Lainie Jones Comprehensive Cancer Survivorship Act of 2026

(1) A cancer survivor is any individual with a history of cancer, from the time of diagnosis through the rest of their life, across the continuum of care.

(2) Today, there are approximately 18,000,000 Americans who are cancer survivors, and the number of survivors is projected to reach 26,000,000 by 2040. Therefore, there is a great need to be able to provide ways to sustain the care needed and to offer those living with, through, and beyond cancer a safe, supportive, and accommodating environment where such individuals can engage in physical and social support activities to sustain optimal quality of life.

(3) Cancer survivors face difficult emotional, psychological, neurological, financial, legal, and other physical challenges that persist beyond diagnosis and treatment, often arising months and years after active cancer treatment ends.

(4) Cancer survivors have unique needs and must manage short- and long-term effects of their treatment, as well as regular screenings for cancer recurrence or new cancers.

(5) Cancer survivors of racial and ethnic diversity, as well as lower socioeconomic status, have disproportionately lower health-related, quality-of-life scores compared to non-Hispanic White cancer survivors.

(6) Cancer survivors living in rural areas have less access to services and have poorer outcomes than survivors in metropolitan areas.

(7) Children, adolescent, and young adult cancer survivors are particularly susceptible to long-term consequences from treatment, and up to 80 percent have a severe, disabling, life-threatening, or fatal health condition by the age of 50. Best practices in this area would improve treatment, quality of life, and long-term health outcomes.

(8) Clinical trials have shown that cancer survivorship programs help cancer survivors meet or exceed the recommended amount of physical activity, significantly increasing their cardiovascular health and overall quality of life and decreasing their cancer-related fatigue.

(9) Despite the National Cancer Institute and other professional organizations’ definition of a cancer survivor beginning on the day of a cancer diagnosis, there is little agreement among clinicians, researchers, and insurance companies on what services are included in survivorship care and the point at which survivorship care begins.

(10) Cancer survivors, their families, their caregivers, and their providers face many difficulties understanding and coordinating the transition from specialty to primary care, and for this reason communication and treatment are often fragmented and inconsistent.

(11) To avoid additional health-related or financial hardships to cancer survivors and their families, comprehensive and forward-thinking cancer survivorship studies and programs across Federal agencies, in collaboration with States, localities, and medical and professional organizations, are required to engage in a coordinated effort to improve health outcomes and quality of life of survivors.

The term cancer survivor means an individual from the time of cancer diagnosis through the balance of his or her life.

The term caregiver means a family member, friend, or other person who cares for an individual with a chronic or disabling condition, including cancer.

The term patient experience data means patient experiences, perspectives, needs, and priorities related to—

(A) the symptoms of the patient’s conditions and the natural history of such conditions;

(B) the impact of the conditions on the patient’s functioning and quality of life;

(C) the patient’s experience with treatments;

(D) input on which outcomes are important to the patient;

(E) patient preferences for outcomes and treatments; and

(F) the relative importance of any issues as defined by patients.

The term psychosocial effects —

(A) means the psychological, behavioral, emotional, and social effects of a disease, such as cancer, and its treatment; and

(B) in the case of such effects of cancer, includes changes in how a patient thinks, their feelings, moods, beliefs, ways of coping, and relationships with family, friends, and coworkers.

The term psychosocial care means psychological and social services and interventions that enable survivors, patients, their families, and health care providers to optimize health care and to manage the psychological, behavioral, physical, emotional, and social aspects of illness and its consequences so as to promote better health and well-being.

Except as otherwise specified, the term Secretary means the Secretary of Health and Human Services.

The term survivorship means the period from the time of cancer diagnosis until the end of life, including any portions of such period during which interventions are necessary to address—

(A) the physical, mental, emotional, social, and financial effects of cancer that begin at diagnosis and continue through treatment and beyond; and

(B) issues related to follow-up care (including regular health and wellness checkups), late and long-term effects of treatment, screening for cancer recurrence and new cancers, and quality of life.

The term survivorship care plan —

(A) means an individualized care plan for patients who have been diagnosed with cancer; and

(B) includes a treatment summary and any follow-up care guidelines in such plan that—

(i) are for monitoring and maintaining the patient’s medical and psychosocial health and well-being; and

(ii) are meant to be a transition and communication tool for the survivor, their family, their caregiver, and all their health care providers.

The term survivorship navigation means a service that—

(A) helps patients overcome health care system and other barriers; and

(B) provides patients with timely access to high-quality medical, physical, and psychosocial care from their cancer diagnosis through all phases of their cancer experience.

The term treatment summary means a detailed summary of a patient’s disease, the types of treatment the patient received, members of the patient’s care team, and any side effects or other problems, including psychosocial effects, caused by treatment.

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 (II);

(B) by adding and at the end of subparagraph (JJ); and

(C) by adding at the end the following new subparagraph:

(KK) cancer care planning and coordination services (as defined in subsection (nnn));; and

(2) by adding at the end the following new subsection:

(1) The term cancer care planning and coordination services means, with respect to an individual who is diagnosed with cancer, the development of a treatment plan by a physician, physician assistant, or nurse practitioner that—

(A) includes each component of the Institute of Medicine Care Management Plan (as described in the article entitled Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis published by the Institute of Medicine);

(B) is furnished in written form or electronically, at the visit of such individual with such physician, physician assistant, or nurse practitioner, or as soon after the date of the visit as practicable; and

(C) 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 such individual.

(2) The Secretary shall establish frequencies at which services described in paragraph (1) may be furnished, provided that such services may be furnished with respect to an individual—

(A) at the time such individual is diagnosed with cancer for purposes of planning treatment;

(B) if there is a change in the condition of such individual or such individual’s treatment preferences;

(C) at the end of active treatment and beginning of survivorship care; and

(D) if there is a recurrence of such cancer.

Section 1848(j)(3) of the Social Security Act (42 U.S.C. 1395w–4(j)(3)) is amended by inserting (2)(KK), after health risk assessment),.

Unless the Secretary 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).

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.

The Secretary shall convene a stakeholder meeting (in this section referred to as the meeting) to evaluate strategies, including the use of information technology, to improve transitions in care from active treatment to long-term.

In conducting the meeting, the Secretary shall ensure that the participants include representatives of patient advocacy organizations, medical professional societies, community-based organizations, electronic health record vendors, information technology experts, and other stakeholders of the meeting.

In conducting the meeting, the Secretary shall ensure that the participants consider existing tools for improving transitions to survivorship care, such as—

(1) the survivorship guidelines of the National Comprehensive Cancer Network and the American Society of Clinical Oncology;

(2) the Passport for Care survivor website;

(3) survivorship care software applications that have been developed by patient advocacy organizations, research foundations, and for-profit entities; and

(4) other information and tools that may improve transitions in care and improve overall quality of survivorship care.

In conducting the meeting, the Secretary shall feature collaboration with the Office for Civil Rights of the Department of Health and Human Services to evaluate the privacy and security implications of—

(1) consolidating treatment history and survivorship guidelines into a personalized survivorship care plan that outlines future health care needs after completion of active treatment;

(2) patient use of computer or mobile phone-based application programs described in subsection (c)(3); and

(3) taking into consideration the results of meeting under subsection (a).

Not later than 36 months after the date of enactment of this Act, the Secretary shall, taking into consideration the results of the meeting, publish information resources for cancer patients and providers on strategies for consolidating treatment history and survivorship guidelines into a personalized survivorship care plan to guide survivorship monitoring and follow-up care.

The information resources referred to in paragraph (1) shall include recommendations on patient use of software application programs to develop personalized survivorship care plans.

In this section, the term electronic health record means an electronic record of health-related information on an individual that is created, gathered, managed, and consulted by authorized health care clinicians and staff.

Not later than one year after the date of enactment of this Act, the Secretary of Health and Human Services shall develop an alternative payment model for payments made under titles XVIII and XIX of the Social Security Act (42 U.S.C. 1395 et seq., 1396 et seq.) for items and services relating to cancer survivorship care (as defined by the Secretary).

Following development of the alternative payment model under subsection (a), the Secretary shall submit to Congress a report containing a description of such model that includes the following information:

(1) A description of what event would trigger an individual’s entry into such a model (such as the end of the individual’s active cancer treatment, the beginning of the individual’s need for supportive care during active treatment, or another event).

(2) The length of the individual’s participation under such model, including a description of any ability to extend such participation, or a definition of survivorship care as extending until death.

(3) In the case that such model is based on an episode of care, the appropriate length of the survivorship episode of care, whether additional episodes may be triggered, if necessary, and whether the episode should end at the beneficiary’s death but not before.

(4) Strategies to ensure that any episode of care under such a model begins with the development and dissemination of a survivorship care plan for the transition from active cancer treatment to follow-up care to the individual and all relevant health care providers.

(5) A description of the navigation services that will be provided as part of such model.

(6) A description of any bundled payment packages that will be used under such model.

(7) A specification of any follow-up or new screening under such model for unmet needs of individuals participating in such model.

(8) A description of how consistent, shared decision-making will be promoted under such model so that individuals are given the knowledge needed for self-management between episodes of care.

(9) A specification of which types of health care providers may furnish items and services under such model, including genetic counselors and mental health professionals.

(10) Strategies for applying evidence-based risk stratification principles to direct survivors to personalized care pathways that match the level of care needed to the relative risks and needs of the survivor.

(11) Strategies for coordination of care between such providers, such as between specialists and primary care providers, and how principal responsibility will be assigned for an episode of care.

(12) Strategies for addressing social determinants of health through such model.

(13) A description of how such model will promote—

(A) prevention, early detection surveillance, and treatment for individuals continuing to receive systemic therapy after the end of active cancer treatment;

(B) such individuals’ understanding of, and access to, treatment;

(C) survivorship research; and

(D) the continuing health of cancer survivors.

(14) An analysis of how different forms and stages of cancer may require the development of different survivorship plans and suggest variations in elements of the alternative payment model based on form and stage of cancer.

(15) A plan for testing any alternative payment model described in the report, including the timing of such testing, an analysis of the impact of such testing, any barriers to implementing such testing, and any other recommendations determined appropriate by the Secretary.

The Secretary of Labor, in consultation with the Secretary of Health and Human Services, shall carry out a program to award grants to non-profit organizations and other entities to provide education and targeted assistance—

(1) to eligible cancer survivors facing barriers to employment, including those who remain in the workforce during treatment, those who reduce working hours while in treatment, and those who reenter the workforce after a treatment-related departure; and

(2) to the families and caregivers of such eligible cancer survivors.

The program under this section shall include the following:

(1) Assistance, career and training services, and supportive services for eligible cancer survivors who stay in the workforce during treatment, and for their families and caregivers, including—

(A) transportation assistance;

(B) childcare assistance;

(C) nutritional assistance;

(D) physical activity assistance;

(E) psychosocial assistance;

(F) financial assistance during a period of medical leave; and

(G) other similar assistance.

(2) Assistance and education for eligible cancer survivors who leave the workforce during treatment, and for their families and caregivers, including—

(A) financial assistance during a period of medical leave;

(B) assistance with premiums for continuation coverage provided pursuant to part 6 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1161 et seq.), title XXII of the Public Health Service Act (42 U.S.C. 300bb–1 et seq.), or section 4980B of the Internal Revenue Code of 1986 (26 U.S.C. 4980B); and

(C) career and training services, including upskilling and reskilling, for eligible cancer survivors who are not able to return to work after treatment.

(3) Assistance, career and training services, and supportive services for eligible cancer survivors who are unable to work after a cancer diagnosis, and their families and caregivers, including—

(A) assistance in applying for—

(i) supplemental security income benefits under title XVI of the Social Security Act (42 U.S.C. 1381 et seq.);

(ii) disability insurance benefits under section 223 of the Social Security Act (42 U.S.C. 423);

(iii) benefits under a State plan, or waiver of such plan, under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.);

(iv) with respect to minimizing delays in eligibility before a cancer survivor becomes eligible for Medicare coverage, benefits under the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1801 et seq.), including with respect to enrolling in plans under part C or D of such title and supplemental plans under section 1882 of such title;

(v) State and private sector assistance programs for such cancer survivors; and

(vi) career and training services available under title I, II, or IV of the Workforce Innovation and Opportunity Act (29 U.S.C. 3101 et seq.); and

(B) information on the eligibility of a cancer survivor, and their families and caregivers, for benefits or services described in any of clauses (i) through (vi) of subparagraph (A).

In carrying out this section, the Secretary of Labor, in consultation with the Secretary of Health and Human Services, shall use evidence-based resources, including—

(1) nationally recognized evidence-based guidelines; and

(2) other resources as determined by the Secretary.

In this section:

(1) The term eligible cancer survivor means a cancer survivor (as defined in section 3) who—

(A) remains in the workforce during cancer treatment;

(B) reduces working hours during cancer treatment;

(C) reenters the workforce after a cancer treatment-related departure; or

(D) leaves the workforce as the result of a cancer diagnosis or related complications.

(2) The term supportive services has the meaning given such term in section 3 of the Workforce Innovation and Opportunity Act (29 U.S.C. 3102).

The Secretary shall carry out a comprehensive cancer survivorship program that includes a program of supportive care services in accordance with subsection (b) to improve the quality of life and long-term survivorship of cancer survivors.

The Secretary shall carry out a program of awarding grants to eligible entities to provide services to cancer survivors to enhance their quality of life and improve their long-term survival rates. Not later than 18 months after the date of enactment of this Act, the Secretary shall commence operating such program.

In this subsection, the term eligible entity includes an entity that is—

(A) a State comprehensive cancer program;

(B) a National Cancer Institute-designated cancer center or centers; or

(C) a community-based organization, including a patient advocacy organization, that—

(i) has the capacity to reach cancer survivors through local, State, or national organizations; and

(ii) is focused on cancer survivors and strategies for meeting their needs related to their health and well-being.

A grant received under this subsection shall be used to provide services to cancer survivors to enhance their quality of life and improve their long-term survival rates, such as by assisting survivors to—

(A) engage in moderate physical activity and other health-promoting activities, including ceasing tobacco use and increasing consumption of healthy foods;

(B) increase access to services to mitigate anxiety, depression, and uncertainty;

(C) utilize community support services to fully implement survivorship care plans;

(D) access nutrition education and counseling; and

(E) adhere to a schedule for, and access, screening for recurrence of cancer or the occurrence of other primary cancers.

To seek a grant under this subsection, an eligible entity shall submit an application, at such time as may be required by the Secretary, that includes—

(A) an explanation of how the entity will—

(i) provide cancer survivors access to cancer patient navigator services;

(ii) overcome barriers to care for communities of color and multilingual communities;

(iii) provide culturally competent care; and

(iv) work with and support caregivers of cancer survivors;

(B) a description of how the entity receives referrals of cancer survivors from health care professionals, including health care professionals serving historically disadvantaged and underserved communities;

(C) documentation of the curriculum that will be used for providers in the program, including mechanisms to update the staff on curriculum changes; and

(D) an agreement to provide the Secretary semiannual reports on—

(i) the number of participants served;

(ii) quality-of-life measures for participants; and

(iii) plans for fostering communication between oncology and non-oncology providers serving participants.

The Secretary shall—

(A) conduct outreach to inform health care professionals of the availability of programs and activities funded under this subsection;

(B) analyze the data submitted by grantees under this subsection to determine the number of cancer survivors served and the impact of the program under this subsection on their quality of life;

(C) share best practices among all grantees under this subsection; and

(D) consider strategies for the coordination of the program carried out under this section with the alternative payment model for quality survivorship care developed under section 6 to ensure that enrollees in the alternative payment model have access to the services that will be funded through the program.

Not later than 6 months after the date of enactment of this Act, the Secretary shall enter into an agreement with the Government Accountability Office to conduct a study of the progress made in cancer survivorship over the period beginning on the date of enactment of the National Cancer Act of 1971 (Public Law 92–216).

The study under subsection (a) shall investigate developments over the period described in subsection (a) in—

(1) the nature and quality of survivorship care;

(2) transitions from active treatment to survivorship care;

(3) the quality of life of cancer survivors;

(4) outcomes for cancer survivors;

(5) disparities in access to care and survivorship outcomes;

(6) the health care systems for providing survivorship care;

(7) the contribution of community-based services to the survivorship care system; and

(8) payment for survivorship care by public and private third-party payors.

The study under subsection (a) shall—

(1) consider the contribution of the Office of Cancer Survivorship to the evolution of cancer survivorship care over the last 25 years; and

(2) assess the impact of the mission of the Office and the resources provided to the Office on its leadership in cancer survivorship care.

In conducting the study under subsection (a), the Comptroller General of the United States shall hold a public meeting with a broad cross section of stakeholders to inform the study’s findings and conclusions. Such stakeholders shall include—

(1) cancer survivors and their caregivers and families;

(2) patient organizations representing cancer survivors;

(3) oncologists involved in survivorship care and the professional societies representing them;

(4) primary care providers involved in survivor-ship care and the professional societies representing them;

(5) other health professionals providing survivorship care and the professional societies representing them;

(6) community-based organizations involved in survivorship care;

(7) representatives of the National Cancer Institute;

(8) third-party payors;

(9) researchers engaged in survivorship research;

(10) epidemiologists with knowledge of trends in cancer survivorship; and

(11) such other stakeholders as the Comptroller General deems important to participate in the public meeting.

The Comptroller General of the United States shall—

(1) release a report on the results of the study under subsection (a); and

(2) in addition to the public meeting convened under subsection (d)—

(A) convene another public meeting to be held on the day of the release of the report; and

(B) include in such meeting all categories of stakeholders listed in subsection (d).

Section 1902(a)(10) of the Social Security Act (42 U.S.C. 1396a(a)(10)) is amended—

(1) in subparagraph (F), by striking; and and inserting a semicolon;

(2) in subparagraph (G), by adding at the end and; and

(3) by inserting after subparagraph (G) the following new subparagraph:

(H) notwithstanding section 1902(a)(10)(B) (relating to comparability), for making medical assistance available for healthcare transitions for survivors of childhood and adolescent cancer (as defined in section 1905(jj));.

Section 1905 of the Social Security Act (42 U.S.C. 1396d) is amended by adding at the end the following new subsection:

For purposes of section 1902(a)(10)(H) and this subsection, the term healthcare transitions for survivors of childhood and adolescent cancer —

(A) means transition services from active oncological care to primary care of a child or adolescent with cancer ensuring development and delivery of survivorship care plans to patients, families and primary care providers and transition coverage; and

(B) includes—

(i) transition care based on the Children’s Oncology Group (in this section referred to as the COG) Long-term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers; and

(ii) coverage based on the COG exposure-based standard of care for risk assessment and surveillance recommendations;

(iii) transition services that include evidence-based recommendations for screening and management of late effects that may arise as a result of treatment for childhood cancer, increase awareness of potential late effects, and follow-up care for childhood cancer and adolescent survivors; and

(iv) at least 2 survivorship transition care visits per year.

Section 1902(a)(10) of the Social Security Act (42 U.S.C. 1396a) is amended—

(A) in subparagraph (F), by striking; and and inserting a semicolon;

(B) in subparagraph (G), by adding at the end and; and

(C) by inserting after subparagraph (G) the following new subparagraph:

(H) notwithstanding section 1902(a)(10)(B) (relating to comparability), for making medical assistance available for cancer fertility services (as defined in subsection (kk));.

Section 1905 of the Social Security Act (42 U.S.C. 1396d), as amended by section 10(4) of this Act, is further amended by adding at the end the following new subsection:

For purposes of section 1902(a)(10)(H) and this subsection, the term cancer fertility services —

(A) means fertility treatment and fertility preservation services for individuals diagnosed with cancer who—

(i) are undergoing treatment for such cancer where such treatment may lead to iatrogenic infertility;

(ii) previously underwent such treatment and may be at risk of such infertility due to such treatment; or

(iii) are preparing to undergo such treatment where such treatment may lead to such infertility; and

(B) includes—

(i) other services, including experimental and non-experimental services to preserve fertility or treat infertility (as determined by the Secretary, consistent with established medical practices and professional guidelines published by the American Society for Reproductive Medicine, the American Society of Clinical Oncology, or other professional medical organizations specified by the Secretary); and

(ii) long-term storage costs—

(I) with respect to individuals under the age of 18, for a period of not less than 15 years; and

(II) with respect to individuals age 18 or older, for a period of not less than 10 years.

Notwithstanding any other provision of this title, in the case of a State (other than the 50 States and the District of Columbia), the requirement stated in section 1902(a)(10)(H) shall be optional.

Section 1916 of the Social Security Act (42 U.S.C. 1396o) is amended—

(i) in subsection (a)(2)—

(I) in subparagraph (I), by striking at the end, or and inserting a semicolon;

(II) in subparagraph (J), by striking at the end; and and inserting; or; and

(III) by adding at the end the following new subparagraph:

(K) cancer fertility services (as defined in section 1905(kk)); and; and

(ii) in subsection (b)(2)—

(I) in subparagraph (I), by striking at the end, or and inserting a semicolon;

(II) in subparagraph (J), by striking at the end; and and inserting; or; and

(III) by adding at the end the following new subparagraph:

(K) cancer fertility services (as defined in section 1905(jj)); and.

Section 1916A(b)(3)(B) of the Social Security Act (42 U.S.C. 1396o–1(b)(3)(B)) is amended by adding at the end the following new clause:

(xv) Cancer fertility services (as defined in section 1905(jj)).

Section 2103(c) of the Social Security Act (42 U.S.C. 1397cc(c)) is amended—

(A) by redesignating the paragraph (12) added by section 11405(b)(1) of Public Law 117–169 as paragraph (13); and

(B) by inserting after paragraph (11) the following new paragraph:

Regardless of the type of coverage elected by a State under subsection (a), the child health assistance provided for a targeted low-income child, and, in the case of a State that elects to provide pregnancy-related assistance pursuant to section 2112, the pregnancy-related assistance provided for a targeted low-income pregnant woman (as such terms are defined for purposes of such section), shall include coverage of cancer fertility services (as described in section 1905(jj)).

Section 2103(e)(2) of the Social Security Act (42 U.S.C. 1397cc(e)(2)) is amended—

(A) in the heading, by inserting Cancer fertility services after COVID–19 treatment; and

(B) by inserting cancer fertility services (as described in section 1905(jj)), after testing or treatments described in section 1916(a)(2)(I) furnished during the period described in such section.

The amendment made by paragraph (1)(A) shall take effect on October 1, 2026.

The amendments made by this section (other than the amendment made by subsection (b)(1)(A)) shall apply with respect to medical assistance, child health assistance, and pregnancy-related assistance furnished on or after the date that is 18 months after the date of the enactment of this Act.

The Secretary shall establish within Office of the Director of the National Cancer Institute (referred to in this section as NCI) the Office of Cancer Survivorship (referred to in this section as the Office).

The Office shall function as the entity within NCI with primary responsibility for improving cancer survivorship for individuals living with and through cancer.

The Office shall undertake the following responsibilities:

(1) Management of a portfolio of research grants focused on survivorship topics, including—

(A) late and long-term effects of cancer and cancer treatment;

(B) interventions to address late and long-term effects of cancer;

(C) health delivery models that ensure access to quality survivorship care for all survivors; and

(D) communication and education efforts to enhance access to survivorship care for all survivors.

(2) Professional education efforts to share best practices in survivorship care and to improve survivorship care delivery.

(3) Survivor education efforts related to—

(A) understanding the late and long-term effects of cancer and cancer treatment;

(B) improving access to monitoring and follow-up care after active treatment for all survivors; and

(C) enhancing survivor management of long-term follow-up survivorship care.