[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 2720 Introduced in Senate (IS)]


  1st Session
                                S. 2720

  To direct the Secretary of Veterans Affairs to establish a national 
     clinical pathway for prostate cancer, and for other purposes.



                           September 13, 2021

 Mr. Moran (for himself and Mr. Tester) introduced the following bill; 
which was read twice and referred to the Committee on Veterans' Affairs


                                 A BILL

  To direct the Secretary of Veterans Affairs to establish a national 
     clinical pathway for prostate cancer, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,


    This Act may be cited as the ``Veterans' Prostate Cancer Treatment 
and Research Act''.


    Congress makes the following findings:
            (1) Prostate cancer is the number one cancer diagnosed in 
        the Veterans Health Administration.
            (2) A 1996 report published by the National Academy of 
        Sciences, Engineering, and Medicine established a link between 
        prostate cancer and exposure to herbicides, such as Agent 
            (3) It is essential to acknowledge that due to these 
        circumstances, certain veterans are made aware that they are 
        high-risk individuals when it comes to the potential to develop 
        prostate cancer.
            (4) In being designated as ``high risk'', it is essential 
        that veterans are proactive in seeking earlier preventative 
        clinical services for the early detection and successful 
        treatment of prostate cancer, whether that be through the 
        Veterans Health Administration or through a community provider.
            (5) Clinical preventative services and initial detection 
        are some of the most important components in the early 
        detection of prostate cancer for veterans at high risk of 
        prostate cancer.
            (6) For veterans with prostate cancer, including prostate 
        cancer that has metastasized, precision oncology, including 
        biomarker-driven clinical trials and innovations underway 
        through the Prostate Cancer Foundation and Department of 
        Veterans Affairs partnership, represents one of the most 
        promising areas of interventions, treatments, and cures for 
        such veterans and their families.

              PROSTATE CANCER.

    (a) Establishment of Clinical Pathway.--
            (1) In general.--Not later than 365 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall establish an interdisciplinary clinical pathway for all 
        stages of prostate cancer, from early detection to end of life 
        care. The clinical pathway shall be established in the National 
        Surgery Office of the Department of Veterans Affairs in close 
        collaboration with the National Program Office of Oncology, the 
        Office of Research and Development, and other relevant entities 
        of the Department, including Primary Care.
            (2) Elements.--The national clinical pathway established 
        under this subsection shall include the following elements:
                    (A) A diagnosis pathway for prostate cancer that 
                includes early screening and diagnosis protocol, 
                including screening recommendations for veterans with 
                evidence-based risk factors.
                    (B) A treatment pathway that details the respective 
                roles of each office of the Department that will 
                interact with veterans receiving prostate cancer care, 
                including treatment protocol recommendations for 
                veterans with evidence-based risk factors.
                    (C) Treatment recommendations for all stages of 
                prostate cancer that reflect nationally recognized 
                standards for oncology, including National 
                Comprehensive Cancer Network guidelines.
                    (D) A suggested protocol timeframe for each point 
                of care, from early screening to treatment and end-of-
                life care, based on severity and stage of cancer.
                    (E) A plan that includes, as appropriate, both 
                Department medical facilities and community-based 
                partners and providers and research centers 
                specializing in prostate cancer, especially such 
                centers that have entered into partnerships with the 
            (3) Collaboration and coordination.--In establishing the 
        clinical pathway required under this section, the Secretary may 
        collaborate and coordinate with--
                    (A) the National Institutes of Health;
                    (B) the National Cancer Institute;
                    (C) the National Institute on Minority Health and 
                Health Disparities;
                    (D) the Centers for Disease Control and Prevention;
                    (E) the Centers for Medicare and Medicaid Services;
                    (F) the Patient-Centered Outcomes Research 
                    (G) the Food and Drug Administration;
                    (H) the Department of Defense; and
                    (I) other Institutes and Centers as the Secretary 
                determines necessary.
            (4) Consultation requirement.--In establishing the clinical 
        pathway required under this section, the Secretary shall 
        consult with, and incorporate feedback from, veterans who have 
        received prostate cancer care at Department medical facilities 
        as well as experts in multi-disciplinary cancer care and 
        clinical research.
            (5) Publication.--The Secretary shall--
                    (A) publish the clinical pathway established under 
                this subsection on a publicly available Department 
                website; and
                    (B) update the clinical pathway as needed by review 
                of the medical literature and available evidence-based 
                guidelines at least annually, in accordance with the 
                criteria under paragraph (2).
    (b) Development of Comprehensive Prostate Cancer Program and 
Implementation of the Prostate Cancer Clinical Pathway.--
            (1) Establishment.--Not later than 180 days after the date 
        of the enactment of this Act, the Secretary shall submit to 
        Congress a plan to establish a prostate cancer program using 
        the comprehensive prostate cancer clinical pathway developed 
        under subsection (a).
            (2) Program requirements.--The comprehensive prostate 
        cancer program shall--
                    (A) receive direct oversight from the Deputy 
                Undersecretary for Health of the Department of Veterans 
                    (B) include a yearly program implementation 
                evaluation to facilitate replication for other disease 
                states or in other healthcare institutions;
                    (C) be metric driven and include the development of 
                biannual reports on the quality of prostate cancer 
                care, which shall be provided to the leadership of the 
                Department, medical centers, and providers and made 
                publicly available in an electronic form; and
                    (D) include an education plan for patients and 
            (3) Program implementation evaluation.--The Secretary shall 
        establish a program evaluation tool to learn best practices and 
        to inform the Department and Congress regarding further use of 
        the disease specific model of care delivery.
            (4) Prostate cancer research.--The Secretary shall submit 
        to Congress a plan that provides for continual funding through 
        the Office of Research and Development of the Department of 
        Veterans for supporting prostate cancer research designed to 
        position the Department as a national resource for prostate 
        cancer detection and treatment. Such plan shall--
                    (A) include details regarding the funding of and 
                coordination between the National Precision Oncology 
                Program of the Department and the PCF-VA Precision 
                Oncology Centers of Excellence as related to the 
                requirements of this Act; and
                    (B) affirm that no funding included in such funding 
                plan is duplicative in nature.
    (c) Report on National Registry.--The Secretary of Veterans Affairs 
shall submit to Congress a report on the barriers and challenges 
associated with creating a national prostate cancer registry. Such 
report shall include recommendations for centralizing data about 
veterans with prostate cancer for the purpose of improving outcomes and 
serving as a resource for providers.
    (d) Definitions.--In this section:
            (1) The term ``clinical pathway'' means a health care 
        management tool designed around research and evidence-backed 
        practices that provides direction for the clinical care and 
        treatment of a specific episode of a condition or ailment.
            (2) The term ``evidence-based risk factors'' includes race, 
        ethnicity, socioeconomic status, geographic location, exposure 
        risks, genetic risks, including family history, and such other 
        factors as the Secretary determines appropriate.