II

106TH CONGRESS

2D SESSION S. 3003

To preserve access to outpatient cancer therapy services under the medicare

program by requiring the Health Care Financing Administration to follow

appropriate procedures and utilize a formal nationwide analysis by the

Comptroller General of the United States in making any changes to

the rates of reimbursement for such services.

IN THE SENATE OF THE UNITED STATES

SEPTEMBER 5, 2000

Mr. ASHCROFT (for himself, Mr. HAGEL, and Mr. ABRAHAM) introduced the

following bill; which was read twice and referred to the Committee on Finance

A BILL

To preserve access to outpatient cancer therapy services

under the medicare program by requiring the Health

Care Financing Administration to follow appropriate procedures and utilize a formal nationwide analysis by the

Comptroller General of the United States in making

any changes to the rates of reimbursement for such

services.

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.

4 This Act may be cited as the ‘‘Cancer Care Preserva5 tion Act of 2000’’.
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1 SEC. 2. FINDING.

2 Congress finds that in light of the tremendous ad3 vances achieved by this Nation in its war on cancer, in4 cluding the development of breakthrough therapies, the ex5 pansion of the cancer care delivery system to convenient

6 and low-cost community settings, and the unprecedented

7 annual reduction in American cancer deaths beginning in

8 1998, legislation is needed to ensure that these advances

9 are not undermined by inappropriate changes to rates of

10 reimbursement for outpatient cancer therapy services

11 under the medicare program under title XVIII of the So12 cial Security Act (42 U.S.C. 1395 et seq.).

13 SEC. 3. PRESERVATION OF REIMBURSEMENT RATES FOR

14 OUTPATIENT CANCER THERAPY SERVICES.

15 Notwithstanding any other provision of law, the Ad16 ministrator of the Health Care Financing Administration

17 may not implement any reduction to the rates of reim18 bursement for outpatient cancer therapy services under

19 the medicare program under title XVIII of the Social Se20 curity Act (42 U.S.C. 1395 et seq.), unless such

21 reductions—

22 (1) are developed in consultation with the

23 Comptroller General of the United States, the Medi24 care Payment Advisory Commission established

25 under section 1805 of such Act (42 U.S.C. 1395b–

26 6) (in this Act referred to as ‘‘MedPAC’’), and rep-
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1 resentatives of the cancer care community, including

2 patients, survivors, nurses, physicians, and research3 ers;

4 (2) provide for appropriate payment rates for

5 outpatient cancer therapy services, based upon the

6 determinations made by the Comptroller General of

7 the United States in the nationwide analysis re8 quired under section 4 of this Act; and

9 (3) are authorized by an Act of Congress.

10 SEC. 4. FORMAL NATIONWIDE ANALYSIS OF CLINICAL RE11 SOURCES NECESSARY TO PROVIDE SAFE

12 OUTPATIENT CANCER THERAPY SERVICES.

13 (a) ANALYSIS.—

14 (1) IN GENERAL.—The Comptroller General of

15 the United States shall conduct a nationwide anal16 ysis to determine the physician and non-physician

17 clinical resources necessary to provide safe out18 patient cancer therapy services and the appropriate

19 payment rates for such services under the medicare

20 program under title XVIII of the Social Security Act

21 (42 U.S.C. 1395 et seq.).

22 (2) ISSUES ANALYZED.—In conducting the

23 analysis under paragraph (1), the Comptroller Gen24 eral of the United States shall determine—
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1 (A) the adequacy of practice expense rel2 ative value units associated with the utilization

3 of those clinical resources;

4 (B) the adequacy of work units in the

5 practice expense formula; and

6 (C) the necessity for an additional reim7 bursement methodology for outpatient cancer

8 therapy services that falls outside the practice

9 expense formula.

10 (3) CONSULTATION.—In conducting the anal11 ysis under paragraph (1), the Comptroller General

12 of the United States shall consult with Adminis13 trator of the Health Care Financing Administration,

14 MedPAC, and representatives of the cancer care

15 community, including patients, survivors, nurses,

16 physicians, and researchers.

17 (b) REPORT.—Not later than 1 year after the date

18 of enactment of this Act, the Comptroller General of the

19 United States shall submit a report to Congress on the

20 analysis conducted under subsection (a) together with rec21 ommendations for such legislative and administrative ac22 tion as the Comptroller General of the United States de23 termines appropriate.

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