,,ii  #aahth ,,congress  #ast ,session  
,s4 #bbac  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #bb1     
#bjbc ,ms4 ,klobuchar 7for herself and  
,mr4 ,cardin7 introduced the following  
bill2 which was read twice and referred 
to the ,committee on ,finance  ,a ,,bill
  ,to address the health of cancer      
survivors and unmet needs that survivors
 face through the entire continuum of   
care from diagnosis through active      
treatment and posttreatment1 in order to
 improve survivorship1 treatment1       
transition to recovery and beyond1      
quality of life and palliative care1 and
 long-term health outcomes1 including by
 developing a minimum standard of care  
for cancer survivorship1 irrespective of
 the type of cancer1 a survivor's       
background1 or forthcoming survivorship 
needs1 and for other purposes4  #a4     
,short title2 table of contents  7a7    
,short title ,this ,act may be cited as 
the ,comprehensive ,cancer ,survivorship
 ,act4  7b7 ,table of contents ,the     

table of contents of this ,act is as    
follows3  ,sec4 #a4 ,short title2 table 
of contents4 ,sec4 #b4 ,findings4 ,sec4 
#c4 ,definitions4 ,sec4 #d4 ,coverage of
 cancer care planning and coordination  
services4 ,sec4 #e4 ,survivorship       
transition tools4 ,sec4 #f4 ,alternative
 payment model4 ,sec4 #g4 ,survivorship 
navigation4 ,sec4 #h4 ,survivorship care
 demonstration program4 ,sec4 #i4       
,cancer survivor employment assistance  
program4 ,sec4 #aj4 ,comprehensive      
cancer survivorship program4 ,sec4 #aa4 
,adult cancer survivorship study4 ,sec4 
#ab4 ,survivorship progress report4     
,sec4 #ac4 ,promoting ,state innovations
 to ease transitions to the primary care
 setting for children with cancer4 ,sec4
 #ad4 ,childhood cancer demonstration   
model and standard of care4 ,sec4 #ae4  
,medicaid coverage of cancer fertility  
services for cancer survivors4  #b4     
,findings ,congress finds the following3
 7#a7 ,a cancer survivor is any         
individual with a history of cancer1    

from the time of diagnosis through the  
rest of their life1 across the continuum
 of care4  7#b7 ,today1 there are       
approximately #ah1jjj1jjj ,americans who
 are cancer survivors1 and the number of
 survivors is projected to reach        
#bf1jjj1jjj by #bjdj4 ,therefore1 there 
is a great need to be able to provide   
ways to sustain the care needed and to  
offer those living with1 through1 and   
beyond cancer a safe1 supportive1 and   
accommodating environment where such    
individuals can engage in physical and  
social support activities to sustain    
optimal quality of life4  7#c7 ,cancer  
survivors face difficult emotional1     
psychological1 neurological1 financial1 
legal1 and other physical challenges    
that persist beyond diagnosis and       
treatment1 often arising months and     
years after active cancer treatment     
ends4  7#d7 ,cancer survivors have      
unique needs and must manage short- and 
long-term effects of their treatment1 as
 well as regular screenings for cancer  

recurrence or new cancers4  7#e7 ,cancer
 survivors of racial and ethnic         
diversity1 as well as lower             
socioeconomic status1 have              
disproportionately lower health-related1
 quality-of-life scores compared to     
non-,hispanic ,white cancer survivors4  
7#f7 ,cancer survivors living in rural  
areas have less access to services and  
have poorer outcomes than survivors in  
metropolitan areas4  7#g7 ,children1    
adolescent1 and young adult cancer      
survivors are particularly susceptible  
to long-term consequences from          
treatment1 and up to #hj percent have a 
severe1 disabling1 life-threatening1 or 
fatal health condition by the age of    
#ej4 ,best practices in this area would 
improve treatment1 quality of life1 and 
long-term health outcomes4  7#h7        
,clinical trials have shown that cancer 
survivorship programs help cancer       
survivors meet or exceed the recommended
 amount of physical activity1           
significantly increasing their          

cardiovascular health and overall       
quality of life and decreasing their    
cancer-related fatigue4  7#i7 ,despite  
the ,national ,cancer ,institute and    
other professional organizations'       
definition of a cancer survivor         
beginning on the day of a cancer        
diagnosis1 there is little agreement    
among clinicians1 researchers1 and      
insurance companies on what services are
 included in survivorship care and the  
point at which survivorship care begins4
  7#aj7 ,cancer survivors1 their        
families1 their caregivers1 and their   
providers face many difficulties        
understanding and coordinating the      
transition from specialty to primary    
care1 and for this reason communication 
and treatment are often fragmented and  
inconsistent4  7#aa7 ,to avoid          
additional health-related or financial  
hardships to cancer survivors and their 
families1 comprehensive and             
forward-thinking cancer survivorship    
studies and programs across ,federal    

agencies1 in collaboration with ,states1
 localities1 and medical and            
professional organizations1 are required
 to engage in a coordinated effort to   
improve health outcomes and quality of  
life of survivors4  #c4 ,definitions ,in
 this ,act3 7#a7 ,cancer survivor ,the  
term cancer survivor means an individual
 from the time of cancer diagnosis      
through the balance of his or her life4 
7#b7 ,caregiver ,the term caregiver     
means a family member1 friend1 or other 
person who cares for an individual with 
a chronic or disabling condition1       
including cancer4  7#c7 ,patient        
experience data ,the term patient       
experience data means patient           
experiences1 perspectives1 needs1 and   
priorities related to--  7,a7 the       
symptoms of the patient's conditions and
 the natural history of such conditions2
  7,b7 the impact of the conditions on  
the patient's functioning and quality of
 life2  7,c7 the patient's experience   
with treatments2  7,d7 input on which   

outcomes are important to the patient2  
7,e7 patient preferences for outcomes   
and treatments2 and  7,f7 the relative  
importance of any issues as defined by  
patients4  7#d7 ,psychosocial effects   
,the term psychosocial effects-- 7,a7   
means the psychological1 behavioral1    
emotional1 and social effects of a      
disease1 such as cancer1 and its        
treatment2 and  7,b7 in the case of such
 effects of cancer1 includes changes in 
how a patient thinks1 their feelings1   
moods1 beliefs1 ways of coping1 and     
relationships with family1 friends1 and 
coworkers4  7#e7 ,psychosocial care ,the
 term psychosocial care means           
psychological and social services and   
interventions that enable survivors1    
patients1 their families1 and health    
care providers to optimize health care  
and to manage the psychological1        
behavioral1 physical1 emotional1 and    
social aspects of illness and its       
consequences so as to promote better    
health and well-being4  7#f7 ,secretary 

,except as otherwise specified1 the term
 ,secretary means the ,secretary of     
,health and ,human ,services4  7#g7     
,survivorship ,the term survivorship    
means the period from the time of cancer
 diagnosis until the end of life1       
including any portions of such period   
during which interventions are necessary
 to address--  7,a7 the physical1       
mental1 emotional1 social1 and financial
 effects of cancer that begin at        
diagnosis and continue through treatment
 and beyond2 and  7,b7 issues related to
 follow-up care 7including regular      
health and wellness checkups71 late and 
long-term effects of treatment1         
screening for cancer recurrence and new 
cancers1 and quality of life4  7#h7     
,survivorship care plan ,the term       
survivorship care plan-- 7,a7 means an  
individualized care plan for patients   
who have been diagnosed with cancer2 and
  7,b7 includes a treatment summary and 
any follow-up care guidelines in such   
plan that-- 7i7 are for monitoring and  

maintaining the patient's medical and   
psychosocial health and well-being2 and 
7ii7 are meant to be a transition and   
communication tool for the survivor1    
their family1 their caregiver1 and all  
their health care providers4  7#i7      
,survivorship navigation ,the term      
survivorship navigation means a service 
that--  7,a7 helps patients overcome    
health care system and other barriers2  
and  7,b7 provides patients with timely 
access to high-quality medical1         
physical1 and psychosocial care from    
their cancer diagnosis through all      
phases of their cancer experience4      
7#aj7 ,treatment summary ,the term      
treatment summary means a detailed      
summary of a patient's disease1 the     
types of treatment the patient received1
 members of the patient's care team1 and
 any side effects or other problems1    
including psychosocial effects1 caused  
by treatment4  #d4 ,coverage of cancer  
care planning and coordination services 
7a7 ,in general ,section #ahfa of the   

,social ,security ,act 7#db ,u4,s4,c4   
#aciex7 is amended--  7#a7 in subsection
 7s77#b7-- 7,a7 by striking and at the  
end of subparagraph 7,,ii72  7,b7 by    
adding and at the end of subparagraph   
7,,jj72 and  7,c7 by adding at the end  
the following new subparagraph3  7,,kk7 
cancer care planning and coordination   
services 7as defined in subsection      
7nnn772  2 and  7#b7 by adding at the   
end the following new subsection3  7nnn7
 ,cancer ,care ,planning and            
,coordination ,services  7#a7 ,the term 
cancer care planning and coordination   
services means1 with respect to an      
individual who is diagnosed with cancer1
 the development of a treatment plan by 
a physician1 physician assistant1 or    
nurse practitioner that-- 7,a7 includes 
each component of the ,institute of     
,medicine ,care ,management ,plan 7as   
described in the article entitled       
,delivering ,high-,quality ,cancer      
,care3 ,charting a ,new ,course for a   
,system in ,crisis published by the     

,institute of ,medicine72  7,b7 is      
furnished in written form or            
electronically1 at the visit of such    
individual with such physician1         
physician assistant1 or nurse           
practitioner1 or as soon after the date 
of the visit as practicable2 and  7,c7  
is furnished1 to the greatest extent    
practicable1 in a form that             
appropriately takes into account        
cultural and linguistic needs of the    
individual in order to make the plan    
accessible to such individual4  7#b7    
,the ,secretary shall establish         
frequencies at which services described 
in paragraph 7#a7 may be furnished1     
provided that such services may be      
furnished with respect to an            
individual-- 7,a7 at the time such      
individual is diagnosed with cancer for 
purposes of planning treatment2  7,b7 if
 there is a change in the condition of  
such individual or such individual's    
treatment preferences2  7,c7 at the end 
of active treatment and beginning of    

survivorship care2 and  7,d7 if there is
 a recurrence of such cancer4  4  7b7   
,payment under physician fee schedule   
7#a7 ,in general ,section #ahdh7;j77#c7 
of the ,social ,security ,act 7#db      
,u4,s4,c4 #aciew-#d7;j77#c77 is amended 
by inserting 7#b77,,kk71 after health   
risk assessment714  7#b7 ,initial rates 
,unless the ,secretary otherwise        
provides1 the payment rate specified    
under the physician fee schedule under  
the amendment made by paragraph 7#a7 for
 cancer care planning and coordination  
services shall be the same payment rate 
as provided for transitional care       
management services 7as defined in ,,cpt
 code #iidif74  7c7 ,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 ,act4  #e4            
,survivorship transition tools  7a7 ,in 
general ,the head of the ,office of the 
,national ,coordinator for ,health      

,information ,technology1 in            
collaboration with ,director of the     
,agency for ,healthcare ,research and   
,quality1 shall-- 7#a7 evaluate existing
 models for survivorship care plans1 as 
they relate to both adults and children1
 through engagement with professional   
societies1 payors1 patient advocacy     
organizations1 community-based          
organizations1 electronic health record 
vendors1 and other stakeholders2  7#b7  
evaluate other existing tools for       
developing survivorship care plans1 such
 as-- 7,a7 survivorship guidelines of   
the ,national ,comprehensive ,cancer    
,network and the ,american ,society of  
,clinical ,oncology2 or  7,b7 tools such
 as ,passport for ,care2  7#c7          
collaborate with the ,office for ,civil 
,rights of the ,department of ,health   
and ,human ,services to evaluate the    
privacy and security implications of--  
7,a7 consolidating treatment history and
 survivorship guidelines into a         
personalized survivorship care plan1 as 

described in paragraph 7#d72 and  7,b7  
patient use of computer or mobile       
phone-based application programs        
described in paragraph 7#d77;,b72 and   
7#d7 taking into consideration the      
results of evaluation under paragraphs  
7#a7 and 7#b7-- 7,a7 not later than #cf 
months after the date of enactment of   
this ,act1 publish information resources
 for cancer patients and providers on   
strategies for consolidating treatment  
history and survivorship guidelines into
 a personalized survivorship care plan  
to guide survivorship monitoring and    
follow-up care2 and  7,b7 include in    
such information resources              
recommendations about possible patient  
use of application programs 7apps7 to   
develop personalized survivorship care  
plans4  7b7 ,definition ,in this        
section1 the term electronic health     
record means an electronic record of    
health-related information on an        
individual that is created1 gathered1   
managed1 and consulted by authorized    

health care clinicians and staff4  #f4  
,alternative payment model ,not later   
than #ah months after the date of       
enactment of this ,act1 the ,secretary  
of ,health and ,human ,services shall   
develop an alternative payment model for
 payment under title ,,xviii and ,,xix  
of the ,social ,security ,act 7#db      
,u4,s4,c4 #acie et seq41 #acif et seq47 
for items and services relating to      
cancer survivorship care 7as defined by 
the ,secretary74 ,following such        
testing1 the ,secretary shall submit to 
,congress a report containing a         
description of such model that includes 
the following information3 7#a7 ,a      
description of what event would trigger 
an individual's entry into such a model 
7such as the end of the individual's    
active cancer treatment1 the beginning  
of the individual's need for supportive 
care during active treatment1 or another
 event74  7#b7 ,the length of the       
individual's participation under such   
model1 including a description of any   

ability to extend such participation4   
7#c7 ,in the case that such model is    
based on an episode of care1 the        
appropriate length of the survivorship  
episode of care and whether additional  
episodes may be triggered1 if necessary4
  7#d7 ,strategies to ensure that any   
episode of care under such a model      
begins with the development and         
dissemination of a survivorship care    
plan for the transition from active     
cancer treatment to follow-up care to   
the individual and all relevant health  
care providers4  7#e7 ,a description of 
any bundled payment packages that will  
be used under such model4  7#f7 ,a      
specification of any follow-up or new   
screening under such model for unmet    
needs of individuals participating in   
such model4  7#g7 ,how consistent1      
shared decision making will be promoted 
under such model so that individuals are
 given the knowledge needed for         
self-management between episodes of     
care4  7#h7 ,a specification of which   

types of health care providers may      
furnish items and services under such   
model1 including genetic counselors and 
mental health professionals4  7#i7      
,strategies for applying evidence-based 
risk stratification principles to direct
 survivors to personalized care pathways
 that match the level of care needed to 
the relative risks and needs of the     
survivor4  7#aj7 ,strategies for        
coordination of care between such       
providers1 such as between specialists  
and primary care providers1 and how     
principal responsibility will be        
assigned for an episode of care4  7#aa7 
,strategies for addressing social       
determinants of health through such     
model4  7#ab7 ,a description of how such
 model will promote-- 7,a7 prevention1  
early detection surveillance1 and       
treatment for individuals continuing to 
receive systemic therapy after the end  
of active cancer treatment2  7,b7 such  
individuals' understanding of1 and      
access to1 treatment2  7,c7 survivorship

 research2 and  7,d7 the continuing     
health of cancer survivors4  7#ac7 ,an  
analysis of how different forms and     
stages of cancer may require the        
development of different survivorship   
plans and alternative payment models    
based on varying episodes of care4      
7#ad7 ,a plan for testing any           
alternative payment model described in  
the report1 including the timing of such
 testing1 an analysis of the impact of  
such testing1 any barriers to           
implementing such testing1 and any other
 recommendations determined appropriate 
by the ,secretary4  #g4 ,survivorship   
navigation  7a7 ,review of programs and 
navigation study  7#a7 ,in general ,not 
later than #ah months after the date of 
enactment of this ,act1 the ,secretary  
shall--  7,a7 complete a review of      
previous and current cancer survivorship
 navigation programs1 including any     
applicable standards of care such as    
those of the ,professional ,oncology    
,navigation ,task ,force1 and the       

,academy of ,oncology ,nurse  ,patient  
,navigators1 the ,oncology ,nursing     
,society2 and  7,b7 submit a report to  
the ,congress on the results of such    
review4  7#b7 ,considerations ,in       
carrying out subsection 7a71 the        
,secretary shall take into consideration
 each of the following3 7,a7 ,how cancer
 survivorship navigation program        
services might be provided from         
diagnosis across the continuum of care  
through survivorship1 taking into       
consideration--  7i7 the type of        
navigation services that are most       
effective for survivors at the time of  
diagnosis2 and  7ii7 the type of        
navigation services that are most useful
 for survivors who are managing the late
 and long-term effects of cancer and    
cancer treatment4  7,b7 ,how navigation 
services might evolve over the continuum
 of care and how to encourage a dynamic 
navigation system4  7,c7 ,training needs
 for navigators4  7,d7 ,comparison and  
delineation of navigation services      

provided by lay and professional        
navigators4  7,e7 ,evaluation of optimal
 strategies for offering survivors      
navigation services and encouraging     
their utilization of such services4     
7,f7 ,defining-- 7i7 the continuum of   
care during which services are provided2
 and  7ii7 the nature of services for a 
long-term survivor4  7,g7 ,the location 
of navigation services 7such as whether 
such services should be provided as part
 of oncology practices or outside of    
oncology practices74  7,h7 ,federal     
financing for navigation services 7such 
as whether to finance such services     
through a grant program funded through  
annual discretionary appropriations74   
7,i7 ,alternative delivery and payment  
models for cancer survivorship          
navigation services1 including          
consideration of--  7i7 an              
episode-of-care model for providing     
cancer survivorship navigation services1
 or a patient-focused navigation benefit
 that survivors could utilize in        

different settings1 with the navigation 
services meeting standards set by the   
,secretary2 and  7ii7 services funded   
through the ,medicare and ,medicaid     
programs4  7,j7 ,resources and the role 
of patient advocacy organizations and   
peer support networks in cancer         
survivorship navigation services4  7b7  
,demonstration program for navigation   
services for cancer survivors  7#a7 ,in 
general ,the ,secretary shall carry out 
a demonstration program consisting of   
awarding grants to eligible entities to 
provide navigation services to cancer   
survivors4  7#b7 ,timing ,the ,secretary
 shall initiate the demonstration       
program under this subsection not later 
than #ab months after completing the    
review as required under subsection     
7a77#a77;,a74  7#c7 ,eligible entities  
,to be eligible to receive a grant under
 this subsection1 an entity shall--     
7,a7 have staff and expertise to provide
 navigation services2 and  7,b7 be--    
7i7 a community-based organization2     

7ii7 a patient-centered education and   
service organization2  7iii7 a nonprofit
 patient or cancer advocacy             
organization2  7iv7 a community cancer  
provider2  7v7 a cancer center2  7vi7 a 
hospital2  7vii7 a community health     
center2  7viii7 a rural health clinic2  
or  7ix7 another type of entity as the  
,secretary determines appropriate4  7#d7
 ,use of funds ,a recipient of a grant  
under this section shall use the grant  
to provide navigation services to cancer
 survivors1 including by--  7,a7        
offering navigation services from       
diagnosis through the continuum of care1
 including long-term survivorship1 or   
offering navigation services from the   
end of active treatment with an emphasis
 on facilitating the transition from    
active treatment to long-term           
survivorship care and throughout        
survivorship2  7,b7 in a timely manner1 
assisting cancer survivors to navigate  
cancer treatment and follow-up services1
 such as screenings1 risk assessment1   

mitigation1 health promotion activities1
 providing health information and       
education1 coaching1 and support2  7,c7 
addressing cancer care disparities in   
the design and delivery of services2    
7,d7 ensuring coordination with the     
survivor's health care providers2  7,e7 
following evidence-based survivorship   
care guidelines in the design and       
delivery of survivorship services2  7,f7
 ensuring the delivery of culturally    
appropriate services and materials2 and 
7,g7 assisting cancer survivors to meet 
and overcome barriers to treatment and  
follow-up services1 such as any such    
barriers relating to food insecurity1   
housing1 transportation1 labor1 access  
to broadband connectivity1 the          
availability of telehealth1 or child    
care1 with emphasis placed on high-risk 
populations4  #h4 ,survivorship care    
demonstration program  7a7 ,in general  
,the ,secretary shall carry out a       
demonstration program for a period of #e
 years consisting of awarding grants to 

improve the quality of cancer           
survivorship care4  7b7 ,timing ,the    
,secretary shall initiate the           
demonstration program under this section
 not later than #a year after the date  
of enactment of this ,act4  7c7         
,demonstration sites ,the ,secretary    
shall ensure that grants are awarded    
under this section to improve the       
quality of cancer survivorship care at a
 wide diversity of sites1 including--   
7#a7 in urban1 suburban1 rural1 and     
,tribal areas2  7#b7 in one or more     
territories of the ,united ,states2 and 
7#c7 at cancer care sites including     
cancer centers1 academic health centers1
 ,federally qualified health centers1   
rural health clinics1 physician offices1
 ,tribal organizations1 community-based 
health care providers1 and health care  
providers serving medically underserved 
communities4  7d7 ,areas of focus under 
the demonstration program ,the          
demonstration program under this section
 shall be designed to ensure the        

development of a variety of models for  
survivorship care that will permit      
evaluation of a variety of care         
strategies1 including--  7#a7           
utilization of navigators to assist     
survivors in obtaining survivorship     
care2  7#b7 employment of               
risk-stratification to better determine 
the nature and intensity of services    
that survivors require2  7#c7           
transitions of care from cancer care    
providers to primary care providers1    
through transition-of-care models that  
involve collaboration between cancer    
care specialists and primary care       
providers2  7#d7 the training needs of  
primary care providers to be better     
equipped to work with survivors in      
primary care settings2  7#e7 utilization
 of survivorship care plans to          
facilitate coordination of survivorship 
care2  7#f7 experimentation with        
providing cancer survivorship care at   
home2  7#g7 use of information          
technology to plan and coordinate care  

to improve the consistent               
identification1 collection1 and         
measurement of all forms of patient     
experience data1 including              
patient-reported outcomes of            
patient-reported symptoms and           
quality-of-life measures2 and  7#h7     
expansion of existing successful models 
of survivorship care4  7e7 ,evaluation  
of demonstration program ,the ,secretary
 shall-- 7#a7 develop a plan for        
evaluating the projects that are        
conducted as part of the demonstration  
program under this section2 and  7#b7   
not later than #ah months after the end 
of the #e-year demonstration program1   
complete such evaluation and submit a   
report to the ,congress on the results  
of such evaluation4  7f7 ,authorization 
of appropriations ,to carry out this    
section1 there is authorized to be      
appropriated #bj1jjj1jjj for each of    
fiscal years #bjbd through #bjbh4  #i4  
,cancer survivor employment assistance  
program  7a7 ,in general ,the ,secretary

 of ,labor1 in consultation with the    
,secretary of ,health and ,human        
,services1 shall carry out a program to 
award grants to nonprofit organizations 
and other entities to provide education 
and targeted assistance-- 7#a7 to       
eligible cancer survivors facing        
barriers to employment1 including those 
who remain in the workforce during      
treatment1 those who reduce working     
hours while in treatment1 and those who 
reenter the workforce after a           
treatment-related departure2 and  7#b7  
to the families and caregivers of such  
eligible cancer survivors4  7b7 ,program
 components ,the program under this     
section shall include the following3    
7#a7 ,assistance1 career and training   
services1 and supportive services for   
eligible cancer survivors who stay in   
the workforce during treatment1 and for 
their families and caregivers1          
including-- 7,a7 transportation         
assistance2  7,b7 childcare assistance2 
7,c7 nutritional assistance2  7,d7      

physical activity assistance2  7,e7     
psychosocial assistance2  7,f7 financial
 assistance during a period of medical  
leave2 and  7,g7 other similar          
assistance4  7#b7 ,assistance and       
education for eligible cancer survivors 
who leave the workforce during          
treatment1 and for their families and   
caregivers1 including-- 7,a7 financial  
assistance during a period of medical   
leave2  7,b7 assistance with premiums   
for continuation coverage provided      
pursuant to part #f of subtitle ,b of   
title ,i of the ,employee ,retirement   
,income ,security ,act of #aigd 7#bi    
,u4,s4,c4 #aafa et seq471 title ,,xxii  
of the ,public ,health ,service ,act    
7#db ,u4,s4,c4 #cjj;bb-#a et seq471 or  
section #dihj;,b of the ,internal       
,revenue ,code of #aihf 7#bf ,u4,s4,c4  
#dihj;,b72 and  7,c7 career and training
 services1 including upskilling and     
reskilling1 for eligible cancer         
survivors who are not able to return to 
work after treatment4  7#c7 ,assistance1

 career and training services1 and      
supportive services for eligible cancer 
survivors who are unable to work after a
 cancer diagnosis1 and their families   
and caregivers1 including-- 7,a7        
assistance in applying for--  7i7       
supplemental security income benefits   
under title ,,xvi of the ,social        
,security ,act 7#db ,u4,s4,c4 #acha et  
seq472  7ii7 disability insurance       
benefits under section #bbc of the      
,social ,security ,act 7#db ,u4,s4,c4   
#dbc72  7iii7 benefits under a ,state   
plan1 or waiver of such plan1 under     
title ,,xix of the ,social ,security    
,act 7#db ,u4,s4,c4 #acif et seq472     
7iv7 with respect to minimizing delays  
in eligibility before a cancer survivor 
becomes eligible for ,medicare coverage1
 benefits under the ,medicare program   
under title ,,xviii of the ,social      
,security ,act 7#db ,u4,s4,c4 #ahja et  
seq471 including with respect to        
enrolling in plans under part ,c or ,d  
of such title and supplemental plans    

under section #ahhb of such title2  7v7 
,state and private sector assistance    
programs for such cancer survivors2 and 
7vi7 career and training services       
available under title ,i1 ,,ii1 or ,,iv 
of the ,workforce ,innovation and       
,opportunity ,act 7#bi ,u4,s4,c4 #caja  
et seq472 and  7,b7 information on the  
eligibility of a cancer survivor1 and   
their families and caregivers1 for      
benefits or services described in any of
 clauses 7i7 through 7vi7 of            
subparagraph 7,a74  7c7 ,evidence-,based
 resources ,in carrying out this        
section1 the ,secretary of ,labor1 in   
consultation with the ,secretary of     
,health and ,human ,services1 shall use 
evidence-based resources1 including--   
7#a7 nationally recognized              
evidence-based guidelines2 and  7#b7    
other resources as determined by the    
,secretary4  7d7 ,definitions ,in this  
section3 7#a7 ,the term eligible cancer 
survivor means a cancer survivor 7as    
defined in section #c7 who--  7,a7      

remains in the workforce during cancer  
treatment2  7,b7 reduces working hours  
during cancer treatment2  7,c7 reenters 
the workforce after a cancer            
treatment-related departure2 or  7,d7   
leaves the workforce as the result of a 
cancer diagnosis or related             
complications4  7#b7 ,the term          
supportive services has the meaning     
given such term in section #c of the    
,workforce ,innovation and ,opportunity 
,act 7#bi ,u4,s4,c4 #cajb74  #aj4       
,comprehensive cancer survivorship      
program  7a7 ,in general ,the ,secretary
 shall carry out a comprehensive cancer 
survivorship program that includes--    
7#a7 a cancer survivorship resource     
center in accordance with subsection 7b7
 to provide evidence-based resources to 
cancer survivors1 their families1 and   
their caregivers2  7#b7 a health care   
professional resource center in         
accordance with subsection 7c7 to assist
 and educate health care professionals  
in the delivery of high-quality         

survivorship care2  7#c7 an educational 
campaign in accordance with subsection  
7d7 to provide health care professionals
 with resources to improve cancer       
survivorship care2 and  7#d7 a program  
of supportive care services in          
accordance with subsection 7e7 to       
improve the quality of life and         
long-term survivorship of cancer        
survivors4  7b7 ,cancer survivorship    
resource center  7#a7 ,establishment    
,the ,secretary shall establish and     
operate a survivorship resource center  
7in this subsection referred to as the  
,center7 that serves as a comprehensive 
source of information and resources     
related to survivorship4  7#b7 ,timing  
,not later than #b years after the date 
of enactment of this ,act1 the          
,secretary shall establish and begin    
operation of the ,center4  7#c7         
,consultation ,in establishing and      
operating the ,center1 the ,secretary   
shall consult with cancer survivors1    
patient organizations1 health           

professionals1 researchers1 health      
education organizations1 oncology       
professional societies and other medical
 societies1 community-based             
organizations1 and science education    
organizations regarding-- 7,a7 the      
information and resources that would    
assist cancer survivors in managing the 
survivorship experience and obtaining   
high-quality care across the continuum  
of care2  7,b7 gaps in such information 
and resources that need to be addressed 
to respond to the needs of cancer       
survivors2 and  7,c7 optimal strategies 
for ensuring that cancer survivors have 
access to the ,center1 including        
strategies that provide virtual options1
 online resources1 and marketing4  7#d7 
,use of available evidence-based        
resources ,in establishing and operating
 the ,center1 the ,secretary shall1 with
 permission and attribution1 rely on and
 utilize the evidence-based materials   
and resources developed1 collected1 and 
distributed by cancer organizations4    

7c7 ,health care professional resource  
center  7#a7 ,in general ,the ,secretary
 shall establish and operate a health   
care professional resource center 7in   
this subsection referred to as the      
,center7 that serves as a comprehensive 
source of information and resources to  
assist health care professionals in the 
delivery of high-quality survivorship   
care4  7#b7 ,reference cancer           
survivorship guidelines ,in establishing
 and operating the ,center1 the         
,secretary shall reference cancer       
survivorship guidelines developed by    
cancer care professional societies1     
patient organizations1 research         
foundations1 and other health care      
professional societies in the           
development of materials related to     
survivorship care4  7#c7 ,support       
partnerships between cancer specialty   
societies and primary care provider     
organizations ,in establishing and      
operating the ,center1 the ,secretary   
shall facilitate collaboration between  

cancer care specialty societies and     
primary care provider organizations in  
the development of standards for        
survivorship care1 including standards  
for coordination of care and transitions
 of care from active treatment to       
long-term survivorship care4  7d7       
,campaign ,to educate survivors and     
health care professionals in            
survivorship care  7#a7 ,in general ,the
 ,secretary acting through the ,director
 of the ,centers for ,disease ,control  
and ,prevention 7in this subsection     
referred to as the ,secretary7 shall--  
7,a7 expand educational programs and    
services to--  7i7 health care          
professionals2 and  7ii7 cancer         
survivors1 their families1 and          
caregivers2 and  7,b7 enhance the       
continuing medical education resources  
on cancer survivorship that are         
available to health care professionals4 
7#b7 ,expand collaboration with         
,comprehensive ,cancer ,control         
,national ,partnership and other        

organizations for survivorship education
 and support  7,a7 ,in general ,the     
,secretary shall expand collaborations  
with organizations that are part of the 
,comprehensive ,cancer ,control         
,national ,partnership and other        
organizations to focus on increasing    
education and awareness related to      
cancer survivorship through materials1  
resources1 and other methods as         
necessary4  7,b7 ,collaborate with the  
organizations in the ,national          
,partnership and other organizations    
,the ,secretary shall collaborate with  
the organizations that are part of the  
,comprehensive ,cancer ,control         
,national ,partnership and other        
organizations to inform cancer survivors
 of survivorship monitoring and         
follow-up standards1 availability of    
survivorship care services1 and how to  
access these services4  7,c7 ,reference 
the survivorship standards of care      
developed and published by cancer       
organizations ,in collaboration with    

organizations that support the ,national
 ,comprehensive ,cancer ,control        
,program1 the ,secretary shall--  7i7   
develop and implement a plan to         
distribute survivorship educational     
materials to ensure that such materials 
are accessible to all cancer survivors1 
their families and caregivers1 and      
health care professionals2 and  7ii7    
reference in such plan the survivorship 
standards of care developed and         
published by such organizations4  7#c7  
,continuing medical education  7,a7     
,development of programs  7i7 ,grants   
and contracts ,the ,secretary shall     
carry out a program of awarding grants  
and contracts to eligible entities to   
support the development of continuing   
medical education programs for          
survivorship care that utilize and rely 
on the guidelines for survivorship care 
developed and published by national     
organizations4  7ii7 ,timing ,not later 
than #ab months after the date of       
enactment of this ,act1 the ,secretary  

shall initiate the program required by  
clause 7i74  7,b7 ,grants for           
development of curriculum for           
survivorship continuing medical         
education  7i7 ,in general ,the         
,secretary shall award grants to        
eligible entities for development of    
diverse1 equitable1 and culturally      
appropriate curricula for survivorship  
care curriculum for medical care4  7ii7 
,scope of curriculum ,to receive a grant
 under this section1 an applicant shall 
demonstrate its ability to develop      
survivorship care curriculum for medical
 care1 taking into consideration        
services from the legal1 social work1   
public health1 behavioral sciences1     
genetic1 epidemiology1 and nursing      
fields4  7,c7 ,eligible entities ,in    
this paragraph1 the term eligible entity
 includes a medical professional        
society1 a patient organization1 an     
academic institution1 a cancer center1  
and any other entity with experience in 
continuing medical education for cancer 

professionals4  7#d7 ,public awareness  
campaign ,the ,secretary1 at an         
appropriate time after the availability 
of patient survivorship materials1      
professional survivorship materials1 and
 continuing medical education programs  
under this subsection1 shall initiate a 
linguistically and culturally           
appropriate public awareness campaign   
that targets the organization's         
catchment area to ensure that cancer    
survivors1 their families and           
caregivers1 health care professionals1  
and the public are aware of the scope of
 survivorship educational and           
informational resources available from  
the ,centers for ,disease ,control and  
,prevention4  7e7 ,cancer survivorship  
quality-of-,life program  7#a7 ,in      
general ,the ,secretary acting through  
the ,director of the ,centers for       
,disease ,control and ,prevention 7in   
this subsection referred to as the      
,secretary7 shall carry out a program of
 awarding grants to eligible entities to

 provide services to cancer survivors to
 enhance their quality of life and      
improve their long-term survival rates4 
,not later than #ah months after the    
date of enactment of this ,act1 the     
,secretary shall commence operating such
 program4  7#b7 ,eligible entity defined
 ,in this subsection1 the term eligible 
entity includes an entity that is--     
7,a7 a ,state comprehensive cancer      
program2  7,b7 a ,national ,cancer      
,institute-designated cancer center or  
centers2 or  7,c7 a community-based     
organization1 including a patient       
advocacy organization1 that-- 7i7 has   
the capacity to reach cancer survivors  
through local1 ,state1 or national      
organizations2 and  7ii7 is focused on  
cancer survivors and strategies for     
meeting their needs related to their    
health and well-being4  7#c7 ,use of    
funds ,a grant received under this      
subsection shall be used to provide     
services to cancer survivors to enhance 
their quality of life and improve their 

long-term survival rates1 such as by    
assisting survivors to--  7,a7 engage in
 moderate physical activity and other   
health-promoting activities1 including  
ceasing tobacco use and increasing      
consumption of healthy foods2  7,b7     
increase access to services to mitigate 
anxiety1 depression1 and uncertainty2   
7,c7 utilize community support services 
to fully implement survivorship care    
plans2  7,d7 access nutrition education 
and counseling2 and  7,e7 adhere to a   
schedule for1 and access1 screening for 
recurrence of cancer or the occurrence  
of other primary cancers4  7#d7         
,standards for application from eligible
 entities ,to seek a grant under this   
subsection1 an eligible entity shall    
submit an application1 at such time as  
may be required by the ,secretary1 that 
includes--  7,a7 an explanation of how  
the entity will-- 7i7 provide cancer    
survivors access to cancer patient      
navigator services2  7ii7 overcome      
barriers to care for communities of     

color and multilingual communities2     
7iii7 provide culturally competent care2
 and  7iv7 work with and support        
caregivers of cancer survivors2  7,b7 a 
description of how the entity receives  
referrals of cancer survivors from      
health care professionals1 including    
health care professionals serving       
historically disadvantaged and          
underserved communities2  7,c7          
documentation of the curriculum that    
will be used for providers in the       
program1 including mechanisms to update 
the staff on curriculum changes2 and    
7,d7 an agreement to provide the        
,secretary semiannual reports on--  7i7 
the number of participants served2  7ii7
 quality-of-life measures for           
participants2 and  7iii7 plans for      
fostering communication between oncology
 and non-oncology providers serving     
participants4  7#e7 ,responsibilities of
 the ,secretary ,the ,secretary shall-- 
7,a7 conduct outreach to inform health  
care professionals of the availability  

of programs and activities funded under 
this subsection2  7,b7 analyze the data 
submitted by grantees under this        
subsection to determine the number of   
cancer survivors served and the impact  
of the program under this subsection on 
their quality of life2 and  7,c7 share  
best practices among all grantees under 
this subsection4  #aa4 ,adult cancer    
survivorship study  7a7 ,in general ,not
 later than #ah months after the date of
 enactment of this ,act1 the ,secretary 
shall complete a landscape analysis     
that--  7#a7 assesses the potential     
benefits of an adult version of the     
,childhood ,cancer ,survivor ,study2    
7#b7 assesses the financial costs and   
other burdens associated with an adult  
cancer survivor study2  7#c7 identifies 
sources of data on adult cancer         
survivors2  7#d7 identifies gaps in data
 on adult cancer survivors1 compared to 
data collected in the ,childhood ,cancer
 ,survivor ,study2 and  7#e7 identifies 
strategies to publish data on adult     

cancer survivors derived from research  
that is conducted or supported by the   
,national ,cancer ,institute1 in a      
manner that is accessible to cancer     
survivors1 health care professionals1   
researchers1 and the public4  7b7       
,report ,not later than #f months after 
the date of completion of the landscape 
analysis under subsection 7a71 the      
,secretary shall submit to the ,congress
 a report on the results of such        
landscape analysis4  #ab4 ,survivorship 
progress report  7a7 ,in general ,not   
later than #f months after the date of  
enactment of this ,act1 the ,secretary  
shall enter into an agreement with the  
,government ,accountability ,office to  
conduct a study of the progress made in 
cancer survivorship over the period     
beginning on the date of enactment of   
the ,national ,cancer ,act of #aiga     
7,public ,law #ib-baf74  7b7 ,scope of  
the study ,the study under subsection   
7a7 shall investigate developments over 
the period described in subsection 7a7  

in--  7#a7 the nature and quality of    
survivorship care2  7#b7 transitions    
from active treatment to survivorship   
care2  7#c7 the quality of life of      
cancer survivors2  7#d7 outcomes for    
cancer survivors2  7#e7 disparities in  
access to care and survivorship         
outcomes2  7#f7 the health care systems 
for providing survivorship care2  7#g7  
the contribution of community-based     
services to the survivorship care       
system2 and  7#h7 payment for           
survivorship care by public and private 
third-party payors4  7c7 ,role of       
,office of ,cancer ,survivorship ,the   
study under subsection 7a7 shall-- 7#a7 
consider the contribution of the ,office
 of ,cancer ,survivorship to the        
evolution of cancer survivorship care   
over the last #be years2 and  7#b7      
assess the impact of the mission of the 
,office and the resources provided to   
the ,office on its leadership in cancer 
survivorship care4  7d7 ,public meeting 
,in conducting the study under          

subsection 7a71 the ,comptroller        
,general of the ,united ,states shall   
hold a public meeting with a broad cross
 section of stakeholders to inform the  
study's findings and conclusions4 ,such 
stakeholders shall include--  7#a7      
cancer survivors and their caregivers   
and families2  7#b7 patient             
organizations representing cancer       
survivors2  7#c7 oncologists involved in
 survivorship care and the professional 
societies representing them2  7#d7      
primary care providers involved in      
survivorship care and the professional  
societies representing them2  7#e7 other
 health professionals providing         
survivorship care and the professional  
societies representing them2  7#f7      
community-based organizations involved  
in survivorship care2  7#g7             
representatives of the ,national ,cancer
 ,institute2  7#h7 third-party payors2  
7#i7 researchers engaged in survivorship
 research2  7#aj7 epidemiologists with  
knowledge of trends in cancer           

survivorship2 and  7#aa7 such other     
stakeholders as the ,comptroller        
,general deems important to participate 
in the public meeting4  7e7 ,report ,the
 ,comptroller ,general of the ,united   
,states shall--  7#a7 release a report  
on the results of the study under       
subsection 7a72 and  7#b7 in addition to
 the public meeting convened under      
subsection 7d7--  7,a7 convene another  
public meeting to be held on the day of 
the release of the report2 and  7,b7    
include in such meeting all categories  
of stakeholders listed in subsection    
7d74  #ac4 ,promoting ,state innovations
 to ease transitions to the primary care
 setting for children with cancer  7a7  
,stakeholder group development of best  
practices2 ,state ,medicaid and ,,chip  
program innovation  7#a7 ,stakeholder   
group best practices ,not later than #ab
 months after the date of the enactment 
of this ,act1 the ,secretary of ,health 
and ,human ,services 7in this section   
referred to as the ,secretary7 shall    

convene a stakeholder group of          
representatives of childhood cancer     
advocacy organizations1 ,medicaid and   
,,chip beneficiaries1 providers with    
childhood cancer pediatric expertise1   
the ,national ,association of ,medicaid 
,directors1 and other relevant          
representatives to develop best         
practices 7and submit to the ,secretary 
and ,congress a report on such best     
practices7 for ,states to ease the      
transition from active oncological care 
to primary care of children or          
adolescents with cancer1 including best 
practices for ensuring development of   
and delivery of summary of care and     
survivorship care plans to patients1    
families1 and primary care providers1   
and best practices for such transitions 
occurring under the ,state ,medicaid    
plan under title ,,xix of the ,social   
,security ,act 7#db ,u4,s4,c4 #acif et  
seq47 or ,state child health plan under 
title ,,xxi of such ,act 7#db ,u4,s4,c4 
#acig;aa et seq471 as applicable4 ,such 

best practices shall include-- 7,a7     
design of models of follow-up care1     
monitoring1 and other survivorship      
programs 7including peer support and    
mentoring programs72  7,b7 development  
of models for providing                 
multidisciplinary care2  7,c7           
dissemination of information to health  
care providers about culturally and     
linguistically appropriate follow-up    
care for cancer survivors and their     
families1 as appropriate and            
practicable2 and  7,d7 dissemination of 
the information and programs described  
in clauses 7i7 through 7iii7 to other   
health care providers 7including primary
 care physicians and internists7 and to 
cancer survivors and their families1    
where appropriate and in accordance with
 ,federal and ,state law4  7#b7 ,state  
,medicaid and ,,chip program innovation 
,the ,secretary shall work with ,states 
on innovative strategies1 based on the  
best practices identified under the     
process described in subsection 7a77#a71

 to ease the transition from active     
oncological care to primary care of     
child or adolescent with cancer ensuring
 development of and delivery of         
survivorship care plans to patients1    
families1 and primary care providers and
 transition coverage under the ,state   
,medicaid plan under title ,,xix of the 
,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq47 or ,state child health   
plan under title ,,xxi of such ,act 7#db
 ,u4,s4,c4 #acig;aa et seq471 as        
applicable4  7#c7 ,nonapplication of    
,federal ,advisory ,committee ,act ,the 
,federal ,advisory ,committee ,act 7#e  
,u4,s4,c4 ,app47 shall not apply to the 
stakeholder group convened under        
paragraph 7#a74  7b7 ,guidance on       
innovative service delivery systems     
demonstration project opportunities ,not
 later than #a year after the date the  
stakeholder group is convened under     
subsection 7a71 the ,secretary of       
,health and ,human ,services shall issue
 guidance to ,state health officials1   

based on best practices developed under 
subsection 7a77#a71 regarding           
opportunities to improve care           
transitions for children and adolescents
 with cancer who transition from        
oncological care to primary care and who
 are otherwise eligible to receive      
medical assistance under title ,,xix of 
such ,act 7#db ,u4,s4,c4 #acif et seq47 
or title ,,xxi of such ,act 7#db        
,u4,s4,c4 #acig;aa et seq474  #ad4      
,childhood cancer demonstration model   
and standard of care ,section           
#aaae;,a7b77#b7 of the ,social ,security
 ,act 7#db ,u4,s4,c4 #acae;a7b77#b77 is 
amended-- 7#a7 in subparagraph 7,a71 by 
striking the period at the end and      
inserting 1 and shall include the model 
described in clause 7xxviii7 of such    
subparagraph42 and  7#b7 in subparagraph
 7,b71 by adding at the end the         
following new clause3  7xxviii7 ,a local
 service delivery and ,state payment    
model for individuals up to age #ba     
enrolled under a ,state plan 7or waiver 

of such plan7 under title ,,xix or a    
,state child health plan 7or waiver of  
such plan7 under title ,,xxi of such    
,act 7#db ,u4,s4,c4 #acig;aa et seq47   
who have been diagnosed with cancer and 
who are in the survivorship phase of    
their treatment4 ,such model shall--    
7,i7 provide for the creation of a      
survivorship plan1 that can be          
integrated into an electronic health    
record1 for such individuals and        
disseminate the plan to such            
individuals1 families of such           
individuals1 and the health providers of
 such individuals2  7,,ii7 offer ,states
 and local providers technical          
assistance to develop and implement     
different survivorship care planning    
services2  7,,iii7 develop a standard of
 care based on the ,children's ,oncology
 ,group 7,,cog7 ,long-,term ,follow-,up 
,guidelines for ,survivors of           
,childhood1 ,adolescent1 and ,young     
,adult ,cancers to manage the transition
 of such individuals from active        

treatment to general care with the      
informed knowledge of such individuals2 
and  7,,iv7 provide incentives to health
 care providers for treating such       
individuals through such model that     
includes at least two survivorship care 
planning visits4  4  #ae4 ,medicaid     
coverage of cancer fertility services   
for cancer survivors  7a7 ,medicaid     
7#a7 ,mandatory coverage ,section       
#aijb7;a77#aj7 of the ,social ,security 
,act 7#db ,u4,s4,c4 #acif;a7 is         
amended-- 7,a7 in subparagraph 7,f71 by 
striking 2 and and inserting a          
semicolon2  7,b7 in subparagrah 7,g71 by
 adding at the end and2 and  7,c7 by    
inserting after subparagraph 7,g7 the   
following new subparagraph3  7,h7       
notwithstanding section                 
#aijb7;a77#aj77;,b7 7relating to        
comparability71 for making medical      
assistance available for cancer         
fertility services 7as defined in       
subsection 7jj772  2 and  7#b7          
,definition ,section #aije of the       

,social ,security ,act 7#db ,u4,s4,c4   
#acif;d7 is amended by adding at the end
 the following new subsection3  7jj7    
,cancer fertility services  7#a7        
,definition ,for purposes of section    
#aijb7;a77#aj77;,h7 and this subsection1
 the term cancer fertility services--   
7,a7 means fertility treatment and      
fertility preservation services for     
individuals diagnosed with cancer who-- 
7i7 are undergoing treatment for such   
cancer where such treatment may lead to 
iatrogenic infertility2  7ii7 previously
 underwent such treatment and may be at 
risk of such infertility due to such    
treatment2 or  7iii7 are preparing to   
undergo such treatment where such       
treatment may lead to such infertility2 
and  7,b7 includes--  7i7 other         
services1 including experimental and    
non-experimental services to preserve   
fertility or treat infertility 7as      
determined by the ,secretary1 consistent
 with established medical practices and 
professional guidelines published by the

 ,american ,society for ,reproductive   
,medicine1 the ,american ,society of    
,clinical ,oncology1 or other           
professional medical organizations      
specified by the ,secretary72 and  7ii7 
long-term storage costs--  7,i7 with    
respect to individuals under the age of 
#ah1 for a period of not less than #ae  
years2 and  7,,ii7 with respect to      
individuals age #ah or older1 for a     
period of not less than #aj years4  7#b7
 ,exception for territories             
,notwithstanding any other provision of 
this title1 in the case of a ,state     
7other than the #ej ,states and the     
,district of ,columbia71 the requirement
 stated in section #aijb7;a77#aj77;,h7  
shall be optional4  4  7#c7 ,prohibition
 on cost-sharing  7,a7 ,in general      
,section #aiaf of the ,social ,security 
,act 7#db ,u4,s4,c4 #acifo7 is amended--
  7i7 in subsection 7a77#b7-- 7,i7 in   
subparagraph 7,i71 by striking at the   
end 1 or and inserting a semicolon2     
7,,ii7 in subparagraph 7,j71 by striking

 at the end 2 and and inserting 2 or2   
and  7,,iii7 by adding at the end the   
following new subparagraph3  7,k7 cancer
 fertility services 7as defined in      
section #aije7;jj772 and  2 and  7ii7 in
 subsection 7b77#b7--  7,i7 in          
subparagraph 7,i71 by striking at the   
end 1 or and inserting a semicolon2     
7,,ii7 in subparagraph 7,j71 by striking
 at the end 2 and and inserting 2 or2   
and  7,,iii7 by adding at the end the   
following new subparagraph3  7,k7 cancer
 fertility services 7as defined in      
section #aije7;jj772 and  4  7,b7       
,application to alternative cost-sharing
 ,section #aiaf;,a7b77#c77;,b7 of the   
,social ,security ,act 7#db ,u4,s4,c4   
#acifo-#a7;b77#c77;,b77 is amended by   
adding at the end the following new     
clause3  7xv7 ,cancer fertility services
 7as defined in section #aije7;jj774  4 
7b7 ,,chip  7#a7 ,in general ,section   
#bajc7;c7 of the ,social ,security ,act 
7#db ,u4,s4,c4 #acig;cc7c77 is amended--
 7,a7 by redesignating the paragraph    

7#ab7 added by section #aadje7;b77#a7 of
 ,public ,law #aag-afi as paragraph     
7#ac72 and  7,b7 by inserting after     
paragraph 7#aa7 the following new       
paragraph3  7#ab7 ,required coverage of 
cancer fertility services for cancer    
survivors ,regardless of the type of    
coverage elected by a ,state under      
subsection 7a71 the child health        
assistance provided for a targeted      
low-income child1 and1 in the case of a 
,state that elects to provide           
pregnancy-related assistance pursuant to
 section #baab1 the pregnancy-related   
assistance provided for a targeted      
low-income pregnant woman 7as such terms
 are defined for purposes of such       
section71 shall include coverage of     
cancer fertility services 7as described 
in section #aije7;jj774  4  7#b7        
,prohibition on cost-sharing ,section   
#bajc7;e77#b7 of the ,social ,security  
,act 7#db ,u4,s4,c4 #acig;cc7e77#b77 is 
amended-- 7,a7 in the heading1 by       
inserting cancer fertility services1    

after covid-#ai treatment12 and  7,b7 by
 inserting cancer fertility services 7as
 described in section #aije7;jj771 after
 testing or treatments described in     
section #aiaf7;a77#b77;,i7 furnished    
during the period described in such     
section14  7#c7 ,effective date ,the    
amendment made by paragraph 7#a77;,a7   
shall take effect on ,october #a1 #bjbc4
  7c7 ,effective date ,the amendments   
made by this section 7other than the    
amendment made by subsection            
7b77#a77;,a77 shall apply with respect  
to medical assistance1 child health     
assistance1 and pregnancy-related       
assistance furnished on or after the    
date that is #ah months after the date  
of the enactment of this ,act4