Improving Cancer Treatment Education Act of 2012 - Amends title XVIII (Medicare) of the Social Security Act, as amended by the Medicare Improvements for Patients and Providers Act of 2008, to provide for Medicare coverage of comprehensive cancer patient treatment education services.
Expresses the sense of Congress wih respect to continued support by the National Institutes of Health (NIH) in the area of symptom management and the role of nurses in providing those interventions.
Amends the Public Health Service Act to direct the NIH Director to expand, intensify, and coordinate programs for the conduct and support of research with respect to: (1) improving the treatment and management of symptoms and side effects associated with cancer and cancer treatment, and (2) evaluating the role of nursing interventions in the amelioration of such symptoms and side effects.
[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3790 Introduced in House (IH)]
112th CONGRESS
2d Session
H. R. 3790
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.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 18, 2012
Mr. Israel (for himself, Mr. Tiberi, Mr. Frank of Massachusetts, Ms.
Norton, Mr. Ellison, Mr. Grijalva, and Mr. Hinchey) 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.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Improving Cancer
Treatment Education Act of 2012''.
(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. Sense of Congress.
Sec. 202. NIH Research on cancer symptom management improvement.
SEC. 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 which 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.
TITLE I--COMPREHENSIVE CANCER PATIENT TREATMENT EDUCATION UNDER THE
MEDICARE PROGRAM
SEC. 101. MEDICARE COVERAGE OF COMPREHENSIVE CANCER PATIENT TREATMENT
EDUCATION SERVICES.
(a) In General.--Section 1861 of the Social Security Act (42 U.S.C.
1395x) is amended--
(1) in subsection (s)(2)--
(A) by striking ``and'' at the end of subparagraph
(EE);
(B) by adding ``and'' at the end of subparagraph
(FF); and
(C) by adding at the end the following new
subparagraph:
``(GG) comprehensive cancer patient treatment education
services (as defined in subsection (iii)(1));''; and
(2) by adding at the end the following new subsection:
``Comprehensive Cancer Patient Treatment Education Services
``(iii)(1) The term `comprehensive cancer patient treatment
education services' means--
``(A) in the case of an individual who is diagnosed with
cancer, the provision of a one-hour patient treatment education
session delivered by a registered nurse that--
``(i) is furnished to the individual and the
caregiver (or caregivers) of the individual in advance
of the onset of treatment and to the extent
practicable, is not furnished on the day of diagnosis
or on the first day of treatment;
``(ii) educates the individual and such caregiver
(or caregivers) to the greatest extent practicable,
about all aspects of the care to be furnished to the
individual, informs the individual regarding any
potential symptoms, side-effects, or adverse events,
and explains ways in which side effects and adverse
events can be minimized and health and well-being
maximized, and provides guidance regarding those side
effects to be reported and to which health care
provider the side effects should be reported;
``(iii) includes the provision, in written form, of
information about the course of treatment, any
responsibilities of the individual with respect to
self-dosing, and ways in which to address symptoms and
side-effects; and
``(iv) is furnished, to the greatest extent
practicable, in an oral, written, or electronic form
that appropriately takes into account cultural and
linguistic needs of the individual in order to make the
information comprehensible to the individual and such
caregiver (or caregivers); and
``(B) with respect to an individual for whom a course of
cancer treatment or therapy is materially modified, a one-hour
patient treatment education session described in subparagraph
(A), including updated information on the matters described in
such subparagraph should the individual's oncologic health care
professional deem it appropriate and necessary.
``(2) In establishing standards to carry out paragraph (1), the
Secretary shall consult with appropriate organizations representing
providers of oncology patient treatment education services and
organizations representing people with cancer.''.
(b) Payment.--Section 1833(a)(1) of such Act (42 U.S.C.
1395l(a)(1)) is amended--
(1) by striking ``and'' before ``(Z)''; and
(2) by inserting before the semicolon at the end the
following: ``, and (AA) with respect to comprehensive cancer
patient treatment education service (as defined in section
1861(iii)(1)), 150 percent of the payment rate established
under section 1848 for diabetes outpatient self-management
training services (as defined in section 1861(qq)), determined
and applied without regard to any coinsurance''.
(c) Coverage.--Section 1862(a)(1) of such Act (42 U.S.C.
1395y(a)(1)) is amended--
(1) in subparagraph (O), by striking ``and'' at the end;
(2) in subparagraph (P), by striking the semicolon at the
end and inserting ``, and''; and
(3) by adding at the end the following new subparagraph:
``(Q) in the case of comprehensive cancer patient treatment
education services (as defined in subsection (iii)(1)) which
are performed more frequently than is covered under such
section;''.
(d) No Impact on Payment for Other Services.--Nothing in this
section shall be construed to affect or otherwise authorize any
reduction or modification, in the Medicare payment amounts otherwise
established for chemotherapy infusion or injection codes with respect
to the calculation and payment of minutes for chemotherapy teaching or
related services.
(e) 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 Act.
TITLE II--RESEARCH ON CANCER SYMPTOM MANAGEMENT IMPROVEMENT
SEC. 201. SENSE OF CONGRESS.
It is the sense of Congress that--
(1) many people with cancer experience side effects,
symptoms, and late side effects associated with their disease
and their treatment, and such effects can have a serious
adverse impact on the effectiveness of their treatment, their
health, well-being, and quality of life;
(2) with the number of cancer survivors continuing to grow,
addressing the effects of their symptoms and side effects are
becoming increasingly critical in reducing the burden of cancer
and its treatments;
(3) although research is producing new insights into the
causes of and cures for cancer, efforts to manage the symptoms
and side effects of the disease and its treatments have not
kept pace; and
(4) the National Institutes of Health should continue to
support research in the area of symptom management and the role
that nurses play in providing those interventions.
SEC. 202. NIH RESEARCH ON CANCER SYMPTOM MANAGEMENT IMPROVEMENT.
(a) In General.--The Director of the National Institutes of Health
shall expand, intensify, and coordinate programs for the conduct and
support of research with respect to--
(1) improving the treatment and management of symptoms and
side effects associated with cancer and cancer treatment; and
(2) evaluating the role of nursing interventions in the
amelioration of such symptoms and side effects.
(b) Administration.--The Director of the National Institutes of
Health is encouraged to carry out this section through the Director of
the National Cancer Institute, in collaboration with at least the
directors of the National Institute of Nursing Research, the National
Institute of Neurological Disorders and Stroke, the National Institute
of Mental Health, the National Center on Minority Health and Health
Disparities, the National Center for Complementary and Alternative
Medicine, and the Agency for Healthcare Research and Quality.
<all>
Introduced in House
Introduced in House
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.
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.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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