,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #ddgc  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,july #f1 #bjbc,mr4   
,arr+ton 7= himself1 ,mrs4 ,lesko1 &    
,mr4 ,burgess7 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 = site neutral paym5t = canc]   
c>e s]vices "u "p ,b ( ! ,m$ic>e        
program4  #a4 ,%ort title ,?is ,act may 
be cit$ z ! ,m$ic>e ,pati5t ,access to  
,canc] ,treatm5t ,act4  #b4 ,f9d+s2     
,s5se ( ,congress  7a7 ,f9d+s ,congress 
f9ds ! foll[+3 7#a7 ,9 ,janu>y #bjai1   
!re 7 an e/imat$ #af4i million p 9 !    
,unit$ ,/ates ) a hi/ory ( canc] & t    
numb] is expect$ to increase to #bb4b   
million 9 #bjcj4  7#b7 ,9 #bjah1        
national exp5ditures = canc] c>e 7 an   

e/imat$ #aej4h billion4  7#c7 ,! ,unit$ 
,/ates is recogniz$ z a lead] 9 develop+
 new canc] treatm5ts & provid+          
high-quality c>e = pati5ts receiv+ canc]
 c>e4  7#d7 ,canc] survival rates = all 
r>e canc]s is #ag p]c5t high] 9 ! ,unit$
 ,/ates ?an 9 ,europe4  7#e7 ,m ?an half
 ( ! p 9 ! ,unit$ ,/ates ) canc] receive
 treatm5t 9 ! community canc] sett+4    
7#f7 ,ov] ! pa/ #aj ye>s1 !re has be5 a 
%ift 9 outpati5t canc] c>e f !          
physician's (fice to hospital outpati5t 
dep>tm5ts4  7#g7 ,9 ,june #bjbb1 a      
,med,p,a,c report f\nd t ! hospital     
outpati5t dep>tm5t 7,,hopd7 %>e ( (fice 
visits provid$ to fee = s]vice          
b5efici>ies grew f #i4f p]c5t 9 #bjab to
 #ac4a p]c5t 9 #bjai1 & ! ,,hopd %>e (  
*emo!rapy adm9i/ration s]vices rose f   
#ce4b p]c5t to #ej4i p]c5t4  7#h7 ,?is  
%ift 9 c>e 0 p>tially ! result ( !      
increase 9 consolidation among heal?c>e 
provid]s4  7#i7 #dh1djj additional      
physicians left indep5d5t practice &    
became employees ( hospitals or o!r     

corporate entities1 & #bb1gjj ( t gr[?  
occurr$ aft] ! onset ( ,,covid-#ai1     
result+ 9 a #ab p]c5t increase 9        
employm5t4  7#aj7 ,! consolidation (    
heal?c>e practices & ! result+ %ift 9   
c>e to hospital sett+s has increas$ co/s
 = ,m$ic>e b5efici>ies by #aej million &
 ! ,m$ic>e program by #fae million      
betwe5 #bjae & #bjai4  7#aa7 ,?is %ift 9
 c>e has increas$ co/s = pati5ts b has n
 be5 accompani$ by improv$ quality (    
c>e4  7#ab7 ,a #bjai /udy f\nd t av]age 
price = a level #e drug adm9i/ration    
visit increas$ #eg p]c5t 9 outpati5t    
sett+s f #bjji to #bjag b only #ae p]c5t
 9 (fice sett+s4  7#ac7 ,if paym5t rates
 betwe5 sett+s 7 align$ ,m$ic>e program 
sp5d+ 9 #bjai w\ld h decl9$ by #f4f     
billion & b5efici>y co/-%>+ obligations 
by #a4g billion4  7b7 ,s5se ( congress  
,x is ! s5se ( ,congress t1 to ensure ! 
future ( community canc] c>e1 ,m$ic>e   
reimbursem5t %\ld be equal = ! same     
s]vice provid$ to a canc] pati5t        
reg>dless ( :e!r ! s]vice is deliv]$ 9 !

 hospital outpati5t dep>tm5t or         
physician's (fice4  #c4 ,site neutral   
paym5t = canc] c>e s]vices "u ,m$ic>e "p
 ,b ,section #ahcc7t7 ( ! ,social       
,security ,act 7#db ,u4,s4,c4 #aciel7t77
 is am5d$-- 7#a7 9 p>agraph 7#a77;,b7-- 
7,a7 9 clause 7iv71 by /rik+ 2 & &      
ins]t+ a semicolon2  7,b7 9 clause 7v71 
by /rik+ ! p]iod at ! end & ins]t+ 2 &2 
&  7,c7 by add+ at ! end ! foll[+ new   
clause3  7vi7 does n include canc] c>e  
s]vices 7z def9$ 9 p>agraph 7#bc77;,a77 
t are furni%$ dur+ #bjbe or a subsequ5t 
ye>4  2 &  7#b7 by add+ at ! end !      
foll[+ new p>agraph3  7#bc7 ,site       
neutral paym5t = canc] c>e s]vices  7,a7
 ,canc] c>e s]vices def9$ ,= purposes ( 
p>agraph 7#a77;,b77vi7 & ?is p>agraph1 !
 t]m canc] c>e s]vices means s]vices    
specifi$ by ! ,secret>y-- 7i7 t )\t     
application ( ?is p>agraph or p>agraph  
7#a77;,b77vi71 w\ld be payable "u ?is   
subsection or pursuant to p>agraph      
7#ba72  7ii7 t are furni%$ 9 conjunction
 ) ! diagnosis or treatm5t ( canc]2 &   

7iii7 = :i* paym5t may be made "u       
section #ahdh7;b7 if su* s]vices 7      
furni%$ 9 a physician (fice sett+4  7,b7
 ,paym5t ,paym5t = canc] c>e s]vices    
%all be made 9 ! same mann] & to ! same 
ext5t z paym5t is made pursuant to      
p>agraph 7#ba77;,c7 "u ! applicable     
paym5t sy/em describ$ 9 su* p>agraph )  
respect to applicable items & s]vices   
furni%$ by an (f-campus outpati5t       
dep>tm5t ( a provid] t are describ$ 9   
p>agraph 7#a77;,b77v74  4