,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #eahc  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,augu/ #aa1 #bjbc,mr4 
,de,saulnier 7= himself1 ,mr4 ,rask91   
,ms4 ,blunt ,ro*e/]1 ,ms4 ,wild1 ,mr4   
,khanna1 ,ms4 ,cl>ke ( ,new ,york1 ,mrs4
 ,watson ,coleman1 ,mr4 ,bi%op (        
,georgia1 ,ms4 ,norton1 & ,ms4 ,wass]man
 ,s*ultz7 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 ,act4  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 ins]t+ & at ! end (  
subp>agraph 7,,jj72 &  7,b7 by add+ at !
 end ! foll[+ new subp>agraph3  7,,kk7  
canc] c>e plann+ & coord9ation s]vices  
7z def9$ 9 subsection 7nnn772  2 &  7#b7
 by add+ at ! end ! foll[+ new          
subsection3  7nnn7 ,canc] ,c>e ,plann+ &
 ,coord9ation ,s]vices  7#a7 ,! t]m     
canc] c>e plann+ & coord9ation s]vices  
means1 ) respect to an individual :o is 
diagnos$ ) canc]1 ! developm5t ( a      
treatm5t plan by a physician1 physician 
assi/ant1 or nurse practition] t-- 7,a7 
includes ea* compon5t ( ! ,in/itute (   
,m$ic9e ,c>e ,managem5t ,plan 7z        
describ$ 9 ! article entitl$ ,deliv]+   
,high-,quality ,canc] ,c>e3 ,*>t+ a ,new
 ,c\rse = a ,sy/em 9 ,crisis publi%$ by 
! ,in/itute ( ,m$ic9e72  7,b7 is furni%$
 9 writt5 =m or electronically1 at !    
visit ( su* individual ) su* physician1 
physician assi/ant1 or nurse            
practition]1 or z soon aft] ! date ( !  
visit z practicable2 &  7,c7 is furni%$1
 to ! greate/ ext5t practicable1 9 an   

appropriate =m t appropriately takes    
into acc\nt cultural & l+ui/ic ne$s ( ! 
individual 9 ord] to make ! plan        
accessible to ! individual4  7#b7 ,!    
,secret>y %all e/abli% frequ5cies at :i*
 s]vices describ$ 9 p>agraph 7#a7 may be
 furni%$1 provid$ t su* s]vices may be  
furni%$ ) respect to an individual--    
7,a7 at ! "t su* individual is diagnos$ 
) canc] = purposes ( plann+ treatm5t2   
7,b7 if !re is a *ange 9 ! condition (  
su* individual or su* individual's      
treatm5t pref]5ces2  7,c7 at ! end (    
active treatm5t & beg9n+ ( survivor%ip  
c>e2 &  7,d7 if !re is a recurr5ce ( su*
 canc]4  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#b77,,kk71 aft] heal?  
risk assessm5t714  7#b7 ,initial rates  
,unless ! ,secret>y 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