Congresswoman Lois Capps (D-CA) and Congressman Charles Boustany (R-LA) introduced legislation on June 25, 2013, to establish a cancer care planning service in the Medicare program.   The legislation, championed by the National Coalition for Cancer Survivorship (NCCS) and a coalition of cancer advocacy groups, oncology professional societies, and cancer centers, represents a patient-centered delivery and payment reform.   A Medicare cancer care planning service will encourage shared decision-making between patients and physicians and equip cancer patients with care plans for management of their care.

The Planning Actively for Cancer Treatment (PACT) Act, H.R. 2477, is a response to recommendations from patient advocates, supported by expert advice from the Institute of Medicine National Cancer Policy Board, for payment for a Medicare service that would encourage communication between cancer care providers and patients and result in the development of a written plan of care.  The legislation is also supported by cancer care providers, who are making greater efforts to develop written care plans despite the lack of dedicated payment for the time and expertise required for such plans.

In the six years since the legislation was drafted, Congresswoman Capps has served as its chief legislative champion, introducing it in four Congresses.  In the last three Congresses, she has been joined by Congressman Boustany.  In introducing the legislation, Congresswoman Capps, a member of the Health Subcommittee of the House Energy and Commerce Committee, said, “More than 1.6 million Americans will be diagnosed with cancer in 2013, and almost 14 million Americans have a history of cancer.  And while many of those newly diagnosed, and those living with cancer will receive the best that the American health care system has to offer, even those receiving outstanding care report gaps in the cancer care system.  The PACT Act would fill many of those gaps by allowing the patient and his or her care team to develop a roadmap for a patient starting the difficult journey that begins with a cancer diagnosis. ”

Dr. Boustany, a member of the Ways and Means Committee, said upon bill introduction, “Each year, more American lives are affected by the disease known as cancer.  Unfortunately, cancer treatment plans vary among health care providers.  The PACT Act assures gaps in the cancer care system are closed in order to provide better care and assistance to cancer patients.”

Ellen Stovall, NCCS  senior health policy advisor and a 42-year survivor of three separate cancer diagnoses, said, “The PACT Act has the potential to make a real difference in cancer care in our lifetime.  Medical providers want to deliver the best care possible, but in order to do that, the patient’s wishes must be clearly understood. By encouraging deliberate discussion and planning before, during and after cancer treatment, we can help make cancer patients—and the health system that cares for them—better.”

The introduction of the legislation comes as the House Ways and Means Committee, House Energy and Commerce Committee, and Senate Finance Committee are planning to review legislation that will repeal the sustainable growth rate formula for setting physician payment rates and make even more far-reaching reforms of Medicare physician payment.  The PACT Act, which would strengthen Medicare physician payment while improving patient care, is an approach to reform that might be considered by the committees looking at payment changes.


The legislation is supported by:


American Cancer Society Cancer Action Network (ACS CAN)

American Society of Clinical Oncology

Cancer Support Community

Colon Cancer Alliance

Fight Colorectal Cancer

Leukemia & Lymphoma Society

The Life Raft Group


Lymphoma Research Foundation

National Coalition for Cancer Survivorship

National Comprehensive Cancer Network

National Lung Cancer Partnership

Sisters Network

Susan G. Komen Advocacy Alliance

ThyCa: Thyroid Cancer Survivors’ Association


University of Arizona Cancer Center

University of Cincinnati Cancer Institute

Lombardi Comprehensive Cancer Center at Georgetown University

The GW Cancer Institute, George Washington University

University of Kansas Cancer Center

Barbara Ann Karmanos Cancer Institute

H. Lee Moffitt Cancer Center & Research Institute

University of New Mexico Cancer Center

NYU Cancer Institute

NYU Langone Medical Center

University of North Carolina Lineberger Comprehensive Cancer Center

University of Pittsburgh Cancer Institute

Stephenson Cancer Center at the University of Oklahoma