,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #affa  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,april #ai1 #bjac ,mr4
 ,israel 7= himself & ,mr4 ,tib]i7      
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d title ,,xviii ( !     
,social ,security ,act to provide       
compreh5sive canc] pati5t treatm5t      
education "u ! ,m$ic>e program & to     
provide = rese>* to improve canc]       
symptom managem5t4  #a4 ,%ort title2    
table ( cont5ts  7a7 ,%ort title ,?is   
,act may be cit$ z ! ,improv+ ,canc]    
,treatm5t ,education ,act ( #bjac4  7b7 
,table ( cont5ts ,! table ( cont5ts (   
?is ,act is z foll[s3  ,sec4 #a4 ,%ort  
title2 table ( cont5ts4 ,sec4 #b4       
,f9d+s4 ,title ,i--,compreh5sive ,canc] 
,pati5t ,treatm5t ,education ,"u !      

,m$ic>e ,program ,sec4 #aja4 ,m$ic>e    
cov]age ( compreh5sive canc] pati5t     
treatm5t education s]vices4 ,title      
,,ii--,rese>* on ,canc] ,symptom        
,managem5t ,improvem5t ,sec4 #bja4 ,s5se
 ( ,congress4 ,sec4 #bjb4 ,,nih ,rese>* 
on canc] symptom managem5t improvem5t4  
#b4 ,f9d+s ,! ,congress makes ! foll[+  
f9d+s3  7#a7 ,_m p ) canc] exp]i5ce side
 effects1 symptoms1 & late complications
 associat$ ) _! disease & _! treatm5t1  
:i* c h a s]i\s adv]se impact on _!     
heal?1 well-be+1 & quality ( life4  7#b7
 ,_m side effects & symptoms associat$ )
 canc] & its treatm5t c be r$uc$ or     
controll$ by ! provision ( timely       
symptom managem5t & s]vices & also by   
educat+ p ) canc] & _! c>egiv]s ab\t !  
pot5tial effects be=e treatm5t beg9s4   
7#c7 ,/udies h f\nd t individualiz$     
educational int]v5tion = canc] pa9      
managem5t f a regi/]$ nurse 0 effective 
= pati5ts ) canc] be+ treat$ 9 outpati5t
 & home-bas$ sett+s4 ,simil>ly1 ! numb] 
( c>egiv]s :o said !y 7 well in=m$ &    

confid5t ab\t c>egiv+ aft] att5d+ a     
family c>egiv] canc] education program  
increas$ aft] program att5dance4  7#d7  
,p ) canc] b5efit f hav+ an educational 
session ) oncology nurses 9 advance ( ! 
initiation ( treatm5t to le>n h[ to     
r$uce ! risk ( & manage adv]se effects &
 maximize well-be+4 ,help+ pati5ts to   
manage _! side effects r$uces adv]se    
ev5ts & ! ne$ = urg5t or inpati5t c>e4  
7#e7 ,! ,oncology ,nurs+ ,society has   
receiv$ reports f its memb]s t1 because 
! ,m$ic>e program & o!r pay]s d n cov] !
 provision ( pati5t treatm5t education1 
pati5ts & _! c>egiv]s (t5 d n receive   
adequate education be=e ! onset ( su*   
pati5ts' treatm5t = canc] reg>d+ ! c\rse
 ( su* treatm5t & ! possible side       
effects & symptoms su* pati5ts may      
exp]i5ce4 ,! ,oncology ,nurs+ ,society  
recomm5ds t all pati5ts be+ treat$ =    
canc] h a "o-on-"o educational session )
 a nurse 9 advance ( ! onset ( su*      
treatm5t s t su* pati5ts & _! c>egiv]s  
receive ! in=mation !y ne$ to help      

m9imize adv]se ev5ts relat$ to su*      
treatm5t & maximize ! well-be+ ( su*    
pati5ts4  7#f7 ,insuffici5t or          
non-exi/5t ,m$ic>e paym5ts c\pl$ ) poor 
inve/m5t 9 symptom managem5t rese>*     
contribute to ! inadequate education (  
pati5ts1 poor managem5t & monitor+ (    
canc] symptoms1 & inadequate h&l+ ( late
 effects ( canc] & its treatm5t4  7#g7  
,p ) canc] (t5 d n h ! symptoms         
associat$ ) _! disease & ! associat$    
treatm5t manag$ 9 a compreh5sive or     
appropriate mann]4  7#h7 ,p ) canc]     
des]ve to h access to compreh5sive c>e t
 includes appropriate treatm5t & symptom
 managem5t4  7#i7 ,pati5ts :o receive   
infus$ *emo!rapy likely obta9 "s        
treatm5t education dur+ ! c\rse ( !     
adm9i/ration ( _! treatm5t2 yet1 _m d n1
 & individuals :o may receive a diff]5t 
type ( canc] c>e1 su* z radiation or    
surgical int]v5tions or oral *emo!rapy  
tak5 at home1 likely d n receive        
treatm5t education dur+ _! treatm5t4    
7#aj7 ,compreh5sive canc] c>e mu/       

include access to s]vices & managem5t   
associat$ ) nausea1 vomit+1 fatigue1    
depression1 pa91 & o!r symptoms4  7#aa7 
,! ,in/itute ( ,m$ic9e report1 ,ensur+  
,quality ,canc] ,c>e ass]ts t mu* c be  
done to relieve ! symptoms1 ease        
di/ress1 provide com=t1 & 9 o!r ways    
improve ! quality ( life ( someone )    
canc]4 ,= a p]son ) canc]1 ma9t5ance (  
quality ( life requires1 at a m9imum1   
relief f pa9 & o!r di/ress+ symptoms1   
relief f anxiety & depressions1 includ+ 
! fe> ( pa91 & a s5se ( security t      
assi/ance w be readily available if     
ne$$44  7#ab7 ,! ,in/itute ( ,m$ic9e    
report1 ,canc] ,c>e = ! ,:ole ,pati5t3  
,meet+ ,psy*osocial ,heal? ,ne$s        
recognizes t canc] pati5ts' psy*osocial 
ne$s include in=mation ab\t _! !rapies &
 ! pot5tial side effects4  7#ac7 ,z m   
?an half ( all canc] diagnoses occur    
among individuals age #fe & old]1 !     
*all5ges ( manag+ canc] symptoms are    
gr[+ = pati5ts enroll$ 9 ! ,m$ic>e      
program4  7#ad7 ,provision ( ,m$ic>e    

paym5t = compreh5sive canc] pati5t      
treatm5t education1 c\pl$ ) exp&$ canc] 
symptom managem5t rese>*1 w help improve
 c>e & quality ( life = p ) canc] f ! "t
 ( diagnosis ?r\gh survivor%ip or end ( 
life4  ,i ,compreh5sive ,canc] ,pati5t  
,treatm5t ,education ,"u ! ,m$ic>e      
,program  #aja4 ,m$ic>e cov]age (       
compreh5sive canc] pati5t treatm5t      
education s]vices  7a7 ,9 g5]al ,section
 #ahfa ( ! ,social ,security ,act 7#db  
,u4,s4,c4 #aciex7 is am5d$--  7#a7 9    
subsection 7s77#b7--  7,a7 by /rik+ & at
 ! end ( subp>agraph 7,,ee72  7,b7 by   
add+ & at ! end ( subp>agraph 7,,ff72 & 
7,c7 by add+ at ! end ! foll[+ new      
subp>agraph3  7,,gg7 compreh5sive canc] 
pati5t treatm5t education s]vices 7z    
def9$ 9 subsection 7iii77#a772  2 &     
7#b7 by add+ at ! end ! foll[+ new      
subsection3  7iii7 ,compreh5sive canc]  
pati5t treatm5t education s]vices  7#a7 
,! t]m compreh5sive canc] pati5t        
treatm5t education s]vices means--  7,a7
 9 ! case ( an individual :o is diagnos$

 ) canc]1 ! provision ( a "o-h\r pati5t 
treatm5t education session deliv]$ by a 
regi/]$ nurse t--  7i7 is furni%$ to !  
individual & ! c>egiv] 7or c>egiv]s7 ( !
 individual 9 advance ( ! onset (       
treatm5t & to ! ext5t practicable1 is n 
furni%$ on ! day ( diagnosis or on !    
fir/ day ( treatm5t2  7ii7 educates !   
individual & su* c>egiv] 7or c>egiv]s7  
to ! greate/ ext5t practicable1 ab\t all
 aspects ( ! c>e to be furni%$ to !     
individual1 in=ms ! individual reg>d+   
any pot5tial symptoms1 side-effects1 or 
adv]se ev5ts1 & expla9s ways 9 :i* side 
effects & adv]se ev5ts c be m9imiz$ &   
heal? & well-be+ maximiz$1 & provides   
guidance reg>d+ ^? side effects to be   
report$ & to :i* heal? c>e provid] !    
side effects %\ld be report$2  7iii7    
includes ! provision1 9 writt5 =m1 (    
in=mation ab\t ! c\rse ( treatm5t1 any  
responsibilities ( ! individual )       
respect to self-dos+1 & ways 9 :i* to   
address symptoms & side-effects2 &  7iv7
 is furni%$1 to ! greate/ ext5t         

practicable1 9 an oral1 writt51 or      
electronic =m t appropriately takes into
 acc\nt cultural & l+ui/ic ne$s ( !     
individual 9 ord] to make ! in=mation   
compreh5sible to ! individual & su*     
c>egiv] 7or c>egiv]s72 &  7,b7 ) respect
 to an individual = :om a c\rse ( canc] 
treatm5t or !rapy is mat]ially modifi$1 
a "o-h\r pati5t treatm5t education      
session describ$ 9 subp>agraph 7,a71    
includ+ updat$ in=mation on ! matt]s    
describ$ 9 su* subp>agraph %\ld !       
individual's oncologic heal? c>e        
pr(essional deem x appropriate &        
necess>y4  7#b7 ,9 e/abli%+ /&>ds to    
c>ry out p>agraph 7#a71 ! ,secret>y %all
 consult ) appropriate organizations    
repres5t+ provid]s ( oncology pati5t    
treatm5t education s]vices &            
organizations repres5t+ p ) canc]4  4   
7b7 ,paym5t ,section #ahcc7;a77#a7 ( su*
 ,act 7#db ,u4,s4,c4 #aciel7a77#a77 is  
am5d$--  7#a7 by /rik+ & be=e 7,z72 &   
7#b7 by ins]t+ be=e ! semicolon at ! end
 ! foll[+3 1 & 7,,aa7 ) respect to      

compreh5sive canc] pati5t treatm5t      
education s]vices 7z def9$ 9 section    
#ahfa7;iii77#a771 #aej p]c5t ( ! paym5t 
rate e/abli%$ "u section #ahdh =        
diabetes outpati5t self-managem5t tra9+ 
s]vices 7z def9$ 9 section #ahfa7qq771  
det]m9$ & appli$ )\t reg>d to any       
co9surance4  7c7 ,cov]age ,section      
#ahfb7;a77#a7 ( su* ,act 7#db ,u4,s4,c4 
#aciey7a77#a77 is am5d$--  7#a7 9       
subp>agraph 7,o71 by /rik+ & at ! end2  
7#b7 9 subp>agraph 7,p71 by /rik+ !     
semicolon at ! end & ins]t+ 1 &2 &  7#c7
 by add+ at ! end ! foll[+ new          
subp>agraph3  7,q7 9 ! case (           
compreh5sive canc] pati5t treatm5t      
education s]vices 7z def9$ 9 subsection 
7iii77#a77 :i* are p]=m$ m frequ5tly ?an
 is cov]$ "u su* section2  4  7d7 ,no   
impact on paym5t = o!r s]vices ,no?+ 9  
?is section %all be con/ru$ to affect or
 o!rwise au?orize any r$uction or       
modification1 9 ! ,m$ic>e paym5t am\nts 
o!rwise e/abli%$ = *emo!rapy infusion or
 injection codes ) respect to !         

calculation & paym5t ( m9utes =         
*emo!rapy tea*+ or relat$ s]vices4  7e7 
,effective date ,! am5dm5ts made by ?is 
section %all apply to s]vices furni%$ on
 or aft] ! fir/ day ( ! fir/ cal5d> ye> 
t beg9s aft] ! date ( ! enactm5t ( ?is  
,act4  ,,ii ,rese>* on ,canc] ,symptom  
,managem5t ,improvem5t  #bja4 ,s5se (   
,congress ,x is ! s5se ( ,congress t--  
7#a7 _m p ) canc] exp]i5ce side effects1
 symptoms1 & late side effects associat$
 ) _! disease & _! treatm5t1 & su*      
effects c h a s]i\s adv]se impact on !  
effectiv5ess ( _! treatm5t1 _! heal?1   
well-be+1 & quality ( life2  7#b7 ) !   
numb] ( canc] survivors cont9u+ to gr[1 
address+ ! effects ( _! symptoms & side 
effects is becom+ increas+ly critical 9 
r$uc+ ! burd5 ( canc] & its treatm5ts2  
7#c7 al?\gh rese>* is produc+ new       
insights into ! causes ( & cures =      
canc]1 ef=ts to manage ! symptoms & side
 effects ( ! disease & its treatm5ts h n
 kept pace2 &  7#d7 ! ,national         
,in/itutes ( ,heal? %\ld cont9ue to     

support rese>* 9 ! area ( symptom       
managem5t & ! role t nurses play 9      
provid+ ^? int]v5tions4  #bjb4 ,,nih    
,rese>* on canc] symptom managem5t      
improvem5t  7a7 ,9 g5]al ,! ,director ( 
! ,national ,in/itutes ( ,heal? %all    
exp&1 int5sify1 & coord9ate programs = !
 conduct & support ( rese>* ) respect   
to--  7#a7 improv+ ! treatm5t &         
managem5t ( symptoms & side effects     
associat$ ) canc] & canc] treatm5t2 &   
7#b7 evaluat+ ! role ( nurs+ int]v5tions
 9 ! amelioration ( su* symptoms & side 
effects4  7b7 ,adm9i/ration ,! ,director
 ( ! ,national ,in/itutes ( ,heal? is   
enc\rag$ to c>ry out ?is section ?r\gh !
 ,director ( ! ,national ,canc]         
,in/itute1 9 collaboration ) at lea/ !  
directors ( ! ,national ,in/itute (     
,nurs+ ,rese>*1 ! ,national ,in/itute ( 
,neurological ,disord]s & ,/roke1 !     
,national ,in/itute ( ,m5tal ,heal?1 !  
,national ,c5t] on ,m9ority ,heal? &    
,heal? ,disp>ities1 ! ,national ,c5t] = 
,complem5t>y & ,alt]native ,m$ic9e1 & ! 

,ag5cy = ,heal?c>e ,rese>* & ,quality4