I 
118TH CONGRESS 
1ST SESSION H. R. 4363 
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 
JUNE 23, 2023 
Ms. WASSERMAN SCHULTZ (for herself, Mr. FITZPATRICK, Mr. DESAULNIER, 
Mr. CARSON, Mr. MFUME, Mr. MOSKOWITZ, and Ms. CLARKE of New 
York) 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 the Workforce, 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 employment assistance program. 
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 cancer fertility services for cancer survivors. 
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, legal, 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, as well as lower socioeconomic status, have dis-
proportionately lower health-related, quality-of-life 
scores compared to non-Hispanic White cancer sur-
vivors. 
(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 
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percent have a severe, disabling, life-threatening, or 
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) 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. 
(10) 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. 
(11) To avoid additional health-related or finan-
cial hardships to cancer survivors and their families, 
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comprehensive and forward-thinking cancer survivor-
ship studies and programs across Federal agencies, 
in collaboration with States, localities, and medical 
and professional organizations, are required to en-
gage in a coordinated effort to improve health out-
comes and quality of life of survivors. 
SEC. 3. DEFINITIONS. 
In this Act: 
(1) CANCER SURVIVOR.—The term ‘‘cancer sur-
vivor’’ means an individual from the time of cancer 
diagnosis through the balance of his or her life. 
(2) CAREGIVER.—The term ‘‘caregiver’’ means 
a family member, friend, or other person who cares 
for an individual with a chronic or disabling condi-
tion, including cancer. 
(3) PATIENT
EXPERIENCE
DATA.—The term 
‘‘patient experience data’’ means patient experiences, 
perspectives, needs, and priorities related to— 
(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; 
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(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 
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. 
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(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 diagnosed with cancer; 
and 
(B) includes a treatment summary and any 
follow-up care guidelines in such plan that— 
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