I 
111TH CONGRESS 
1ST SESSION H. R. 2872 
To improve the quality and cost effectiveness of cancer care to Medicare 
beneficiaries by establishing a national demonstration project. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 15, 2009 
Mr. DAVIS of Alabama (for himself, Ms. KILROY, and Mr. ISRAEL) 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 com-
mittee concerned 
A BILL 
To improve the quality and cost effectiveness of cancer care 
to Medicare beneficiaries by establishing a national dem-
onstration project. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Quality Can-
cer Care Demonstration Project Act of 2009’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) In order to ensure the delivery of quality, 
cost-efficient medical care, Medicare must transform 
the payment system to one based on evidence-based 
guidelines and demonstrated quality delivery of care. 
(2) An Institute of Medicine report entitled 
‘‘Ensuring Quality Cancer Care’’ recommends that 
the following items are essential components in qual-
ity cancer care delivery: 
(A) An agreed-upon treatment plan that 
outlines the goals of care. 
(B) Access to clinical trials. 
(C) Policies to ensure full disclosure of in-
formation about appropriate treatment options 
to patients. 
(D) A mechanism to coordinate services. 
(3) Additionally, the report notes the impor-
tance of ensuring quality of care at the end of life, 
in particular, the management of cancer-related pain 
and timely referral to palliative and hospice care. 
(4) According to the Institute of Medicine, the 
quality of cancer care must be measured by using a 
core set of quality measures. Cancer care quality 
measures should be used to hold providers, including 
health care systems, health plans, and physicians, 
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accountable for demonstrating that they provide and 
improve quality of care. 
(5) Although two of the critical components of 
cancer care are treatment planning and end-of-life 
care, none of the 153 quality measures in the Cen-
ters for Medicare & Medicaid Services (CMS) 2009 
Physician Quality Reporting Initiative (PQRI) ad-
dresses overall treatment planning or end-of-life care 
for cancer patients. 
(6) The medical literature suggests that adher-
ence to quality metrics and evidence-based guidelines 
help lower costs by reducing use of physician serv-
ices, hospitalizations, and supplemental and expen-
sive drugs.’’ 
SEC. 3. MEDICARE QUALITY CANCER CARE DEMONSTRA-
TION PROJECT. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall establish a quality cancer care demonstra-
tion project under this section (in this section referred to 
as the ‘‘QCCD project’’) for the purpose of establishing 
quality metrics and aligning Medicare payment incentives 
in the areas of treatment planning and end-of-life care for 
Medicare beneficiaries with cancer. 
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(b) TEST
METRICS
AND
REPORTING
SYSTEMS 
THROUGH
A
PAY-FOR-REPORTING
INCENTIVE
PRO-
GRAM.—Under the QCCD project, the Secretary shall do 
the following: 
(1) Identify and address gaps in current quality 
measures related to the areas of active treatment 
planning and end-of-life care by refining the per-
formance measures described in paragraphs (1) and 
(2) of subsection (d) relating to active treatment 
planning and end-of-life care for clinician-level re-
porting. 
(2) Explore the potential to report quality data 
through registries or other electronic means for 
treatment planning and end-of-life care data, includ-
ing identifying data elements necessary to measure 
quality of treatment planning and end-of-life care 
and determine how those elements could be collected 
through claims data or registries or other electronic 
means. 
(3) Test and validate identified treatment plan-
ning and end-of-life quality measures through a pay- 
for-reporting program with oncologists, which pro-
gram— 
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(A) ensures that oncologists are able to ac-
curately report on measures through simple 
HCPCS coding mechanisms; and 
(B) tests processes of submitting treat-
ment planning and end-of-life measures through 
registries or other electronic means. 
(c) INCENTIVE PAYMENT.— 
(1) IN GENERAL.—Under the QCCD project, 
the Secretary shall provide for a separate payment 
under section 1848 of the Social Security Act (42 
U.S.C. 1395w–4), to be divided into a baseline pay-
ment amount and an additional payment amount, as 
specified by the Secretary, for a treatment planning 
code and for an end-of-life code. The amount of such 
payments under the project shall be designed to 
total $300,000,000 each year. Payments under the 
project shall be designed to be paid on an ongoing 
basis as claims are submitted. 
(2) REQUIREMENT TO SATISFY BASELINE MAN-
DATORY
MEASURES
TO
RECEIVE
BASELINE
PAY-
MENT.—In order for a physician to receive any pay-
ment under the QCCD project for treatment plan-
ning or end-of-life care, a physician must report in 
a manner specified under the project that all of the 
baseline mandatory measures described in paragraph 
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