1209 
(A) the racial disparities in the incidences 
of prostate cancer and mortality rates with re-
spect to such disease; and 
(B) any barriers in access to care and par-
ticipation in clinical trials that are specific to 
racial minorities. 
(6) AUTHORIZATION OF APPROPRIATIONS.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), there is authorized to be appro-
priated 
to 
carry 
out 
this 
subsection, 
$100,000,000 for each of fiscal years 2023 
through 2027. 
(B) 
SPECIFIC
ALLOCATIONS.—Of 
the 
amount authorized to be appropriated under 
subparagraph (A) for each of the fiscal years 
described in such subparagraph— 
(i) no less than 10 percent may be 
used to carry out the grant program under 
paragraph (2); and 
(ii) no more than 1 percent may be 
used to carry out paragraph (4). 
(c) PUBLIC AWARENESS
AND EDUCATION CAM-
PAIGN.— 
(1) NATIONAL CAMPAIGN.—The Secretary shall 
carry out a national campaign to increase the aware-
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ness and knowledge of individuals in the United 
States with respect to the need for prostate cancer 
screening and for improved detection technologies. 
(2) REQUIREMENTS.—The national campaign 
conducted under this subsection shall include— 
(A) roles for the Health Resources Services 
Administration, the Office of Minority Health 
of the Department of Health and Human Serv-
ices, the Centers for Disease Control and Pre-
vention, and the Office of Minority Health and 
Health Equity of the Centers for Disease Con-
trol and Prevention; and 
(B) the development and distribution of 
written educational materials, and the develop-
ment and placing of public service announce-
ments, that are intended to encourage men to 
seek prostate cancer screening and to create 
awareness of the need for improved imaging 
technologies for prostate cancer screening and 
diagnosis, including in vitro blood testing and 
imaging technologies. 
(3) RACIAL
DISPARITIES.—In developing the 
national campaign under paragraph (1), the Sec-
retary shall recognize and address— 
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(A) the racial disparities in the incidences 
of prostate cancer and mortality rates with re-
spect to such disease; and 
(B) any barriers in access to care and par-
ticipation in clinical trials that are specific to 
racial minorities. 
(4) GRANTS.—The Secretary shall establish a 
program to award grants to nonprofit private enti-
ties to enable such entities to test alternative out-
reach and education strategies to increase the 
awareness and knowledge of individuals in the 
United States with respect to the need for prostate 
cancer screening and improved imaging technologies. 
(5) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
this subsection $10,000,000 for each of fiscal years 
2023 through 2027. 
(d) IMPROVING
PROSTATE
CANCER
SCREENING 
BLOOD TESTS.— 
(1) IN GENERAL.—The Secretary, in coordina-
tion with the Secretary of Defense, shall support re-
search to develop an improved prostate cancer 
screening blood test using in-vitro detection. 
(2) AUTHORIZATION
OF
APPROPRIATIONS.— 
There is authorized to be appropriated to carry out 
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this subsection, $20,000,000 for each of fiscal years 
2023 through 2027. 
(e) REPORTING AND COMPLIANCE.— 
(1) REPORT AND STRATEGY.—Not later than 
12 months after the date of the enactment of this 
Act, the Secretary shall submit to Congress a report 
that details the strategy of the Secretary for imple-
menting the requirements of this section and the 
status of such efforts. 
(2) FULL
COMPLIANCE.—Not later than 36 
months after the date of the enactment of this Act, 
and annually thereafter, the Secretary shall submit 
to Congress a report that— 
(A) describes the research and development 
and public awareness and education campaigns 
funded under this section; 
(B) provides evidence that projects involv-
ing high-risk, high impact technologic innova-
tion, proof of concept, and pilot studies are 
prioritized; 
(C) provides evidence that the Secretary 
recognizes and addresses any barriers in access 
to care and participation in clinical trials that 
are specific to racial minorities in the imple-
mentation of this section; 
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(D) contains assurances that all the other 
provisions of this section are fully implemented; 
and 
(E) certifies compliance with the provisions 
of this section, or in the case of a Federal agen-
cy that has not complied with any of such pro-
visions, an explanation as to such failure to 
comply. 
SEC. 7004. PROSTATE CANCER DETECTION RESEARCH AND 
EDUCATION. 
(a) PLAN TO DEVELOP AND VALIDATE A TEST OR 
TESTS FOR PROSTATE CANCER.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the 
‘‘Secretary’’), acting through the Director of the Na-
tional Institutes of Health, shall establish an advi-
sory council on prostate cancer (referred to in this 
section as the ‘‘advisory council’’) to draft a plan for 
the development and validation of an accurate test 
or tests, such as biomarkers or imaging, to detect 
and diagnose prostate cancer. 
(2) ADVISORY COUNCIL.— 
(A) MEMBERSHIP.— 
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(i) FEDERAL
MEMBERS.—The advi-
sory council shall be comprised of the fol-
lowing experts: 
(I) A designee of the Centers for 
Disease Control and Prevention. 
(II) A designee of the Centers for 
Medicare & Medicaid Services. 
(III) A designee of the Office of 
the Director of the National Cancer 
Institute. 
(IV) A designee of the Director 
of the Department of Defense Con-
gressionally Directed Medical Re-
search Programs. 
(V) A designee of the Director of 
the National Institute of Biomedical 
Imaging and Bioengineering. 
(VI) A designee of the Director 
of the National Institute of General 
Medical Sciences. 
(VII) A designee of the Director 
of the National Institute on Minority 
Health and Health Disparities. 
(VIII) A designee of the Director 
of the National Institutes of Health. 
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1216 
(B) MEETINGS.—The advisory council 
shall meet quarterly and such meetings shall be 
open to the public. 
(C) ADVICE.—The advisory council shall 
advise the Secretary, or the Secretary’s des-
ignee. 
(D) ANNUAL REPORT.—Not later than 1 
year after the date of enactment of this Act, the 
advisory council shall provide to the Secretary, 
or the Secretary’s designee, and Congress— 
(i) an initial evaluation of all federally 
funded efforts in prostate cancer research 
relating to the development and validation 
of an accurate test or tests to detect and 
diagnose prostate cancer; 
(ii) a plan for the development and 
validation of a reliable test or tests for the 
detection and accurate diagnosis of pros-
tate cancer; and 
(iii) a set of standards for prostate 
cancer screening, developed in coordination 
with the United States Preventive Services 
Task Force, to ensure that any tools for 
screening, detection, and diagnosis devel-
oped in accordance with the plan under 
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1217 
clause (ii) will meet the requirements of 
the Task Force for recommendation as a 
proven preventive or diagnostic service. 
(E) TERMINATION.—The advisory council 
shall terminate on December 31, 2026. 
(3) FUNDING.—Notwithstanding any other pro-
vision of law, the Secretary may make available 
$1,000,000, from any unobligated amounts appro-
priated to the National Institutes of Health, for each 
of fiscal years 2023 through 2027 to carry out this 
subsection. 
(b) COORDINATION AND INTENSIFICATION OF PROS-
TATE CANCER RESEARCH.— 
(1) IN GENERAL.—The Director of the National 
Institutes of Health, in consultation with the Sec-
retary of Defense, shall coordinate and intensify re-
search in accordance with the plan provided under 
subsection (a)(2)(D)(ii), with particular attention 
provided to leveraging existing research to develop 
and validate a test or tests, such as biomarkers or 
imaging, to detect and accurately diagnose prostate 
cancer in order to improve quality of life for millions 
of individuals in the United States, and decrease 
health care system costs. 
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(2) FUNDING.—Notwithstanding any other pro-
vision of law, the Secretary may make available 
$30,000,000, from any unobligated amounts appro-
priated to the National Institutes of Health, for each 
of fiscal years 2024 through 2028 to carry out this 
subsection. 
SEC. 7005. NATIONAL PROSTATE CANCER COUNCIL. 
(a) NATIONAL PROSTATE CANCER COUNCIL.— 
(1) ESTABLISHMENT.—There is established in 
the Office of the Secretary of Health and Human 
Services (referred to in this section as the ‘‘Sec-
retary’’) the National Prostate Cancer Council on 
Screening, Early Detection, Assessment, and Moni-
toring of Prostate Cancer (referred to in this section 
as the ‘‘Council’’). 
(2) PURPOSE OF THE COUNCIL.—The Council 
shall— 
(A) develop and implement a national stra-
tegic plan for the accelerated creation, advance-
ment, and testing of diagnostic tools to improve 
screening, early detection, assessment, and 
monitoring of prostate cancer, including— 
(i) early detection of aggressive pros-
tate cancer to save lives; 
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1219 
(ii) monitoring of tumor response to 
treatment, including recurrence and pro-
gression; and 
(iii) accurate assessment and surveil-
lance of indolent disease to reduce unnec-
essary biopsies and treatment; 
(B) provide information and coordination 
of prostate cancer research and services across 
all Federal agencies; 
(C) review diagnostic tools and their over-
all effectiveness at screening, detecting, assess-
ing, and monitoring of prostate cancer; 
(D) evaluate all programs in prostate can-
cer that are in existence on the date of enact-
ment of this Act, including Federal budget re-
quests and approvals and public-private part-
nerships; 
(E) submit an annual report to the Sec-
retary and Congress on the creation and imple-
mentation of the national strategic plan under 
subparagraph (A); and 
(F) ensure the inclusion of men at high- 
risk for prostate cancer, including men from 
minority ethnic and racial populations and men 
who are least likely to receive care, in clinical, 
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research, and service efforts, with the purpose 
of decreasing health disparities. 
(3) MEMBERSHIP.— 
(A) FEDERAL
MEMBERS.—The Council 
shall be led by the Secretary or the Secretary’s 
designee and comprised of the following experts: 
(i) Two representatives of the Na-
tional Institutes of Health, including 1 rep-
resentative of the National Institute of 
Biomedical Imaging and Bioengineering 
and 1 representative of the National Can-
cer Institute. 
(ii) A representative of the Centers 
for Disease Control and Prevention. 
(iii) A representative of the Centers 
for Medicare & Medicaid Services. 
(iv) A designee of the Director of the 
Department of Defense Congressionally 
Directed Medical Research Programs. 
(v) A designee of the Director of the 
Office of Minority Health. 
(vi) A representative of the Food and 
Drug Administration. 
(vii) A representative of the Agency 
for Healthcare Research and Quality. 
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(B) NON-FEDERAL
MEMBERS.—In addi-
tion to the members described in subparagraph 
(A), the Council shall include 14 expert mem-
bers from outside the Federal Government, 
which shall include— 
(i) 6 prostate cancer patient advo-
cates, including— 
(I) 2 patient-survivors; 
(II) 2 caregivers of prostate can-
cer patients; and 
(III) 2 representatives from na-
tional prostate cancer disease organi-
zations that fund research or have 
demonstrated experience in providing 
assistance to patients, families, and 
medical professionals, including infor-
mation on health care options, edu-
cation, and referral; and 
(ii) 8 health care stakeholders with 
specific expertise in prostate cancer re-
search in the critical areas of clinical ex-
pertise, including medical oncology, radi-
ology, radiation oncology, urology, and pa-
thology. 
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(4) MEETINGS.—The Council shall meet quar-
terly and meetings shall be open to the public. 
(5) ADVICE.—The Council shall advise the Sec-
retary, or the Secretary’s designee. 
(6) ANNUAL REPORT.—The Council shall sub-
mit annual reports, beginning not later than 1 year 
after the date of enactment of this Act, to the Sec-
retary or the Secretary’s designee and to Congress. 
The annual report shall include— 
(A) in the first year— 
(i) an evaluation of all federally fund-
ed efforts in prostate cancer research and 
gaps relating to the development and vali-
dation of diagnostic tools for prostate can-
cer; and 
(ii) recommendations for priority ac-
tions to expand, eliminate, coordinate, or 
condense programs based on the perform-
ance, mission, and purpose of the pro-
grams; and 
(B) annually thereafter for 5 years— 
(i) an outline for the development and 
implementation of a national research plan 
for creation and validation of accurate di-
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1223 
agnostic tools to improve prostate cancer 
care in accordance with paragraph (1); 
(ii) roles for the National Cancer In-
stitute, National Institute on Minority 
Health and Health Disparities, and the Of-
fice of Minority Health of the Department 
of Health and Human Services; 
(iii) an analysis of the disparities in 
the incidence and mortality rates of pros-
tate cancer in men at high risk of the dis-
ease, including individuals with family his-
tory, increasing age, or African-American 
heritage; and 
(iv) a review of the progress towards 
the realization of the proposed strategic 
plan. 
(7) TERMINATION.—The Council shall termi-
nate on December 31, 2027. 
SEC. 7006. IMPROVED MEDICAID COVERAGE FOR CERTAIN 
BREAST AND CERVICAL CANCER PATIENTS 
IN THE TERRITORIES. 
(a) ELIMINATION OF FUNDING LIMITATIONS.—Sec-
tion 1108(g)(4) of the Social Security Act (42 U.S.C. 
1308(g)(4)) is amended— 
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(1) by striking ‘‘paragraphs (1), (2), (3), and 
(4) of’’; and 
(2) by adding at the end the following: ‘‘With 
respect to fiscal years beginning with fiscal year 
2023, payment for medical assistance for individuals 
who are eligible for such assistance only on the basis 
of section 1902(a)(10)(A)(ii)(XVIII) shall not be 
taken into account in applying subsection (f) (as in-
creased in accordance with this subsection) to Puer-
to Rico, the Virgin Islands, Guam, the Northern 
Mariana Islands, or American Samoa for such fiscal 
year.’’. 
(b) APPLICATION OF ENHANCED FMAP FOR HIGH-
EST STATE.—Section 1905(b) of such Act (42 U.S.C. 
1396d(b)) is amended by adding at the end the following: 
‘‘Notwithstanding the first sentence of this subsection, 
with respect to medical assistance described in clause (4) 
of such sentence that is furnished in Puerto Rico, the Vir-
gin Islands, Guam, the Northern Mariana Islands, or 
American Samoa in a fiscal year, the Federal medical as-
sistance percentage is equal to the highest such percentage 
applied under such clause for such fiscal year for any of 
the 50 States or the District of Columbia that provides 
such medical assistance for any portion of such fiscal 
year.’’. 
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(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to payment for medical assistance 
for items and services furnished on or after October 1, 
2023. 
SEC. 7007. CANCER PREVENTION AND TREATMENT DEM-
ONSTRATION FOR ETHNIC AND RACIAL MI-
NORITIES. 
(a) DEMONSTRATION.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the 
‘‘Secretary’’) shall conduct demonstration projects 
for the purpose of developing models and evaluating 
methods that— 
(A) improve the quality of items and serv-
ices provided to target individuals in order to 
facilitate reduced disparities in early detection 
and treatment of cancer; 
(B) improve clinical outcomes, satisfaction, 
quality of life, appropriate use of items and 
services covered under the Medicare program 
under title XVIII of the Social Security Act (42 
U.S.C. 1395 et seq.), and referral patterns with 
respect to target individuals with cancer; 
(C) eliminate disparities in the rate of pre-
ventive cancer screening measures, such as Pap 
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1226 
smears, prostate cancer screenings, colon and 
colorectal cancer screenings, breast cancer 
screenings, and computed tomography scans, 
for lung cancer among target individuals; 
(D) promote collaboration with community- 
based organizations to ensure cultural com-
petency of health care professionals and lin-
guistic access for target individuals who are 
persons with limited English proficiency; and 
(E) encourage the incorporation of commu-
nity health workers to increase the efficiency 
and appropriateness of cancer screening pro-
grams. 
(2) COMMUNITY HEALTH WORKER DEFINED.— 
In this section, the term ‘‘community health worker’’ 
includes a community health advocate, a lay health 
worker, a community health representative, a peer 
health promoter, a community health outreach work-
er, and a promotore de salud, who promotes health 
or nutrition within the community in which the indi-
vidual resides. 
(3) TARGET
INDIVIDUAL
DEFINED.—In this 
section, the term ‘‘target individual’’ means an indi-
vidual of a racial and ethnic minority group, as de-
fined in section 1707(g)(1) of the Public Health 
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Service Act (42 U.S.C. 300u–6(g)(1)), who is enti-
tled to benefits under part A, and enrolled under 
part B, of title XVIII of the Social Security Act. 
(b) PROGRAM DESIGN.— 
(1) INITIAL DESIGN.—Not later than 1 year 
after the date of the enactment of this Act, the Sec-
retary shall evaluate best practices in the private 
sector, community programs, and academic research 
of methods that reduce disparities among individuals 
of racial and ethnic minority groups in the preven-
tion and treatment of cancer and shall design the 
demonstration projects based on such evaluation. 
(2) NUMBER AND PROJECT AREAS.—Not later 
than 2 years after the date of the enactment of this 
Act, the Secretary shall implement at least 9 dem-
onstration projects, including the following: 
(A) Two projects, each of which shall tar-
get different ethnic subpopulations, for each of 
the 4 following major racial and ethnic minority 
groups: 
(i) American Indians and Alaska Na-
tives, Eskimos, and Aleuts. 
(ii) Asian Americans. 
(iii) Blacks and African Americans. 
(iv) Latinos and Hispanics. 
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(v) Native Hawaiians and other Pa-
cific Islanders. 
(B) One project within the Pacific Islands 
or United States insular areas. 
(C) At least one project in a rural area. 
(D) At least one project in an inner-city 
area. 
(3) EXPANSION
OF
PROJECTS; IMPLEMENTA-
TION OF DEMONSTRATION PROJECT RESULTS.—The 
Secretary shall continue the existing demonstration 
projects and may expand the number of demonstra-
tion projects if the initial report under subsection (c) 
contains 
an 
evaluation 
that 
demonstration 
projects— 
(A) reduce expenditures under the Medi-
care program under title XVIII of the Social 
Security Act (42 U.S.C. 1395 et seq.); or 
(B) do not increase expenditures under 
such Medicare program and reduce racial and 
ethnic health disparities in the quality of health 
care services provided to target individuals and 
increase satisfaction of Medicare beneficiaries 
and health care providers. 
(c) REPORT TO CONGRESS.— 
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(1) IN GENERAL.—Not later than 2 years after 
the date the Secretary implements the initial dem-
onstration projects, and biannually thereafter, the 
Secretary shall submit to Congress a report regard-
ing the demonstration projects. 
(2) CONTENT OF REPORT.—Each report under 
paragraph (1) shall include the following: 
(A) A description of the demonstration 
projects. 
(B) An evaluation of— 
(i) the cost-effectiveness of the dem-
onstration projects; 
(ii) the quality of the health care serv-
ices provided to target individuals under 
the demonstration projects; and 
(iii) beneficiary and health care pro-
vider satisfaction under the demonstration 
projects. 
(C) Any other information regarding the 
demonstration projects that the Secretary de-
termines to be appropriate. 
(d) WAIVER AUTHORITY.—The Secretary shall waive 
compliance with the requirements of title XVIII of the So-
cial Security Act (42 U.S.C. 1395 et seq.) to such extent 
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and for such period as the Secretary determines is nec-
essary to conduct demonstration projects. 
SEC. 7008. REDUCING CANCER DISPARITIES WITHIN MEDI-
CARE. 
(a) DEVELOPMENT OF MEASURES OF DISPARITIES 
IN QUALITY OF CANCER CARE.— 
(1) DEVELOPMENT OF MEASURES.—The Sec-
retary of Health and Human Services (in this sec-
tion referred to as the ‘‘Secretary’’) shall enter into 
an agreement with an entity that specializes in de-
veloping quality measures for cancer care under 
which the entity shall develop a uniform set of meas-
ures to evaluate disparities in the quality of cancer 
care and annually update such set of measures. 
(2) MEASURES TO BE INCLUDED.—Such set of 
measures shall include, with respect to the treatment 
of cancer, measures of patient outcomes, the process 
for delivering medical care related to such treat-
ment, patient counseling and engagement in deci-
sion-making, patient experience of care, resource 
use, and practice capabilities, such as care coordina-
tion. 
(b) ESTABLISHMENT OF REPORTING PROCESS.— 
(1) IN GENERAL.—The Secretary shall establish 
a reporting process that requires and provides for a 
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method for health care providers specified under 
paragraph (2) to submit to the Secretary and make 
public data on the performance of such providers 
during each reporting period through use of the 
measures developed pursuant to subsection (a). Such 
data shall be submitted in a form and manner and 
at a time specified by the Secretary. 
(2) SPECIFICATION OF PROVIDERS TO REPORT 
ON
MEASURES.—The Secretary shall specify the 
classes of Medicare providers of services and sup-
pliers, including hospitals, cancer centers, physi-
cians, primary care providers, and specialty pro-
viders, that will be required under such process to 
publicly report on the measures specified under sub-
section (a). 
(3) ASSESSMENT
OF
CHANGES.—Under such 
reporting process, the Secretary shall establish a for-
mat that assesses changes in both the absolute and 
relative disparities in cancer care over time. These 
measures shall be presented in an easily comprehen-
sible format, such as those presented in the final 
publications relating to Healthy People 2010 or the 
National Healthcare Disparities Report. 
(4) INITIAL IMPLEMENTATION.—The Secretary 
shall implement the reporting process under this 
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subsection for reporting periods beginning not later 
than 6 months after the date that measures are first 
established under subsection (a). 
Subtitle 
B—Viral 
Hepatitis 
and 
Liver Cancer Control and Pre-
vention 
SEC. 7051. VIRAL HEPATITIS AND LIVER CANCER CONTROL 
AND PREVENTION. 
(a) SHORT TITLE.—This section may be cited as the 
‘‘Viral Hepatitis and Liver Cancer Control and Prevention 
Act of 2022’’. 
(b) FINDINGS.—Congress finds the following: 
(1) In the United States, nearly 5,000,000 per-
sons are living with the hepatitis B virus (referred 
to in this section as ‘‘HBV’’) or the hepatitis C virus 
(referred to in this section as ‘‘HCV’’). 
(2) The Centers for Disease Control and Pre-
vention (referred to in this section as the ‘‘CDC’’), 
has recognized HCV as the Nation’s most common 
chronic bloodborne virus infection and HBV as the 
deadliest vaccine-preventable disease. 
(3) HBV is transmitted through contact with 
infectious blood, semen, or other bodily fluids and is 
100 times more infectious than HIV. HCV is trans-
mitted by contact with infectious blood, particularly 
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through percutaneous exposures (such as puncture 
through the skin). 
(4) In the United States, chronic HBV and 
HCV are the most common causes of liver cancer, 
the second deadliest and fastest growing cancer in 
this country. These viruses are the most common 
cause of chronic liver disease, liver cirrhosis, and the 
most common indications for liver transplantation. 
In 2019, nearly 16,000 deaths per year in the 
United States were attributed to chronic HBV and 
HCV. Chronic HCV is also a leading cause of death 
in Americans living with HIV/AIDS, many of those 
living with HIV/AIDS are coinfected with chronic 
HBV, chronic HCV, or both. 
(5) The CDC estimates that in 2019, 57,500 
people in the United States were newly infected with 
HCV and 20,700 people in the United States were 
newly infected with HBV. These estimates could be 
much higher due to many reasons, including lack of 
screening education and awareness, and perceived 
marginalization of the populations at risk. 
(6) The CDC reported a 374 percent increase 
in hepatitis C cases from 2010 to 2017, stemming 
from the opioid, heroin, and overdose epidemics af-
fecting communities nationwide. From 2014 to 
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2015, the number of reported cases of acute hepa-
titis B infection in the United States rose for the 
first time since 2006, increasing by 20.7 percent, 
which is also largely attributable to the opioid epi-
demic. 
(7) HBV and HCV disproportionately affect 
certain populations in the United States. Although 
representing only about 6 percent of the population, 
Asian Americans and Pacific Islanders account for 
half of all chronic HBV cases in the United States. 
Baby boomers (those born between 1945 and 1965) 
account for approximately 75 percent of domestic 
chronic HCV cases. In addition, African Americans, 
Latinos, and American Indian and Native Alaskans 
are among the groups which have disproportionately 
high rates of HBV or HCV infections in the United 
States. 
(8) Liver cancer is a leading cause of cancer 
death among the Asian American and Pacific Is-
lander community. Asian and Pacific Islander men 
and women are more than twice as likely to develop 
liver cancer compared to the non-Hispanic White 
population. The higher incidence rate of liver cancer 
is partially explained by higher incidence rates of 
hepatitis B and diabetes, which are comorbidities 
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shown to increase an individual’s risk of developing 
liver cancer. 
(9) Chronic HBV and chronic HCV usually do 
not cause symptoms early in the course of the dis-
ease, but after many years of a clinically ‘‘silent’’ 
phase, CDC estimates show more than 33 percent of 
infected individuals will develop cirrhosis, end-stage 
liver disease, or liver cancer. Since most individuals 
with chronic HBV, HCV, or both are unaware of 
their infection, they do not know to take precautions 
to prevent the spread of their infection and can un-
knowingly exacerbate their own disease progression. 
For those chronically infected with HBV or HCV, 
regular monitoring can lead to the early detection of 
liver cancer at a stage where a treatment is still pos-
sible. 
(10) For both chronic HBV and chronic HCV, 
behavioral changes and appropriate medical care can 
slow disease progression if diagnosis is made early. 
Early diagnosis, which is determined through simple 
blood tests, can reduce the risk of transmission and 
disease progression through education and vaccina-
tion of household members and other susceptible 
persons at risk. 
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(11) Treatment for chronic HCV can eradicate 
the disease in approximately 90 percent of those cur-
rently treated. While there is no cure for chronic 
HBV, available treatments can effectively suppress 
viral replication in the overwhelming majority of 
those treated, thereby reducing the risk of trans-
mission and progression to liver scarring or liver 
cancer. 
(12) The annual health care costs attributable 
to HBV and HCV in the United States are signifi-
cant. For HBV, it is estimated to be approximately 
$2,500,000,000 ($2,000 per infected person). In 
2000, the lifetime cost of HBV, before the avail-
ability of most current therapies, was approximately 
$80,000 per chronically infected person, totaling 
more than $100,000,000,000. For HCV, medical 
costs for patients are expected to increase from 
$30,000,000,000 in 2009 to over $85,000,000,000 
in 2024. Avoiding these costs by screening and diag-
nosing individuals earlier, and connecting them to 
appropriate treatment and care, will save lives and 
critical health care dollars. Currently, without a 
comprehensive screening, testing, and diagnosis pro-
gram, most patients are diagnosed too late when 
they need a liver transplant costing at least 
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$314,000 for uncomplicated cases or when they have 
liver cancer or end-stage liver disease which costs 
$30,980 to $110,576 per hospital admission. As 
health care costs continue to grow, it is critical that 
the Federal Government invests in effective mecha-
nisms to avoid documented cost drivers. 
(13) In 2021, the Department of Health and 
Human Services released its ‘‘Viral Hepatitis Na-
tional Strategic Plan: A Roadmap for Elimination 
for the United States, 2021–2025’’ (referred to in 
this section as the ‘‘HHS Strategic Plan’’). In 
March 2017, the National Academies of Sciences, 
Engineering, and Medicine released a report enti-
tled, ‘‘A National Strategy for the Elimination of 
Hepatitis B and C: Phase Two Report’’ (referred to 
in this section as the ‘‘NAS report’’), recommending 
specific actions to eliminate viral hepatitis as public 
health problems in the United States by 2030. 
(14) According to the NAS report, chronic 
HBV and HCV infections cause substantial mor-
bidity and mortality despite being preventable and 
treatable. Deficiencies in the implementation of es-
tablished guidelines for the prevention, diagnosis, 
and medical management of chronic HBV and HCV 
infections perpetuate personal and economic bur-
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dens. Existing grants are not sufficient for the scale 
of the health burden presented by HBV and HCV. 
(15) Screening and testing for HBV and HCV 
is aligned with the goals of Healthy People 2030 to 
increase immunization rates, reduce rates of infec-
tious diseases, and improve health for people with 
chronic infections. Awareness of disease and access 
to prevention and treatment remain essential compo-
nents for reducing infectious disease transmission. 
(16) Federal support is necessary to increase 
knowledge and awareness of HBV and HCV and to 
assist State and local prevention and control efforts 
in reducing the morbidity and mortality of these 
epidemics. 
(17) The Secretary of Health and Human Serv-
ices has the discretion to carry out this section (in-
cluding the amendments made by this section) di-
rectly and through whichever of the agencies of the 
Public Health Service the Secretary determines to be 
appropriate, which may (in the Secretary’s discre-
tion) include the Centers for Disease Control and 
Prevention, the Health Resources and Services Ad-
ministration, the Substance Abuse and Mental 
Health Services Administration, the National Insti-
tutes of Health (including the National Institute on 
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Minority Health and Health Disparities), and other 
agencies of such Service. 
(c) BIENNIAL ASSESSMENT OF HHS HEPATITIS B 
AND HEPATITIS C PREVENTION, EDUCATION, RESEARCH, 
AND MEDICAL MANAGEMENT PLAN.—Title III of the 
Public Health Service Act (42 U.S.C. 241 et seq.) is fur-
ther amended— 
(1) by striking section 317N (42 U.S.C. 247b– 
15); and 
(2) by adding after part V the following: 
‘‘PART W—BIENNIAL ASSESSMENT OF HHS HEPA-
TITIS B AND HEPATITIS C PREVENTION, EDU-
CATION, RESEARCH, AND MEDICAL MANAGE-
MENT PLAN 
‘‘SEC. 399OO. BIENNIAL UPDATE OF THE PLAN. 
‘‘(a) IN GENERAL.—The Secretary shall conduct a bi-
ennial assessment of the Secretary’s plan for the preven-
tion, control, and medical management of, and education 
and research relating to, hepatitis B and hepatitis C, for 
the purposes of— 
‘‘(1) incorporating into such plan new knowl-
edge or observations relating to hepatitis B and hep-
atitis C (such as knowledge and observations that 
may be derived from clinical, laboratory, and epide-
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miological research and disease detection, preven-
tion, and surveillance outcomes); 
‘‘(2) addressing gaps in the coverage or effec-
tiveness of the plan; and 
‘‘(3) evaluating and, if appropriate, updating 
recommendations, guidelines, or educational mate-
rials of the Centers for Disease Control and Preven-
tion or the National Institutes of Health for health 
care providers or the public on viral hepatitis in 
order to be consistent with the plan. 
‘‘(b) PUBLICATION OF NOTICE OF ASSESSMENTS.— 
Not later than October 1 of the first even-numbered year 
beginning after the date of the enactment of this part, 
and October 1 of each even-numbered year thereafter, the 
Secretary shall publish in the Federal Register a notice 
of the results of the assessments conducted under sub-
section (a). Such notice shall include— 
‘‘(1) a description of any revisions to the plan 
referred to in subsection (a) as a result of the as-
sessment; 
‘‘(2) an explanation of the basis for any such 
revisions, including the ways in which such revisions 
can reasonably be expected to further promote the 
original goals and objectives of the plan; and 
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‘‘(3) in the case of a determination by the Sec-
retary that the plan does not need revision, an expla-
nation of the basis for such determination. 
‘‘SEC. 399OO–1. ELEMENTS OF PROGRAM. 
‘‘(a) EDUCATION AND AWARENESS PROGRAMS.—The 
Secretary, acting through the Director of the Centers for 
Disease Control and Prevention, the Administrator of the 
Health Resources and Services Administration, and the 
Assistant Secretary for Mental Health and Substance Use, 
and in accordance with the plan referred to in section 
399OO(a), shall implement programs to increase aware-
ness and enhance knowledge and understanding of hepa-
titis B and hepatitis C. Such programs shall include— 
‘‘(1) the conduct of culturally and linguistically 
appropriate health education in primary and sec-
ondary schools, college campuses, public awareness 
campaigns, and community outreach activities (espe-
cially to the ethnic communities with high rates of 
chronic hepatitis B and chronic hepatitis C and 
other high-risk groups) to promote public awareness 
and knowledge about the value of hepatitis A and 
hepatitis B immunization; risk factors, transmission, 
and prevention of hepatitis B and hepatitis C; the 
value of screening for the early detection of hepatitis 
B and hepatitis C; and options available for the 
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treatment of chronic hepatitis B and chronic hepa-
titis C; 
‘‘(2) the promotion of immunization programs 
that increase awareness and access to hepatitis A 
and hepatitis B vaccines for susceptible adults and 
children; 
‘‘(3) the training of health care professionals 
regarding the importance of vaccinating individuals 
infected with hepatitis C and individuals who are at 
risk for hepatitis C infection against hepatitis A and 
hepatitis B; 
‘‘(4) the training of health care professionals 
regarding the importance of vaccinating individuals 
chronically infected with hepatitis B and individuals 
who are at risk for chronic hepatitis B infection 
against the hepatitis A virus; 
‘‘(5) the training of health care professionals 
and health educators to make them aware of the 
high rates of chronic hepatitis B and chronic hepa-
titis C in certain adult ethnic populations, and the 
importance of prevention, detection, and medical 
management of hepatitis B and hepatitis C and of 
liver cancer screening; 
‘‘(6) the development and distribution of health 
education curricula (including information relating 
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to the special needs of individuals infected with or 
at risk of hepatitis B and hepatitis C, such as the 
importance of prevention and early intervention, reg-
ular monitoring, the recognition of psychosocial 
needs, appropriate treatment, and liver cancer 
screening) for individuals providing hepatitis B and 
hepatitis C counseling; and 
‘‘(7) support for the implementation of the cur-
ricula described in paragraph (6) by State and local 
public health agencies. 
‘‘(b) IMMUNIZATION, PREVENTION, AND CONTROL 
PROGRAMS.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, shall support the integra-
tion of activities described in paragraph (3) into ex-
isting clinical and public health programs at State, 
local, territorial, and Tribal levels (including commu-
nity health clinics, programs for the prevention and 
treatment of HIV/AIDS, sexually transmitted infec-
tions, and substance abuse, and programs for indi-
viduals in correctional settings). 
‘‘(2) COORDINATION
OF
DEVELOPMENT
OF 
FEDERAL SCREENING GUIDELINES.— 
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‘‘(A) REFERENCES.—For purposes of this 
subsection, the term ‘CDC Director’ means the 
Director of the Centers for Disease Control and 
Prevention, and the term ‘AHRQ Director’ 
means 
the 
Director 
of 
the 
Agency 
for 
Healthcare Research and Quality. 
‘‘(B) AGENCY
FOR
HEALTHCARE
RE-
SEARCH
AND
QUALITY.—Due to the rapidly 
evolving standard of care associated with diag-
nosing and treating viral hepatitis infection, the 
AHRQ Director shall convene the Preventive 
Services Task Force under section 915(a) to re-
view its recommendation for screening for HBV 
and HCV infection every 3 years. 
‘‘(3) ACTIVITIES.— 
‘‘(A) VOLUNTARY TESTING PROGRAMS.— 
‘‘(i) IN
GENERAL.—The Secretary 
shall establish a mechanism by which to 
support and promote the development of 
State, local, territorial, and Tribal vol-
untary hepatitis B and hepatitis C testing 
programs to screen the high-prevalence 
populations to aid in the early identifica-
tion of chronically infected individuals. 
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‘‘(ii) CONFIDENTIALITY OF THE TEST 
RESULTS.—The Secretary shall prohibit 
the use of the results of a hepatitis B or 
hepatitis C test conducted by a testing pro-
gram developed or supported under this 
subparagraph for any of the following: 
‘‘(I) Issues relating to health in-
surance. 
‘‘(II) To screen or determine 
suitability for employment. 
‘‘(III) To discharge a person 
from employment. 
‘‘(B) COUNSELING REGARDING VIRAL HEP-
ATITIS.—The Secretary shall support State, 
local, territorial, and Tribal programs in a wide 
variety of settings, including those providing 
primary and specialty health care services in 
nonprofit private and public sectors, to— 
‘‘(i) provide individuals with ongoing 
risk factors for hepatitis B and hepatitis C 
infection with client-centered education 
and counseling which concentrates on— 
‘‘(I) promoting testing of individ-
uals that have been exposed to their 
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1246 
blood, family members, and their sex-
ual partners; and 
‘‘(II) changing behaviors that 
place individuals at risk for infection; 
‘‘(ii) provide individuals chronically in-
fected with hepatitis B or hepatitis C with 
education, health information, and coun-
seling to reduce their risk of— 
‘‘(I) dying from end-stage liver 
disease and liver cancer; and 
‘‘(II) transmitting viral hepatitis 
to others; and 
‘‘(iii) provide people chronically in-
fected with hepatitis B or hepatitis C who 
are pregnant or of childbearing age with 
culturally and linguistically appropriate 
health information, such as how to prevent 
hepatitis B perinatal infection, and to al-
leviate fears associated with pregnancy or 
raising a family. 
‘‘(C) IMMUNIZATION.—The Secretary shall 
support State, local, territorial, and Tribal ef-
forts to expand the current vaccination pro-
grams to protect every child in the Nation and 
all susceptible adults, particularly those infected 
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with hepatitis C and high-prevalence ethnic 
populations and other high-risk groups, from 
the risks of acute and chronic hepatitis B infec-
tion by— 
‘‘(i) ensuring continued funding for 
hepatitis B vaccination for all children 18 
years of age or younger through the Vac-
cines for Children program; 
‘‘(ii) ensuring that the recommenda-
tions of the Advisory Committee on Immu-
nization Practices of the Centers for Dis-
ease Control and Prevention are followed 
regarding hepatitis B vaccination for in-
fants, children, and adults; 
‘‘(iii) requiring proof of hepatitis B 
vaccination for entry into public or private 
daycare, preschool, elementary school, sec-
ondary school, and institutions of higher 
education; 
‘‘(iv) expanding the availability of 
hepatitis B vaccination for all adults to 
protect them from becoming acutely or 
chronically infected, including ethnic and 
other populations with high prevalence 
rates of chronic hepatitis B infection; 
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‘‘(v) expanding the availability of hep-
atitis B vaccination for all adults, particu-
larly those of reproductive age (women and 
men less than 45 years of age), to protect 
them from the risk of hepatitis B infection; 
‘‘(vi) ensuring the vaccination of indi-
viduals infected, or at risk for infection, 
with hepatitis C against hepatitis A, hepa-
titis B, and other infectious diseases, as 
appropriate, for which such individuals 
may be at increased risk; and 
‘‘(vii) ensuring the vaccination of indi-
viduals infected, or at risk for infection, 
with hepatitis B against hepatitis A virus 
and other infectious diseases, as appro-
priate, for which such individuals may be 
at increased risk. 
‘‘(D) MEDICAL REFERRAL.—The Secretary 
shall support State, local, territorial, and Tribal 
programs that support— 
‘‘(i) referral of persons chronically in-
fected with hepatitis B or hepatitis C— 
‘‘(I) for medical evaluation to de-
termine 
the 
appropriateness 
for 
antiviral treatment to reduce the risk 
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of progression to cirrhosis and liver 
cancer; and 
‘‘(II) for ongoing medical man-
agement including regular monitoring 
of liver function and screening for 
liver cancer; and 
‘‘(ii) referral of persons infected with 
acute or chronic hepatitis B infection or 
acute or chronic hepatitis C infection for 
drug and alcohol abuse treatment where 
appropriate. 
‘‘(4) INCREASED SUPPORT FOR ADULT VIRAL 
HEPATITIS PREVENTION COORDINATORS.—The Sec-
retary, acting through the CDC Director, shall pro-
vide increased support to adult viral hepatitis pre-
vention coordinators in State, local, territorial, and 
Tribal health departments in order to enhance the 
additional management, networking, and technical 
expertise needed to ensure successful integration of 
hepatitis B and hepatitis C prevention and control 
activities into existing public health programs. 
‘‘(c) EPIDEMIOLOGICAL SURVEILLANCE.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, shall support the establish-
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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 
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. 
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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 Health, Education, Labor, 
and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representa-
tives. 
‘‘(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 
treatments and prevention (such as the hepatitis C 
vaccine), and noninvasive tests that help to predict 
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the risk of progression to liver cirrhosis and liver 
cancer; 
‘‘(3) conduct research that will lead to better 
noninvasive or blood tests to screen for liver cancer, 
and more effective treatments of liver cancer caused 
by chronic hepatitis B and chronic hepatitis C; and 
‘‘(4) conduct research comparing the effective-
ness of screening, diagnostic, management, and 
treatment approaches for chronic hepatitis B, chron-
ic hepatitis C, and liver cancer in the affected com-
munities. 
‘‘(e) UNDERSERVED AND DISPROPORTIONATELY AF-
FECTED POPULATIONS.—In carrying out this section, the 
Secretary shall provide expanded support for individuals 
with limited access to health education, testing, and health 
care services and groups that may be disproportionately 
affected by hepatitis B and hepatitis C. 
‘‘(f) EVALUATION
OF PROGRAM.—The Secretary 
shall develop benchmarks for evaluating the effectiveness 
of the programs and activities conducted under this sec-
tion and make determinations as to whether such bench-
marks have been achieved. 
‘‘SEC. 399OO–2. GRANTS. 
‘‘(a) IN GENERAL.—The Secretary may award grants 
to, or enter into contracts or cooperative agreements with, 
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States, political subdivisions of States, territories, Indian 
Tribes, or nonprofit entities that have special expertise re-
lating to hepatitis B, hepatitis C, or both, to carry out 
activities under this part. 
‘‘(b) APPLICATION.—To be eligible for a grant, con-
tract, or cooperative agreement under subsection (a), an 
entity shall prepare and submit to the Secretary an appli-
cation at such time, in such manner, and containing such 
information as the Secretary may require. 
‘‘SEC. 399OO–3. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There are authorized to be appropriated to carry out 
this part $90,000,000 for fiscal year 2023, $90,000,000 
for fiscal year 2023, $110,000,000 for fiscal year 2024, 
$130,000,000 for fiscal year 2025, and $150,000,000 for 
fiscal year 2026.’’. 
SEC. 7052. LIVER CANCER AND DISEASE PREVENTION, 
AWARENESS, 
AND 
PATIENT 
TRACKING 
GRANTS. 
Subpart I of part D of title III of the Public Health 
Service Act (42 U.S.C. 254b et seq.) is amended by adding 
at the end the following new section: 
‘‘SEC. 330Q. LIVER CANCER AND DISEASE PREVENTION, 
AWARENESS, 
AND 
PATIENT 
TRACKING 
GRANTS. 
‘‘(a) PREVENTION INITIATIVE GRANT PROGRAM.— 
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section (f) to supplement public engage-
ment carried out by the Committee under 
subparagraph (C). 
(C) PUBLIC ENGAGEMENT.— 
(i) IN
GENERAL.—The Committee 
shall, throughout the process of carrying 
out the duties of the Committee described 
in subsection (d)— 
(I) meaningfully engage with rel-
evant stakeholders, particularly— 
(aa) members and represent-
atives of environmental justice 
communities; 
(bb) environmental justice 
advocates; and 
(cc) individuals with exper-
tise in cumulative impacts and 
geospatial data; and 
(II) ensure that the input of the 
stakeholders described in subclause (I) 
is central to the activities of the Com-
mittee. 
(ii) PLAN.— 
(I) IN
GENERAL.—In carrying 
out clause (i), the Committee shall de-
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velop a plan, in consultation with the 
advisory council, for comprehensive 
public engagement with, and incorpo-
ration of feedback from, environ-
mental justice advocates and members 
of environmental justice communities. 
(II) STRATEGIES TO OVERCOME 
BARRIERS
TO
PUBLIC
ENGAGE-
MENT.—The plan developed under 
subclause (I) shall include strategies 
to overcome barriers to public engage-
ment, including— 
(aa) language barriers; 
(bb) transportation barriers; 
(cc) economic barriers; and 
(dd) lack of internet access. 
(III) CONSIDERATION.—In devel-
oping the plan under subclause (I), 
the Committee shall consider the di-
verse and varied experiences of envi-
ronmental justice communities relat-
ing to the scope and types of environ-
mental hazards and socioeconomic in-
justices. 
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