‘‘(C) The identification of predictors of ad-
verse neurocognitive and psychosocial outcomes. 
‘‘(D) The identification of the molecular 
underpinnings of long-term complications. 
‘‘(E) The development of risk prediction 
models to identify those at highest risk of long- 
term complications. 
‘‘(F) Initiatives to protect cancer survivors 
from the late effects of cancer treatment, by de-
veloping targeted interventions to reduce the 
burden of morbidity borne by cancer survivors. 
‘‘(G) Transitions in care for pediatric can-
cer survivors. 
‘‘(H) Training of professionals to provide 
linguistically and culturally competent follow-up 
care to pediatric cancer survivors. 
‘‘(I) Different models of follow-up care. 
‘‘(J) Examining the cost-effectiveness of 
the different models of follow-up care.’’. 
SEC. 203. COMPREHENSIVE LONG-TERM FOLLOW-UP SERV-
ICES FOR PEDIATRIC CANCER SURVIVORS. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 317T the following:
‘‘SEC. 317U. STANDARDS FOR COMPREHENSIVE LONG-TERM 
CARE FOR PEDIATRIC CANCER SURVIVORS 
THROUGH THE LIFESPAN. 
‘‘The Secretary may establish a task force to develop 
and test standards, outcomes, and metrics for high-quality 
childhood cancer survivorship care in consultation with a 
full spectrum of representation of experts in late effects 
of disease and treatment of childhood cancers, including— 
‘‘(1) oncologists who treat children and adoles-
cents; 
‘‘(2) oncologists who treat adults; 
‘‘(3) primary care providers engaged in survi-
vorship care; 
‘‘(4) survivors of childhood cancer; 
‘‘(5) parents of children who have been diag-
nosed with and treated for cancer and parents of 
long-term survivors; 
‘‘(6) professionals who are engaged in the devel-
opment of clinical practice guidelines; 
‘‘(7) nurses and social workers; 
‘‘(8) mental health professionals; 
‘‘(9) allied health professionals, including phys-
ical therapists and occupational therapists; 
‘‘(10) experts in health care quality measure-
ment and improvement; and
‘‘(11) others, as the Secretary determines ap-
propriate.’’. 
SEC. 204. SURVIVORSHIP DEMONSTRATION PROJECT. 
(a) IN GENERAL.—Not later than 1 year after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services (referred to in this section as the 
‘‘Secretary’’) may carry out a demonstration project over 
a 3-year period, designed to improve the quality and effi-
ciency of care provided to childhood cancer survivors 
throughout their lifespan, through improved care coordi-
nation as survivors transitions to adult care. 
(b) SELECTION OF DEMONSTRATION SITES.— 
(1) MAXIMUM NUMBER OF SITES.—The max-
imum number of sites at which the demonstration 
project under subsection (a) is carried out may not 
exceed 10. 
(2) DIVERSITY OF SITES.—In selecting entities 
to participate in the demonstration project, the Sec-
retary may, to the extent practicable, include in such 
selection— 
(A) small-, medium-, and large-sized sites; 
and 
(B) sites located in different geographic 
areas.
(c) 
ACTIVITIES
UNDER
DEMONSTRATION 
PROJECT.—The activities conducted under the demonstra-
tion project under subsection (a) may, in addition to any 
other activity specified by the Secretary, include activities 
that seek to develop different models of care coordination, 
including transitions of care, follow-up care, monitoring, 
and other survivorship related programs that utilize a 
multidisciplinary, team based approach to care, including 
any of the following activities: 
(1) Coordination of care and transitions of care 
between cancer care providers, primary care physi-
cians, mental health professionals and any other rel-
evant providers. 
(2) Dissemination of information to, and train-
ing of, health care providers about linguistically and 
culturally competent follow-up care specific to cancer 
survivors. 
(3) Development of monitoring programs for 
cancer survivors and their families. 
(4) Incorporation of peer support and men-
toring programs to improve the quality of life of can-
cer survivors. 
(5) Designing systems and models for the effec-
tive transfer of treatment information and care sum-
maries from cancer care providers to other health
care providers (including risk factors and a care 
plan). 
(6) Evaluation of functional status and incorpo-
ration of specific functional needs into the care plan-
ning process. 
(7) Dissemination of the information on activi-
ties and programs conducted under this section to 
other health care providers (including primary care 
physicians) and to cancer survivors and their fami-
lies, where appropriate. 
(8) Other items determined by the Secretary. 
(d) MEASURES.—The Secretary may use the fol-
lowing measures to assess the performance of each site: 
(1) Patient care and patient/family satisfaction 
measures. 
(2) Resource utilization measures. 
(3) Adult survivorship measures, as appro-
priate. 
(e) GAO REPORT.—The Comptroller General of the 
United States shall submit a report to Congress evaluating 
the success of the demonstration project. Such report shall 
include an assessment of the impact of the project upon 
the quality and cost-efficiency of services furnished to indi-
viduals under this title, including an assessment of the sat-
isfaction of such individuals with respect to such services
that were furnished under such project. Such report shall 
include recommendations regarding the possible expansion 
of the demonstration project. 
Subtitle B—Coverage and Payment 
of High Quality Care 
SEC. 211. REPORT BY THE COMPTROLLER GENERAL. 
(a) IN GENERAL.—The Comptroller General of the 
United States shall conduct a review and submit rec-
ommendations to Congress on existing barriers to obtain-
ing and paying for adequate medical care for survivors of 
childhood cancer. 
(b) CONSIDERATIONS.—In carrying out the review 
and formulating recommendations under subsection (a), 
the Comptroller General shall— 
(1) identify existing barriers to the availability 
of complete and coordinated survivorship care for 
survivors of childhood cancer and to the availability 
of expert pediatric palliative care, including consider-
ation of— 
(A) understanding and education among 
patients, health care providers, regulators, and 
third-party payors; 
(B) adequacy of payment codes to cover 
necessary survivorship services;
(C) access to necessary medical and other 
services for such survivors, including the serv-
ices described in subsection (c); and 
(D) lack of pediatric palliative care across 
all stages of illness and hospice services for pa-
tients approaching the end of life; and 
(2) make recommendations to provide improved 
access and payment plans for childhood cancer sur-
vivorship programs and palliative care, including 
psychosocial services and coverage of such services. 
(c) SERVICES DESCRIBED.—The services described in 
this subsection are the following: 
(1) Coordinated multidisciplinary long-term fol-
low-up care with access to appropriate pediatric sub-
specialists and adult subspecialists with specific ex-
pertise in survivorship, including subspecialists with 
expertise in oncology, radiation oncology, surgery, 
cardiology, psychiatry or psychology, endocrinology, 
pulmonology, nephrology, dermatology, gynecology, 
and urology. 
(2) Appropriate organ function testing (particu-
larly screening for potential problems at much 
younger ages than usually indicated in the general 
population) and treatment, including—
(A) neuropsychological testing and mental 
health services; 
(B) fertility testing and treatment; 
(C) evaluation and treatment for endocrine 
disorders including growth hormone and testos-
terone replacement; 
(D) diagnostic imaging to screen for late 
effects of treatment (including subsequent can-
cers), such as mammograms and magnetic reso-
nance imaging testing to screen for possible 
breast cancer; 
(E) screening for cardiac problems, such 
as echocardiograms; 
(F) screening for osteoporosis with bone 
densitometry, 
including 
duel 
x-ray 
absorptiometry 
and 
monitoring 
hydroxyvitamin D levels; 
(G) dental coverage and necessary dental 
implants; 
(H) hearing aids and other prosthetic de-
vices; and
(I) screening for lung problems, such as 
pulmonary function testing. 
Passed the House of Representatives December 6, 
2016. 
Attest: 
Clerk.
114TH CONGRESS 
2D SESSION 
H. R. 3381 
AN ACT 
To maximize discovery, and accelerate development 
and availability, of promising childhood cancer 
treatments, and for other purposes.