I 112th CONGRESS 1st Session H. R. 3622 IN THE HOUSE OF REPRESENTATIVES December 8, 2011 Mr. Israel (for himself, Mr. Tiberi, Mr. Grijalva, Mr. Hinchey, Mr. Ellison, Mr. Frank of Massachusetts, and Ms. Norton) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to provide comprehensive cancer patient treatment education under the Medicare program and to provide for research to improve cancer symptom management.

1.

Short title; table of contents

(a)

Short title

This Act may be cited as the Assuring and Improving Cancer Treatment Education and Cancer Symptom Management Act of 2011. (b)

Table of contents

The table of contents of this Act is as follows: Sec. 1. Short title; table of contents. Sec. 2. Findings. Title I—Comprehensive Cancer Patient Treatment Education Under the Medicare Program Sec. 101. Medicare coverage of comprehensive cancer patient treatment education services. Title II—Research on Cancer Symptom Management Improvement Sec. 201. Expansion of research. Sec. 202. Nursing intervention research grants. Sec. 203. Institute of Medicine study on the provision of symptom management and supportive care in people with cancer.

2.

Findings

The Congress makes the following findings: (1)Many people with cancer experience side effects, symptoms, and late complications associated with their disease and their treatment, which can have a serious adverse impact on their health, well-being, and quality of life. (2)Many side effects and symptoms associated with cancer and its treatment can be reduced or controlled by the provision of timely symptom management and services and also by educating people with cancer and their caregivers about the potential effects before treatment begins. (3)Studies have found that individualized educational intervention for cancer pain management from a registered nurse was effective for patients with cancer being treated in outpatient and home-based settings. Similarly, the number of caregivers who said they were well informed and confident about caregiving after attending a family caregiver cancer education program increased after program attendance. (4)People with cancer benefit from having an educational session with oncology nurses in advance of the initiation of treatment to learn how to reduce the risk of and manage adverse effects and maximize well-being. Helping patients to manage their side effects reduces adverse events and the need for urgent or inpatient care. (5)The Oncology Nursing Society has received reports from its members that, because the Medicare program and other payers do not cover the provision of patient treatment education, patients and their caregivers often do not receive adequate education before the onset of such patients’ treatment for cancer regarding the course of such treatment and the possible side effects and symptoms such patients may experience. The Oncology Nursing Society recommends that all patients being treated for cancer have a one-on-one educational session with a nurse in advance of the onset of such treatment so that such patients and their caregivers receive the information they need to help minimize adverse events related to such treatment and maximize the well-being of such patients. (6)Insufficient or non-existent Medicare payments coupled with poor investment in symptom management research contribute to the inadequate education of patients, poor management and monitoring of cancer symptoms, and inadequate handling of late effects of cancer and its treatment. (7)People with cancer often do not have the symptoms associated with their disease and the associated treatment managed in a comprehensive or appropriate manner. (8)People with cancer deserve to have access to comprehensive care that includes appropriate treatment and symptom management. (9)Patients who receive infused chemotherapy likely obtain some treatment education during the course of the administration of their treatment; yet, many do not, and individuals who may receive a different type of cancer care, such as radiation or surgical interventions or oral chemotherapy taken at home, likely do not receive treatment education during their treatment. (10)Comprehensive cancer care must include access to services and management associated with nausea, vomiting, fatigue, depression, pain, and other symptoms. (11)The Institute of Medicine report, “Ensuring Quality Cancer Care” asserts that much can be done to relieve the symptoms, ease distress, provide comfort, and in other ways improve the quality of life of someone with cancer. For a person with cancer, maintenance of quality of life requires, at a minimum, relief from pain and other distressing symptoms, relief from anxiety and depressions, including the fear of pain, and a sense of security that assistance with be readily available if needed.. (12)The Institute of Medicine report, Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs recognizes that cancer patients’ psychosocial needs include information about their therapies and the potential side effects. (13)As more than half of all cancer diagnoses occur among individuals age 65 and older, the challenges of managing cancer symptoms are growing for patients enrolled in the Medicare program. (14)Provision of Medicare payment for comprehensive cancer patient treatment education, coupled with expanded cancer symptom management research, will help improve care and quality of life for people with cancer from the time of diagnosis through survivorship or end of life.