I

106TH CONGRESS

1ST SESSION H. R. 1090

To amend title XVIII of the Social Security Act to exclude cancer treatment

services from the prospective payment system for hospital outpatient

department services under the Medicare Program.

IN THE HOUSE OF REPRESENTATIVES

MARCH 11, 1999

Mr. GREEN of Texas (for himself, Mr. TOWNS, Mr. LATOURETTE, Mr.

SHOWS, Mr. MEEHAN, Mr. GONZALEZ, Mr. FROST, Mr. PALLONE, Mr.

NADLER, Mrs. MALONEY of New York, Mr. BENTSEN, Ms. DELAURO,

Mrs. KELLY, Mr. LAFALCE, Mr. RODRIGUEZ, Mrs. MINK of Hawaii, Mr.

RAHALL, Mr. FOLEY, Mr. WALSH, Mr. WYNN, Mr. KOLBE, and Mrs.

EMERSON) introduced the following bill; which was referred to the Committee on 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 exclude

cancer treatment services from the prospective payment

system for hospital outpatient department services under

the Medicare Program.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
2

•HR 1090 IH

1 SECTION 1. SHORT TITLE; FINDINGS.

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

3 ‘‘Medicare Full Access to Cancer Treatment Act of 1999’’.

4 (b) FINDINGS.—Congress makes the following find5 ings:

6 (1) The treatment of cancer is complex and de7 pends on the differing needs of individual patients.

8 (2) Patients with cancer should have access to

9 the latest and most effective treatments available.

10 (3) Supportive care drugs are an integral and

11 necessary part of comprehensive quality cancer

12 treatment.

13 (4) The Medicare Program’s payment policy

14 should respect the differing needs of cancer patients

15 and encourage the use of the most safe and effective

16 treatments in medically appropriate settings.

17 (5) The Medicare Program should not create fi18 nancial incentives that reward the use of older, less

19 effective drugs, that reward the use of inadequate

20 supportive care treatments, and otherwise undermine

21 the delivery and availability of safe and effective

22 cancer care.

23 (6) Any prospective payment system for services

24 furnished under the Medicare Program to Medicare

25 beneficiaries that is passed by Congress and imple26 mented by the Health Care Financing Administra-
3

•HR 1090 IH

1 tion must not undermine the principles stated in

2 paragraphs (1) through (5).

3 SEC. 2. PAYMENT FOR CANCER SERVICES EXCLUDED FROM

4 HOSPITAL OUTPATIENT DEPARTMENT SERV5 ICES PROSPECTIVE PAYMENT SYSTEM.

6 (a) IN GENERAL.—Section 1833(t)(1) of the Social

7 Security Act (42 U.S.C. 1395l(t)(1)) is amended—

8 (1) in subparagraph (B), by striking ‘‘For’’ and

9 inserting ‘‘Except as provided in subparagraph (C),

10 for’’, and

11 (2) by adding at the end the following new sub12 paragraph:

13 ‘‘(C) EXCLUDED SERVICES.—The term

14 ‘covered OPD services’ does not include any of

15 the following items and services:

16 ‘‘(i) OUTPATIENT CANCER TREAT17 MENT.—Services consisting of any drug or

18 biologic therapy as treatment, supportive

19 care, or both for patients with cancer.’’.

20 (b) EFFECTIVE DATE.—The amendments made by

21 subsection (a) apply with respect to payments under the

22 Medicare Program for hospital outpatient department

23 services made on or after the date of the enactment of

24 this Act.

Æ