Cancer Care Planning and Communications Act

This bill amends Title XVIII of the Social Security Act to establish Medicare coverage for cancer care planning and coordination services. It directs Medicare to pay for the creation of detailed cancer treatment plans for beneficiaries diagnosed with cancer.

* **Medicare beneficiaries:** Patients diagnosed with cancer who receive care planning services. * **Healthcare providers:** Physicians, physician assistants, and nurse practitioners who develop cancer treatment plans. * **Federal agencies:** The Department of Health and Human Services (HHS), which is tasked with setting billing rules and payment rates.

* **Service standards:** Cancer treatment plans **must** include all components required by the Institute of Medicine (IOM) Care Management Plan. * **Delivery requirements:** Providers **must** give the plan to the patient in written or electronic form during the visit or as soon as practical afterward. Providers **must** also accommodate the patient's cultural and linguistic needs to the greatest extent practicable. * **Permitted timing:** Providers **are authorized** to furnish and bill for these planning services at specific milestones: * At the initial cancer diagnosis; * When the patient's condition or treatment preferences change; * At the end of active treatment when transitioning to survivorship care; or * If the cancer recurs. * **Effective date:** These coverage and payment provisions apply to services provided on or after January 1 of the first calendar year after the bill becomes law.

* **Payment structure:** Cancer care planning services will be integrated into the Medicare Physician Fee Schedule. * **Payment rate:** The bill sets the default initial Medicare payment rate equal to the rate for transitional care management services (CPT code 99496). However, the Secretary of HHS is authorized to establish a different rate. * Total program spending amounts or budget appropriations are not specified in the bill text.

* **Eligible providers only:** Only physicians, physician assistants, and nurse practitioners are authorized to create and bill for these plans. * **Frequency limits:** The Secretary of HHS **must** establish specific rules governing how often providers can bill Medicare for these services.

Starting January 1 of the year after it is enacted, this bill establishes Medicare coverage allowing doctors, nurse practitioners, and physician assistants to be paid for developing structured, written cancer care plans for patients at key stages of their diagnosis and treatment.