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[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3705 Introduced in House (IH)]

112th CONGRESS
  1st Session
                                H. R. 3705

To amend title XVIII of the Social Security Act to provide for coverage 
of comprehensive cancer care planning under the Medicare Program and to 
  improve the care furnished to individuals diagnosed with cancer by 
   establishing grants programs for provider education, and related 
                               research.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                           December 16, 2011

  Mrs. Capps (for herself and Mr. Boustany) introduced the following 
 bill; which was referred to the Committee on Energy and Commerce, and 
  in addition to the Committee on Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL

 
To amend title XVIII of the Social Security Act to provide for coverage 
of comprehensive cancer care planning under the Medicare Program and to 
  improve the care furnished to individuals diagnosed with cancer by 
   establishing grants programs for provider education, and related 
                               research.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    This Act may be cited as the ``Comprehensive Cancer Care 
Improvement Act of 2011''.

Sec. 1. Short title; Table of contents.
Sec. 2. Findings.
     TITLE I--COMPREHENSIVE CANCER CARE UNDER THE MEDICARE PROGRAM

Sec. 101. Coverage of cancer care planning services.
  TITLE II--PROVIDER EDUCATION REGARDING PALLIATIVE CARE AND SYMPTOM 
                               MANAGEMENT

Sec. 201. Grants to improve health professional education.
Sec. 202. Grants to improve continuing professional education.
TITLE III--RESEARCH ON TOPICS RELATED TO COORDINATION OF CARE, SYMPTOM 
          MANAGEMENT, AND PALLIATIVE CARE FOR CANCER PATIENTS

Sec. 301. Research program.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Individuals with cancer often do not have access to a 
        cancer care system that provides comprehensive and coordinated 
        care of high quality.
            (2) The cancer care system has not traditionally offered 
        individuals with cancer a prospective and comprehensive plan 
        for treatment and symptom management, strategies for updating 
        and evaluating such plan with the assistance of a health care 
        professional, and a follow-up plan for monitoring and treating 
        possible late effects of cancer and its treatment.
            (3) Cancer survivors often experience the under-diagnosis 
        and under-treatment of the symptoms of cancer, a problem that 
        begins at the time of diagnosis and may become more severe with 
        disease progression and at the end of life. The failure to 
        treat the symptoms, side effects, and late effects of cancer 
        and cancer treatment may have a serious adverse impact on the 
        health, survival, well-being, and quality of life of cancer 
        survivors.
            (4) Cancer survivors who are members of racial and ethnic 
        minority groups may face severe obstacles in receiving 
        coordinated cancer care that includes appropriate management of 
        cancer symptoms and treatment side effects.
            (5) Individuals with cancer are sometimes not provided 
        information about their disease and treatment options that 
        might result in their request for and engagement in coordinated 
        care that includes appropriate treatment and symptom 
        management.
            (6) Comprehensive cancer care should incorporate access to 
        psychosocial services and management of the symptoms of cancer 
        and the symptoms of cancer treatment, including pain, nausea, 
        vomiting, fatigue, and depression.
            (7) Comprehensive cancer care should include a means for 
        providing cancer survivors with a comprehensive care summary 
        and a plan for follow-up care after primary treatment to ensure 
        that cancer survivors have access to follow-up monitoring and 
        treatment of possible late effects of cancer and cancer 
        treatment.
            (8) The Institute of Medicine report entitled ``Ensuring 
        Quality Cancer Care'' described the elements of quality care 
        for an individual with cancer, including--
                    (A) the development of initial treatment 
                recommendations by an experienced health care provider;
                    (B) the development of a plan for the course of 
                treatment of the individual and communication of the 
                plan to the individual;
                    (C) access to the resources necessary to implement 
                the course of treatment;
                    (D) access to high-quality clinical trials;
                    (E) a mechanism to coordinate services for the 
                treatment of the individual; and
                    (F) psychosocial support services and compassionate 
                care for the individual.
            (9) In its report ``From Cancer Patient to Cancer Survivor: 
        Lost in Transition'', the Institute of Medicine recommended 
        that individuals with cancer completing primary treatment be 
        provided a comprehensive summary of their care along with a 
        follow-up survivorship plan of treatment.
            (10) Since more than half of all cancer diagnoses occur 
        among elderly Medicare beneficiaries, the problems of providing 
        cancer care are problems of the Medicare program.
            (11) Shortcomings in providing cancer care, resulting in 
        inadequate management of cancer symptoms and insufficient 
        monitoring and treatment of late effects of cancer and its 
        treatment, are related to problems of Medicare payments for 
        such care, inadequate professional training, and insufficient 
        investment in research on symptom management.
            (12) Changes in Medicare payment for comprehensive cancer 
        care, enhanced public and professional education regarding 
        symptom management, and more research related to coordination 
        of care, symptom management and palliative care will enhance 
        patient decisionmaking about treatment options and will 
        contribute to improved care for individuals with cancer from 
        the time of diagnosis of the individual through the end of the 
        life of the individual.

     TITLE I--COMPREHENSIVE CANCER CARE UNDER THE MEDICARE PROGRAM

SEC. 101. COVERAGE OF CANCER CARE PLANNING SERVICES.

    (a) In General.--Section 1861 of the Social Security Act is 
amended--
            (1) in subsection (s)(2)--
                    (A) by striking ``and'' at the end of subparagraph 
                (EE);
                    (B) by adding ``and'' at the end of subparagraph 
                (FF); and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(GG) comprehensive cancer care planning services 
                (as defined in subsection (iii));''; and
            (2) by adding at the end the following new subsection:
    ``Comprehensive Cancer Care Planning Services
    ``(iii)(1) The term `comprehensive cancer care planning services' 
means--
                    ``(A) with respect to an individual who is 
                diagnosed with cancer, the development of a plan of 
                care that--
                            ``(i) details, to the greatest extent 
                        practicable, all aspects of the care to be 
                        provided to the individual, with respect to the 
                        treatment of such cancer, including any 
                        curative treatment, comprehensive symptom 
                        management, and palliative care;
                            ``(ii) is furnished, in person, in written 
                        form, to the individual within a period 
                        specified by the Secretary that is as soon as 
                        practicable after the date on which the 
                        individual is so diagnosed;
                            ``(iii) is furnished, to the greatest 
                        extent practicable, in a form that 
                        appropriately takes into account cultural and 
                        linguistic needs of the individual in order to 
                        make the plan accessible to the individual; and
                            ``(iv) is in accordance with standards 
                        determined by the Secretary to be appropriate;
                    ``(B) with respect to an individual for whom a plan 
                of care has been developed under subparagraph (A), the 
                revision of such plan of care as necessary to account 
                for any substantial change in the condition of the 
                individual, recurrence of disease, or significant 
                revision of the elements of curative or palliative care 
                for the individual, if such revision--
                            ``(i) is in accordance with clauses (i), 
                        (iii), and (iv) of such subparagraph; and
                            ``(ii) is furnished in written form to the 
                        individual within a period specified by the 
                        Secretary that is as soon as practicable after 
                        the date of such revision;
                    ``(C) with respect to an individual who has 
                completed the primary treatment for cancer, as defined 
                by the Secretary (such as the completion of 
                chemotherapy or radiation treatment), the development 
                of a follow-up cancer care plan that--
                            ``(i) describes the elements of the primary 
                        treatment, including symptom management and 
                        palliative care, furnished to such individual;
                            ``(ii) provides recommendations for the 
                        subsequent care of the individual with respect 
                        to the cancer involved;
                            ``(iii) is furnished, in person, in written 
                        form, to the individual within a period 
                        specified by the Secretary that is as soon as 
                        practicable after the completion of such 
                        primary treatment;
                            ``(iv) is furnished, to the greatest extent 
                        practicable, in a form that appropriately takes 
                        into account cultural and linguistic needs of 
                        the individual in order to make the plan 
                        accessible to the individual; and
                            ``(v) is in accordance with standards 
                        determined by the Secretary to be appropriate; 
                        and
                    ``(D) with respect to an individual for whom a 
                follow-up cancer care plan has been developed under 
                subparagraph (C), the revision of such plan as 
                necessary to account for any substantial change in the 
                condition of the individual, diagnosis of a second 
                cancer, or significant revision of the plan for follow-
                up care, if such revision--
                            ``(i) is in accordance with clauses (i), 
                        (ii), (iv), and (v) of such subparagraph; and
                            ``(ii) is furnished in written form to the 
                        individual within a period specified by the 
                        Secretary that is as soon as practicable after 
                        the date of such revision.
            ``(2) The Secretary shall establish standards to carry out 
        paragraph (1) in consultation with appropriate organizations 
        representing providers of services related to cancer treatment 
        and organizations representing survivors of cancer. Such 
        standards shall include standards for determining the need and 
        frequency for revisions of the plans of care and follow-up 
        plans based on changes in the condition of the individual or 
        elements and intent of treatment and standards for the 
        communication of the plan to the patient.''.
    (b) Payment.--Section 1833(a)(1) of the Social Security Act (42 
U.S.C. 1395l(a)(1)) is amended by striking ``and'' before ``(Z)'' and 
inserting before the semicolon at the end the following: ``, and (AA) 
with respect to comprehensive cancer care planning services described 
in any of subparagraphs (A) through (D) of section 1861(iii)(1), the 
amount paid shall be an amount equal to the sum of (i) the national 
average amount under the physician fee schedule established under 
section 1848 for a new patient office consultation of the highest level 
of service in the non-facility setting, and (ii) the national average 
amount under such fee schedule for a physician certification described 
in section 1814(a)(2) for home health services furnished to an 
individual by a home health agency under a home health plan of care''.
    (c) Effective Date.--The amendments made by this section shall 
apply to services furnished on or after the first day of the first 
calendar year that begins after the date of the enactment of this Act.

  TITLE II--PROVIDER EDUCATION REGARDING PALLIATIVE CARE AND SYMPTOM 
                               MANAGEMENT

SEC. 201. GRANTS TO IMPROVE HEALTH PROFESSIONAL EDUCATION.

    (a) In General.--The Secretary of Health and Human Services shall 
make grants to eligible entities to enable the entities to improve the 
quality of graduate and postgraduate training of physicians, nurses, 
and other health care providers in developing cancer care plans for 
cancer patients and communicating such plans to the individual 
patients.
    (b) Application.--To seek a grant under this section, an eligible 
entity shall submit an application at such time, in such manner, and 
containing such information as the Secretary may require. At a minimum, 
the Secretary shall require that each such application demonstrate--
            (1) the ability to train health professionals in--
                    (A) the provision of cancer care that fully 
                coordinates active treatment, symptom management, and 
                palliative care; and
                    (B) the communication of a written plan for 
                coordinated cancer care to the patient; and
            (2) the ability to collect and analyze data related to the 
        effectiveness of such training programs.
    (c) Evaluation.--The Secretary shall develop and implement a plan 
for evaluating the effects of the training programs funded under this 
section.
    (d) Definitions.--In this section:
            (1) The term ``eligible entity'' means an entity that is 
        a--
                    (A) cancer center (including an NCI-designated 
                cancer center);
                    (B) academic health center;
                    (C) physician practice;
                    (D) school of nursing;
                    (E) visiting nurse association;
                    (F) home care agency; or
                    (G) a private non-profit organization with 
                expertise and experience in health provider training.
            (2) The term ``NCI-designated cancer center'' means a 
        cancer center receiving funds through a P30 Cancer Center 
        Support Grant of the National Cancer Institute.
            (3) The term ``Secretary'' means the Secretary of Health 
        and Human Services.
    (e) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated $5,000,000 for each of the 
fiscal years 2012 through 2016.

SEC. 202. GRANTS TO IMPROVE CONTINUING PROFESSIONAL EDUCATION.

    (a) In General.--The Secretary of Health and Human Services shall 
make grants to eligible entities to improve the quality of continuing 
professional education provided to qualified individuals regarding the 
development and communication of written cancer care plans that outline 
a system of care that coordinates active treatment and palliative care.
    (b) Application.--To seek a grant under this section, an eligible 
entity shall submit an application at such time, in such manner, and 
containing such information as the Secretary may require. At a minimum, 
the Secretary shall require that each such application demonstrate--
            (1) experience in sponsoring continuing professional 
        education programs;
            (2) the ability to reach health care providers and other 
        professionals who are engaged in cancer care with such 
        continuing professional education programs;
            (3) the capacity to develop innovative training programs 
        aimed at enhancing the delivery of coordinated cancer care that 
        includes appropriate symptom management and palliative care; 
        and
            (4) the ability to evaluate the effectiveness of such 
        professional education and training programs.
    (c) Evaluation.--The Secretary shall develop and implement a plan 
for evaluating the effects of the continuing professional education and 
training programs funded under this section.
    (d) Definitions.--In this section:
            (1) The term ``eligible entity'' means an entity that is 
        a--
                    (A) cancer center (including an NCI-designated 
                cancer center);
                    (B) academic health center;
                    (C) school of nursing;
                    (D) professional society that supports continuing 
                professional education programs; or
                    (E) private non-profit organization with expertise 
                and experience in health provider training.
            (2) The term ``NCI-designated cancer center'' means a 
        cancer center receiving funds through a P30 Cancer Center 
        Support Grant of the National Cancer Institute.
            (3) The term ``qualified individual'' means a physician, 
        nurse, social worker, chaplain, psychologist, or other 
        individual who is involved in providing comprehensive cancer 
        care, including active treatment, symptom management, and 
        palliative care, to cancer patients.
            (4) The term ``Secretary'' means the Secretary of Health 
        and Human Services.
    (e) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated $5,000,000 for each of the 
fiscal years 2012 through 2016.

TITLE III--RESEARCH ON TOPICS RELATED TO COORDINATION OF CARE, SYMPTOM 
          MANAGEMENT, AND PALLIATIVE CARE FOR CANCER PATIENTS

SEC. 301. RESEARCH PROGRAM.

    (a) In General.--The Secretary of Health and Human Services shall 
provide investment, through existing research programs, for research on 
topics related to cancer care planning, cancer care coordination, 
symptom management, palliative care, and comprehensive survivorship 
care
    (b) In carrying out the research authorized under this section, the 
Secretary should provide for the participation of institutes and 
centers of the National Institutes of Health, the Centers for Medicare 
& Medicaid Services, and any other national research institute that has 
been engaged in research described in subsection (a).
    (c) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated $5,000,000 for each of the 
fiscal years 2012 through 2016.
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