(1)(A) or (2)(A), respectively, of subsection (d) were 
satisfied. 
(3) REQUIREMENT TO SATISFY ALL MEASURES 
TO RECEIVE ADDITIONAL PAYMENT.—In order for a 
physician to receive the additional payment amount 
described in paragraph (1) under this subsection for 
treatment planning or end-of-life care, a physician 
must report in a manner specified under the project 
that all of measures described in paragraph (1) or 
(2), respectively, of subsection (d) were satisfied. 
(d) MEASURES.— 
(1) TREATMENT
PLANNING
MEASURES.—The 
specific measures related to treatment planning and 
any subsequent modifications described in this para-
graph are as follows: 
(A) BASELINE MANDATORY MEASURES.— 
(i) Documented pathology report. 
(ii) Documented clinical staging prior 
to initiation of first course of treatment. 
(iii) Performed treatment education 
by oncology nursing staff. 
(iv) Provided the patient with a writ-
ten care plan for patients in active treat-
ment, which advises patient of relevant op-
tions. 
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(B) AUGMENTED.— 
(i) 
Implemented 
practice-endorsed 
treatment plan consistent with nationally 
recognized evidence based guidelines. 
(ii) Documented clinical trial dis-
cussed with the patient, or that no clinical 
trial available. 
(iii) Documented discussion or coordi-
nation with other physicians involved in 
the patient’s care. 
(2) END-OF-LIFE CARE MEASURES.—The spe-
cific measures related to end-of-life care described in 
this paragraph are as follows: 
(A) BASELINE MANDATORY.— 
(i) Documented advanced care plan-
ning session with the patient. 
(ii) 
Symptoms 
assessed 
and 
ad-
dressed. 
(iii) Recommended the patient to hos-
pice program, whether for institutional or 
home-based hospice care. 
(B) AUGMENTED.— 
(i) Documented no acute care hospital 
admissions (including admission to an 
emergency room or intensive care unit but 
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excluding admission to a hospice or pallia-
tive care unit) within 30 days of death. 
(ii) Advanced directive discussion with 
the patient documented in the physician’s 
records and, if agreed to, inclusion of an 
advanced directive in such records. 
(iii) Documented that no chemo-
therapy administered within 30 days of 
death. 
(e) DURATION OF PROJECT.— 
(1) IN GENERAL.—The Secretary shall conduct 
the demonstration project over a sufficient period (of 
not less than 2 years) to allow for refinement of 
metrics and reporting methodologies and for anal-
yses. The project shall continue, subject to para-
graph (2), to operate until the Secretary has devel-
oped and implemented under part B of the Medicare 
program a payment system that relates payment 
under such part for professional oncology services to 
performance on measures developed and refined 
under the demonstration project. 
(2) TRANSITION.—The Secretary shall provide 
for a transition period over the course of 2 years 
during which oncologists are permitted to transition 
from the payment system under the demonstration 
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project to the payment system described in para-
graph (1). 
(f) PROJECT EVALUATION.— 
(1) IN GENERAL.—The Secretary shall conduct 
an evaluation of the QCCD project— 
(A) to determine oncologist participation in 
the project; 
(B) to assess the cost effectiveness of the 
project, including an analyses of the cost sav-
ings (if any) to the Medicare part A and B pro-
grams resulting from a general reduction in 
physician services, hospitalizations, and supple-
mental care drug costs; 
(C) to compare outcomes of patients par-
ticipating in the project to outcomes for those 
not participating in the project; 
(D) to determine the satisfaction of pa-
tients participating in the project; and 
(E) to evaluate other such matters as the 
Secretary determines is appropriate. 
(2) REPORTING.—Not later than 90 days after 
the completion of the second year following the com-
mencement of the QCCD project, the Secretary shall 
submit to Congress a report on the evaluation con-
ducted under paragraph (1) together which such rec-
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ommendations for legislation or administrative ac-
tion as the Secretary determines is appropriate. 
Æ 
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