1.Short title; Table of
contentsThis Act may be cited
as the Comprehensive Cancer Care
Improvement Act of 2011
.
Sec. 1. Short title; Table of contents.
Sec. 2. Findings.
Title I—COMPREHENSIVE CANCER CARE UNDER THE MEDICARE
PROGRAM
Sec. 101. Coverage of cancer care planning
services.
Title II—PROVIDER EDUCATION REGARDING PALLIATIVE CARE AND SYMPTOM
MANAGEMENT
Sec. 201. Grants to improve health professional
education.
Sec. 202. Grants to improve continuing professional
education.
Title III—RESEARCH ON TOPICS RELATED TO COORDINATION OF CARE,
SYMPTOM MANAGEMENT, AND PALLIATIVE CARE FOR CANCER PATIENTS
Sec. 301. Research program.
2.Congress makes the following
findings:
(1)Individuals with
cancer often do not have access to a cancer care system that provides
comprehensive and coordinated care of high quality.
(2)The cancer care
system has not traditionally offered individuals with cancer a prospective and
comprehensive plan for treatment and symptom management, strategies for
updating and evaluating such plan with the assistance of a health care
professional, and a follow-up plan for monitoring and treating possible late
effects of cancer and its treatment.
(3)Cancer survivors
often experience the under-diagnosis and under-treatment of the symptoms of
cancer, a problem that begins at the time of diagnosis and may become more
severe with disease progression and at the end of life. The failure to treat
the symptoms, side effects, and late effects of cancer and cancer treatment may
have a serious adverse impact on the health, survival, well-being, and quality
of life of cancer survivors.
(4)Cancer survivors
who are members of racial and ethnic minority groups may face severe obstacles
in receiving coordinated cancer care that includes appropriate management of
cancer symptoms and treatment side effects.
(5)Individuals with
cancer are sometimes not provided information about their disease and treatment
options that might result in their request for and engagement in coordinated
care that includes appropriate treatment and symptom management.
(6)Comprehensive
cancer care should incorporate access to psychosocial services and management
of the symptoms of cancer and the symptoms of cancer treatment, including pain,
nausea, vomiting, fatigue, and depression.
(7)Comprehensive
cancer care should include a means for providing cancer survivors with a
comprehensive care summary and a plan for follow-up care after primary
treatment to ensure that cancer survivors have access to follow-up monitoring
and treatment of possible late effects of cancer and cancer treatment.
(8)The Institute of
Medicine report entitled Ensuring Quality Cancer Care described
the elements of quality care for an individual with cancer, including—
(A)the development of
initial treatment recommendations by an experienced health care
provider;
(B)the development of
a plan for the course of treatment of the individual and communication of the
plan to the individual;
(C)access to the
resources necessary to implement the course of treatment;
(D)access to
high-quality clinical trials;
(E)a mechanism to
coordinate services for the treatment of the individual; and
(F)psychosocial
support services and compassionate care for the individual.
(9)In its report
From Cancer Patient to Cancer Survivor: Lost in Transition, the
Institute of Medicine recommended that individuals with cancer completing
primary treatment be provided a comprehensive summary of their care along with
a follow-up survivorship plan of treatment.
(10)Since more than
half of all cancer diagnoses occur among elderly Medicare beneficiaries, the
problems of providing cancer care are problems of the Medicare program.
(11)Shortcomings in
providing cancer care, resulting in inadequate management of cancer symptoms
and insufficient monitoring and treatment of late effects of cancer and its
treatment, are related to problems of Medicare payments for such care,
inadequate professional training, and insufficient investment in research on
symptom management.
(12)Changes in
Medicare payment for comprehensive cancer care, enhanced public and
professional education regarding symptom management, and more research related
to coordination of care, symptom management and palliative care will enhance
patient decisionmaking about treatment options and will contribute to improved
care for individuals with cancer from the time of diagnosis of the individual
through the end of the life of the individual.
<enum>I</enum><header>COMPREHENSIVE
CANCER CARE UNDER THE MEDICARE PROGRAM</header>
<section id="H04B42C6A404B47F7A032C35377748C7A"><enum>101.</enum><header>Coverage of
cancer care planning services</header>
<subsection id="H1C92A7F87D5F40CBBDC1F7AE4D8E7BDF"><enum>(a)</enum><header>In
general</header><text>Section 1861 of the Social Security Act is
amended—</text>
<paragraph id="HB3DFE99B50D54D758632AB72D407461F"><enum>(1)</enum><text>in subsection
(s)(2)—</text>
<subparagraph id="HAF8211B3F2EC4280861415A5BC9E9D3D"><enum>(A)</enum><text>by striking
<quote>and</quote> at the end of subparagraph (EE);</text>
</subparagraph><subparagraph id="H9F2C1AE11991499FA316D862C928C789"><enum>(B)</enum><text>by adding
<quote>and</quote> at the end of subparagraph (FF); and</text>
</subparagraph><subparagraph id="HA7EC977421CB4E02850AED08D1377350"><enum>(C)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block id="HC2B54D6BA800444A93B7376F0D3FC994" style="OLC">
<subparagraph id="H9B30EC70E04A4AB58A1E6BD923C8C484"><enum>(GG)</enum><text>comprehensive
cancer care planning services (as defined in subsection
(iii));</text>
</subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H6350BE1600F04E40992F03820A4FB270"><enum>(2)</enum><text>by adding at the
end the following new subsection:</text>
<quoted-block id="HC0A6CD6408384750BE4CA60E79C42321" style="OLC">
<text display-inline="no-display-inline"><header-in-text level="subsection" style="OLC">Comprehensive Cancer Care Planning Services</header-in-text></text>
<subsection display-inline="no-display-inline" id="HC9387BAB84614C1292B047ADCF170373"><enum>(iii)</enum><paragraph commented="no" display-inline="yes-display-inline" id="H0730727BF91C46639E1369458CFA34FA"><enum>(1)</enum><text>The term
<term>comprehensive cancer care planning services</term> means—</text>
<subparagraph id="HB56E78ACEA35435EA4E920DBB8F0E580"><enum>(A)</enum><text>with respect to an
individual who is diagnosed with cancer, the development of a plan of care
that—</text>
<clause id="H620D55944ED146FA9CF8FA13CE5BDF2C"><enum>(i)</enum><text>details, to the
greatest extent practicable, all aspects of the care to be provided to the
individual, with respect to the treatment of such cancer, including any
curative treatment, comprehensive symptom management, and palliative
care;</text>
</clause><clause id="HF88B8CD75C2442069938297A8F6C4E32"><enum>(ii)</enum><text>is furnished, in
person, in written form, to the individual within a period specified by the
Secretary that is as soon as practicable after the date on which the individual
is so diagnosed;</text>
</clause><clause id="H781A6981F00547029F5B60ED5D5067BB"><enum>(iii)</enum><text>is furnished, to
the greatest extent practicable, in a form that appropriately takes into
account cultural and linguistic needs of the individual in order to make the
plan accessible to the individual; and</text>
</clause><clause id="HB5475CD2991D4D088BB8D95FE88F9370"><enum>(iv)</enum><text>is in accordance
with standards determined by the Secretary to be appropriate;</text>
</clause></subparagraph><subparagraph id="HC2D01F9CBAD747D4B3DFEF530998F5A2"><enum>(B)</enum><text>with respect to an
individual for whom a plan of care has been developed under subparagraph (A),
the revision of such plan of care as necessary to account for any substantial
change in the condition of the individual, recurrence of disease, or
significant revision of the elements of curative or palliative care for the
individual, if such revision—</text>
<clause id="HEB7A643AAF6C48D29C36285807D6CF53"><enum>(i)</enum><text>is
in accordance with clauses (i), (iii), and (iv) of such subparagraph;
and</text>
</clause><clause id="H3EE9BD3E53834B9EA964AB823942954F"><enum>(ii)</enum><text>is furnished in
written form to the individual within a period specified by the Secretary that
is as soon as practicable after the date of such revision;</text>
</clause></subparagraph><subparagraph id="HE97C72F49E3E4AB983F199851DF4700A"><enum>(C)</enum><text>with respect to an
individual who has completed the primary treatment for cancer, as defined by
the Secretary (such as the completion of chemotherapy or radiation treatment),
the development of a follow-up cancer care plan that—</text>
<clause id="H38DCE1C696DA4AAF886820CA8111CECD"><enum>(i)</enum><text>describes the
elements of the primary treatment, including symptom management and palliative
care, furnished to such individual;</text>
</clause><clause id="H2365BFB53D054DF1BE7EF2C847BA52DC"><enum>(ii)</enum><text>provides
recommendations for the subsequent care of the individual with respect to the
cancer involved;</text>
</clause><clause id="HC347BE9AF26B43518B6DBE53F891DDE3"><enum>(iii)</enum><text display-inline="yes-display-inline">is furnished, in person, in written form,
to the individual within a period specified by the Secretary that is as soon as
practicable after the completion of such primary treatment;</text>
</clause><clause id="H64F45788A59A4C56B5B6E202A297E6EA"><enum>(iv)</enum><text>is furnished, to
the greatest extent practicable, in a form that appropriately takes into
account cultural and linguistic needs of the individual in order to make the
plan accessible to the individual; and</text>
</clause><clause id="HE6BED8C20E374223988E064829D33BD5"><enum>(v)</enum><text>is
in accordance with standards determined by the Secretary to be appropriate;
and</text>
</clause></subparagraph><subparagraph id="HCDFA8D77A9C7454A978FEBCA74CC662D"><enum>(D)</enum><text>with respect to an
individual for whom a follow-up cancer care plan has been developed under
subparagraph (C), the revision of such plan as necessary to account for any
substantial change in the condition of the individual, diagnosis of a second
cancer, or significant revision of the plan for follow-up care, if such
revision—</text>
<clause id="HF78D3D504F93483A88673E9463B372F6"><enum>(i)</enum><text>is
in accordance with clauses (i), (ii), (iv), and (v) of such subparagraph;
and</text>
</clause><clause id="HA48B87C13EDC48A89B2D1059D3EA9411"><enum>(ii)</enum><text>is furnished in
written form to the individual within a period specified by the Secretary that
is as soon as practicable after the date of such revision.</text>
</clause></subparagraph></paragraph><paragraph id="H84ED61525FD84432AABCDC67EE517BE0"><enum>(2)</enum><text>The Secretary
shall establish standards to carry out paragraph (1) in consultation with
appropriate organizations representing providers of services related to cancer
treatment and organizations representing survivors of cancer. Such standards
shall include standards for determining the need and frequency for revisions of
the plans of care and follow-up plans based on changes in the condition of the
individual or elements and intent of treatment and standards for the
communication of the plan to the
patient.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H2E6D8F2D38B5450080CB25DF51819897"><enum>(b)</enum><header>Payment</header><text>Section
1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended by
striking <quote>and</quote> before <quote>(Z)</quote> and inserting before the
semicolon at the end the following: <quote>, and (AA) with respect to
comprehensive cancer care planning services described in any of subparagraphs
(A) through (D) of section 1861(iii)(1), the amount paid shall be an amount
equal to the sum of (i) the national average amount under the physician fee
schedule established under section 1848 for a new patient office consultation
of the highest level of service in the non-facility setting, and (ii) the
national average amount under such fee schedule for a physician certification
described in section 1814(a)(2) for home health services furnished to an
individual by a home health agency under a home health plan of
care</quote>.</text>
</subsection><subsection id="HE6B3BF25E18F4BA0B2C28A5F5D5C539E"><enum>(c)</enum><header>Effective
date</header><text>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 Act.</text>
</subsection></section><enum>II</enum><header>PROVIDER
EDUCATION REGARDING PALLIATIVE CARE AND SYMPTOM MANAGEMENT</header>
<section id="HEF4FF148E46942C0AB7A2F5C4C5EBD89"><enum>201.</enum><header>Grants to
improve health professional education</header>
<subsection id="HC05D2F71B7244DCB8DFB879F838B43EE"><enum>(a)</enum><header>In
general</header><text>The Secretary of Health and Human Services shall make
grants to eligible entities to enable the entities to improve the quality of
graduate and postgraduate training of physicians, nurses, and other health care
providers in developing cancer care plans for cancer patients and communicating
such plans to the individual patients.</text>
</subsection><subsection id="H0E8D9BDB15974B2DBB773090D9D1B423"><enum>(b)</enum><header>Application</header><text>To
seek a grant under this section, an eligible entity shall submit an application
at such time, in such manner, and containing such information as the Secretary
may require. At a minimum, the Secretary shall require that each such
application demonstrate—</text>
<paragraph id="H0A53D54FB8BB4F30B6E3A461E00B24C3"><enum>(1)</enum><text>the ability to
train health professionals in—</text>
<subparagraph id="H505D1A87543A4ACCB76D1895FCCE3B79"><enum>(A)</enum><text>the provision of
cancer care that fully coordinates active treatment, symptom management, and
palliative care; and</text>
</subparagraph><subparagraph id="HED0703960EE04739BC4FEED561247304"><enum>(B)</enum><text>the communication
of a written plan for coordinated cancer care to the patient; and</text>
</subparagraph></paragraph><paragraph id="HDD3614277F9C4C3E973D94C0D6B8258E"><enum>(2)</enum><text>the ability to
collect and analyze data related to the effectiveness of such training
programs.</text>
</paragraph></subsection><subsection id="H1D775E978EA34B208D8498D298617F46"><enum>(c)</enum><header>Evaluation</header><text>The
Secretary shall develop and implement a plan for evaluating the effects of the
training programs funded under this section.</text>
</subsection><subsection id="HB0622B4EF0EA4EB8A10B4C4FE5B2986C"><enum>(d)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H72EC7E6106594732953EE09839C44420"><enum>(1)</enum><text display-inline="yes-display-inline">The term <term>eligible entity</term> means
an entity that is a—</text>
<subparagraph id="H54F565CF80DA4E9E9DEB92D05F2ABB38"><enum>(A)</enum><text>cancer center
(including an NCI-designated cancer center);</text>
</subparagraph><subparagraph id="H0232CFC62F31489BB4FF082FB69FCB68"><enum>(B)</enum><text>academic health
center;</text>
</subparagraph><subparagraph id="HE0CAEFD418C54FC0927F35B55A26ACBE"><enum>(C)</enum><text>physician
practice;</text>
</subparagraph><subparagraph id="H4AD534869AC14051ABE3475900FEF719"><enum>(D)</enum><text>school of
nursing;</text>
</subparagraph><subparagraph id="H7BACC4D24A31486A88E616AC06D785A8"><enum>(E)</enum><text>visiting nurse
association;</text>
</subparagraph><subparagraph id="H07F7CC1A7A204D6B8696C2F91E7B6AA8"><enum>(F)</enum><text>home care agency;
or</text>
</subparagraph><subparagraph id="H39750BC0846F4CC6802BB82952C94D9B"><enum>(G)</enum><text>a private
non-profit organization with expertise and experience in health provider
training.</text>
</subparagraph></paragraph><paragraph id="HDE5A88E2643241F68BFBFA69A5604E52"><enum>(2)</enum><text>The term
<term>NCI-designated cancer center</term> means a cancer center receiving funds
through a P30 Cancer Center Support Grant of the National Cancer
Institute.</text>
</paragraph><paragraph id="HA429053B4248497A82C1012405E05A36"><enum>(3)</enum><text>The term
<term>Secretary</term> means the Secretary of Health and Human Services.</text>
</paragraph></subsection><subsection id="H6494206937DB470C9DA1A6BBB0686326"><enum>(e)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated $5,000,000 for each of the fiscal years 2012 through
2016.</text>
</subsection></section><section id="H8CF0E43F74B24EF8BFAE0A334DA0C8A4"><enum>202.</enum><header>Grants to
improve continuing professional education</header>
<subsection id="H1DF8303CBFBF44E1A6C40A1B4C7DDACE"><enum>(a)</enum><header>In
general</header><text>The Secretary of Health and Human Services shall make
grants to eligible entities to improve the quality of continuing professional
education provided to qualified individuals regarding the development and
communication of written cancer care plans that outline a system of care that
coordinates active treatment and palliative care.</text>
</subsection><subsection id="H6AF429ABF142441EB135D7215C92F47B"><enum>(b)</enum><header>Application</header><text>To
seek a grant under this section, an eligible entity shall submit an application
at such time, in such manner, and containing such information as the Secretary
may require. At a minimum, the Secretary shall require that each such
application demonstrate—</text>
<paragraph id="HE8DC8E5E08004629A2A1ACFD68E103F7"><enum>(1)</enum><text>experience in
sponsoring continuing professional education programs;</text>
</paragraph><paragraph id="H6168BB47F85341298186B419FA9AF0A0"><enum>(2)</enum><text>the ability to
reach health care providers and other professionals who are engaged in cancer
care with such continuing professional education programs;</text>
</paragraph><paragraph id="HBAC3D8E04E7749849B566D6FFAAD653B"><enum>(3)</enum><text>the capacity to
develop innovative training programs aimed at enhancing the delivery of
coordinated cancer care that includes appropriate symptom management and
palliative care; and</text>
</paragraph><paragraph id="H737C97350CA945428DCBEB5722A15807"><enum>(4)</enum><text>the ability to
evaluate the effectiveness of such professional education and training
programs.</text>
</paragraph></subsection><subsection id="H35AB653D91AE480A81CB5F0E0FFF120F"><enum>(c)</enum><header>Evaluation</header><text display-inline="yes-display-inline">The Secretary shall develop and implement a
plan for evaluating the effects of the continuing professional education and
training programs funded under this section.</text>
</subsection><subsection id="HC97D78B32B02466DAE6B7AE959747AD6"><enum>(d)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H9D6A42392F1E40709DAB8AD3731CE5C6"><enum>(1)</enum><text>The term
<term>eligible entity</term> means an entity that is a—</text>
<subparagraph id="H6DE427306CA54B77875D76BDB3C5CBBE"><enum>(A)</enum><text>cancer center
(including an NCI-designated cancer center);</text>
</subparagraph><subparagraph id="HB9FFC40A017B420A93C835D5F8720772"><enum>(B)</enum><text>academic health
center;</text>
</subparagraph><subparagraph id="HFC5D0318FD5048298D72A3E3A4C9CDC5"><enum>(C)</enum><text>school of
nursing;</text>
</subparagraph><subparagraph id="HEB5DC68634F245209BCD82B42ACD14EB"><enum>(D)</enum><text>professional
society that supports continuing professional education programs; or</text>
</subparagraph><subparagraph id="H16E3755C117C4CDC9260F877E9A0D581"><enum>(E)</enum><text display-inline="yes-display-inline">private non-profit organization with
expertise and experience in health provider training.</text>
</subparagraph></paragraph><paragraph id="H4725F341A5994EA38F4C993E754B38DB"><enum>(2)</enum><text>The term
<term>NCI-designated cancer center</term> means a cancer center receiving funds
through a P30 Cancer Center Support Grant of the National Cancer
Institute.</text>
</paragraph><paragraph id="HE4D0F95E62D04638B3ED83E0B088F893"><enum>(3)</enum><text>The term
<term>qualified individual</term> means a physician, nurse, social worker,
chaplain, psychologist, or other individual who is involved in providing
comprehensive cancer care, including active treatment, symptom management, and
palliative care, to cancer patients.</text>
</paragraph><paragraph id="H06745390BDEF4AA99DDDCCDF6B31BD31"><enum>(4)</enum><text>The term
<term>Secretary</term> means the Secretary of Health and Human Services.</text>
</paragraph></subsection><subsection id="H056A78EEFBF44A42A4B86BDB494BB7F4"><enum>(e)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated $5,000,000 for each of the fiscal years 2012 through
2016.</text>
</subsection></section><enum>III</enum><header>RESEARCH ON
TOPICS RELATED TO COORDINATION OF CARE, SYMPTOM MANAGEMENT, AND PALLIATIVE CARE
FOR CANCER PATIENTS</header>
<section id="H29894AD9DA0A44779AD921EABB80B098"><enum>301.</enum><header>Research
program</header>
<subsection id="H6BE34EE357E04DDB876B4B28CE9383E9"><enum>(a)</enum><header>In
general</header><text>The Secretary of Health and Human Services shall provide
investment, through existing research programs, for research on topics related
to cancer care planning, cancer care coordination, symptom management,
palliative care, and comprehensive survivorship care</text>
</subsection><subsection id="HD25E8FB9983247C2818F558EBB877D6B"><enum>(b)</enum><text>In carrying out
the research authorized under this section, the Secretary should provide for
the participation of institutes and centers of the National Institutes of
Health, the Centers for Medicare & Medicaid Services, and any other
national research institute that has been engaged in research described in
subsection (a).</text>
</subsection><subsection id="H662CE891F51F4D9189872D4C56E3056B"><enum>(c)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated $5,000,000 for each of the fiscal years 2012 through
2016.</text>
</subsection></section>