 

5 medical leave; 

6 (B) assistance with premiums for continu7 ation coverage provided pursuant to part 6 of 

8 subtitle B of title I of the Employee Retirement 

9 Income Security Act of 1974 (29 U.S.C. 1161 

10 et seq.), title XXII of the Public Health Service 

11 Act (42 U.S.C. 300bb–1 et seq.), or section 

12 4980B of the Internal Revenue Code of 1986 

13 (26 U.S.C. 4980B); and 

14 (C) career and training services, including 

15 upskilling and reskilling, for eligible cancer sur16 vivors who are not able to return to work after 

17 treatment. 

18 (3) Assistance, career and training services, and 

19 supportive services for eligible cancer survivors who 

20 are unable to work after a cancer diagnosis, and 

21 their families and caregivers, including— 

22 (A) assistance in applying for— 

23 (i) supplemental security income bene24 fits under title XVI of the Social Security 

25 Act (42 U.S.C. 1381 et seq.); 


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1 (ii) disability insurance benefits under 

2 section 223 of the Social Security Act (42 

3 U.S.C. 423); 

4 (iii) benefits under a State plan, or 

5 waiver of such plan, under title XIX of the 

6 Social Security Act (42 U.S.C. 1396 et 

7 seq.); 

8 (iv) with respect to minimizing delays 

9 in eligibility before a cancer survivor be10 comes eligible for Medicare coverage, bene11 fits under the Medicare program under 

12 title XVIII of the Social Security Act (42 

13 U.S.C. 1801 et seq.), including with re14 spect to enrolling in plans under part C or 

15 D of such title and supplemental plans 

16 under section 1882 of such title; 

17 (v) State and private sector assistance 

18 programs for such cancer survivors; and 

19 (vi) career and training services avail20 able under title I, II, or IV of the Work21 force Innovation and Opportunity Act (29 

22 U.S.C. 3101 et seq.); and 

23 (B) information on the eligibility of a can24 cer survivor, and their families and caregivers, 


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1 for benefits or services described in any of 

2 clauses (i) through (vi) of subparagraph (A). 

3 (c) EVIDENCE-BASED RESOURCES.—In carrying out 

4 this section, the Secretary of Labor, in consultation with 

5 the Secretary of Health and Human Services, shall use 

6 evidence-based resources, including— 

7 (1) nationally recognized evidence-based guide8 lines; and 

9 (2) other resources as determined by the Sec10 retary. 

11 (d) DEFINITIONS.—In this section: 

12 (1) The term ‘‘eligible cancer survivor’’ means 

13 a cancer survivor (as defined in section 3) who— 

14 (A) remains in the workforce during cancer 

15 treatment; 

16 (B) reduces working hours during cancer 

17 treatment; 

18 (C) reenters the workforce after a cancer 

19 treatment-related departure; or 

20 (D) leaves the workforce as the result of a 

21 cancer diagnosis or related complications. 

22 (2) The term ‘‘supportive services’’ has the 

23 meaning given such term in section 3 of the Work24 force Innovation and Opportunity Act (29 U.S.C. 

25 3102). 


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1 SEC. 10. COMPREHENSIVE CANCER SURVIVORSHIP PRO2 GRAM. 

3 (a) IN GENERAL.—The Secretary shall carry out a 

4 comprehensive cancer survivorship program that in5 cludes— 

6 (1) a cancer survivorship resource center in ac7 cordance with subsection (b) to provide evidence8 based resources to cancer survivors, their families, 

9 and their caregivers; 

10 (2) a health care professional resource center in 

11 accordance with subsection (c) to assist and educate 

12 health care professionals in the delivery of high-qual13 ity survivorship care; 

14 (3) an educational campaign in accordance with 

15 subsection (d) to provide health care professionals 

16 with resources to improve cancer survivorship care; 

17 and 

18 (4) a program of supportive care services in ac19 cordance with subsection (e) to improve the quality 

20 of life and long-term survivorship of cancer sur21 vivors. 

22 (b) CANCER SURVIVORSHIP RESOURCE CENTER.— 

23 (1) ESTABLISHMENT.—The Secretary shall es24 tablish and operate a survivorship resource center 

25 (in this subsection referred to as the ‘‘Center’’) that 


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1 serves as a comprehensive source of information and 

2 resources related to survivorship. 

3 (2) TIMING.—Not later than 2 years after the 

4 date of enactment of this Act, the Secretary shall es5 tablish and begin operation of the Center. 

6 (3) CONSULTATION.—In establishing and oper7 ating the Center, the Secretary shall consult with 

8 cancer survivors, patient organizations, health pro9 fessionals, researchers, health education organiza10 tions, oncology professional societies and other med11 ical societies, community-based organizations, and 

12 science education organizations regarding— 

13 (A) the information and resources that 

14 would assist cancer survivors in managing the 

15 survivorship experience and obtaining high16 quality care across the continuum of care; 

17 (B) gaps in such information and re18 sources that need to be addressed to respond to 

19 the needs of cancer survivors; and 

20 (C) optimal strategies for ensuring that 

21 cancer survivors have access to the Center, in22 cluding strategies that provide virtual options, 

23 online resources, and marketing. 

24 (4) USE OF AVAILABLE EVIDENCE-BASED RE25 SOURCES.—In establishing and operating the CenVerDate Sep 11 2014 22:51 Jan 03, 2023 Jkt 039200 PO 00000 Frm 00029 Fmt 6652 Sfmt 6201 E:\BILLS\S5295.IS S5295

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1 ter, the Secretary shall, with permission and attribu2 tion, rely on and utilize the evidence-based materials 

3 and resources developed, collected, and distributed 

4 by cancer organizations. 

5 (c) HEALTH CARE PROFESSIONAL RESOURCE CEN6 TER.— 

7 (1) IN GENERAL.—The Secretary shall establish 

8 and operate a health care professional resource cen9 ter (in this subsection referred to as the ‘‘Center’’) 

10 that serves as a comprehensive source of information 

11 and resources to assist health care professionals in 

12 the delivery of high-quality survivorship care. 

13 (2) REFERENCE CANCER SURVIVORSHIP GUIDE14 LINES.—In establishing and operating the Center, 

15 the Secretary shall reference cancer survivorship 

16 guidelines developed by cancer care professional soci17 eties, patient organizations, research foundations, 

18 and other health care professional societies in the 

19 development of materials related to survivorship 

20 care. 

21 (3) SUPPORT PARTNERSHIPS BETWEEN CANCER

22 SPECIALTY SOCIETIES AND PRIMARY CARE PRO23 VIDER ORGANIZATIONS.—In establishing and oper24 ating the Center, the Secretary shall facilitate col25 laboration between cancer care specialty societies 


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1 and primary care provider organizations in the de2 velopment of standards for survivorship care, includ3 ing standards for coordination of care and transi4 tions of care from active treatment to long-term sur5 vivorship care. 

6 (d) CAMPAIGN TO EDUCATE SURVIVORS AND

7 HEALTH CARE PROFESSIONALS IN SURVIVORSHIP

8 CARE.— 

9 (1) IN GENERAL.—The Secretary acting 

10 through the Director of the Centers for Disease 

11 Control and Prevention (in this subsection referred 

12 to as the ‘‘Secretary’’) shall— 

13 (A) expand educational programs and serv14 ices to— 

15 (i) health care professionals; and 

16 (ii) cancer survivors, their families, 

17 and caregivers; and 

18 (B) enhance the continuing medical edu19 cation resources on cancer survivorship that are 

20 available to health care professionals. 

21 (2) EXPAND COLLABORATION WITH COM22 PREHENSIVE CANCER CONTROL NATIONAL PARTNER23 SHIP AND OTHER ORGANIZATIONS FOR SURVIVOR24 SHIP EDUCATION AND SUPPORT.— 


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1 (A) IN GENERAL.—The Secretary shall ex2 pand collaborations with organizations that are 

3 part of the Comprehensive Cancer Control Na4 tional Partnership and other organizations to 

5 focus on increasing education and awareness re6 lated to cancer survivorship through materials, 

7 resources, and other methods as necessary. 

8 (B) COLLABORATE WITH THE ORGANIZA9 TIONS IN THE NATIONAL PARTNERSHIP AND

10 OTHER ORGANIZATIONS.—The Secretary shall 

11 collaborate with the organizations that are part 

12 of the Comprehensive Cancer Control National 

13 Partnership and other organizations to inform 

14 cancer survivors of survivorship monitoring and 

15 follow-up standards, availability of survivorship 

16 care services, and how to access these services. 

17 (C) REFERENCE THE SURVIVORSHIP

18 STANDARDS OF CARE DEVELOPED AND PUB19 LISHED BY CANCER ORGANIZATIONS.—In col20 laboration with the organizations that are part 

21 of the Comprehensive Cancer Control National 

22 Partnership, the Secretary shall— 

23 (i) develop and implement a plan to 

24 distribute survivorship educational mate25 rials to ensure that such materials are acVerDate Sep 11 2014 22:51 Jan 03, 2023 Jkt 039200 PO 00000 Frm 00032 Fmt 6652 Sfmt 6201 E:\BILLS\S5295.IS S5295

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1 cessible to all cancer survivors, their fami2 lies and caregivers, and health care profes3 sionals; and 

4 (ii) reference in such plan the survi5 vorship standards of care developed and 

6 published by such organizations. 

7 (3) CONTINUING MEDICAL EDUCATION.— 

8 (A) IN GENERAL.—The Secretary shall 

9 carry out a program to support the development 

10 of continuing medical education programs for 

11 survivorship care that utilize and rely on the 

12 guidelines for survivorship care developed and 

13 published by national organizations. 

14 (B) TIMING.—Not later than 12 months 

15 after the date of enactment of this Act, the Sec16 retary shall initiate the program required by 

17 subparagraph (A). 

18 (C) GRANTS FOR DEVELOPMENT OF CUR19 RICULUM FOR SURVIVORSHIP CONTINUING MED20 ICAL EDUCATION.— 

21 (i) IN GENERAL.—The Secretary shall 

22 award grants to eligible entities for devel23 opment of diverse, equitable, and culturally 

24 appropriate curricula for survivorship care 

25 curriculum for medical care. 


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1 (ii) ELIGIBLE ENTITIES.—In this sub2 paragraph, the term ‘‘eligible entity’’ in3 cludes a medical professional society, a pa4 tient organization, an academic institution, 

5 a cancer center, and any other entity with 

6 experience in continuing medical education 

7 for cancer professionals. 

8 (iii) SCOPE OF CURRICULUM.—To re9 ceive a grant under this section, an appli10 cant shall demonstrate its ability to de11 velop survivorship care curriculum for 

12 medical care, taking into consideration 

13 services from the legal, social work, public 

14 health, behavioral sciences, genetic, epide15 miology, and nursing fields. 

16 (4) PUBLIC AWARENESS CAMPAIGN.—The Sec17 retary, at an appropriate time after the availability 

18 of patient survivorship materials, professional survi19 vorship materials, and continuing medical education 

20 programs under this subsection, shall initiate a lin21 guistically and cultural appropriate public awareness 

22 campaign that targets the organization’s catchment 

23 area to ensure that cancer survivors, their families 

24 and caregivers, health care professionals, and the 

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1 cational and informational resources available from 

2 the Centers for Disease Control and Prevention. 

3 (e) CANCER SURVIVORSHIP QUALITY-OF-LIFE PRO4 GRAM.— 

5 (1) IN GENERAL.—The Secretary acting 

6 through the Director of the Centers for Disease 

7 Control and Prevention (in this subsection referred 

8 to as the ‘‘Secretary’’) shall carry out a program of 

9 awarding grants to eligible entities to provide serv10 ices to cancer survivors to enhance their quality of 

11 life and improve their long-term survival rates. Not 

12 later than 18 months after the date of enactment of 

13 this Act, the Secretary shall commence operating 

14 such program. 

15 (2) ELIGIBLE ENTITY DEFINED.—In this sub16 section, the term ‘‘eligible entity’’ includes an entity 

17 that is— 

18 (A) a State comprehensive cancer program; 

19 (B) a National Cancer Institute-designated 

20 cancer center or centers; or 

21 (C) a community-based organization, in22 cluding a patient advocacy organization, that— 

23 (i) has the capacity to reach cancer 

24 survivors through local, State, or national 

25 organizations; and 


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1 (ii) is focused on cancer survivors and 

2 strategies for meeting their needs related 

3 to their health and well-being. 

4 (3) USE OF FUNDS.—A grant received under 

5 this subsection shall be used to provide services to 

6 cancer survivors to enhance their quality of life and 

7 improve their long-term survival rates, such as by 

8 assisting survivors to— 

9 (A) engage in moderate physical activity 

10 and other health-promoting activities, including 

11 ceasing tobacco use and increasing consumption 

12 of healthy foods; 

13 (B) increase access to support services to 

14 mitigate anxiety, depression, and uncertainty; 

15 (C) utilize community support services to 

16 fully implement survivorship care plans; 

17 (D) access nutrition education and coun18 seling; and 

19 (E) adhere to a schedule for, and access, 

20 screening for recurrence of cancer or the occur21 rence of other primary cancers. 

22 (4) STANDARDS FOR APPLICATION FROM ELIGI23 BLE ENTITIES.—To seek a grant under this sub24 section, an eligible entity shall submit an applicaVerDate Sep 11 2014 22:51 Jan 03, 2023 Jkt 039200 PO 00000 Frm 00036 Fmt 6652 Sfmt 6201 E:\BILLS\S5295.IS S5295

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1 tion, at such time as may be required by the Sec2 retary, that includes— 

3 (A) an explanation of how the entity will— 

4 (i) provide cancer survivors access to 

5 cancer patient navigator services; 

6 (ii) overcome barriers to care for com7 munities of color and multilingual commu8 nities; 

9 (iii) provide culturally competent care; 

10 and 

11 (iv) work with and support caregivers 

12 of cancer survivors; 

13 (B) a description of how the entity receives 

14 referrals of cancer survivors from health care 

15 professionals, including health care profes16 sionals serving historically disadvantaged and 

17 underserved communities; 

18 (C) documentation of the curriculum that 

19 will be used for providers in the program, in20 cluding mechanisms to update the staff on cur21 riculum changes; and 

22 (D) an agreement to provide the Secretary 

23 semiannual reports on— 

24 (i) the number of participants served; 


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1 (ii) quality-of-life measures for partici2 pants; and 

3 (iii) plans for fostering communication 

4 between oncology and non-oncology pro5 viders serving participants. 

6 (5) RESPONSIBILITIES OF THE SECRETARY.— 

7 The Secretary shall— 

8 (A) conduct outreach to inform health care 

9 professionals of the availability of programs and 

10 activities funded under this subsection; 

11 (B) analyze the data submitted by grantees 

12 under this subsection to determine the number 

13 of cancer survivors served and the impact of the 

14 program under this subsection on their quality 

15 of life; and 

16 (C) share best practices among all grantees 

17 under this subsection. 

18 SEC. 11. ADULT CANCER SURVIVORSHIP STUDY. 

19 (a) IN GENERAL.—Not later than 18 months after 

20 the date of enactment of this Act, the Secretary shall com21 plete a landscape analysis that— 

22 (1) assesses the potential benefits of an adult 

23 version of the Childhood Cancer Survivor Study; 

24 (2) assesses the financial costs and other bur25 dens associated with an adult cancer survivor study; 


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1 (3) identifies sources of data on adult cancer 

2 survivors; 

3 (4) identifies gaps in data on adult cancer sur4 vivors, compared to data collected in the Childhood 

5 Cancer Survivor Study; and 

6 (5) identifies strategies to publish data on adult 

7 cancer survivors derived from research that is con8 ducted or supported by the National Cancer Insti9 tute, in a manner that is accessible to cancer sur10 vivors, health care professionals, researchers, and 

11 the public. 

12 (b) REPORT.—Not later than 6 months after the date 

13 of completion of the feasibility analysis under subsection 

14 (a), the Secretary shall submit to the Congress a report 

15 on the results of such feasibility analysis. 

16 SEC. 12. SURVIVORSHIP PROGRESS REPORT. 

17 (a) IN GENERAL.—Not later than 6 months after the 

18 date of enactment of this Act, the Secretary shall enter 

19 into an agreement with the Government Accountability Of20 fice to conduct a study of the progress made in cancer 

21 survivorship over the period beginning on the date of en22 actment of the National Cancer Act of 1971 (Public Law 

23 92–216). 


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1 (b) SCOPE OF THE STUDY.—The study under sub2 section (a) shall investigate developments over the period 

3 described in subsection (a) in— 

4 (1) the nature and quality of survivorship care; 

5 (2) transitions from active treatment to survi6 vorship care; 

7 (3) the quality of life of cancer survivors; 

8 (4) outcomes for cancer survivors; 

9 (5) disparities in access to care and survivor10 ship outcomes; 

11 (6) the health care systems for providing survi12 vorship care; 

13 (7) the contribution of community-based serv14 ices to the survivorship care system; and 

15 (8) payment for survivorship care by public and 

16 private third-party payors. 

17 (c) ROLE OF OFFICE OF CANCER SURVIVORSHIP.— 

18 The study under subsection (a) shall— 

19 (1) consider the contribution of the Office of 

20 Cancer Survivorship to the evolution of cancer survi21 vorship care over the last 25 years; and 

22 (2) assess the impact of the mission of the Of23 fice and the resources provided to the Office on its 

24 leadership in cancer survivorship care. 


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1 (d) PUBLIC MEETING.—In conducting the study 

2 under subsection (a), the Comptroller General of the 

3 United States shall hold a public meeting with a broad 

4 cross section of stakeholders to inform the study’s findings 

5 and conclusions. Such stakeholders shall include— 

6 (1) cancer survivors; 

7 (2) patient organizations representing cancer 

8 survivors; 

9 (3) oncologists involved in survivorship care and 

10 the professional societies representing them; 

11 (4) primary care providers involved in survivor12 ship care and the professional societies representing 

13 them; 

14 (5) other health professionals providing survi15 vorship care and the professional societies rep16 resenting them; 

17 (6) community-based organizations involved in 

18 survivorship care; 

19 (7) representatives of the National Cancer In20 stitute; 

21 (8) third-party payors; 

22 (9) researchers engaged in survivorship re23 search; 

24 (10) epidemiologists with knowledge of trends 

25 in cancer survivorship; and 


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1 (11) such other stakeholders as the Comptroller 

2 General deems important to participate in the public 

3 meeting. 

4 (e) REPORT.—The Comptroller General of the United 

5 States shall— 

6 (1) release a report on the results of the study 

7 under subsection (a); and 

8 (2) in addition to the public meeting convened 

9 under subsection (d)— 

10 (A) convene another public meeting to be 

11 held on the day of the release of the report; and 

12 (B) include in such meeting all categories 

13 of stakeholders listed in subsection (d). 

14 SEC. 13. PROMOTING STATE INNOVATIONS TO EASE TRAN15 SITIONS TO THE PRIMARY CARE SETTING 

16 FOR CHILDREN WITH CANCER. 

17 (a) STAKEHOLDER GROUP DEVELOPMENT OF BEST

18 PRACTICES; STATE MEDICAID AND CHIP PROGRAM IN19 NOVATION.— 

20 (1) STAKEHOLDER GROUP BEST PRACTICES.— 

21 Not later than 12 months after the date of the en22 actment of this Act, the Secretary of Health and 

23 Human Services (in this section referred to as the 

24 ‘‘Secretary’’) shall convene a stakeholder group of 

25 representatives of childhood cancer advocacy organiVerDate Sep 11 2014 22:51 Jan 03, 2023 Jkt 039200 PO 00000 Frm 00042 Fmt 6652 Sfmt 6201 E:\BILLS\S5295.IS S5295

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1 zations, Medicaid and CHIP beneficiaries, providers 

2 with childhood cancer expertise, the National Asso3 ciation of Medicaid Directors, and other relevant 

4 representatives to develop best practices (and submit 

5 to the Secretary and Congress a report on such best 

6 practices) for States to ease the transition from ac7 tive oncological care to primary care of children or 

8 adolescents with cancer, including best practices for 

9 ensuring development of and delivery of survivorship 

10 care plans to patients, families, and primary care 

11 providers and best practices for such transitions oc12 curring under the State Medicaid plan under title 

13 XIX of the Social Security Act (42 U.S.C. 1396 et 

14 seq.) or State child health plan under title XXI of 

15 such Act (42 U.S.C. 1397aa et seq.), as applicable. 

16 Such best practices shall include practices to ensure 

17 that— 

18 (A) cancer care providers transfer diag19 nosis and treatment information to patient pri20 mary care providers; 

21 (B) cancer care providers develop an indi22 vidualized survivorship care plan of potential 

23 late effects; 


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1 (C) cancer care providers deliver the plan 

2 to the patient and family members through an 

3 in-person visit; 

4 (D) cancer care providers deliver the plan 

5 to the primary care provider through electronic 

6 health records or other means; and 

7 (E) relevant health entities develop sys8 tems that promote the coordination and effec9 tive transition of care between cancer care pro10 viders, primary care physicians, and other 

11 health care professionals. 

12 (2) STATE MEDICAID AND CHIP PROGRAM INNO13 VATION.—The Secretary shall work with States on 

14 innovative strategies, based on the best practices de15 veloped under on the best practices identified under 

16 the process described in subsection (a)(1), to ease 

17 the transition from active oncological care to pri18 mary care of child or adolescent with cancer ensur19 ing development of and delivery of survivorship care 

20 plans to patients, families, and primary care pro21 viders and transition coverage under the State Med22 icaid plan under title XIX of the Social Security Act 

23 (42 U.S.C. 1396 et seq.) or State child health plan 

24 under title XXI of such Act (42 U.S.C. 1397aa et 

25 seq.), as applicable. 


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1 (b) GUIDANCE ON INNOVATIVE SERVICE DELIVERY

2 SYSTEMS DEMONSTRATION PROJECT OPPORTUNITIES.— 

3 Not later than 1 year after the date the stakeholder group 

4 is convened under subsection (a), the Secretary, acting 

5 through the Administrator of the Centers for Medicare & 

6 Medicaid Services, shall issue guidance to State health of7 ficials, based on best practices developed under subsection 

8 (a)(1), regarding opportunities to design demonstration 

9 projects under the Social Security Act to improve care 

10 transitions for children and adolescents with cancer who 

11 transition from oncological care to primary care and who 

12 are otherwise eligible to receive medical assistance under 

13 title XIX of such Act (42 U.S.C. 1396 et seq.) or title 

14 XXI of such Act (42 U.S.C. 1397aa et seq.). 

15 (c) NONAPPLICATION OF FEDERAL ADVISORY COM16 MITTEE ACT.—The Federal Advisory Committee Act shall 

17 not apply to the stakeholder group convened under para18 graph (1). 

19 SEC. 14. CHILDHOOD CANCER DEMONSTRATION MODEL 

20 AND STANDARD OF CARE. 

21 Section 1115A(b)(2) of the Social Security Act (42 

22 U.S.C. 1315a(b)(2)) is amended— 

23 (1) in subparagraph (A), by striking the period 

24 at the end and inserting ‘‘, and shall include the 


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1 model described in clause (xxviii) of such subpara2 graph.’’; and 

3 (2) in subparagraph (B), by adding at the end 

4 the following new clause: 

5 ‘‘(xxviii) A local service delivery and 

6 State payment model for individuals up to 

7 age 21 enrolled under a State plan (or 

8 waiver of such plan) under title XIX or a 

9 State child health plan (or waiver of such 

10 plan) under title XXI of such Act (42 

11 U.S.C. 1397aa et seq.) who have been di12 agnosed with cancer and who are in the 

13 survivorship phase of their treatment. Such 

14 model shall— 

15 ‘‘(I) provide for the creation of a 

16 survivorship plan, that can be inte17 grated into an electronic health 

18 record, for such individuals and dis19 seminate the plan to such individuals, 

20 families of such individuals, and the 

21 health providers of such individuals; 

22 ‘‘(II) offer States and local pro23 viders technical assistance to develop 

24 and implement different survivorship 

25 care planning services; 


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1 ‘‘(III) develop a standard of care 

2 based on the Children’s Oncology 

3 Group (COG) Long-Term Follow-Up 

4 Guidelines for Survivors of Childhood, 

5 Adolescent, and Young Adult Cancers 

6 to manage the transition of such indi7 viduals from active treatment to gen8 eral care with the informed knowledge 

9 of such individuals; and 

10 ‘‘(IV) provide incentives to health 

11 care providers for treating such indi12 viduals through such model that in13 cludes at least two survivorship care 

14 planning visits.’’. 

15 SEC. 15. MEDICAID COVERAGE OF FERTILITY PRESERVA16 TION SERVICES FOR CANCER PATIENTS. 

17 (a) MEDICAID.— 

18 (1) IN GENERAL.—Section 1905(a) of the So19 cial Security Act (42 U.S.C. 1396d(a)) is amend20 ed— 

21 (A) in paragraph (30), by striking ‘‘and’’ 

22 at the end; 

23 (B) by redesignating paragraph (31) as 

24 paragraph (32); and 


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1 (C) by inserting after paragraph (30) the 

2 following new paragraph: 

3 ‘‘(31) standard fertility preservation services 

4 (as specified by the Secretary consistent with estab5 lished medical practices and professional guidelines 

6 published by the American Society for Reproductive 

7 Medicine, the American Society of Clinical Oncology, 

8 or other professional medical organizations specified 

9 by the Secretary) for individuals diagnosed with can10 cer who— 

11 ‘‘(A) are undergoing treatment for such 

12 cancer where such treatment may lead to iatro13 genic infertility; 

14 ‘‘(B) previously underwent such treatment 

15 and may be at risk of such infertility due to 

16 such treatment; or 

17 ‘‘(C) are preparing to undergo such treat18 ment where such treatment may lead to such 

19 infertility.’’. 

20 (2) MANDATORY BENEFIT.—Section 

21 1902(a)(10)(A) of the Social Security Act (42 

22 U.S.C. 1396a(a)(10)(A)) is amended by striking 

23 ‘‘and (30)’’ and inserting ‘‘(30), and (31)’’. 

24 (b) CHIP.— 


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1 (1) IN GENERAL.—Section 2103(c) of the So2 cial Security Act (42 U.S.C. 1397cc(c)) is amended 

3 by adding at the end the following new paragraph: 

4 ‘‘(12) REQUIRED COVERAGE OF FERTILITY

5 PRESERVATION SERVICES FOR CANCER PATIENTS.— 

6 Regardless of the type of coverage elected by a State 

7 under subsection (a), the child health assistance pro8 vided for a targeted low-income child, and, in the 

9 case of a State that elects to provide pregnancy-re10 lated assistance pursuant to section 2112, the preg11 nancy-related assistance provided for a targeted low12 income pregnant woman (as such terms are defined 

13 for purposes of such section), shall include coverage 

14 of standard fertility preservation services (as de15 scribed in section 1905(a)(31)) for individuals de16 scribed in such section.’’. 

17 (2) CONFORMING AMENDMENT.— 

18 (A) IN GENERAL.—Section 2103(c) of the 

19 Social Security Act (42 U.S.C. 1397cc(c)) is 

20 amended by redesignating the paragraph (12) 

21 added by section 11405(b)(1) of Public Law 

22 117–169 as paragraph (13). 

23 (B) EFFECTIVE DATE.—The amendment 

24 made by subparagraph (A) shall take effect on 

25 October 1, 2023. 


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1 (c) EFFECTIVE DATE.—The amendments made by 

2 this section (other than the amendment made by sub3 section (b)(2)) shall apply with respect to medical assist4 ance, child health assistance, and pregnancy-related as5 sistance furnished on or after the date that is 18 months 

6 after the date of the enactment of this Act. 

Æ 


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