I 
117TH CONGRESS 
1ST SESSION H. R. 5675 
To amend the Public Health Service Act to provide for and support liver 
illness visibility, education, and research, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 21, 2021 
Ms. VELA´ZQUEZ (for herself, Mr. FITZPATRICK, Mr. ESPAILLAT, and Ms. 
NORTON) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to provide for 
and support liver illness visibility, education, and re-
search, 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. 
This Act may be cited as the ‘‘Liver Illness Visibility, 
Education, and Research Act of 2021’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) Liver cancer is the fastest-growing cause of 
cancer death in the United States and among the 
leading causes of cancer deaths globally. 
(2) The Division of Cancer Control and Popu-
lation Sciences of the National Cancer Institute esti-
mated that there will be 42,230 new liver cancer di-
agnoses in the year 2021, and approximately 30,200 
will die from the disease. 
(3) Liver cancer is a leading cause of cancer 
death among the Asian American and Pacific Is-
lander community. 
(4) The most vulnerable Asian Americans are 
those who are foreign-born, low-income, and living in 
ethnic enclaves. 
(5) Asian and Pacific Islander men and women 
are more than twice as likely to develop liver cancer 
compared to the non-Hispanic White population. 
(6) Among the Asian and Pacific Islander pop-
ulation, the higher incidence rate of liver cancer is 
partially explained by higher incidence rates of hepa-
titis B and diabetes, which are comorbidities shown 
to increase an individual’s risk of developing liver 
cancer. 
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(7) The most common causes of liver cancer in-
clude hepatitis B virus and hepatitis C virus infec-
tion. 
(8) Hepatitis B is a primary risk factor for de-
veloping liver cancer, and 1 in 4 of those chronically 
infected with hepatitis B develop cirrhosis, liver fail-
ure, or liver cancer. 
(9) Half of all individuals with hepatitis B in 
the United States are Asian American or Pacific Is-
lander, though this group accounts for only 5 per-
cent of the population of the United States. 
(10) Among African immigrants in the United 
States, the prevalence of hepatitis B infection is ap-
proximately 1 in 10, and African immigrants make 
up 30 percent of those with chronic hepatitis B in-
fection in the United States. 
(11) Among Hispanic/Latino communities, liver 
cancer incidence and death rates are twice as high 
compared to the non-Hispanic White population. 
(12) Hispanics/Latinos are 60 percent more 
likely to die from viral hepatitis than non-Hispanic 
Whites. 
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SEC. 3. LIVER CANCER AND DISEASE RESEARCH. 
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 following new section: 
‘‘SEC. 417H. LIVER CANCER AND DISEASE RESEARCH. 
‘‘(a) EXPANSION
AND COORDINATION
OF ACTIVI-
TIES.—The Director of the Institute shall expand, inten-
sify, and coordinate the activities of the Institute with re-
spect to research on liver cancer and other liver diseases. 
‘‘(b) PROGRAMS FOR LIVER CANCER.—In carrying 
out subsection (a), the Director of the Institute shall— 
‘‘(1) provide for an expansion and intensifica-
tion of the conduct and support of— 
‘‘(A) basic research concerning the etiology 
and causes of liver cancer; 
‘‘(B) clinical research and related activities 
concerning the causes, prevention, detection, 
and treatment of liver cancer; 
‘‘(C) control programs with respect to liver 
cancer, in accordance with section 412, includ-
ing community-based programs designed to as-
sist members of medically underserved popu-
lations (including women), low-income popu-
lations, or minority groups; and 
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‘‘(D) information and education programs 
with respect to liver cancer, in accordance with 
section 413; 
‘‘(2) issue targeted calls for proposals from re-
search scientists for purposes of funding priority 
areas of liver cancer research; 
‘‘(3) establish a special emphasis panel (as de-
fined by the National Institutes of Health) to review 
any proposal submitted pursuant to paragraph (2); 
and 
‘‘(4) based on reviews by the special emphasis 
panel under paragraph (3), select which proposals to 
fund or support. 
‘‘(c) INTER-INSTITUTE WORKING GROUP.—The Di-
rector of the Institute shall establish an inter-institute 
working group to coordinate research agendas focused on 
finding better outcomes and cures for liver cancer and 
other liver diseases, including hepatitis B and nonalcoholic 
steatohepatitis. 
‘‘(d) GRANTS AND COOPERATIVE AGREEMENTS.— 
‘‘(1) IN GENERAL.—The Secretary may award 
grants and enter into cooperative agreements with 
entities for the purpose of expanding and supporting 
research on— 
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‘‘(A) conditions known to increase an indi-
vidual’s risk of developing a major liver disease, 
such as liver cancer, hepatitis B, hepatitis C, 
nonalcoholic fatty liver disease, nonalcoholic 
steatohepatitis, and cirrhosis of the liver; and 
‘‘(B) opportunities for preventative and di-
agnostic measures for such a disease, including 
the study of molecular pathology and biomark-
ers for early detection of such disease. 
‘‘(2) EXPERIMENTAL
TREATMENT
AND
PRE-
VENTION.—In the case of an entity that is a hospital 
or a health care facility, the Secretary may award a 
grant or enter into a cooperative agreement with 
such an entity for the purpose of supporting an ex-
perimental treatment or prevention program for liver 
cancer carried out by such entity. 
‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
For purposes of carrying out this subsection, there 
is authorized to be appropriated $45,000,000 for 
each of fiscal years 2022 through 2026. Any 
amounts appropriated under this paragraph shall re-
main available until expended.’’. 
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SEC. 4. LIVER CANCER AND DISEASE PREVENTION, AWARE-
NESS, 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. 330O. LIVER CANCER AND DISEASE PREVENTION, 
AWARENESS, 
AND 
PATIENT 
TRACKING 
GRANTS. 
‘‘(a) PREVENTION INITIATIVE GRANT PROGRAM.— 
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Director of the Centers for Disease 
Control and Prevention, may award grants and 
enter into cooperative agreements with entities for 
the purpose of expanding and supporting— 
‘‘(A) prevention activities (including pro-
viding screenings, vaccinations, or other pre-
ventative treatment) for conditions known to in-
crease an individual’s risk of developing a major 
liver disease, such as liver cancer, hepatitis B, 
hepatitis C, nonalcoholic fatty liver disease, 
nonalcoholic steatohepatitis, and cirrhosis of the 
liver; 
‘‘(B) activities relating to surveillance, 
diagnostics, and provision of guidance for indi-
viduals at high risk for contracting liver cancer 
and other liver diseases; and 
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