I 
117TH CONGRESS 
1ST SESSION H. R. 4414 
To amend title XVIII of the Social Security Act to provide for coverage 
of cancer care planning and coordination under the Medicare program. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 13, 2021 
Mr. DESAULNIER (for himself and Mr. CARTER of Georgia) introduced the 
following bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for coverage of cancer care planning and coordination 
under the Medicare program. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Cancer Care Planning and Communications Act of 
2021’’. 
(b) FINDINGS.—Congress makes the following find-
ings: 
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(1) Cancer care in the United States is often 
described as the best in the world because patients 
have access to many treatment options, including 
cutting-edge therapies that save lives and improve 
the quality of life. 
(2) Access to the best treatment options is not 
equal across all populations and in all communities. 
The 1999 Institute of Medicine report entitled ‘‘The 
Unequal Burden of Cancer’’ found that low-income 
people often lack access to adequate cancer care and 
that ethnic minorities have not benefitted fully from 
cancer treatment advances. 
(3) In addition, despite access to high-quality 
treatment options for many, individuals with cancer 
often do not have access to a cancer care system 
that incorporates shared decision making and the co-
ordination of all elements of care. 
(4) Cancer survivors often experience the 
under-diagnosis and under-treatment of the symp-
toms of cancer and side effects of cancer treatment, 
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 symp-
toms, side effects, and late effects of cancer and can-
cer treatment may have a serious adverse impact on 
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the health, survival, well-being, and quality of life of 
cancer survivors. 
(5) Individuals with cancer often do not partici-
pate in a shared decision-making process that con-
siders all treatment options and do not benefit from 
coordination of all elements of active treatment and 
palliative care. 
(6) Quality cancer care should incorporate ac-
cess to psychosocial services and management of the 
symptoms of cancer and the symptoms of cancer 
treatment, including pain, nausea, vomiting, fatigue, 
and depression. 
(7) Quality cancer care should include a means 
for engaging cancer survivors in a shared decision- 
making process that produces a comprehensive care 
summary and a plan for follow-up care after primary 
treatment to ensure that cancer survivors have ac-
cess to follow-up monitoring and treatment of pos-
sible late effects of cancer and cancer treatment, in-
cluding appropriate psychosocial services. 
(8) The Institute of Medicine report entitled 
‘‘Ensuring Quality Cancer Care’’ described the ele-
ments of quality care for an individual with cancer 
to include— 
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(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 com-
munication 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 com-
passionate care for the individual. 
(9) In its report ‘‘From Cancer Patient to Can-
cer Survivor: Lost in Transition’’, the Institute of 
Medicine recommended that individuals with cancer 
completing primary treatment be provided a com-
prehensive summary of their care along with a fol-
low-up survivorship plan of treatment. 
(10) In ‘‘Cancer Care for the Whole Patient’’, 
the Institute of Medicine stated that the develop-
ment of a plan that includes biomedical and psycho-
social care should be a standard for quality cancer 
care in any quality measurement system. 
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(11) The Commission on Cancer has encour-
aged survivorship care planning by making the de-
velopment of such plans for patients one of the 
standards of accreditation for cancer care providers, 
but cancer care professionals report difficulties com-
pleting the plans. 
(12) Because more than half of all cancer diag-
noses occur among elderly Medicare beneficiaries, 
addressing cancer care inadequacies through Medi-
care reforms will provide benefits to millions of 
Americans. Providing Medicare beneficiaries more 
routine access to cancer care plans and survivorship 
care plans is a key to shared decision making and 
better coordination of care. 
(13) Important payment and delivery reforms 
that incorporate cancer care planning and coordina-
tion are already being tested in the Medicare pro-
gram; the Oncology Care Model has been imple-
mented in a number of oncology practices, and addi-
tional models that will include care planning have 
been proposed. 
(14) The alternative payment models, including 
the Oncology Care Model, provide access to cancer 
care planning for Medicare beneficiaries who receive 
their cancer care in practices that are part of the 
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