379 
reduction of cesarean birth rates, elective inductions, 
prematurity rates, and low birth weight rates within 
an underserved population that has a disproportion-
ately large burden of suboptimal maternity out-
comes, including maternal mortality and morbidity, 
infant mortality, prematurity, or low birth weight; 
(2) work with partners on special interest 
projects, as specified by the Centers for Disease 
Control and Prevention and other relevant agencies 
within the Department of Health and Human Serv-
ices, and on projects funded by other sources; and 
(3) involve a minimum of two distinct birth set-
ting models, such as a hospital labor and delivery 
model and freestanding birth center model; or a hos-
pital labor and delivery model and planned home 
birth model. 
(c) INTERDISCIPLINARY PROVIDERS.—Each Center 
for Excellence on Optimal Maternity Outcomes shall in-
clude the following interdisciplinary providers of maternity 
care: 
(1) Obstetrician-gynecologists. 
(2) At least two of the following providers: 
(A) Family practice physicians. 
(B) Nurse practitioners. 
(C) Physician assistants. 
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(D) Certified professional midwives. 
(d) SERVICES.—Research conducted by each Center 
for Excellence on Optimal Maternity Outcomes shall in-
clude at least 2 (and preferably more) of the following sup-
portive provider services: 
(1) Mental health. 
(2) Doula labor support. 
(3) Nutrition education. 
(4) Childbirth education. 
(5) Social work. 
(6) Physical therapy or occupation therapy. 
(7) Substance abuse services. 
(8) Home visiting. 
(e) COORDINATION.—The programs of research at 
each of the two Centers of Excellence on Optimal Mater-
nity Outcomes shall compliment and not replicate the 
work of the other. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$2,000,000 for each of the fiscal years 2015 through 
2019. 
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SEC. 520. EXPANDING MODELS ALLOWED TO BE TESTED BY 
CENTER FOR MEDICARE AND MEDICAID IN-
NOVATION TO INCLUDE MATERNITY CARE 
MODELS. 
Section 1115A(b)(2)(B) of the Social Security Act 
(42 U.S.C. 1315a(b)(2)(B)) is amended by adding at the 
end the following new clause: 
‘‘(xxi) Promoting evidence-based mod-
els of care that have been associated with 
reductions in maternal and infant health 
disparities, including incorporating the use 
of doula and promotoras support for preg-
nant and childbearing women into evi-
dence-based models of prenatal care, labor 
and delivery, and postpartum care, and 
supporting the appropriate use of out-of- 
hospital birth models, including births at 
home and in freestanding birth centers.’’. 
SEC. 521. DEVELOPMENT OF INTERPROFESSIONAL MATER-
NITY 
CARE 
EDUCATIONAL 
MODELS 
AND 
TOOLS. 
(a) IN GENERAL.—Not later than 6 months after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services, acting in conjunction with the Ad-
ministrator of Health Resources and Services Administra-
tion, shall convene, for a 1-year period, an Interprofes-
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sional Maternity Provider Education Commission to dis-
cuss and make recommendations for— 
(1) a consensus standard physiologic maternity 
care curriculum that takes into account the core 
competencies for basic midwifery practice such as 
those developed by the American College of Nurse 
Midwives and the North American Registry of Mid-
wives, and the educational objectives for physicians 
practicing in obstetrics and gynecology as deter-
mined by the Council on Resident Education in Ob-
stetrics and Gynecology; 
(2) suggestions for multidisciplinary use of the 
consensus physiologic curriculum; 
(3) strategies to integrate and coordinate edu-
cation across maternity care disciplines, including 
recommendations to increase medical and midwifery 
student exposure to out-of-hospital birth; and 
(4) pilot demonstrations of interprofessional 
educational models. 
(b) PARTICIPANTS.—The Commission shall include 
maternity care educators, curriculum developers, service 
leaders, certification leaders, and accreditation leaders 
from the various professions that provide maternity care 
in this country. Such professions shall include obstetrician 
gynecologists, certified nurse midwives or certified mid-
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wives, family practice physicians, nurse practitioners, phy-
sician assistants, certified professional midwives, and 
perinatal nurses. Additionally, the Commission shall in-
clude representation from maternity care consumer advo-
cates. 
(c) CURRICULUM.—The consensus standard physio-
logic maternity care curriculum described in subsection 
(a)(1) shall— 
(1) have a public health focus with a foundation 
in health promotion and disease prevention; 
(2) foster physiologic childbearing and woman 
and family centered care; 
(3) integrate strategies to reduce maternal and 
infant morbidity and mortality; 
(4) incorporate recommendations to ensure re-
spectful, safe, and seamless consultation, referral, 
transport, and transfer of care when necessary; and 
(5) include cultural sensitivity and strategies to 
decrease disparities in maternity outcomes. 
(d) REPORT.—Not later than 6 months after the final 
meeting of the Commission, the Secretary of Health and 
Human Services shall— 
(1) submit to Congress a report containing the 
recommendations made by the Commission under 
this section; and 
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(2) make such report publicly available. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$1,000,000 for each of the fiscal years 2015 and 2016, 
and such sums as are necessary for each of the fiscal years 
2017 through 2019. 
SEC. 522. INCLUDING WITHIN INPATIENT HOSPITAL SERV-
ICES 
UNDER 
MEDICARE 
SERVICES 
FUR-
NISHED BY CERTAIN STUDENTS, INTERNS, 
AND RESIDENTS SUPERVISED BY CERTIFIED 
NURSE MIDWIVES. 
(a) IN GENERAL.—Section 1861(b) of the Social Se-
curity Act (42 U.S.C. 1395x(b)) is amended— 
(1) in paragraph (6), by striking ‘‘; or’’ and in-
serting ‘‘, or in the case of services in a hospital or 
osteopathic hospital by a student midwife or an in-
tern or resident-in-training under a teaching pro-
gram previously described in this paragraph who is 
in the field of obstetrics and gynecology, if such stu-
dent midwife, intern, or resident-in-training is super-
vised by a certified nurse-midwife to the extent per-
mitted under applicable State law and as may be au-
thorized by the hospital;’’; 
(2) in paragraph (7), by striking the period at 
the end and inserting ‘‘; or’’; and 
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(3) by adding at the end the following new 
paragraph: 
‘‘(8) a certified nurse-midwife where the hos-
pital has a teaching program approved as specified 
in paragraph (6), if (A) the hospital elects to receive 
any payment due under this title for reasonable 
costs of such services, and (B) all certified nurse- 
midwives in such hospital agree not to bill charges 
for professional services rendered in such hospital to 
individuals covered under the insurance program es-
tablished by this title.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to services furnished on or after 
the date of the enactment of this Act. 
SEC. 523. GRANTS TO PROFESSIONAL ORGANIZATIONS TO 
INCREASE DIVERSITY IN MATERNITY CARE 
PROFESSIONALS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, through the Administrator of the Health 
Resources and Services Administration, shall carry out a 
grant program under which the Secretary may make to 
eligible health professional organizations— 
(1) for fiscal year 2015, planning grants de-
scribed in subsection (b); and 
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(2) for the subsequent 4-year period, implemen-
tation grants described in subsection (c). 
(b) PLANNING GRANTS.— 
(1) IN GENERAL.—Planning grants described in 
this subsection are grants for the following purposes: 
(A) To collect data and identify any work-
force disparities, with respect to a health pro-
fession, at each of the following areas along the 
health professional continuum: 
(i) Pipeline availability with respect to 
students at the high school and college or 
university levels considering and working 
toward entrance in the profession. 
(ii) Entrance into the training pro-
gram for the profession. 
(iii) Graduation from such training 
program. 
(iv) Entrance into practice. 
(v) Retention in practice for more 
than a 5-year period. 
(B) To develop one or more strategies to 
address the workforce disparities within the 
health profession, as identified under (and in 
response to the findings pursuant to) subpara-
graph (A). 
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(2) APPLICATION.—To be eligible to receive a 
grant under this subsection, an eligible health pro-
fessional organization shall submit to the Secretary 
of Health and Human Services an application in 
such form and manner and containing such informa-
tion as specified by the Secretary. 
(3) AMOUNT.—Each grant awarded under this 
subsection shall be for an amount not to exceed 
$300,000. 
(4) REPORT.—Each recipient of a grant under 
this subsection shall submit to the Secretary of 
Health and Human Services a report containing— 
(A) information on the extent and distribu-
tion of workforce disparities identified through 
the grant; and 
(B) reasonable objectives and strategies 
developed to address such disparities within a 
5-, 10-, and 25-year period. 
(c) IMPLEMENTATION GRANTS.— 
(1) IN GENERAL.—Implementation grants de-
scribed in this subsection are grants to implement 
one or more of the strategies developed pursuant to 
a planning grant awarded under subsection (b). 
(2) APPLICATION.—To be eligible to receive a 
grant under this subsection, an eligible health pro-
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fessional organization shall submit to the Secretary 
of Health and Human Services an application in 
such form and manner as specified by the Secretary. 
Each such application shall contain information on 
the capability of the organization to carry out a 
strategy described in paragraph (1), involvement of 
partners or coalitions, plans for developing sustain-
ability of the efforts after the culmination of the 
grant cycle, and any other information specified by 
the Secretary. 
(3) AMOUNT.—Each grant awarded under this 
subsection shall be for an amount not to exceed 
$500,000 each year during the 4-year period of the 
grant. 
(4) REPORTS.—For each of the first 3 years for 
which an eligible health professional organization is 
awarded a grant under this subsection, the organiza-
tion shall submit to the Secretary of Health and 
Human Services a report on the activities carried 
out by such organization through the grant during 
such year and objectives for the subsequent year. 
For the fourth year for which an eligible health pro-
fessional organization is awarded a grant under this 
subsection, the organization shall submit to the Sec-
retary a report that includes an analysis of all the 
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activities carried out by the organization through the 
grant and a detailed plan for continuation of out- 
reach efforts. 
(d) ELIGIBLE HEALTH PROFESSIONAL ORGANIZA-
TION DEFINED.—For purposes of this section, the term 
‘‘eligible health professional organization’’ means a profes-
sional 
organization 
representing 
obstetrician-gyne-
cologists, certified nurse midwives, certified midwives, 
family practice physicians, nurse practitioners whose scope 
of practice includes maternity care, physician assistants 
whose scope of practice includes obstetrical care, or cer-
tified professional midwives. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$2,000,000 for fiscal year 2015 and $3,000,000 for each 
of the fiscal years 2016 through 2019. 
TITLE VI—MENTAL HEALTH 
SEC. 601. COVERAGE OF MARRIAGE AND FAMILY THERA-
PIST 
SERVICES, 
MENTAL 
HEALTH 
COUN-
SELOR SERVICES, AND SUBSTANCE ABUSE 
COUNSELOR SERVICES UNDER PART B OF 
THE MEDICARE PROGRAM. 
(a) COVERAGE OF SERVICES.— 
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of mental illnesses which the mental health counselor is 
legally authorized to perform under State law (or the 
State regulatory mechanism provided by the State law) of 
the State in which such services are performed, as would 
otherwise be covered if furnished by a physician or as inci-
dent to a physician’s professional service, but only if no 
facility or other provider charges or is paid any amounts 
with respect to the furnishing of such services. 
‘‘(4) The term ‘mental health counselor’ means an 
individual who— 
‘‘(A) possesses a master’s or doctor’s degree in 
mental health counseling or a related field; 
‘‘(B) after obtaining such a degree has per-
formed at least 2 years of supervised mental health 
counselor practice; and 
‘‘(C) in the case of an individual performing 
services in a State that provides for licensure or cer-
tification of mental health counselors or professional 
counselors, is licensed or certified as a mental health 
counselor or professional counselor in such State. 
‘‘(5) The term ‘substance abuse counselor services’ 
means services performed by a substance abuse counselor 
(as defined in paragraph (6)) for the diagnosis and treat-
ment of substance abuse and addiction which the sub-
stance abuse counselor is legally authorized to perform 
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under State law (or the State regulatory mechanism pro-
vided by the State law) of the State in which such services 
are performed, as would otherwise be covered if furnished 
by a physician or as incident to a physician’s professional 
service, but only if no facility or other provider charges 
or is paid any amounts with respect to the furnishing of 
such services. 
‘‘(6) The term ‘substance abuse counselor’ means an 
individual who— 
‘‘(A) has performed at least 2 years of super-
vised substance abuse counselor practice; 
‘‘(B) in the case of an individual performing 
services in a State that provides for licensure or cer-
tification of substance abuse counselors or profes-
sional counselors, is licensed or certified as a sub-
stance abuse counselor or professional counselor in 
such State; or 
‘‘(C) the individual is a drug and alcohol coun-
selor as defined in section 40.281 of title 49, Code 
of Federal Regulations.’’. 
(3) PROVISION
FOR
PAYMENT
UNDER
PART 
B.—Section 1832(a)(2)(B) of such Act (42 U.S.C. 
1395k(a)(2)(B)) is amended by adding at the end 
the following new clause: 
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‘‘(v) marriage and family therapist 
services, mental health counselor services, 
and substance abuse counselor services;’’. 
(4) AMOUNT OF PAYMENT.—Section 1833(a)(1) 
of such Act (42 U.S.C. 1395l(a)(1)) is amended— 
(A) by striking ‘‘and (Z)’’ and inserting 
‘‘(Z)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (AA) with respect 
to marriage and family therapist services, men-
tal health counselor services, and substance 
abuse 
counselor 
services 
under 
section 
1861(s)(2)(GG), the amounts paid shall be 80 
percent of the lesser of the actual charge for 
the services or 75 percent of the amount deter-
mined for payment of a psychologist under sub-
paragraph (L)’’. 
(5) EXCLUSION
OF
MARRIAGE
AND
FAMILY 
THERAPIST SERVICES AND MENTAL HEALTH COUN-
SELOR SERVICES FROM SKILLED NURSING FACILITY 
PROSPECTIVE
PAYMENT
SYSTEM.—Section 
1888(e)(2)(A)(ii) 
of 
such 
Act 
(42 
U.S.C. 
1395yy(e)(2)(A)(ii)) is amended by inserting ‘‘mar-
riage and family therapist services (as defined in 
section 1861(kkk)(1)), mental health counselor serv-
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ices (as defined in section 1861(kkk)(3)),’’ after 
‘‘qualified psychologist services,’’. 
(6) INCLUSION
OF
MARRIAGE
AND
FAMILY 
THERAPISTS, MENTAL HEALTH COUNSELORS, AND 
SUBSTANCE ABUSE COUNSELORS AS PRACTITIONERS 
FOR
ASSIGNMENT
OF
CLAIMS.—Section 
1842(b)(18)(C) 
of 
such 
Act 
(42 
U.S.C. 
1395u(b)(18)(C)) is amended by adding at the end 
the following new clauses: 
‘‘(vii) A marriage and family therapist (as de-
fined in section 1861(kkk)(2)). 
‘‘(viii) A mental health counselor (as defined in 
section 1861(kkk)(4)). 
‘‘(ix) A substance abuse counselor (as defined 
in section 1861 (kkk)(6)).’’. 
(b) COVERAGE OF CERTAIN MENTAL HEALTH SERV-
ICES PROVIDED IN CERTAIN SETTINGS.— 
(1) RURAL HEALTH CLINICS AND FEDERALLY 
QUALIFIED
HEALTH
CENTERS.—Section 
1861(aa)(1)(B) of the Social Security Act (42 
U.S.C. 1395x(aa)(1)(B)) is amended by striking ‘‘or 
by a clinical social worker (as defined in subsection 
(hh)(1)),’’ and inserting ‘‘, by a clinical social worker 
(as defined in subsection (hh)(1)), by a marriage 
and family therapist (as defined in subsection 
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(kkk)(2)), or by a mental health counselor (as de-
fined in subsection (kkk)(4)), or by a substance 
abuse counselor (as defined in section 1861 
(kkk)(6)).’’. 
(2) 
HOSPICE
PROGRAMS.—Section 
1861(dd)(2)(B)(i)(III) of such Act (42 U.S.C. 
1395x(dd)(2)(B)(i)(III)) is amended by inserting ‘‘or 
one marriage and family therapist (as defined in 
subsection (kkk)(2))’’ after ‘‘social worker’’. 
(c) AUTHORIZATION
OF MARRIAGE
AND FAMILY 
THERAPISTS TO DEVELOP DISCHARGE PLANS FOR POST- 
HOSPITAL SERVICES.—Section 1861(ee)(2)(G) of the So-
cial Security Act (42 U.S.C. 1395x(ee)(2)(G)) is amended 
by inserting ‘‘marriage and family therapist (as defined 
in subsection (kkk)(2)),’’ after ‘‘social worker,’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to services furnished 
on or after January 1, 2015. 
SEC. 602. MINORITY FELLOWSHIP PROGRAM. 
Title V of the Public Health Service Act is amended 
by inserting after section 506B of such Act (42 U.S.C. 
290aa–5b) the following: 
‘‘SEC. 506C. MINORITY FELLOWSHIP PROGRAM. 
‘‘(a) FELLOWSHIPS.—The Administrator shall main-
tain a program, to be known as the Minority Fellowship 
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Program, under which the Administrator awards grants 
or contracts to national associations or other appropriate 
entities for the financial support of graduate students, 
postdoctoral fellows, and residents in the professions of 
psychology, psychiatry, social work, psychiatric advance- 
practice nursing, marriage and family therapy, and profes-
sional counseling to students who demonstrate a commit-
ment to clinical or research careers focused on racial and 
ethnic minority populations. 
‘‘(b) TERM OF FINANCIAL SUPPORT.—Financial sup-
port provided to an individual pursuant to subsection (a) 
shall be for a term of not more than 12 months and may 
be renewed thereafter. 
‘‘(c) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $10,000,000 for each of fiscal years 2015 through 
2019.’’. 
SEC. 603. INTEGRATED HEALTH CARE DEMONSTRATION 
PROGRAM. 
Part D of title V of the Public Health Service Act 
(42 U.S.C. 290dd et seq.) is amended by adding at the 
end the following: 
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‘‘SEC. 544. INTERPROFESSIONAL HEALTH CARE TEAMS FOR 
PROVISION OF BEHAVIORAL HEALTH CARE 
IN PRIMARY CARE SETTINGS. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Deputy Assistant Secretary for Minority Health, shall 
award grants to eligible entities for the purpose of pro-
viding technical assistance and training regarding the ef-
fective development and implementation of integrated 
interprofessional health care teams that provide behavioral 
health care. 
‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 
a grant under this section, an entity shall be a federally 
qualified health center (as defined in section 1861(aa) of 
the Social Security Act) serving a high proportion of indi-
viduals from racial and ethnic minority groups (as defined 
in section 1707(g)). 
‘‘(c) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $20,000,000 for each of fiscal years 2014 through 
2016.’’. 
SEC. 604. ADDRESSING RACIAL AND ETHNIC MINORITY 
MENTAL HEALTH DISPARITIES RESEARCH 
GAPS. 
Not later than 6 months after the date of the enact-
ment of this Act, the Director of the National Institute 
on Minority Health and Health Disparities shall enter into 
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an arrangement with the Institute of Medicine (or, if the 
Institute declines to enter into such an arrangement, an-
other appropriate entity)— 
(1) to conduct a study with respect to mental 
and behavioral health disparities in racial and ethnic 
minority groups (as defined in section 1707(g) of 
the Public Health Service Act (42 U.S.C. 300u– 
6(g)); and 
(2) to submit to the Congress a report on the 
results of such study, including— 
(A) a compilation of information on the dy-
namics of mental disorders in such racial and 
ethnic minority groups; 
(B) an identification of gaps in knowledge 
and research needs; and 
(C) recommendations for an interprofes-
sional research agenda at the National Insti-
tutes of Health aimed at reducing and ulti-
mately eliminating mental and behavioral health 
disparities in such racial and ethnic minority 
groups. 
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SEC. 605. HEALTH PROFESSIONS COMPETENCIES TO AD-
DRESS RACIAL AND ETHNIC MINORITY MEN-
TAL HEALTH DISPARITIES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Administrator of the 
Substance Abuse and Mental Health Services Administra-
tion, shall award grants to qualified national organizations 
for the purpose of developing, and disseminating to health 
professional educational programs, curricula or core com-
petencies addressing mental health disparities among ra-
cial and ethnic minority groups. 
(b) USE OF FUNDS.—Organizations receiving funds 
under subsection (a) shall use the funds to develop and 
disseminate curricula or core competencies, as described 
in such subsection, for use in the training of students in 
the professions of social work, psychology, psychiatry, 
marriage and family therapy, mental health counseling, 
and substance abuse counseling. 
(c) ALLOWABLE ACTIVITIES.—Organizations receiv-
ing funds under subsection (a) may use the funds to en-
gage in the following activities related to the development 
and dissemination of curricula or core competencies: 
(1) Formation of committees or working groups 
comprised of experts from accredited health profes-
sions schools to identify core competencies relating 
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to mental health disparities among racial and ethnic 
minority groups. 
(2) Planning of workshops in national fora to 
allow for public input into the educational needs as-
sociated with mental health disparities among racial 
and ethnic minority groups. 
(3) Dissemination and promotion of the use of 
curricula or core competencies in undergraduate and 
graduate health professions training programs na-
tionwide. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘qualified national organization’’ 
means a national organization that focuses on the 
education of students in programs of social work, 
psychology, psychiatry, and marriage and family 
therapy. 
(2) The term ‘‘racial and ethnic minority 
group’’ has the meaning given to such term in sec-
tion 1707(g) of the Public Health Service Act (42 
U.S.C. 300u–6(g)). 
(e) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2014 through 2018. 
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TITLE VII—ADDRESSING HIGH 
IMPACT MINORITY DISEASES 
Subtitle A—Cancer 
SEC. 701. LUNG CANCER MORTALITY REDUCTION. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Lung Cancer Mortality Reduction Act of 2014’’. 
(b) FINDINGS.—Congress makes the following find-
ings: 
(1) Lung cancer is the leading cause of cancer 
death for both men and women, accounting for 28 
percent of all cancer deaths. 
(2) Lung cancer kills more people annually 
than breast cancer, prostate cancer, colon cancer, 
liver cancer, melanoma, and kidney cancer combined. 
(3) Since the National Cancer Act of 1971 
(Public Law 92–218; 85 Stat. 778), coordinated and 
comprehensive research has raised the 5-year sur-
vival rates for breast cancer to 88 percent, for pros-
tate cancer to 99 percent, and for colon cancer to 
64 percent. 
(4) However, the 5-year survival rate for lung 
cancer is still only 15 percent and a similar coordi-
nated and comprehensive research effort is required 
to achieve increases in lung cancer survivability 
rates. 
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(5) Sixty percent of lung cancer cases are now 
diagnosed nonsmokers or former smokers. 
(6) Two-thirds of nonsmokers diagnosed with 
lung cancer are women. 
(7) Certain minority populations, such as Afri-
can-American males, have disproportionately high 
rates of lung cancer incidence and mortality, not-
withstanding their similar smoking rate. 
(8) Members of the baby boomer generation are 
entering their sixties, the most common age at which 
people develop lung cancer. 
(9) Tobacco addiction and exposure to other 
lung cancer carcinogens such as Agent Orange and 
other herbicides and battlefield emissions are serious 
problems among military personnel and war vet-
erans. 
(10) Significant and rapid improvements in 
lung cancer mortality can be expected through great-
er use and access to lung cancer screening tests for 
at-risk individuals. 
(11) Additional strategies are necessary to fur-
ther enhance the existing tests and therapies avail-
able to diagnose and treat lung cancer in the future. 
(12) The August 2001 Report of the Lung 
Cancer Progress Review Group of the National Can-
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404 
cer Institute stated that funding for lung cancer re-
search was ‘‘far below the levels characterized for 
other common malignancies and far out of propor-
tion to its massive health impact’’. 
(13) The Report of the Lung Cancer Progress 
Review Group identified as its ‘‘highest priority’’ the 
creation of integrated, multidisciplinary, multi-insti-
tutional research consortia organized around the 
problem of lung cancer rather than around specific 
research disciplines. 
(14) The United States must enhance its re-
sponse to the issues raised in the Report of the 
Lung Cancer Progress Review Group, and this can 
be accomplished through the establishment of a co-
ordinated effort designed to reduce the lung cancer 
mortality rate by 50 percent by 2015 and targeted 
funding to support this coordinated effort. 
(c) SENSE OF CONGRESS CONCERNING INVESTMENT 
IN LUNG CANCER RESEARCH.—It is the sense of the Con-
gress that— 
(1) lung cancer mortality reduction should be 
made a national public health priority; and 
(2) a comprehensive mortality reduction pro-
gram coordinated by the Secretary of Health and 
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Human Services is justified and necessary to ade-
quately address and reduce lung cancer mortality. 
(d) LUNG CANCER MORTALITY REDUCTION PRO-
GRAM.— 
(1) IN GENERAL.—Subpart 1 of part C of title 
IV of the Public Health Service Act (42 U.S.C. 285 
et seq.) is amended by adding at the end the fol-
lowing: 
‘‘SEC. 417H. LUNG CANCER MORTALITY REDUCTION PRO-
GRAM. 
‘‘(a) IN GENERAL.—Not later than 6 months after 
the date of the enactment of this section, the Secretary, 
in consultation with the Secretary of Defense, the Sec-
retary of Veterans Affairs, the Director of the National 
Institutes of Health, the Director of the Centers for Dis-
ease Control and Prevention, the Commissioner of Food 
and Drugs, the Administrator of the Centers for Medicare 
& Medicaid Services, the Director of the National Institute 
on Minority Health and Health Disparities, and other 
members of the Lung Cancer Advisory Board established 
under section 701 of the Health Equity and Accountability 
Act of 2014, shall implement a comprehensive program, 
to be known as the Lung Cancer Mortality Reduction Pro-
gram, to achieve a reduction of at least 25 percent in the 
mortality rate of lung cancer by 2020. 
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‘‘(b) REQUIREMENTS.—The Program shall include at 
least the following: 
‘‘(1) With respect to the National Institutes of 
Health— 
‘‘(A) a strategic review and prioritization 
by the National Cancer Institute of research 
grants to achieve the goal of the Lung Cancer 
Mortality Reduction Program in reducing lung 
cancer mortality; 
‘‘(B) the provision of funds to enable the 
Airway Biology and Disease Branch of the Na-
tional Heart, Lung, and Blood Institute to ex-
pand its research programs to include pre-
dispositions to lung cancer, the interrelationship 
between lung cancer and other pulmonary and 
cardiac disease, and the diagnosis and treat-
ment of these interrelationships; 
‘‘(C) the provision of funds to enable the 
National Institute of Biomedical Imaging and 
Bioengineering to expedite the development of 
computer-assisted diagnostic, surgical, treat-
ment, and drug-testing innovations to reduce 
lung cancer mortality, such as through expan-
sion of the Institute’s Quantum Grant Program 
and Image-Guided Interventions programs; and 
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‘‘(D) the provision of funds to enable the 
National Institute of Environmental Health 
Sciences to implement research programs rel-
ative to the lung cancer incidence. 
‘‘(2) With respect to the Food and Drug Ad-
ministration— 
‘‘(A) activities under section 530 of the 
Federal Food, Drug, and Cosmetic Act; and 
‘‘(B) activities under section 561 of the 
Federal Food, Drug, and Cosmetic Act to ex-
pand access to investigational drugs and devices 
for the diagnosis, monitoring, or treatment of 
lung cancer. 
‘‘(3) With respect to the Centers for Disease 
Control and Prevention, the establishment of an 
early disease research and management program 
under section 1511. 
‘‘(4) With respect to the Agency for Healthcare 
Research and Quality, the conduct of a biannual re-
view of lung cancer screening, diagnostic, and treat-
ment protocols, and the issuance of updated guide-
lines. 
‘‘(5) The cooperation and coordination of all 
minority and health disparity programs within the 
Department of Health and Human Services to en-
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408 
sure that all aspects of the Lung Cancer Mortality 
Reduction Program under this section adequately 
address the burden of lung cancer on minority and 
rural populations. 
‘‘(6) The cooperation and coordination of all to-
bacco control and cessation programs within agen-
cies of the Department of Health and Human Serv-
ices to achieve the goals of the Lung Cancer Mor-
tality Reduction Program under this section with 
particular emphasis on the coordination of drug and 
other cessation treatments with early detection pro-
tocols.’’. 
(2) FEDERAL
FOOD, DRUG, AND
COSMETIC 
ACT.—Subchapter B of chapter V of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 360aaa et 
seq.) is amended by adding at the end the following: 
‘‘DRUGS RELATING TO LUNG CANCER 
‘‘SEC. 530. (a) IN GENERAL.—The provisions of this 
subchapter shall apply to a drug described in subsection 
(b) to the same extent and in the same manner as such 
provisions apply to a drug for a rare disease or condition. 
‘‘(b) QUALIFIED DRUGS.—A drug described in this 
subsection is— 
‘‘(1) a chemoprevention drug for precancerous 
conditions of the lung; 
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‘‘(2) a drug for targeted therapeutic treat-
ments, including any vaccine, for lung cancer; and 
‘‘(3) a drug to curtail or prevent nicotine addic-
tion. 
‘‘(c) BOARD.—The Board established under the 
Health Equity and Accountability Act of 2014 shall mon-
itor the program implemented under this section.’’. 
(3) ACCESS TO UNAPPROVED THERAPIES.—Sec-
tion 561(e) of the Federal Food, Drug, and Cos-
metic Act (21 U.S.C. 360bbb(e)) is amended by in-
serting before the period the following: ‘‘and shall 
include expanding access to drugs under section 
530, with substantial consideration being given to 
whether the totality of information available to the 
Secretary regarding the safety and effectiveness of 
an investigational drug, as compared to the risk of 
morbidity and death from the disease, indicates that 
a patient may obtain more benefit than risk if treat-
ed with the drug’’. 
(4) CDC.—Title XV of the Public Health Serv-
ice Act (42 U.S.C. 300k et seq.) is amended by add-
ing at the end the following: 
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410 
‘‘SEC. 1511. EARLY DISEASE RESEARCH AND MANAGEMENT 
PROGRAM. 
‘‘The Secretary shall establish and implement an 
early disease research and management program targeted 
at the high incidence and mortality rates of lung cancer 
among minority and low-income populations.’’. 
(e) DEPARTMENT OF DEFENSE AND THE DEPART-
MENT OF VETERANS AFFAIRS.—The Secretary of Defense 
and the Secretary of Veterans Affairs shall coordinate 
with the Secretary of Health and Human Services— 
(1) in the development of the Lung Cancer 
Mortality Reduction Program under section 417H; 
(2) in the implementation within the Depart-
ment of Defense and the Department of Veterans 
Affairs of an early detection and disease manage-
ment research program for military personnel and 
veterans whose smoking history and exposure to car-
cinogens during active duty service has increased 
their risk for lung cancer; and 
(3) in the implementation of coordinated care 
programs for military personnel and veterans diag-
nosed with lung cancer. 
(f) LUNG CANCER ADVISORY BOARD.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall convene a Lung Cancer Advi-
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411 
sory Board (referred to in this section as the 
‘‘Board’’)— 
(A) to monitor the programs established 
under this section (and the amendments made 
by this section); and 
(B) to provide annual reports to the Con-
gress concerning benchmarks, expenditures, 
lung cancer statistics, and the public health im-
pact of such programs. 
(2) COMPOSITION.—The Board shall be com-
posed of— 
(A) the Secretary of Health and Human 
Services; 
(B) the Secretary of Defense; 
(C) the Secretary of Veterans Affairs; and 
(D) two representatives each from the 
fields of clinical medicine focused on lung can-
cer, lung cancer research, imaging, drug devel-
opment, and lung cancer advocacy, to be ap-
pointed by the Secretary of Health and Human 
Services. 
(g) AUTHORIZATION OF APPROPRIATIONS.— 
(1) IN
GENERAL.—To carry out this section 
(and the amendments made by this section), there 
are authorized to be appropriated such sums as may 
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be necessary for each of fiscal years 2015 through 
2019. 
(2) LUNG CANCER MORTALITY REDUCTION PRO-
GRAM.—Of the amounts authorized to be appro-
priated by subsection (a), there are authorized to be 
appropriated— 
(A) $25,000,000 for fiscal year 2015, and 
such sums as may be necessary for each of fis-
cal years 2016 through 2019, for the activities 
described in section 417H(b)(1)(B) of the Pub-
lic Health Service Act, as added by subsection 
(d)(1); 
(B) $25,000,000 for fiscal year 2015, and 
such sums as may be necessary for each of fis-
cal years 2016 through 2019, for the activities 
described in section 417H(b)(1)(C) of such Act; 
(C) $10,000,000 for fiscal year 2015, and 
such sums as may be necessary for each of fis-
cal years 2016 through 2019, for the activities 
described in section 417H(b)(1)(D) of such Act; 
and 
(D) $15,000,000 for fiscal year 2015, and 
such sums as may be necessary for each of fis-
cal years 2016 through 2019, for the activities 
described in section 417H(b)(3) of such Act. 
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SEC. 702. EXPANDING PROSTATE CANCER RESEARCH, OUT-
REACH, SCREENING, TESTING, ACCESS, AND 
TREATMENT EFFECTIVENESS. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Prostate Research, Outreach, Screening, Testing, Access, 
and Treatment Effectiveness Act of 2014’’ or the ‘‘PROS-
TATE Act’’. 
(b) FINDINGS.—Congress makes the following find-
ings: 
(1) Prostate cancer is the second leading cause 
of cancer death among men. 
(2) In 2010, more than 217,730 new patients 
were diagnosed with prostate cancer and more than 
32,000 men died from this disease. 
(3) Roughly 2,000,000 Americans are living 
with a diagnosis of prostate cancer and its con-
sequences. 
(4) While prostate cancer generally affects older 
individuals, younger men are also at risk for the dis-
ease, and when prostate cancer appears in early 
middle age it frequently takes on a more aggressive 
form. 
(5) There are significant racial and ethnic dis-
parities that demand attention, namely African- 
Americans have prostate cancer mortality rates that 
are more than double those in the White population. 
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(6) Underserved rural populations have higher 
rates of mortality compared to their urban counter-
parts, and innovative and cost-efficient methods to 
improve rural access to high quality care should take 
advantage of advances in telehealth to diagnose and 
treat prostate cancer when appropriate. 
(7) Certain veterans populations may have 
nearly twice the incidence of prostate cancer as the 
general population of the United States. 
(8) Urologists may constitute the specialists 
who diagnose and treat the vast majority of prostate 
cancer patients. 
(9) Although much basic and translational re-
search has been completed and much is currently 
known, there are still many unanswered questions. 
For example, it is not fully understood how much of 
known disparities are attributable to disease eti-
ology, access to care, or education and awareness in 
the community. 
(10) Causes of prostate cancer are not known. 
There is not good information regarding how to dif-
ferentiate accurately, early on, between aggressive 
and indolent forms of the disease. As a result, there 
is significant overtreatment in prostate cancer. 
There are no treatments that can durably arrest 
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growth or cure prostate cancer once it has metasta-
sized. 
(11) A significant proportion (roughly 23 to 54 
percent) of cases may be clinically indolent and 
‘‘overdiagnosed’’, resulting in significant overtreat-
ment. More accurate tests will allow men and their 
families to face less physical, psychological, financial, 
and emotional trauma and billions of dollars could 
be saved in private and public health care systems 
in an area that has been identified by the Medicare 
Program as one of eight high-volume, high-cost 
areas in the Resource Utilization Report Program 
authorized by Congress under the Medicare Im-
provements for Patients and Providers Act of 2008. 
(12) Prostate cancer research and health care 
programs across Federal agencies should be coordi-
nated to improve accountability and actively encour-
age the translation of research into practice, to iden-
tify and implement best practices, in order to foster 
an integrated and consistent focus on effective pre-
vention, diagnosis, and treatment of this disease. 
(c) PROSTATE CANCER COORDINATION AND EDU-
CATION.— 
(1) INTERAGENCY PROSTATE CANCER COORDI-
NATION AND EDUCATION TASK FORCE.—Not later 
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than 180 days after the date of the enactment of 
this section, the Secretary of Veterans Affairs, in co-
operation with the Secretary of Defense and the Sec-
retary of Health and Human Services, shall estab-
lish an Interagency Prostate Cancer Coordination 
and Education Task Force (in this section referred 
to as the ‘‘Prostate Cancer Task Force’’). 
(2) DUTIES.—The Prostate Cancer Task Force 
shall— 
(A) develop a summary of advances in 
prostate cancer research supported or con-
ducted by Federal agencies relevant to the diag-
nosis, prevention, and treatment of prostate 
cancer, including psychosocial impairments re-
lated to prostate cancer treatment, and compile 
a list of best practices that warrant broader 
adoption in health care programs; 
(B) consider establishing, and advocating 
for, a guidance to enable physicians to allow 
screening of men who are over age 74, on a 
case-by-case basis, taking into account quality 
of life and family history of prostate cancer; 
(C) share and coordinate information on 
Federal research and health care program ac-
tivities, including activities related to— 
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(i) determining how to improve re-
search and health care programs, including 
psychosocial impairments related to pros-
tate cancer treatment; 
(ii) identifying any gaps in the overall 
research inventory and in health care pro-
grams; 
(iii) identifying opportunities to pro-
mote translation of research into practice; 
and 
(iv) maximizing the effects of Federal 
efforts by identifying opportunities for col-
laboration and leveraging of resources in 
research and health care programs that 
serve those susceptible to or diagnosed 
with prostate cancer; 
(D) develop a comprehensive interagency 
strategy and advise relevant Federal agencies in 
the solicitation of proposals for collaborative, 
multidisciplinary research and health care pro-
grams, including proposals to evaluate factors 
that may be related to the etiology of prostate 
cancer, that would— 
(i) result in innovative approaches to 
study emerging scientific opportunities or 
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‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, shall support the establish-
ment and maintenance of a national chronic and 
acute hepatitis B and hepatitis C surveillance pro-
gram, in order to identify— 
‘‘(A) trends in the incidence of acute and 
chronic hepatitis B and acute and chronic hepa-
titis C; 
‘‘(B) trends in the prevalence of acute and 
chronic hepatitis B and acute and chronic hepa-
titis C infection among groups that may be dis-
proportionately affected; and 
‘‘(C) trends in liver cancer and end-stage 
liver disease incidence and deaths, caused by 
chronic hepatitis B and chronic hepatitis C in 
the high-risk ethnic populations. 
‘‘(2) SEROPREVALENCE
AND
LIVER
CANCER 
STUDIES.—The Secretary, acting through the Direc-
tor of the Centers for Disease Control and Preven-
tion, shall prepare a report outlining the population- 
based seroprevalence studies currently underway, fu-
ture planned studies, the criteria involved in deter-
mining which seroprevalence studies to conduct, 
defer, or suspend, and the scope of those studies, the 
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economic and clinical impact of hepatitis B and hep-
atitis C, and the impact of chronic hepatitis B and 
chronic hepatitis C infections on the quality of life. 
Not later than one year after the date of the enact-
ment of this part, the Secretary shall submit the re-
port to the Committee on Energy and Commerce of 
the House of Representatives and the Committee on 
Health, Education, Labor, and Pensions of the Sen-
ate. 
‘‘(3) CONFIDENTIALITY.—The Secretary shall 
not disclose any individually identifiable information 
identified under paragraph (1) or derived through 
studies under paragraph (2). 
‘‘(d) RESEARCH.—The Secretary, acting through the 
Director of the Centers for Disease Control and Preven-
tion, the Director of the National Cancer Institute, and 
the Director of the National Institutes of Health, shall— 
‘‘(1) conduct epidemiologic and community- 
based research to develop, implement, and evaluate 
best practices for hepatitis B and hepatitis C pre-
vention especially in the ethnic populations with high 
rates of chronic hepatitis B and chronic hepatitis C 
and other high-risk groups; 
‘‘(2) conduct research on hepatitis B and hepa-
titis C natural history, pathophysiology, improved 
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clinical conditions through HIV screening and rapid 
linkage to high quality HIV medical care. 
(2) To reduce new HIV infections among Med-
icaid and Medicare beneficiaries through routine 
HIV testing, prevention services for HIV negative 
beneficiaries, and intensive ‘‘prevention for positive’’ 
services for HIV positive beneficiaries. 
(3) To reduce morbidity, mortality, and high 
cost inpatient and specialty care among HIV positive 
beneficiaries by ensuring access to high quality HIV 
medical care, HIV medications, and support services. 
(4) To promote HIV treatment adherence and 
retention in care through intensive case manage-
ment, treatment education, and outreach services. 
(5) To effectively treat behavioral health condi-
tions among HIV positive beneficiaries that impair 
their HIV treatment adherence and lead to sec-
ondary HIV infections through services funded 
under Medicare and Medicaid and programs admin-
istered by SAMHSA. 
(6) To promote independence, treatment adher-
ence, and stable housing for HIV positive bene-
ficiaries through highly coordinated HIV health, 
housing, and support services funded by HRSA and 
HUD. 
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