I 
117TH CONGRESS 
2D SESSION 
H. R. 9565 
To address the health of cancer survivors and unmet needs that survivors 
face through the entire continuum of care from diagnosis through active 
treatment and posttreatment, in order to improve survivorship, treatment, 
transition to recovery and beyond, quality of life and palliative care, 
and long-term health outcomes, including by developing a minimum 
standard of care for cancer survivorship, irrespective of the type of 
cancer, a survivor’s background, or forthcoming survivorship needs, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 14, 2022 
Ms. WASSERMAN
SCHULTZ
(for herself, Mr. FITZPATRICK, and Mr. 
DESAULNIER) introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees 
on Ways and Means, and Education and Labor, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To address the health of cancer survivors and unmet needs 
that survivors face through the entire continuum of care 
from 
diagnosis 
through 
active 
treatment 
and 
posttreatment, in order to improve survivorship, treat-
ment, transition to recovery and beyond, quality of life 
and palliative care, and long-term health outcomes, in-
cluding by developing a minimum standard of care for 
cancer survivorship, irrespective of the type of cancer, 
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a survivor’s background, or forthcoming survivorship 
needs, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Comprehensive Cancer Survivorship Act’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
Sec. 3. Definitions. 
Sec. 4. Coverage of cancer care planning and coordination services. 
Sec. 5. Survivorship transition tools. 
Sec. 6. Alternative payment model. 
Sec. 7. Survivorship navigation. 
Sec. 8. Survivorship care demonstration program. 
Sec. 9. Cancer survivor workforce assistance grants. 
Sec. 10. Comprehensive cancer survivorship program. 
Sec. 11. Adult cancer survivorship study. 
Sec. 12. Survivorship progress report. 
Sec. 13. Promoting State innovations to ease transitions to the primary care 
setting for children with cancer. 
Sec. 14. Childhood cancer demonstration model and standard of care. 
Sec. 15. Medicaid coverage of fertility preservation services for cancer patients. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) A cancer survivor is any individual with a 
history of cancer, from the time of diagnosis through 
the rest of their life, across the continuum of care. 
(2) Today, there are approximately 18,000,000 
Americans who are cancer survivors, and the num-
ber of survivors is projected to reach 26,000,000 by 
2040. Therefore, there is a great need to be able to 
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provide ways to sustain the care needed and to offer 
those living with, through, and beyond cancer a safe, 
supportive, and accommodating environment where 
such individuals can engage in physical and social 
support activities to sustain optimal quality of life. 
(3) Cancer survivors face difficult emotional, 
psychological, neurological, financial, and other 
physical challenges that persist beyond diagnosis and 
treatment, often arising months and years after ac-
tive cancer treatment ends. 
(4) Cancer survivors have unique needs and 
must manage short- and long-term effects of their 
treatment, as well as regular screenings for cancer 
recurrence or new cancers. 
(5) Cancer survivors of racial and ethnic diver-
sity have disproportionately lower health-related, 
quality-of-life scores compared to non-Hispanic 
White cancer survivors. 
(6) Cancer survivors living in rural areas have 
less access to services and have poorer outcomes 
than survivors in metropolitan areas. 
(7) Children, adolescent, and young adult can-
cer survivors are particularly susceptible to long- 
term consequences from treatment, and up to 80 
percent have a severe, disabling, life-threatening, or 
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fatal health condition by the age of 50. Best prac-
tices in this area would improve treatment, quality 
of life, and long-term health outcomes. 
(8) Clinical trials have shown that cancer survi-
vorship programs help cancer survivors meet or ex-
ceed the recommended amount of physical activity, 
significantly increasing their cardiovascular health 
and overall quality of life and decreasing their can-
cer-related fatigue. 
(9) Survivorship care refers to the medical or 
psychosocial care of an individual who has completed 
their primary treatment for cancer, or of an indi-
vidual who is undergoing maintenance or intermit-
tent medical treatment or maintenance psychosocial 
care for cancer, or of an individual living with meta-
static disease under continuous medical or psycho-
social treatment. 
(10) Despite the National Cancer Institute and 
other professional organizations’ definition of a can-
cer survivor beginning on the day of a cancer diag-
nosis, there is little agreement among clinicians, re-
searchers, and insurance companies on what services 
are included in ‘‘survivorship care’’ and the point at 
which ‘‘survivorship care’’ begins. 
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(11) Cancer survivors, their families, their care-
givers, and their providers face many difficulties un-
derstanding and coordinating the transition from 
specialty to primary care, and for this reason com-
munication and treatment are often fragmented and 
inconsistent. 
(12) To avoid additional health-related or finan-
cial hardships to cancer survivors and their families, 
comprehensive and forward-thinking cancer survivor-
ship studies and programs across Federal agencies 
are required to engage in a coordinated effort to im-
prove health outcomes and quality of life of sur-
vivors. 
SEC. 3. DEFINITIONS. 
In this Act: 
(1) CANCER SURVIVOR.—The term ‘‘cancer sur-
vivor’’ means anyone who remains alive from the 
time of a cancer diagnosis. 
(2) CAREGIVER.—The term ‘‘caregiver’’ means 
a family member, friend, or other person who cares 
for an older person or adult with a chronic or dis-
abling condition, including cancer. 
(3) PATIENT
EXPERIENCE
DATA.—The term 
‘‘patient experience data’’ means patient experiences, 
perspectives, needs, and priorities related to— 
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(A) the symptoms of the patient’s condi-
tions and the natural history of such conditions; 
(B) the impact of the conditions on the pa-
tient’s functioning and quality of life; 
(C) the patient’s experience with treat-
ments; 
(D) input on which outcomes are impor-
tant to the patient; 
(E) patient preferences for outcomes and 
treatments; and 
(F) the relative importance of any issues 
as defined by patients. 
(4) PSYCHOSOCIAL EFFECTS.—The term ‘‘psy-
chosocial effects’’— 
(A) means the psychological, behavioral, 
emotional, and social effects of a disease, such 
as cancer, and its treatment; and 
(B) in the case of such effects of cancer, 
includes changes in how a patient thinks, their 
feelings, moods, beliefs, ways of coping, and re-
lationships with family, friends, and coworkers. 
(5) PSYCHOSOCIAL CARE.—The term ‘‘psycho-
social care’’ means psychological and social services 
and interventions that enable survivors, patients, 
their families, and health care providers to optimize 
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health care and to manage the psychological, behav-
ioral, physical, emotional, and social aspects of ill-
ness and its consequences so as to promote better 
health and well-being. 
(6) SECRETARY.—Except as otherwise speci-
fied, the term ‘‘Secretary’’ means the Secretary of 
Health and Human Services. 
(7) SURVIVORSHIP.—The term ‘‘survivorship’’ 
means the period from the time of cancer diagnosis 
until the end of life, including any portions of such 
period during which interventions are necessary to 
address— 
(A) the physical, mental, emotional, social, 
and financial effects of cancer that begin at di-
agnosis and continue through treatment and be-
yond; and 
(B) issues related to follow-up care (includ-
ing regular health and wellness checkups), late 
and long-term effects of treatment, screening 
for cancer recurrence and new cancers, and 
quality of life. 
(8) SURVIVORSHIP
CARE
PLAN.—The term 
‘‘survivorship care plan’’— 
(A) means an individualized care plan for 
patients who have been treated for cancer; and 
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(B) includes a treatment summary and any 
follow-up care guidelines in such plan that— 
(i) are for monitoring and maintain-
ing the patient’s medical and psychosocial 
health and well-being; and 
(ii) are meant to be a transition and 
communication tool for the survivor, their 
family, their caregiver, and all their health 
care providers. 
(9) SURVIVORSHIP
NAVIGATION.—The term 
‘‘survivorship navigation’’ means a service that— 
(A) helps patients overcome health care 
system and social determinants of health bar-
riers; and 
(B) provides patients with timely access to 
high-quality medical, physical, and psychosocial 
care from their cancer diagnosis through all 
phases of their cancer experience. 
(10) TREATMENT SUMMARY.—The term ‘‘treat-
ment summary’’ means a detailed summary of a pa-
tient’s disease, the types of treatment the patient re-
ceived, members of the patient’s care team, and any 
side effects or other problems, including psychosocial 
effects, caused by treatment. 
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SEC. 4. COVERAGE OF CANCER CARE PLANNING AND CO-
ORDINATION SERVICES. 
(a) IN GENERAL.—Section 1861 of the Social Secu-
rity Act (42 U.S.C. 1395x) is amended— 
(1) in subsection (s)(2)— 
(A) by striking ‘‘and’’ at the end of sub-
paragraph (GG); 
(B) by adding ‘‘and’’ at the end of sub-
paragraph (HH); and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(II) cancer care planning and coordination 
services (as defined in subsection (lll))’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘Cancer Care Planning and Coordination Services 
‘‘(lll)(1) The term ‘cancer care planning and coordi-
nation services’ means, with respect to an individual who 
is diagnosed with cancer, the development of a treatment 
plan by a physician, physician assistant, or nurse practi-
tioner that— 
‘‘(A) includes each component of the Institute 
of Medicine Care Management Plan (as described in 
the article entitled ‘Delivering High-Quality Cancer 
Care: Charting a New Course for a System in Crisis’ 
published by the Institute of Medicine); 
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‘‘(B) is furnished in written form or electroni-
cally, at the visit of such individual with such physi-
cian, physician assistant, or nurse practitioner, or as 
soon after the date of the visit as practicable; and 
‘‘(C) is furnished, to the greatest extent prac-
ticable, in a form that appropriate takes into ac-
count cultural and linguistic needs of the individual 
in order to make the plan accessible to the indi-
vidual. 
‘‘(2) The Secretary shall establish frequencies at 
which services described in paragraph (1) may be fur-
nished, provided that such services may be furnished with 
respect to an individual— 
‘‘(A) at the time such individual is diagnosed 
with cancer for purposes of planning treatment; 
‘‘(B) if there is a change in the condition of 
such individual or such individual’s treatment pref-
erences; 
‘‘(C) at the end of active treatment and begin-
ning of survivorship care; and 
‘‘(D) if there is a recurrence of such cancer.’’. 
(b) PAYMENT UNDER PHYSICIAN FEE SCHEDULE.— 
(1) IN
GENERAL.—Section 1848(j)(3) of the 
Social Security Act (42 U.S.C. 1395w–4(j)(3)) is 
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SEC. 10. COMPREHENSIVE CANCER SURVIVORSHIP PRO-
GRAM. 
(a) IN GENERAL.—The Secretary shall carry out a 
comprehensive cancer survivorship program that in-
cludes— 
(1) a cancer survivorship resource center in ac-
cordance with subsection (b) to provide evidence- 
based resources to cancer survivors, their families, 
and their caregivers; 
(2) a health care professional resource center in 
accordance with subsection (c) to assist and educate 
health care professionals in the delivery of high-qual-
ity survivorship care; 
(3) an educational campaign in accordance with 
subsection (d) to provide health care professionals 
with resources to improve cancer survivorship care; 
and 
(4) a program of supportive care services in ac-
cordance with subsection (e) to improve the quality 
of life and long-term survivorship of cancer sur-
vivors. 
(b) CANCER SURVIVORSHIP RESOURCE CENTER.— 
(1) ESTABLISHMENT.—The Secretary shall es-
tablish and operate a survivorship resource center 
(in this subsection referred to as the ‘‘Center’’) that 
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(d) PUBLIC MEETING.—In conducting the study 
under subsection (a), the Comptroller General of the 
United States shall hold a public meeting with a broad 
cross section of stakeholders to inform the study’s findings 
and conclusions. Such stakeholders shall include— 
(1) cancer survivors; 
(2) patient organizations representing cancer 
survivors; 
(3) oncologists involved in survivorship care and 
the professional societies representing them; 
(4) primary care providers involved in survivor-
ship care and the professional societies representing 
them; 
(5) other health professionals providing survi-
vorship care and the professional societies rep-
resenting them; 
(6) community-based organizations involved in 
survivorship care; 
(7) representatives of the National Cancer In-
stitute; 
(8) third-party payors; 
(9) researchers engaged in survivorship re-
search; 
(10) epidemiologists with knowledge of trends 
in cancer survivorship; and 
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