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Question: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Independent Contractor Tax
Simplification Act of 1995''.

SEC. 2. FINDINGS.

The Congress finds that:
(1) Simplifying the tax rules with respect to independent
contractors was the top vote-getter at the 1995 White House
Conference on Small Business. Conference delegates recommended
that Congress ''should recognize the legitimacy of an
independent contractor''. The Conference found that the current
common law is ''too subjective'' and called upon the Congress
to establish ''realistic and consistent guidelines''.
(2) It is in the best interests of taxpayers and the
Federal Government to have fair and objective rules for
determining who is an employee and who is an independent
contractor.

SEC. 3. STANDARDS FOR DETERMINING WHETHER INDIVIDUALS ARE NOT
EMPLOYEES.

(a) In General.--Chapter 25 of the Internal Revenue Code of 1986
(general provisions relating to employment taxes) is amended by adding
after section 3510 the following new section:

''SEC. 3511. STANDARDS FOR DETERMINING WHETHER INDIVIDUALS ARE NOT
EMPLOYEES.

''(a) General Rule.--For purposes of this subtitle, and
notwithstanding any provision of this subtitle to the contrary, if the
requirements of subsections (b), (c), and (d) are met with respect to
any service performed by any individual, then with respect to such
service--
''(1) the service provider shall not be treated as an
employee,
''(2) the service recipient shall not be treated as an
employer, and
''(3) the payor shall not be treated as an employer.
''(b) Service Provider Requirements With Regard to Service
Recipient.--For the purposes of subsection (a), the requirements of
this subsection are met if the service provider, in connection with
performing the service--
''(1) has a significant investment in assets and/or
training,
''(2) incurs significant unreimbursed expenses,
''(3) agrees to perform the service for a particular amount
of time or to complete a specific result and is liable for
damages for early termination without cause,
''(4) is paid primarily on a commissioned basis, or
''(5) purchases products for resale.
''(c) Additional Service Provider Requirements With Regard to
Others.--For the purposes of subsection (a), the requirements of this
subsection are met if--
''(1) the service provider--
''(A) has a principal place of business,
''(B) does not primarily provide the service in the
service recipient's place of business, or
''(C) pays a fair market rent for use of the
service recipient's place of business; or
''(2) the service provider--
''(A) is not required to perform service
exclusively for the service recipient, and
''(B) in the year involved, or in the preceding or
subsequent year--
''(i) has performed a significant amount of
service for other persons,
''(ii) has offered to perform service for
other persons through--
''(I) advertising,
''(II) individual written or oral
solicitations,
''(III) listing with registries,
agencies, brokers, and other persons in
the business of providing referrals to
other service recipients, or
''(IV) other similar activities, or
''(iii) provides service under a business
name which is registered with (or for which a
license has been obtained from) a State, a
political subdivision of a State, or any agency
or instrumentality of 1 or more States or
political subdivisions.
''(d) Written Document Requirements.--For purposes of subsection
(a), the requirements of this subsection are met if the services
performed by the individual are performed pursuant to a written
contract between such individual and the person for whom the services
are performed, or the payor, and such contract provides that the
individual will not be treated as an employee with respect to such
services for purposes of this subtitle.
''(e) Special Rules.--For purposes of this section--
''(1) If for any taxable year any service recipient or
payor fails to meet the applicable reporting requirements of
sections 6041(a), 6041A(a), or 6051 with respect to a service
provider, then, unless such failure is due to reasonable cause
and not willful neglect, this section shall not apply in
determining whether such service provider shall not be treated
as an employee of such service recipient or payor for such
year.
''(2) If the service provider is performing services
through an entity owned in whole or in part by such service
provider, then the references to 'service provider' in
subsections (b) through (d) may include such entity, provided
that the written contract referred to in paragraph (1) of
subsection (d) may be with either the service provider or such
entity and need not be with both.
''(f) Definitions.--For the purposes of this section--
''(1) Service provider.--The term 'service provider' means
any individual who performs service for another person.
''(2) Service recipient.--Except as provided in paragraph
(5), the term 'service recipient' means the person for whom the
service provider performs such service.
''(3) Payor.--Except as provided in paragraph (5), the term
'payor' means the person who pays the service provider for the
performance of such service in the event that the service
recipients do not pay the service provider.
''(4) In connection with performing the service.--The term
'in connection with performing the service' means in connection
or related to--
''(A) the actual service performed by the service
provider for the service recipients or for other
persons for whom the service provider has performed
similar service, or
''(B) the operation of the service provider's trade
or business.
''(5) Exceptions.--The terms 'service recipient' and
'payor' do not include any entity which is owned in whole or in
part by the service provider.''
(b) Clerical Amendment.--The table of sections for chapter 25 of
such Code is amended by adding at the end the following new item:

''Sec. 3511. Standards for determining
whether individuals are not
employees.''
(c) Effective Date.--The amendments made by this Act shall apply to
services performed after December 31, 1995.

Answer: Independent Contractor Tax Simplification Act of 1995 - Amends the Internal Revenue Code to provide that, for purposes of determining the employment status of individuals as employees, a service provider shall not be treated as an employee, a service recipient shall not be treated as an employer, and a payor shall not be treated as an employer if: (1) a service provider has a significant investment in assets and training, incurs significant unreimbursed expenses, agrees to perform the service for a specified amount of time or to complete a specific result and is responsible for damages for early termination without cause, receives payment primarily on a commission basis, or has purchased resale products; (2) the service provider has a principal place of business, does not primarily provide service in the service recipient's place of business, or pays a fair market rent for use of the recipient's place of business or does not have to perform service only for the service recipient and, in the current year or in the proceeding or subsequent years, has performed or has offered to perform a significant amount of service for other persons; and (3) the services by an individual are performed according to a written contract between the service recipient or payor which provides that the individual will not be treated as an employee.

Question: SECTION 1. SHORT TITLE.

This Act may be cited as the ''End-User Protection Act of 2014''.

SEC. 2. DEFINITIONS.

(a) In General.--Section 1a of the Commodity Exchange Act (7 U.S.C.
1a) is amended--
(1) by redesignating paragraphs (8) through (51) as
paragraphs (9) through (52), respectively;
(2) by inserting after paragraph (7) the following:
''(8) Commercial market participant.--The term 'commercial
market participant' means any producer, processor, merchant, or
commercial user of an exempt or agricultural commodity, or the
products or by-products of an exempt or agricultural
commodity.'';
(3) in subparagraph (B) of paragraph (48) (as so
redesignated), by striking clause (ii) and inserting the
following:
''(ii) any purchase or sale of a
nonfinancial commodity or security for deferred
shipment or delivery, so long as the
transaction is intended to be physically
settled, including any stand-alone or embedded
option for which exercise would result in a
physical delivery obligation;''; and
(4) in paragraph (50) (as redesignated by paragraph (1)),
by striking subparagraph (D) and inserting the following:
''(D) De minimis exception.--
''(i) In general.--The Commission shall
exempt from designation as a swap dealer an
entity that engages in a de minimis quantity of
swap dealing (which shall not be less than
$8,000,000,000) in connection with transactions
with or on behalf of its customers.
''(ii) Regulations.--The Commission shall
promulgate regulations to establish the factors
to be used in a determination under clause (i)
to exempt, including any monetary or other
levels established by the Commission, and those
levels shall only be amended or changed through
an affirmative action of the Commission
undertaken by rule or regulation.''.
(b) Financial Entity.--Section 2(h)(7)(C) of the Commodity Exchange
Act (7 U.S.C. 2(h)(7)(C)) is amended--
(1) in clause (iii)--
(A) by striking ''an entity whose'' and inserting
the following: ''an entity--
''(I) whose'';
(B) by striking the period at the end and inserting
a semicolon; and
(C) by adding at the end the following:
''(II) that is--
''(aa) a commercial market
participant;
''(bb) included in clause
(i)(VIII); and
''(cc) not supervised by a
prudential regulator; or
''(III) that is included in clause
(i)(VIII) because--
''(aa) the entity regularly
enters into foreign exchange or
derivatives transactions on
behalf of, or to hedge or
mitigate, whether directly or
indirectly, the commercial risk
of 1 or more entities within
the same commercial enterprise
as the entity; or
''(bb) of the making of
loans to 1 or more entities
within the same commercial
enterprise as the entity.'';
and
(2) by adding at the end the following:
''(iv) Same commercial enterprise.--For
purposes of clause (iii)(III), an entity shall
be considered to be within the same commercial
enterprise as another entity if--
''(I) 1 of the entities owns,
directly or indirectly, at least a
majority ownership interest in the
other entity and reports its financial
statements on a consolidated basis and
the consolidated financial statements
include the financial results of both
entities; or
''(II) a third party owns at least
a majority ownership interest in both
entities and reports its financial
statements on a consolidated basis and
the financial statements of the third
party include the financial results of
both entities.
''(v) Predominantly engaged.--
''(I) In general.--Not later than
90 days after the date of enactment of
this clause, the Commission shall
promulgate regulations defining the
term 'predominantly engaged' for
purposes of clause (i)(VIII).
''(II) Minimum revenues.--The
regulations shall provide that an
entity shall not be considered to be
predominantly engaged in activities
that are in the business of banking or
financial in nature if the consolidated
revenues of the entity derived from the
activities constitute less than a
percentage (as specified by the
Commission in the regulations) of the
total consolidated revenues of the
entity.
''(III) Revenues from banking or
financial activities.--In determining
the percentage of the revenues of an
entity that are derived from activities
that are in the business of banking or
financial in nature, the regulations
shall exclude all revenues that are or
result from foreign exchange or
derivatives transactions used to hedge
or mitigate commercial risk (as defined
by the Commission in the
regulations).''.

SEC. 3. REPORTING OF ILLIQUID SWAPS SO AS TO NOT DISADVANTAGE CERTAIN
NON-FINANCIAL END USERS.

Section 2(a)(13) of the Commodity Exchange Act (7 U.S.C. 2(a)(13))
is amended--
(1) in subparagraph (C), by striking ''The Commission'' and
inserting ''Except as provided in subparagraph (D), the
Commission'';
(2) by redesignating subparagraphs (D) through (G) as
subparagraphs (E) through (H), respectively; and
(3) by inserting after subparagraph (C) the following:
''(D) Requirements for swap transactions in
illiquid markets.--
''(i) Definition of illiquid markets.--In
this subparagraph, the term 'illiquid markets'
means any market in which the volume and
frequency of trading in swaps is at such a
level as to allow identification of individual
market participants.
''(ii) Requirements.--Notwithstanding
subparagraph (C), the Commission shall--
''(I) provide by rule for the
public reporting of swap transactions,
including price and volume data, in
illiquid markets that are not cleared
and entered into by a nonfinancial
entity that is hedging or mitigating
commercial risk in accordance with
subsection (h)(7)(A); and
''(II) ensure that the swap
transaction information described in
subclause (I) is available to the
public not sooner than 30 days after
the swap transaction has been executed
or at such later date as the Commission
determines appropriate to protect the
identity of participants and positions
in illiquid markets and to prevent the
elimination or reduction of market
liquidity.''.

SEC. 4. TREATMENT OF AFFILIATES.

Section 2(h)(7)(D)(i) of the Commodity Exchange Act (7 U.S.C.
2(h)(7)(D)(i)) is amended--
(1) by striking ''An affiliate'' and inserting ''A person
that is a financial entity and is an affiliate'';
(2) by striking ''(including affiliate entities
predominantly engaged in providing financing for the purchase
of the merchandise or manufactured goods of the person)''; and
(3) by striking ''and as an agent''.

SEC. 5. APPLICABILITY TO BONA FIDE HEDGE TRANSACTIONS OR POSITIONS.

Section 4a(c) of the Commodity Exchange Act (7 U.S.C. 6a(c)) is
amended--
(1) in the second sentence of paragraph (1), by striking
''into the future for which'' and inserting ''in the future, to
be determined by the Commission, for which either an
appropriate swap is available or''; and
(2) in paragraph (2)--
(A) in the matter preceding subparagraph (A), by
striking ''subsection (a)(2)'' and all that follows
through ''position that--'' and inserting ''paragraphs
(2) and (5) of subsection (a) for swaps, contracts of
sale for future delivery, or options on the contracts
or commodities, a bona fide hedging transaction or
position is a transaction or position that--''; and
(B) in subparagraph (A)(ii), by striking ''of
risks'' and inserting ''or management of current or
anticipated risks''; and
(3) by adding at the end the following:
''(3) Commission definition.--The Commission may further
define, by rule or regulation, what constitutes a bona fide
hedging transaction or position so long as the rule or
regulation is consistent with the requirements of subparagraphs
(A) and (B) of paragraph (2).''.

SEC. 6. REPORTING AND RECORDKEEPING.

Section 4g(f) of the Commodity Exchange Act (7 U.S.C. 6g(f)) is
amended--
(1) by striking ''(f) Nothing contained in this section''
and inserting the following:
''(f) Authority of Commission To Make Separate Determinations
Unimpaired.--
''(1) In general.--Except as provided in paragraph (2),
nothing in this section''; and
(2) by adding at the end the following:
''(2) Exception.--If the Commission imposes any requirement
under this section on any person that is not registered, or
required to be registered, with the Commission in any capacity,
that person shall satisfy the requirements of any rule, order,
or regulation under this section by maintaining a written
record of each cash or forward transaction related to a
reportable or hedging commodity interest transaction, futures
contract, option on a futures contract, or swap.
''(3) Sufficiency.--A written record described in paragraph
(2) shall be sufficient if the written record--
''(A) memorializes the final agreement between the
parties, including the material economic terms of the
transaction; and
''(B) is identifiable and searchable by
transaction.''.

SEC. 7. MARGIN REQUIREMENTS.

(a) Commodity Exchange Act Amendment.--Section 4s(e) of the
Commodity Exchange Act (7 U.S.C. 6s(e)) is amended by adding at the end
the following:
''(4) Applicability with respect to counterparties.--The
requirements of paragraphs (2)(A)(ii) and (2)(B)(ii), including
the initial and variation margin requirements imposed by rules
adopted pursuant to paragraphs (2)(A)(ii) and (2)(B)(ii), shall
not apply to a swap in which a counterparty qualifies for an
exception under section 2(h)(7)(A) or 2(h)(7)(D), or an
exemption issued under section 4(c)(1) from the requirements of
section 2(h)(1)(A) for cooperative entities as defined in that
exemption.''.
(b) Securities Exchange Act Amendment.--Section 15F(e) of the
Securities Exchange Act of 1934 (15 U.S.C. 78o-10(e)) is amended by
adding at the end the following:
''(4) Applicability with respect to counterparties.--The
requirements of paragraphs (2)(A)(ii) and (2)(B)(ii) shall not
apply to a security-based swap in which a counterparty
qualifies for an exception under section 3C(g)(1) or satisfies
the criteria in section 3C(g)(4).''.
(c) Implementation.--The amendments made by this section to the
Commodity Exchange Act (7 U.S.C. 1 et seq.) shall be implemented--
(1) without regard to--
(A) chapter 35 of title 44, United States Code; and
(B) the notice and comment provisions of section
553 of title 5, United States Code;
(2) through the promulgation of an interim final rule,
pursuant to which public comment is sought before a final rule
is issued; and
(3) such that paragraph (1) shall apply solely to changes
to rules and regulations, or proposed rules and regulations,
that are limited to and directly a consequence of the
amendments.

SEC. 8. ANALYSIS BY THE COMMODITY FUTURES TRADING COMMISSION OF THE
COSTS AND BENEFITS OF REGULATIONS AND ORDERS.

Section 15(a) of the Commodity Exchange Act (7 U.S.C. 19(a)) is
amended by striking paragraphs (1) and (2) and inserting the following:
''(1) In general.--Before promulgating a regulation under
this Act or issuing an order (except as provided in paragraph
(3)), the Commission, acting through the Office of the Chief
Economist, shall--
''(A) state a justification for the regulation or
order;
''(B) state the baseline for the cost-benefit
analysis and explain how the regulation or order
measures costs against the baseline;
''(C) assess the costs and benefits, both
qualitative and quantitative, of the intended
regulation or order;
''(D) measure, and seek to improve, the actual
results of regulatory requirements; and
''(E) propose or adopt a regulation or order only
on a reasoned determination that the benefits of the
intended regulation or order justify the costs of the
intended regulation or order (recognizing that some
benefits and costs are difficult to quantify).
''(2) Considerations.--In making a reasoned determination
of costs and benefits under paragraph (1), the Commission shall
consider--
''(A) the protection of market participants and the
public;
''(B) the efficiency, competitiveness, and
financial integrity of futures and swaps markets;
''(C) the impact on market liquidity in the futures
and swaps markets;
''(D) price discovery;
''(E) sound risk management practices;
''(F) the cost of available alternatives to direct
regulation;
''(G) the degree and nature of the risks posed by
various activities within the scope of the jurisdiction
of the Commission;
''(H) whether, consistent with obtaining regulatory
objectives, the regulation or order is tailored to
impose the least burden on society, including market
participants, individuals, businesses of differing
sizes, and other entities (including small communities
and governmental entities), taking into account, to the
extent practicable, the cumulative costs of regulations
and orders;
''(I) whether the regulation or order is
inconsistent, incompatible, or duplicative of other
Federal regulations and orders; and
''(J) whether, in choosing among alternative
regulatory approaches, those approaches maximize net
benefits (including potential economic, environmental,
and other benefits, distributive impacts, and
equity).''.

Answer: End-User Protection Act of 2014 - Amends the Commodity Exchange Act with respect to exceptions to the requirement that any swap be cleared by a derivatives clearing organization either registered under that Act, or exempted from registration, if the swap is required to be cleared. Revises the definition of a financial entity subject to such requirement to exclude one that: (1) is a commercial market participant predominantly engaged in activities in the business of banking, or in activities that are financial in nature, but is not supervised by a prudential regulator; or (2) is considered as predominantly engaged in activities in the business of banking or in financial activities because it regularly enters into foreign exchange or derivatives transactions on behalf of, or to hedge or mitigate the commercial risk of, one or more other entities within the entity's same commercial enterprise, or because of making loans to one or more of such other entities. Directs the Commodity Futures Trading Commission (CFTC) to provide by rule for the public reporting of swap transactions, including price and volume data, in illiquid markets that are not cleared and entered into by a nonfinancial entity that is hedging or mitigating commercial risk. Defines "illiquid" as any market in which the volume and frequency of trading in swaps is at such a level as to allow identification of individual market participants. Requires the CFTC to ensure that such swap transaction information is not available to the public until 30 days after the transaction has been executed, or at an appropriate later date, in order to: (1) protect the identity of participants and positions in illiquid markets, and (2) prevent the elimination or reduction of market liquidity. Accords financial entities exempt from swap-clearing requirements the same treatment as exempted affiliates. Revises the exemption of bona fide hedge transactions or positions from certain trading limitations to set criteria for CFTC rules or regulations treating swaps, contracts of sale for future delivery, or options on the contracts or commodities as bona fide hedge transactions or positions also exempt from those limitations. Declares that, if the CFTC imposes any reporting and recordkeeping requirement on any person that is not registered, or required to be registered, with the CFTC, that person shall satisfy the requirements of any pertinent rule, order, or regulation by maintaining a written record of each cash or forward transaction related to a reportable or hedging commodity interest transaction, futures contract, option on a futures contract, or swap. Makes such a written record sufficient if it: (1) memorializes the final agreement between the parties, including the transaction's material economic terms; and (2) is identifiable and searchable by transaction. States that certain requirements for adoption of rules governing capital and margin requirements for swap dealers and major swap participants, including the initial and variation margin requirements imposed by rules adopted according to such requirements, shall not apply to a swap in which a counterparty qualifies for specified exceptions or exemptions. Revises requirements for a CFTC cost-benefit analysis made before an order is issued. Requires the CFTC, acting through the Office of the Chief Economist, among other things to: state a justification for the regulation or order; state the baseline for the cost-benefit analysis and explain how the regulation or order measures costs against the baseline; assess the costs and benefits, both qualitative and quantitative, of the intended regulation or order; measure, and seek to improve, the actual results of regulatory requirements; and propose or adopt a regulation or order only on a reasoned determination that the benefits of the intended regulation or order justify its costs.

Question: SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title.--This Act may be cited as the ''Improving Cancer
Treatment Education Act of 2013''.
(b) Table of Contents.--The table of contents of this Act is as
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
TITLE I--COMPREHENSIVE CANCER PATIENT TREATMENT EDUCATION UNDER THE
MEDICARE PROGRAM

Sec. 101. Medicare coverage of comprehensive cancer patient treatment
education services.
TITLE II--RESEARCH ON CANCER SYMPTOM MANAGEMENT IMPROVEMENT

Sec. 201. Sense of Congress.
Sec. 202. NIH Research on cancer symptom management improvement.

SEC. 2. FINDINGS.

The Congress makes the following findings:
(1) Many people with cancer experience side effects,
symptoms, and late complications associated with their disease
and their treatment, which can have a serious adverse impact on
their health, well-being, and quality of life.
(2) Many side effects and symptoms associated with cancer
and its treatment can be reduced or controlled by the provision
of timely symptom management and services and also by educating
people with cancer and their caregivers about the potential
effects before treatment begins.
(3) Studies have found that individualized educational
intervention for cancer pain management from a registered nurse
was effective for patients with cancer being treated in
outpatient and home-based settings. Similarly, the number of
caregivers who said they were well informed and confident about
caregiving after attending a family caregiver cancer education
program increased after program attendance.
(4) People with cancer benefit from having an educational
session with oncology nurses in advance of the initiation of
treatment to learn how to reduce the risk of and manage adverse
effects and maximize well-being. Helping patients to manage
their side effects reduces adverse events and the need for
urgent or inpatient care.
(5) The Oncology Nursing Society has received reports from
its members that, because the Medicare program and other payers
do not cover the provision of patient treatment education,
patients and their caregivers often do not receive adequate
education before the onset of such patients' treatment for
cancer regarding the course of such treatment and the possible
side effects and symptoms such patients may experience. The
Oncology Nursing Society recommends that all patients being
treated for cancer have a one-on-one educational session with a
nurse in advance of the onset of such treatment so that such
patients and their caregivers receive the information they need
to help minimize adverse events related to such treatment and
maximize the well-being of such patients.
(6) Insufficient or non-existent Medicare payments coupled
with poor investment in symptom management research contribute
to the inadequate education of patients, poor management and
monitoring of cancer symptoms, and inadequate handling of late
effects of cancer and its treatment.
(7) People with cancer often do not have the symptoms
associated with their disease and the associated treatment
managed in a comprehensive or appropriate manner.
(8) People with cancer deserve to have access to
comprehensive care that includes appropriate treatment and
symptom management.
(9) Patients who receive infused chemotherapy likely obtain
some treatment education during the course of the
administration of their treatment; yet, many do not, and
individuals who may receive a different type of cancer care,
such as radiation or surgical interventions or oral
chemotherapy taken at home, likely do not receive treatment
education during their treatment.
(10) Comprehensive cancer care must include access to
services and management associated with nausea, vomiting,
fatigue, depression, pain, and other symptoms.
(11) The Institute of Medicine report, ''Ensuring Quality
Cancer Care'' asserts that ''much can be done to relieve the
symptoms, ease distress, provide comfort, and in other ways
improve the quality of life of someone with cancer. For a
person with cancer, maintenance of quality of life requires, at
a minimum, relief from pain and other distressing symptoms,
relief from anxiety and depressions, including the fear of
pain, and a sense of security that assistance will be readily
available if needed.''.
(12) The Institute of Medicine report, ''Cancer Care for
the Whole Patient: Meeting Psychosocial Health Needs''
recognizes that cancer patients' psychosocial needs include
information about their therapies and the potential side
effects.
(13) As more than half of all cancer diagnoses occur among
individuals age 65 and older, the challenges of managing cancer
symptoms are growing for patients enrolled in the Medicare
program.
(14) Provision of Medicare payment for comprehensive cancer
patient treatment education, coupled with expanded cancer
symptom management research, will help improve care and quality
of life for people with cancer from the time of diagnosis
through survivorship or end of life.

TITLE I--COMPREHENSIVE CANCER PATIENT TREATMENT EDUCATION UNDER THE
MEDICARE PROGRAM

SEC. 101. MEDICARE COVERAGE OF COMPREHENSIVE CANCER PATIENT TREATMENT
EDUCATION SERVICES.

(a) In General.--Section 1861 of the Social Security Act (42 U.S.C.
1395x) is amended--
(1) in subsection (s)(2)--
(A) by striking ''and'' at the end of subparagraph
(EE);
(B) by adding ''and'' at the end of subparagraph
(FF); and
(C) by adding at the end the following new
subparagraph:
''(GG) comprehensive cancer patient treatment education
services (as defined in subsection (iii)(1));''; and
(2) by adding at the end the following new subsection:

''Comprehensive Cancer Patient Treatment Education Services

''(iii)(1) The term 'comprehensive cancer patient treatment
education services' means--
''(A) in the case of an individual who is diagnosed with
cancer, the provision of a one-hour patient treatment education
session delivered by a registered nurse that--
''(i) is furnished to the individual and the
caregiver (or caregivers) of the individual in advance
of the onset of treatment and to the extent
practicable, is not furnished on the day of diagnosis
or on the first day of treatment;
''(ii) educates the individual and such caregiver
(or caregivers) to the greatest extent practicable,
about all aspects of the care to be furnished to the
individual, informs the individual regarding any
potential symptoms, side-effects, or adverse events,
and explains ways in which side effects and adverse
events can be minimized and health and well-being
maximized, and provides guidance regarding those side
effects to be reported and to which health care
provider the side effects should be reported;
''(iii) includes the provision, in written form, of
information about the course of treatment, any
responsibilities of the individual with respect to
self-dosing, and ways in which to address symptoms and
side-effects; and
''(iv) is furnished, to the greatest extent
practicable, in an oral, written, or electronic form
that appropriately takes into account cultural and
linguistic needs of the individual in order to make the
information comprehensible to the individual and such
caregiver (or caregivers); and
''(B) with respect to an individual for whom a course of
cancer treatment or therapy is materially modified, a one-hour
patient treatment education session described in subparagraph
(A), including updated information on the matters described in
such subparagraph should the individual's oncologic health care
professional deem it appropriate and necessary.
''(2) In establishing standards to carry out paragraph (1), the
Secretary shall consult with appropriate organizations representing
providers of oncology patient treatment education services and
organizations representing people with cancer.''.
(b) Payment.--Section 1833(a)(1) of such Act (42 U.S.C.
1395l(a)(1)) is amended--
(1) by striking ''and'' before ''(Z)''; and
(2) by inserting before the semicolon at the end the
following: '', and (AA) with respect to comprehensive cancer
patient treatment education services (as defined in section
1861(iii)(1)), 150 percent of the payment rate established
under section 1848 for diabetes outpatient self-management
training services (as defined in section 1861(qq)), determined
and applied without regard to any coinsurance''.
(c) Coverage.--Section 1862(a)(1) of such Act (42 U.S.C.
1395y(a)(1)) is amended--
(1) in subparagraph (O), by striking ''and'' at the end;
(2) in subparagraph (P), by striking the semicolon at the
end and inserting '', and''; and
(3) by adding at the end the following new subparagraph:
''(Q) in the case of comprehensive cancer patient treatment
education services (as defined in subsection (iii)(1)) which
are performed more frequently than is covered under such
section;''.
(d) No Impact on Payment for Other Services.--Nothing in this
section shall be construed to affect or otherwise authorize any
reduction or modification, in the Medicare payment amounts otherwise
established for chemotherapy infusion or injection codes with respect
to the calculation and payment of minutes for chemotherapy teaching or
related services.
(e) 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--RESEARCH ON CANCER SYMPTOM MANAGEMENT IMPROVEMENT

SEC. 201. SENSE OF CONGRESS.

It is the sense of Congress that--
(1) many people with cancer experience side effects,
symptoms, and late side effects associated with their disease
and their treatment, and such effects can have a serious
adverse impact on the effectiveness of their treatment, their
health, well-being, and quality of life;
(2) with the number of cancer survivors continuing to grow,
addressing the effects of their symptoms and side effects is
becoming increasingly critical in reducing the burden of cancer
and its treatments;
(3) although research is producing new insights into the
causes of and cures for cancer, efforts to manage the symptoms
and side effects of the disease and its treatments have not
kept pace; and
(4) the National Institutes of Health should continue to
support research in the area of symptom management and the role
that nurses play in providing those interventions.

SEC. 202. NIH RESEARCH ON CANCER SYMPTOM MANAGEMENT IMPROVEMENT.

(a) In General.--The Director of the National Institutes of Health
shall expand, intensify, and coordinate programs for the conduct and
support of research with respect to--
(1) improving the treatment and management of symptoms and
side effects associated with cancer and cancer treatment; and
(2) evaluating the role of nursing interventions in the
amelioration of such symptoms and side effects.
(b) Administration.--The Director of the National Institutes of
Health is encouraged to carry out this section through the Director of
the National Cancer Institute, in collaboration with at least the
directors of the National Institute of Nursing Research, the National
Institute of Neurological Disorders and Stroke, the National Institute
of Mental Health, the National Center on Minority Health and Health
Disparities, the National Center for Complementary and Alternative
Medicine, and the Agency for Healthcare Research and Quality.

Answer:
Improving Cancer Treatment Education Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act to extend Medicare coverage to comprehensive cancer patient treatment education services, including a one-hour patient treatment education session delivered, in advance of treatment, by a registered nurse to an individual diagnosed with cancer (or whose course of treatment has been materially modified). Amends the Public Health Service Act to require the Director of the National Institutes of Health (NIH) to expand, intensify, and coordinate research programs to: (1) improve the treatment and management of symptoms and side effects associated with cancer and cancer treatment, and (2) evaluate the role of nursing interventions in the amelioration of such symptoms and side effects.