I 
112TH CONGRESS 
1ST SESSION H. R. 3705 
To amend title XVIII of the Social Security Act to provide for coverage 
of comprehensive cancer care planning under the Medicare Program 
and to improve the care furnished to individuals diagnosed with cancer 
by establishing grants programs for provider education, and related re-
search. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 16, 2011 
Mrs. CAPPS (for herself and Mr. BOUSTANY) 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 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 amend title XVIII of the Social Security Act to provide 
for coverage of comprehensive cancer care planning 
under the Medicare Program and to improve the care 
furnished to individuals diagnosed with cancer by estab-
lishing grants programs for provider education, and re-
lated research. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
This Act may be cited as the ‘‘Comprehensive Cancer 
Care Improvement Act of 2011’’. 
Sec. 1. Short title; Table of contents. 
Sec. 2. Findings. 
TITLE I—COMPREHENSIVE CANCER CARE UNDER THE 
MEDICARE PROGRAM 
Sec. 101. Coverage of cancer care planning services. 
TITLE II—PROVIDER EDUCATION REGARDING PALLIATIVE CARE 
AND SYMPTOM MANAGEMENT 
Sec. 201. Grants to improve health professional education. 
Sec. 202. Grants to improve continuing professional education. 
TITLE III—RESEARCH ON TOPICS RELATED TO COORDINATION 
OF CARE, SYMPTOM MANAGEMENT, AND PALLIATIVE CARE 
FOR CANCER PATIENTS 
Sec. 301. Research program. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) Individuals with cancer often do not have 
access to a cancer care system that provides com-
prehensive and coordinated care of high quality. 
(2) The cancer care system has not traditionally 
offered individuals with cancer a prospective and 
comprehensive plan for treatment and symptom 
management, strategies for updating and evaluating 
such plan with the assistance of a health care pro-
fessional, and a follow-up plan for monitoring and 
treating possible late effects of cancer and its treat-
ment. 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
(3) Cancer survivors often experience the 
under-diagnosis and under-treatment of the symp-
toms of cancer, a problem that begins at the time 
of diagnosis and may become more severe with dis-
ease progression and at the end of life. The failure 
to treat the symptoms, side effects, and late effects 
of cancer and cancer treatment may have a serious 
adverse impact on the health, survival, well-being, 
and quality of life of cancer survivors. 
(4) Cancer survivors who are members of racial 
and ethnic minority groups may face severe obsta-
cles in receiving coordinated cancer care that in-
cludes appropriate management of cancer symptoms 
and treatment side effects. 
(5) Individuals with cancer are sometimes not 
provided information about their disease and treat-
ment options that might result in their request for 
and engagement in coordinated care that includes 
appropriate treatment and symptom management. 
(6) Comprehensive cancer care should incor-
porate access to psychosocial services and manage-
ment of the symptoms of cancer and the symptoms 
of cancer treatment, including pain, nausea, vom-
iting, fatigue, and depression. 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
(7) Comprehensive cancer care should include a 
means for providing cancer survivors with a com-
prehensive care summary and a plan for follow-up 
care after primary treatment to ensure that cancer 
survivors have access to follow-up monitoring and 
treatment of possible late effects of cancer and can-
cer treatment. 
(8) The Institute of Medicine report entitled 
‘‘Ensuring Quality Cancer Care’’ described the ele-
ments of quality care for an individual with cancer, 
including— 
(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. 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
(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) Since more than half of all cancer diag-
noses occur among elderly Medicare beneficiaries, 
the problems of providing cancer care are problems 
of the Medicare program. 
(11) Shortcomings in providing cancer care, re-
sulting in inadequate management of cancer symp-
toms and insufficient monitoring and treatment of 
late effects of cancer and its treatment, are related 
to problems of Medicare payments for such care, in-
adequate professional training, and insufficient in-
vestment in research on symptom management. 
(12) Changes in Medicare payment for com-
prehensive cancer care, enhanced public and profes-
sional education regarding symptom management, 
and more research related to coordination of care, 
symptom management and palliative care will en-
hance patient decisionmaking about treatment op-
tions and will contribute to improved care for indi-
viduals with cancer from the time of diagnosis of the 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
individual through the end of the life of the indi-
vidual. 
TITLE I—COMPREHENSIVE CAN-
CER CARE UNDER THE MEDI-
CARE PROGRAM 
SEC. 101. COVERAGE OF CANCER CARE PLANNING SERV-
ICES. 
(a) IN GENERAL.—Section 1861 of the Social Secu-
rity Act is amended— 
(1) in subsection (s)(2)— 
(A) by striking ‘‘and’’ at the end of sub-
paragraph (EE); 
(B) by adding ‘‘and’’ at the end of sub-
paragraph (FF); and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(GG) comprehensive cancer care planning 
services (as defined in subsection (iii));’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘COMPREHENSIVE CANCER CARE PLANNING SERV-
ICES 
‘‘(iii)(1) The term ‘comprehensive cancer care plan-
ning services’ means— 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
‘‘(A) with respect to an individual who is 
diagnosed with cancer, the development of a 
plan of care that— 
‘‘(i) details, to the greatest extent 
practicable, all aspects of the care to be 
provided to the individual, with respect to 
the treatment of such cancer, including 
any curative treatment, comprehensive 
symptom management, and palliative care; 
‘‘(ii) is furnished, in person, in written 
form, to the individual within a period 
specified by the Secretary that is as soon 
as practicable after the date on which the 
individual is so diagnosed; 
‘‘(iii) is furnished, to the greatest ex-
tent practicable, in a form that appro-
priately takes into account cultural and 
linguistic needs of the individual in order 
to make the plan accessible to the indi-
vidual; and 
‘‘(iv) is in accordance with standards 
determined by the Secretary to be appro-
priate; 
‘‘(B) with respect to an individual for 
whom a plan of care has been developed under 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
subparagraph (A), the revision of such plan of 
care as necessary to account for any substantial 
change in the condition of the individual, recur-
rence of disease, or significant revision of the 
elements of curative or palliative care for the 
individual, if such revision— 
‘‘(i) is in accordance with clauses (i), 
(iii), and (iv) of such subparagraph; and 
‘‘(ii) is furnished in written form to 
the individual within a period specified by 
the Secretary that is as soon as practicable 
after the date of such revision; 
‘‘(C) with respect to an individual who has 
completed the primary treatment for cancer, as 
defined by the Secretary (such as the comple-
tion of chemotherapy or radiation treatment), 
the development of a follow-up cancer care plan 
that— 
‘‘(i) describes the elements of the pri-
mary treatment, including symptom man-
agement and palliative care, furnished to 
such individual; 
‘‘(ii) provides recommendations for 
the subsequent care of the individual with 
respect to the cancer involved; 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
‘‘(iii) is furnished, in person, in writ-
ten form, to the individual within a period 
specified by the Secretary that is as soon 
as practicable after the completion of such 
primary treatment; 
‘‘(iv) is furnished, to the greatest ex-
tent practicable, in a form that appro-
priately takes into account cultural and 
linguistic needs of the individual in order 
to make the plan accessible to the indi-
vidual; and 
‘‘(v) is in accordance with standards 
determined by the Secretary to be appro-
priate; and 
‘‘(D) with respect to an individual for 
whom a follow-up cancer care plan has been de-
veloped under subparagraph (C), the revision of 
such plan as necessary to account for any sub-
stantial change in the condition of the indi-
vidual, diagnosis of a second cancer, or signifi-
cant revision of the plan for follow-up care, if 
such revision— 
‘‘(i) is in accordance with clauses (i), 
(ii), (iv), and (v) of such subparagraph; 
and 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
‘‘(ii) is furnished in written form to 
the individual within a period specified by 
the Secretary that is as soon as practicable 
after the date of such revision. 
‘‘(2) The Secretary shall establish standards to 
carry out paragraph (1) in consultation with appro-
priate organizations representing providers of serv-
ices related to cancer treatment and organizations 
representing survivors of cancer. Such standards 
shall include standards for determining the need and 
frequency for revisions of the plans of care and fol-
low-up plans based on changes in the condition of 
the individual or elements and intent of treatment 
and standards for the communication of the plan to 
the patient.’’. 
(b) PAYMENT.—Section 1833(a)(1) of the Social Se-
curity Act (42 U.S.C. 1395l(a)(1)) is amended by striking 
‘‘and’’ before ‘‘(Z)’’ and inserting before the semicolon at 
the end the following: ‘‘, and (AA) with respect to com-
prehensive cancer care planning services described in any 
of subparagraphs (A) through (D) of section 1861(iii)(1), 
the amount paid shall be an amount equal to the sum of 
(i) the national average amount under the physician fee 
schedule established under section 1848 for a new patient 
office consultation of the highest level of service in the 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
non-facility setting, and (ii) the national average amount 
under such fee schedule for a physician certification de-
scribed in section 1814(a)(2) for home health services fur-
nished to an individual by a home health agency under 
a home health plan of care’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to services furnished on or after 
the first day of the first calendar year that begins after 
the date of the enactment of this Act. 
TITLE 
II—PROVIDER 
EDU-
CATION REGARDING PALLIA-
TIVE CARE AND SYMPTOM 
MANAGEMENT 
SEC. 201. GRANTS TO IMPROVE HEALTH PROFESSIONAL 
EDUCATION. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall make grants to eligible entities to 
enable the entities to improve the quality of graduate and 
postgraduate training of physicians, nurses, and other 
health care providers in developing cancer care plans for 
cancer patients and communicating such plans to the indi-
vidual patients. 
(b) APPLICATION.—To seek a grant under this sec-
tion, an eligible entity shall submit an application at such 
time, in such manner, and containing such information as 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
the Secretary may require. At a minimum, the Secretary 
shall require that each such application demonstrate— 
(1) the ability to train health professionals in— 
(A) the provision of cancer care that fully 
coordinates active treatment, symptom manage-
ment, and palliative care; and 
(B) the communication of a written plan 
for coordinated cancer care to the patient; and 
(2) the ability to collect and analyze data re-
lated to the effectiveness of such training programs. 
(c) EVALUATION.—The Secretary shall develop and 
implement a plan for evaluating the effects of the training 
programs funded under this section. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘eligible entity’’ means an entity 
that is a— 
(A) cancer center (including an NCI-des-
ignated cancer center); 
(B) academic health center; 
(C) physician practice; 
(D) school of nursing; 
(E) visiting nurse association; 
(F) home care agency; or 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
(G) a private non-profit organization with 
expertise and experience in health provider 
training. 
(2) The term ‘‘NCI-designated cancer center’’ 
means a cancer center receiving funds through a 
P30 Cancer Center Support Grant of the National 
Cancer Institute. 
(3) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
(e) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
$5,000,000 for each of the fiscal years 2012 through 
2016. 
SEC. 202. GRANTS TO IMPROVE CONTINUING PROFES-
SIONAL EDUCATION. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall make grants to eligible entities to 
improve the quality of continuing professional education 
provided to qualified individuals regarding the develop-
ment and communication of written cancer care plans that 
outline a system of care that coordinates active treatment 
and palliative care. 
(b) APPLICATION.—To seek a grant under this sec-
tion, an eligible entity shall submit an application at such 
time, in such manner, and containing such information as 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
the Secretary may require. At a minimum, the Secretary 
shall require that each such application demonstrate— 
(1) experience in sponsoring continuing profes-
sional education programs; 
(2) the ability to reach health care providers 
and other professionals who are engaged in cancer 
care with such continuing professional education 
programs; 
(3) the capacity to develop innovative training 
programs aimed at enhancing the delivery of coordi-
nated cancer care that includes appropriate symp-
tom management and palliative care; and 
(4) the ability to evaluate the effectiveness of 
such professional education and training programs. 
(c) EVALUATION.—The Secretary shall develop and 
implement a plan for evaluating the effects of the con-
tinuing professional education and training programs 
funded under this section. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘eligible entity’’ means an entity 
that is a— 
(A) cancer center (including an NCI-des-
ignated cancer center); 
(B) academic health center; 
(C) school of nursing; 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
(D) professional society that supports con-
tinuing professional education programs; or 
(E) private non-profit organization with 
expertise and experience in health provider 
training. 
(2) The term ‘‘NCI-designated cancer center’’ 
means a cancer center receiving funds through a 
P30 Cancer Center Support Grant of the National 
Cancer Institute. 
(3) The term ‘‘qualified individual’’ means a 
physician, nurse, social worker, chaplain, psycholo-
gist, or other individual who is involved in providing 
comprehensive cancer care, including active treat-
ment, symptom management, and palliative care, to 
cancer patients. 
(4) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
(e) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
$5,000,000 for each of the fiscal years 2012 through 
2016. 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS
TITLE III—RESEARCH ON TOP-
ICS RELATED TO COORDINA-
TION 
OF 
CARE, 
SYMPTOM 
MANAGEMENT, AND PALLIA-
TIVE CARE FOR CANCER PA-
TIENTS 
SEC. 301. RESEARCH PROGRAM. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall provide investment, through exist-
ing research programs, for research on topics related to 
cancer care planning, cancer care coordination, symptom 
management, palliative care, and comprehensive survivor-
ship care 
(b) In carrying out the research authorized under this 
section, the Secretary should provide for the participation 
of institutes and centers of the National Institutes of 
Health, the Centers for Medicare & Medicaid Services, and 
any other national research institute that has been en-
gaged in research described in subsection (a). 
(c) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
$5,000,000 for each of the fiscal years 2012 through 
2016. 
Æ 
VerDate Mar 15 2010 
20:26 Dec 23, 2011
Jkt 019200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6301
E:\BILLS\H3705.IH
H3705
jlentini on DSK4TPTVN1PROD with BILLS