text: SECTION 1. SHORT TITLE.
  
      (a) Short Title.--This Act may be cited as the ``Planning Actively 
  for Cancer Treatment (PACT) Act of 2013''.
      (b) Findings.--Congress makes the following findings:
              (1) Individuals with cancer often do not have access to a 
          cancer care system that incorporates shared decision-making and 
          the coordination of all elements of care.
              (2) The cancer care system has not traditionally offered 
          individuals with cancer a shared decision-making process, a 
          prospective and comprehensive plan for treatment, symptom 
          management and supportive care, 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) The 1999 Institute of Medicine report entitled ``The 
          Unequal Burden of Cancer'' found that low-income people often 
          lack access to adequate cancer care and that ethnic minorities 
          have not benefitted fully from cancer treatment advances.
              (5) Individuals with cancer often do not participate in a 
          shared decision-making process that considers all treatment 
          options and do not benefit from coordination of all elements of 
          active treatment and palliative care.
              (6) Quality 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) Quality cancer care should include a means for engaging 
          cancer survivors in a shared decision-making process that 
          produces 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, including 
          appropriate psychosocial services.
              (8) The Institute of Medicine report entitled ``Ensuring 
          Quality Cancer Care'' described the elements of quality care 
          for an individual with cancer to include--
                      (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) In ``Cancer Care for the Whole Patient'', the 
          Institute of Medicine stated that the development of a plan 
          that includes biomedical and psychosocial care should be a 
          standard for quality cancer care in any quality measurement 
          system.
              (11) Because more than half of all cancer diagnoses occur 
          among elderly Medicare beneficiaries, cancer care inadequacies 
          should be addressed through the Medicare program.
              (12) Shortcomings in providing cancer care, resulting in a 
          lack of shared decision-making, inadequate management of cancer 
          symptoms, and insufficient monitoring and treatment of late 
          effects of cancer and its treatment, relate in part to the 
          inadequacy of Medicare payments for such planning and 
          coordination services.
              (13) Changes in Medicare payment for cancer care planning 
          and coordination will support shared decision-making that 
          reviews all treatment options and will contribute to improved 
          care for individuals with cancer from the time of diagnosis 
          through the end of the life.
  
  SEC. 2. COVERAGE OF CANCER CARE PLANNING AND COORDINATION 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) cancer care planning and coordination services (as 
          defined in subsection (iii))''; and
              (2) by adding at the end the following new subsection:
  
              ``Cancer Care Planning and Coordination Services
  
      ``(iii)(1) The term `cancer care planning and coordination 
  services' means--
              ``(A) with respect to an individual who is diagnosed with 
          cancer, the development of a treatment plan by a physician, 
          nurse practitioner, or physician assistant that--
                      ``(i) includes an assessment of the individual's 
                  diagnosis, health status, treatment needs, functional 
                  status, pain control, and psychosocial needs;
                      ``(ii) engages the individual in a shared decision-
                  making process that reviews all treatment options;
                      ``(iii) 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;
                      ``(iv) 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;
                      ``(v) 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
                      ``(vi) is in accordance with standards determined 
                  by the Secretary to be appropriate;
              ``(B) with respect to an individual for whom a treatment 
          plan has been developed under subparagraph (A), the revision of 
          such treatment plan as necessary to account for any substantial 
          change in the condition of the individual, recurrence of 
          disease, changes in the individual's treatment preferences, or 
          significant revision of the elements of curative care or 
          symptom management for the individual, if such revision--
                      ``(i) is in accordance with clauses (i), (ii), (iv) 
                  and (v) of such subparagraph; and
                      ``(ii) 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;
              ``(C) with respect to an individual who has completed the 
          primary treatment for cancer, as defined by the Secretary, the 
          development of a follow-up survivorship care plan that--
                      ``(i) includes an assessment of the individual's 
                  diagnosis, health status, treatment needs, functional 
                  status, pain control, and psychosocial needs;
                      ``(ii) engages the individual in a shared decision-
                  making process that reviews all survivorship care 
                  options;
                      ``(iii) describes the elements of the primary 
                  treatment, including symptom management and palliative 
                  care, furnished to such individual;
                      ``(iv) provides recommendations for the subsequent 
                  care of the individual with respect to the cancer 
                  involved;
                      ``(v) 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;
                      ``(vi) 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
                      ``(vii) is in accordance with standards determined 
                  by the Secretary to be appropriate; and
              ``(D) 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, change in the individual's 
          preference for survivorship care, or significant revision of 
          the plan for follow-up care, if such revision--
                      ``(i) is in accordance with clauses (i), (ii), 
                  (iii), (v), and (vi) of such subparagraph; and
                      ``(ii) 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.
      ``(2) The Secretary shall establish standards to carry out 
  paragraph (1) in consultation with appropriate organizations 
  representing suppliers and 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 treatment plans and follow-up 
  survivorship care 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 individual.
      ``(3) In this subsection, the term `shared decision-making process' 
  means, with respect to an individual, a process in which the individual 
  and the individual's health care providers consider the individual's 
  diagnosis, treatment options, the medical evidence related to treatment 
  options, the risks and benefits of all treatment options, and the 
  individual's preferences regarding treatment, and then jointly develop 
  and implement a treatment plan.''.
      (b) Payment Under Physician Fee Schedule.--
              (1) In general.--Section 1848(j)(3) of the Social Security 
          Act (42 U.S.C. 1395w-4(j)(3)) is amended by inserting ``(GG),'' 
          after ``health risk assessment),''.
              (2) Initial rates.--Unless the Secretary of Health and 
          Human Services otherwise provides, the payment rate specified 
          under the physician fee schedule under the amendment made by 
          paragraph (1) for cancer care planning and coordination 
          services shall be the same payment rate as provided for 
          transitional care management services (as defined in CPT code 
          99496).
      (c) 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.
target: Planning Actively for Cancer Treatment (PACT) Act of 2013 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of cancer care planning and coordination services. 
feat_title: Planning Actively for Cancer Treatment (PACT) Act of 2013