,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #chce  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,july #ah1 #bjai,mr4  
,de,saulnier 7= himself & ,mr4 ,c>t] (  
,georgia7 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 = cov]age ( canc] c>e plann+ &  
coord9ation "u ! ,m$ic>e program4  #a4  
,%ort title  7a7 ,%ort title ,?is ,act  
may be cit$ z ! ,canc] ,c>e ,plann+ &   
,communications ,act ( #bjai4  7b7      
,f9d+s ,congress makes ! foll[+ f9d+s3  
7#a7 ,canc] c>e 9 ! ,unit$ ,/ates is (t5
 describ$ z ! be/ 9 ! _w because pati5ts
 h access to _m treatm5t options1       
includ+ cutt+-edge !rapies t save lives 
& improve ! quality ( life4  7#b7       
,access to ! be/ treatm5t options is n  

equal across all populations & 9 all    
communities4 ,! #aiii ,in/itute (       
,m$ic9e report entitl$ ,! ,unequal      
,burd5 ( ,canc] f\nd t l[-income p (t5  
lack access to adequate canc] c>e & t   
e?nic m9orities h n b5efitt$ fully f    
canc] treatm5t advances4  7#c7 ,9       
addition1 despite access to high-quality
 treatm5t options = _m1 individuals )   
canc] (t5 d n h access to a canc] c>e   
sy/em t incorporates %>$ decision mak+ &
 ! coord9ation ( all elem5ts ( c>e4     
7#d7 ,canc] survivors (t5 exp]i5ce !    
"u-diagnosis & "u-treatm5t ( ! symptoms 
( canc] & side effects ( canc] treatm5t1
 a problem t beg9s at ! "t ( diagnosis &
 may become m sev]e ) disease           
progression & at ! end ( life4 ,!       
failure to treat ! symptoms1 side       
effects1 & late effects ( canc] & canc] 
treatm5t may h a s]i\s adv]se impact on 
! heal?1 survival1 well-be+1 & quality (
 life ( canc] survivors4  7#e7          
,individuals ) canc] (t5 d n p>ticipate 
9 a %>$ decision-mak+ process t consid]s

 all treatm5t options & d n b5efit f    
coord9ation ( all elem5ts ( active      
treatm5t & palliative c>e4  7#f7        
,quality canc] c>e %\ld incorporate     
access to psy*osocial s]vices &         
managem5t ( ! symptoms ( canc] & !      
symptoms ( canc] treatm5t1 includ+ pa91 
nausea1 vomit+1 fatigue1 & depression4  
7#g7 ,quality canc] c>e %\ld include a  
means = engag+ canc] survivors 9 a %>$  
decision-mak+ process t produces a      
compreh5sive c>e summ>y & a plan =      
foll[-up c>e aft] prim>y treatm5t to    
ensure t canc] survivors h access to    
foll[-up monitor+ & treatm5t ( possible 
late effects ( canc] & canc] treatm5t1  
includ+ appropriate psy*osocial s]vices4
  7#h7 ,! ,in/itute ( ,m$ic9e report    
entitl$ ,ensur+ ,quality ,canc] ,c>e    
describ$ ! elem5ts ( quality c>e = an   
individual ) canc] to include-- 7,a7 !  
developm5t ( initial treatm5t           
recomm5dations by an exp]i5c$ heal? c>e 
provid]2  7,b7 ! developm5t ( a plan = !
 c\rse ( treatm5t ( ! individual &      

communication ( ! plan to ! individual2 
7,c7 access to ! res\rces necess>y to   
implem5t ! c\rse ( treatm5t2  7,d7      
access to high-quality cl9ical trials2  
7,e7 a me*anism to coord9ate s]vices = !
 treatm5t ( ! individual2 &  7,f7       
psy*osocial support s]vices &           
compassionate c>e = ! individual4  7#i7 
,9 its report ,f ,canc] ,pati5t to      
,canc] ,survivor3 ,lo/ 9 ,transition1 ! 
,in/itute ( ,m$ic9e recomm5d$ t         
individuals ) canc] complet+ prim>y     
treatm5t be provid$ a compreh5sive      
summ>y ( _! c>e along ) a foll[-up      
survivor%ip plan ( treatm5t4  7#aj7 ,9  
,canc] ,c>e = ! ,:ole ,pati5t1 !        
,in/itute ( ,m$ic9e /at$ t ! developm5t 
( a plan t includes biom$ical &         
psy*osocial c>e %\ld be a /&>d = quality
 canc] c>e 9 any quality measurem5t     
sy/em4  7#aa7 ,! ,commission on ,canc]  
has enc\rag$ survivor%ip c>e plann+ by  
mak+ ! developm5t ( su* plans = pati5ts 
"o ( ! /&>ds ( accr$itation = canc] c>e 
provid]s1 b canc] c>e pr(essionals      

report difficulties complet+ ! plans4   
7#ab7 ,because m ?an half ( all canc]   
diagnoses occur among eld]ly ,m$ic>e    
b5efici>ies1 address+ canc] c>e         
inadequacies ?r\gh ,m$ic>e re=ms w      
provide b5efits to millions ( ,am]icans4
 ,provid+ ,m$ic>e b5efici>ies m r\t9e   
access to canc] c>e plans & survivor%ip 
c>e plans is a key to %>$ decision mak+ 
& bett] coord9ation ( c>e4  7#ac7       
,important paym5t & deliv]y re=ms t     
incorporate canc] c>e plann+ &          
coord9ation are already be+ te/$ 9 !    
,m$ic>e program2 ! ,oncology ,c>e ,model
 has be5 implem5t$ 9 a numb] ( oncology 
practices1 & additional models t w      
include c>e plann+ h be5 propos$4  7#ad7
 ,! alt]native paym5t models1 includ+ ! 
,oncology ,c>e ,model1 provide access to
 canc] c>e plann+ = ,m$ic>e b5efici>ies 
:o receive _! canc] c>e 9 practices t   
are "p ( ! ,oncology ,c>e ,model4 ,o!r  
,m$ic>e b5efici>ies :o are n enroll$ 9  
^! deliv]y demon/rations may n h access 
to a canc] c>e plan or appropriate c>e  

coord9ation4  7#ae7 ,! failure to       
provide a canc] c>e plan to pati5ts 9 _m
 c>e sett+s relates 9 "p to inadequate  
,m$ic>e paym5t = su* plann+ &           
coord9ation s]vices4  7#af7 ,*anges 9   
,m$ic>e paym5t = canc] c>e plann+ &     
coord9ation w support %>$ decision mak+ 
t reviews all treatm5t options & w      
contribute to improv$ c>e = individuals 
) canc] f ! "t ( diagnosis ?r\gh ! end (
 ! life4 ,m$ic>e paym5t = canc] c>e     
plann+ may beg9 a re=m process t helps u
 realize ! well-plann$ & well-coord9at$ 
canc] c>e t has be5 recomm5d$ by !      
,in/itute ( ,m$ic9e_/,national ,academy 
( ,m$ic9e & t is pref]r$ by canc]       
pati5ts across ! ,nation4  #b4 ,cov]age 
( canc] c>e plann+ & coord9ation 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,,gg72  7,b7 by add+ & at !
 end ( subp>agraph 7,,hh72 &  7,c7 by   
add+ at ! end ! foll[+ new subp>agraph3 

7,,ii7 canc] c>e plann+ & coord9ation   
s]vices 7z def9$ 9 subsection 7kkk77  2 
&  7#b7 by add+ at ! end ! foll[+ new   
subsection3  7kkk7 ,canc] ,c>e ,plann+ &
 ,coord9ation ,s]vices  7#a7 ,! t]m     
canc] c>e plann+ & coord9ation s]vices  
means--  7,a7 ) respect to an individual
 :o is diagnos$ ) canc]1 ! developm5t ( 
a treatm5t plan by a physician1 nurse   
practition]1 or physician assi/ant t--  
7i7 includes an assessm5t ( !           
individual's diagnosis1 heal? /atus1    
treatm5t ne$s1 functional /atus1 pa9    
control1 & psy*osocial ne$s2  7ii7      
engages ! individual 9 a %>$            
decision-mak+ process t reviews all     
treatm5t options2  7iii7 details1 to !  
greate/ ext5t practicable all aspects ( 
! c>e to be provid$ to ! individual )   
respect to ! treatm5t ( su* canc]1      
includ+ any curative treatm5t1          
compreh5sive symptom managem5t1 &       
palliative c>e2  7iv7 is furni%$ 9      
p]son1 9 writt5 =m1 to ! individual )9 a
 p]iod specifi$ by ! ,secret>y t is z   

soon z practicable aft] ! date on :i* ! 
individual is s diagnos$2  7v7 is       
furni%$1 to ! greate/ ext5t practicable1
 9 a =m t appropriately takes into      
acc\nt cultural & l+ui/ic ne$s ( !      
individual 9 ord] to make ! plan        
accessible to ! individual2 &  7vi7 is 9
 accordance ) /&>ds det]m9$ by !        
,secret>y to be appropriate2  7,b7 )    
respect to an individual = :om a        
treatm5t plan has be5 develop$ "u       
subp>agraph 7,a71 ! revision ( su*      
treatm5t plan z necess>y to acc\nt = any
 sub/antial *ange 9 ! condition ( !     
individual1 recurr5ce ( disease1 *anges 
9 ! individual's treatm5t pref]5ces1 or 
significant revision ( ! elem5ts (      
curative c>e or symptom managem5t = !   
individual1 if su* revision--  7i7 is 9 
accordance ) clauses 7i71 7ii71 7iv71 & 
7v7 ( su* subp>agraph2 &  7ii7 is       
furni%$ 9 writt5 =m to ! individual )9 a
 p]iod specifi$ by ! ,secret>y t is z   
soon z practicable aft] ! date ( su*    
revision2  7,c7 ) respect to an         

individual :o has complet$ ! prim>y     
treatm5t = canc]1 z def9$ by !          
,secret>y1 ! developm5t ( a foll[-up    
survivor%ip c>e plan t--  7i7 includes  
an assessm5t ( ! individual's diagnosis1
 heal? /atus1 treatm5t ne$s1 functional 
/atus1 pa9 control1 & psy*osocial ne$s2 
7ii7 engages ! individual 9 a %>$       
decision-mak+ process t reviews all     
survivor%ip c>e options2  7iii7         
describes ! elem5ts ( ! prim>y treatm5t1
 includ+ symptom managem5t & palliative 
c>e1 furni%$ to su* individual2  7iv7   
provides recomm5dations = ! subsequ5t   
c>e ( ! individual ) respect to ! canc] 
involv$2  7v7 is furni%$1 9 p]son1 9    
writt5 =m1 to ! individual )9 a p]iod   
specifi$ by ! ,secret>y t is z soon z   
practicable aft] ! completion ( su*     
prim>y treatm5t2  7vi7 is furni%$1 to ! 
greate/ ext5t practicable1 9 a =m t     
appropriately takes into acc\nt cultural
 & l+ui/ic ne$s ( ! individual 9 ord] to
 make ! plan accessible to ! individual2
 &  7vii7 is 9 accordance ) /&>ds       

det]m9$ by ! ,secret>y to be            
appropriate2 &  7,d7 ) respect to an    
individual = :om a foll[-up canc] c>e   
plan has be5 develop$ "u subp>agraph    
7,c71 ! revision ( su* plan z necess>y  
to acc\nt = any sub/antial *ange 9 !    
condition ( ! individual1 diagnosis ( a 
second canc]1 *ange 9 ! individual's    
pref]5ce = survivor%ip c>e1 or          
significant revision ( ! plan = foll[-up
 c>e1 if su* revision--  7i7 is 9       
accordance ) clauses 7i71 7ii71 7iii71  
7v71 & 7vi7 ( su* subp>agraph2 &  7ii7  
is furni%$ 9 writt5 =m to ! individual  
)9 a p]iod specifi$ by ! ,secret>y t is 
z soon z practicable aft] ! date ( su*  
revision4  7#b7 ,! ,secret>y %all       
e/abli% /&>ds to c>ry out p>agraph 7#a7 
9 consultation ) appropriate            
organizations repres5t+ suppli]s &      
provid]s ( s]vices relat$ to canc]      
treatm5t & organizations repres5t+      
survivors ( canc]4 ,su* /&>ds %all      
include /&>ds = det]m9+ ! ne$ & frequ5cy
 = revisions ( ! treatm5t plans &       

foll[-up survivor%ip c>e plans bas$ on  
*anges 9 ! condition ( ! individual or  
elem5ts & int5t ( treatm5t & /&>ds = !  
communication ( ! plan to ! individual4 
7#c7 ,9 ?is subsection1 ! t]m %>$       
decision-mak+ process means1 ) respect  
to an individual1 a process 9 :i* !     
individual & ! individual's heal? c>e   
provid]s consid] ! individual's         
diagnosis1 treatm5t options1 ! m$ical   
evid5ce relat$ to treatm5t options1 !   
risks & b5efits ( all treatm5t options1 
& ! individual's pref]5ces reg>d+       
treatm5t1 & !n jo9tly develop & implem5t
 a treatm5t plan4  4  7b7 ,paym5t "u    
physician fee s*$ule  7#a7 ,9 g5]al     
,section #ahdh7;j77#c7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7;j77#c77 is am5d$ by ins]t+   
7,,ii71 aft] heal? risk assessm5t714    
7#b7 ,initial rates ,unless ! ,secret>y 
( ,heal? & ,human ,s]vices o!rwise      
provides1 ! paym5t rate specifi$ "u !   
physician fee s*$ule "u ! am5dm5t made  
by p>agraph 7#a7 = canc] c>e plann+ &   

coord9ation s]vices %all be ! same      
paym5t rate z provid$ = transitional c>e
 managem5t s]vices 7z def9$ 9 ,,cpt code
 #iidif74  7c7 ,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