H.R. 10087: Cancer Care Planning and Communications Act

This bill would require Medicare to cover a new service called

Cancer Care Planning and Coordination Services

In practical terms, it would pay doctors, physician assistants, or nurse practitioners to create a written or electronic cancer treatment plan for a patient. The plan would need to include the main elements identified by the Institute of Medicine for managing cancer care. The bill says the plan should be provided at the visit, or as soon afterward as practical, and should be made understandable and accessible to the patient, including taking into account cultural and language needs where possible.

The bill would allow these planning services to be provided at key points in care, including:

• when a person is first diagnosed with cancer, to help plan treatment;
• when the person’s condition changes or treatment preferences change;
• when active treatment ends and survivorship care begins; and
• if the cancer comes back.

It would also direct the Secretary of Health and Human Services to set the exact frequency for when these services can be billed under Medicare.

For payment, the bill would add this service to Medicare’s physician fee schedule. It says the initial payment rate would generally be the same as the rate for transitional care management services, unless the Secretary sets a different rate.

The bill’s stated purpose is to make cancer care more organized and coordinated for Medicare beneficiaries by giving patients a clearer treatment plan and support at important stages of care.

Relevant Companies

None found