,i  #aaith ,,congress  #b;d ,session    
,h4 ,r4 #hhci  ,,in ,,the ,,house ,,of  
,,representatives  ,may #ad1 #bjbf ,ms4 
,wasserman ,schultz 7for herself1 ,mr4  
,fitzpatrick1 ,mr4 ,de,saulnier1 ,mr4   
,wilson of ,south ,carolina1 and ,mr4   
,kennedy of ,new ,york7 introduced the  
following bill2 which was referred to   
the ,committee on ,energy and ,commerce1
 and in addition to the ,committees on  
,ways and ,means1 and ,education and    
,workforce1 for a period to be          
subsequently determined by the ,speaker1
 in each case for consideration of such 
provisions as fall within the           
jurisdiction of the committee concerned 
,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 ,lainie ,jones 
,comprehensive ,cancer ,survivorship    
,act of #bjbf4  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        
,stakeholder meeting on survivorship    
transition tools2 publication of        
information resources4 ,sec4 #f4        
,alternative payment model for quality  
cancer survivorship care4 ,sec4 #g4     
,cancer survivor employment assistance  
program4 ,sec4 #h4 ,comprehensive cancer
 survivorship program4 ,sec4 #i4        
,survivorship progress report4 ,sec4    

#aj4 ,medicaid coverage of healthcare   
transitions for survivors of childhood  
and adolescent cancer4 ,sec4 #aa4       
,medicaid coverage of cancer fertility  
services for cancer survivors4 ,sec4    
#ab4 ,office of ,cancer ,survivorship4  
#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            
,stakeholder meeting on survivorship    
transition tools2 publication of        
information resources  7a7 ,in general  
,the ,secretary shall convene a         
stakeholder meeting 7in this section    
referred to as the meeting7 to evaluate 
strategies1 including the use of        
information technology1 to improve      
transitions in care from active         
treatment to long-term4  7b7            
,participants ,in conducting the        
meeting1 the ,secretary shall ensure    
that the participants include           
representatives of patient advocacy     
organizations1 medical professional     
societies1 community-based              
organizations1 electronic health record 
vendors1 information technology experts1
 and other stakeholders of the meeting4 
7c7 ,consideration of existing tools ,in

 conducting the meeting1 the ,secretary 
shall ensure that the participants      
consider existing tools for improving   
transitions to survivorship care1 such  
as-- 7#a7 the survivorship guidelines of
 the ,national ,comprehensive ,cancer   
,network and the ,american ,society of  
,clinical ,oncology2  7#b7 the ,passport
 for ,care survivor website2  7#c7      
survivorship care software applications 
that have been developed by patient     
advocacy organizations1 research        
foundations1 and for-profit entities2   
and  7#d7 other information and tools   
that may improve transitions in care and
 improve overall quality of survivorship
 care4  7d7 ,consideration of privacy   
and security implications ,in conducting
 the meeting1 the ,secretary shall      
feature collaboration 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 plan that outlines    
future health care needs after          
completion of active treatment2  7#b7   
patient use of computer or mobile       
phone-based application programs        
described in subsection 7c77#c72 and    
7#c7 taking into consideration the      
results of meeting under subsection 7a74
  7e7 ,publication of information       
resources  7#a7 ,in general ,not later  
than #cf months after the date of       
enactment of this ,act1 the ,secretary  
shall1 taking into consideration the    
results of the meeting1 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 care4  7#b7 ,inclusion of     
recommendations on patient use of       
software application programs ,the      
information resources referred to in    

paragraph 7#a7 shall include            
recommendations on patient use of       
software application programs to develop
 personalized survivorship care plans4  
7f7 ,electronic health record defined   
,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 for quality  
cancer survivorship care  7a7 ,in       
general ,not later than one year after  
the date of enactment of this ,act1 the 
,secretary of ,health and ,human        
,services shall develop an alternative  
payment model for payments made under   
titles ,,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   
7b7 ,report to ,congress ,following     
development of the alternative payment  

model under subsection 7a71 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 participation1 or
 a definition of survivorship care as   
extending until death4  7#c7 ,in the    
case that such model is based on an     
episode of care1 the appropriate length 
of the survivorship episode of care1    
whether additional episodes may be      
triggered1 if necessary1 and whether the
 episode should end at the beneficiary's
 death but not before4  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 the navigation   
services that will be provided as part  
of such model4  7#f7 ,a description of  
any bundled payment packages that will  
be used under such model4  7#g7 ,a      
specification of any follow-up or new   
screening under such model for unmet    
needs of individuals participating in   
such model4  7#h7 ,a description of 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#i7 ,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#aj7
 ,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#aa7 ,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#ab7 
,strategies for addressing social       
determinants of health through such     
model4  7#ac7 ,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#ad7 ,an  
analysis of how different forms and     
stages of cancer may require the        
development of different survivorship   

plans and suggest variations in elements
 of the alternative payment model based 
on form and stage of cancer4  7#ae7 ,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 ,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  
non-profit 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  #h4        

,comprehensive cancer survivorship      
program  7a7 ,in general ,the ,secretary
 shall carry out a comprehensive cancer 
survivorship program that includes a    
program of supportive care services in  
accordance with subsection 7b7 to       
improve the quality of life and         
long-term survivorship of cancer        
survivors4  7b7 ,cancer survivorship    
quality-of-,life program  7#a7 ,in      
general ,the ,secretary 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  7,c7 share best 
practices among all grantees under this 
subsection2 and  7,d7 consider          
strategies for the coordination of the  
program carried out under this section  
with the alternative payment model for  

quality survivorship care developed     
under section #f to ensure that         
enrollees in the alternative payment    
model have access to the services that  
will be funded through the program4  #i4
 ,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 survivor-ship 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  #aj4 ,medicaid coverage
 of healthcare transitions for survivors
 of childhood and adolescent cancer  7a7
 ,in ,general ,section #aijb7;a77#aj7 of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #acif;a7a77#aj77 is amended-- 
7#a7 in subparagraph 7,f71 by striking 2
 and and inserting a semicolon2  7#b7 in
 subparagraph 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 healthcare     
transitions for survivors of childhood  
and adolescent cancer 7as defined in    
section #aije7;jj772  4  7b7 ,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 ,healthcare           
transitions for survivors of childhood  
and adolescent cancer  7#a7 ,definition 
,for purposes of section                
#aijb7;a77#aj77;,h7 and this subsection1
 the term healthcare transitions for    
survivors of childhood and adolescent   
cancer--  7,a7 means transition services
 from active oncological care to primary
 care of a child or adolescent with     
cancer ensuring development and delivery
 of survivorship care plans to patients1
 families and primary care providers and
 transition coverage2 and  7,b7         
includes--  7i7 transition care based on
 the ,children's ,oncology ,group 7in   
this section referred to as the ,,cog7  
,long-term ,follow-,up ,guidelines for  
,survivors of ,childhood1 ,adolescent1  
and ,young ,adult ,cancers2 and  7ii7   
coverage based on the ,,cog             
exposure-based standard of care for risk
 assessment and surveillance            

recommendations2  7iii7 transition      
services that include evidence-based    
recommendations for screening and       
management of late effects that may     
arise as a result of treatment for      
childhood cancer1 increase awareness of 
potential late effects1 and follow-up   
care for childhood cancer and adolescent
 survivors2 and  7iv7 at least #b       
survivorship transition care visits per 
year4  4  #aa4 ,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 subparagraph 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 7kk772  4  7#b7 ,definition  
,section #aije of the ,social ,security 
,act 7#db ,u4,s4,c4 #acif;d71 as amended
 by section #aj7d7 of this ,act1 is     
further amended by adding at the end the
 following new subsection3  7kk7 ,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 #aije7kk772 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 services    
after ,,covid-#ai treatment2 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     
section4  7#c7 ,effective date ,the     
amendment made by paragraph 7#a77;,a7   
shall take effect on ,october #a1 #bjbf4
  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  #ab4    
,office of ,cancer ,survivorship  7a7   
,in general ,the ,secretary shall       

establish within ,office of the         
,director of the ,national ,cancer      
,institute 7referred to in this section 
as ,,nci7 the ,office of ,cancer        
,survivorship 7referred to in this      
section as the ,office74  7b7 ,purpose  
,the ,office shall function as the      
entity within ,,nci with primary        
responsibility for improving cancer     
survivorship for individuals living with
 and through cancer4  7c7               
,responsibilities ,the ,office shall    
undertake the following                 
responsibilities3  7#a7 ,management of a
 portfolio of research grants focused on
 survivorship topics1 including-- 7,a7  
late and long-term effects of cancer and
 cancer treatment2  7,b7 interventions  
to address late and long-term effects of
 cancer2  7,c7 health delivery models   
that ensure access to quality           
survivorship care for all survivors2 and
  7,d7 communication and education      
efforts to enhance access to            
survivorship care for all survivors4    

7#b7 ,professional education efforts to 
share best practices in survivorship    
care and to improve survivorship care   
delivery4  7#c7 ,survivor education     
efforts related to-- 7,a7 understanding 
the late and long-term effects of cancer
 and cancer treatment2  7,b7 improving  
access to monitoring and follow-up care 
after active treatment for all          
survivors2 and  7,c7 enhancing survivor 
management of long-term follow-up       
survivorship care4