[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1840 Reported in Senate (RS)]

<DOC>





                                                       Calendar No. 317
118th CONGRESS
  2d Session
                                S. 1840

 To amend the Public Health Service Act to reauthorize and improve the 
National Breast and Cervical Cancer Early Detection Program for fiscal 
            years 2024 through 2028, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              June 7, 2023

 Ms. Baldwin (for herself, Ms. Collins, Ms. Cortez Masto, Mrs. Capito, 
Ms. Klobuchar, and Ms. Murkowski) introduced the following bill; which 
  was read twice and referred to the Committee on Health, Education, 
                          Labor, and Pensions

                            February 1, 2024

               Reported by Mr. Sanders, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to reauthorize and improve the 
National Breast and Cervical Cancer Early Detection Program for fiscal 
            years 2024 through 2028, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Screening for Communities 
to Receive Early and Equitable Needed Services for Cancer Act of 2023'' 
or the ``SCREENS for Cancer Act of 2023''.</DELETED>

<DELETED>SEC. 2. FINDINGS.</DELETED>

<DELETED>    Congress finds the following:</DELETED>
        <DELETED>    (1) In 2023, there will be more than 300,590 new 
        cases of invasive breast cancer and nearly 44,000 breast cancer 
        deaths in the United States.</DELETED>
        <DELETED>    (2) In 2023, there will be about 13,960 new cases 
        of invasive cervical cancer and about 4,310 deaths from 
        cervical cancer.</DELETED>
        <DELETED>    (3) Black women have the highest breast, cervical, 
        and uterine cancer death rates of all racial and ethnic groups 
        and are more likely to be diagnosed with triple-negative breast 
        cancer, a more aggressive form of cancer.</DELETED>
        <DELETED>    (4) Research shows that the COVID-19 pandemic was 
        associated with a decline of more than 3,900,000 breast cancer 
        screenings in 2020, as compared to 2019. Similarly, cervical 
        cancer screening utilization dropped by 90 percent in April 
        2020, relative to the prior year.</DELETED>
        <DELETED>    (5) Research suggests that those postponed breast 
        screenings appeared to disproportionately affect women of 
        color: Non-Hispanic White women had 17 percent fewer breast 
        cancer diagnoses, while the year-over-year decline was 53 
        percent for Asian women, 43 percent for Hispanic women, and 27 
        percent for Black women.</DELETED>
        <DELETED>    (6) The National Cancer Institute estimates that 
        pandemic-related disruptions or delays in breast care and 
        screening are expected to result in an excess of 2,500 breast 
        cancer deaths by 2030.</DELETED>
        <DELETED>    (7) Since its creation in 1991, the National 
        Breast and Cervical Cancer Early Detection Program (referred to 
        in this section as the ``NBCCEDP'') has provided lifesaving 
        cancer screening and diagnostic services to low-income, 
        uninsured, or underinsured women in all 50 States, the District 
        of Columbia, 6 territories, and 13 Tribes or Tribal 
        organizations.</DELETED>
        <DELETED>    (8) NBCCEDP seeks to reduce inequities in breast 
        and cervical cancer screening and diagnosis, placing special 
        emphasis on outreach to women who are members of racial or 
        ethnic minority groups, and those who are geographically or 
        culturally isolated.</DELETED>
        <DELETED>    (9) NBCCEDP has served more than 6,100,000 people 
        and provided more than 15,700,000 breast and cervical cancer 
        screening examinations.</DELETED>
        <DELETED>    (10) These screening exams have diagnosed nearly 
        76,000 invasive breast cancers and more than 24,000 
        premalignant breast lesions, as well as more than 5,100 
        invasive cervical cancers and 235,000 premalignant cervical 
        lesions, of which 39 percent were high-grade.</DELETED>
        <DELETED>    (11) The program also provides public education, 
        outreach, patient navigation, and care coordination to increase 
        breast and cervical cancer screening rates and reach 
        underserved populations.</DELETED>
        <DELETED>    (12) Reauthorizing NBCCEDP will result in expanded 
        services, leading to more people being screened and more 
        cancers diagnosed at earlier stages.</DELETED>

<DELETED>SEC. 3. NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION 
              PROGRAM.</DELETED>

<DELETED>    Title XV of the Public Health Service Act (42 U.S.C. 300k 
et seq.) is amended--</DELETED>
        <DELETED>    (1) in section 1501 (42 U.S.C. 300k)--</DELETED>
                <DELETED>    (A) in subsection (a)--</DELETED>
                        <DELETED>    (i) in paragraph (2), by striking 
                        ``the provision of appropriate follow-up 
                        services and support services such as case 
                        management'' and inserting ``that appropriate 
                        follow-up services are provided'';</DELETED>
                        <DELETED>    (ii) in paragraph (3), by striking 
                        ``programs for the detection and control'' and 
                        inserting ``for the prevention, detection, and 
                        control'';</DELETED>
                        <DELETED>    (iii) in paragraph (4), by 
                        striking ``the detection and control'' and 
                        inserting ``the prevention, detection, and 
                        control'';</DELETED>
                        <DELETED>    (iv) in paragraph (5)--</DELETED>
                                <DELETED>    (I) by striking 
                                ``monitor'' and inserting ``ensure''; 
                                and</DELETED>
                                <DELETED>    (II) by striking ``; and'' 
                                and inserting a semicolon;</DELETED>
                        <DELETED>    (v) by redesignating paragraph (6) 
                        as paragraph (9);</DELETED>
                        <DELETED>    (vi) by inserting after paragraph 
                        (5), the following:</DELETED>
        <DELETED>    ``(6) to enhance appropriate support activities to 
        increase breast and cervical cancer screening such as patient 
        navigation, implementation of evidence-based or evidence-
        informed strategies proven to increase breast and cervical 
        cancer screening in health care settings, and facilitating 
        access to health care settings;</DELETED>
        <DELETED>    ``(7) to reduce disparities in incidents of and 
        deaths due to breast and cervical cancer in populations with 
        higher than average rates;</DELETED>
        <DELETED>    ``(8) to ensure equitable access to screening and 
        diagnostic services and improve access for individuals who 
        encounter additional barriers to receiving services, including 
        due to various social determinants of health; and''; 
        and</DELETED>
                        <DELETED>    (vii) in paragraph (9), as so 
                        redesignated, by striking ``through (5)'' and 
                        inserting ``through (8)''; and</DELETED>
                <DELETED>    (B) by striking subsection (d);</DELETED>
        <DELETED>    (2) in section 1503 (42 U.S.C. 300m)--</DELETED>
                <DELETED>    (A) in subsection (a)--</DELETED>
                        <DELETED>    (i) in paragraph (1), by striking 
                        ``that, initially'' and all that follows 
                        through the semicolon and inserting ``that 
                        appropriate breast and cervical cancer 
                        screening and diagnostic services are provided 
                        based on national recommendations; 
                        and'';</DELETED>
                        <DELETED>    (ii) by striking paragraphs (2) 
                        and (4);</DELETED>
                        <DELETED>    (iii) by redesignating paragraph 
                        (3) as paragraph (2); and</DELETED>
                        <DELETED>    (iv) in paragraph (2), as so 
                        redesignated, by striking ``; and'' and 
                        inserting a period; and</DELETED>
                <DELETED>    (B) by striking subsection (d);</DELETED>
        <DELETED>    (3) in section 1508(b) (42 U.S.C. 300n-4(b))--
        </DELETED>
                <DELETED>    (A) by striking ``1 year after the date of 
                the enactment of the National Breast and Cervical 
                Cancer Early Detection Program Reauthorization of 2007, 
                and annually thereafter,'' and inserting ``2 years 
                after the date of enactment of the Screening for 
                Communities to Receive Early and Equitable Needed 
                Services for Cancer Act of 2023, and every 5 years 
                thereafter,'';</DELETED>
                <DELETED>    (B) by striking ``Labor and Human 
                Resources'' and inserting ``Health, Education, Labor, 
                and Pensions''; and</DELETED>
                <DELETED>    (C) by striking ``preceding fiscal year'' 
                and inserting ``preceding 2 fiscal years in the case of 
                the first report after the date of enactment of the 
                Screening for Communities to Receive Early and 
                Equitable Needed Services for Cancer Act of 2023 and 
                preceding 5 fiscal years for each report thereafter''; 
                and</DELETED>
        <DELETED>    (4) in section 1510(a) (42 U.S.C. 300n-5(a))--
        </DELETED>
                <DELETED>    (A) by striking ``and'' after ``2011,''; 
                and</DELETED>
                <DELETED>    (B) by inserting ``, $275,000,000 for 
                fiscal year 2024, $330,000,000 for fiscal year 2025, 
                $385,000,000 for fiscal year 2026, $440,000,000 for 
                fiscal year 2027, and $500,000,000 for fiscal year 
                2028'' before the period at the end.</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Screening for Communities to Receive 
Early and Equitable Needed Services for Cancer Act of 2023'' or the 
``SCREENS for Cancer Act of 2023''.

SEC. 2. NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM.

    Title XV of the Public Health Service Act (42 U.S.C. 300k et seq.) 
is amended--
            (1) in section 1501 (42 U.S.C. 300k)--
                    (A) in subsection (a)--
                            (i) in paragraph (2), by striking ``the 
                        provision of appropriate follow-up services and 
                        support services such as case management'' and 
                        inserting ``that appropriate follow-up services 
                        are provided'';
                            (ii) in paragraph (3), by striking 
                        ``programs for the detection and control'' and 
                        inserting ``for the prevention, detection, and 
                        control'';
                            (iii) in paragraph (4), by striking ``the 
                        detection and control'' and inserting ``the 
                        prevention, detection, and control'';
                            (iv) in paragraph (5)--
                                    (I) by striking ``monitor'' and 
                                inserting ``ensure''; and
                                    (II) by striking ``; and'' and 
                                inserting a semicolon;
                            (v) by redesignating paragraph (6) as 
                        paragraph (9);
                            (vi) by inserting after paragraph (5) the 
                        following:
            ``(6) to enhance appropriate support activities to increase 
        breast and cervical cancer screenings, such as navigation of 
        health care services, implementation of evidence-based or 
        evidence-informed strategies to increase breast and cervical 
        cancer screening in health care settings, and facilitation of 
        access to health care settings;
            ``(7) to reduce disparities in breast and cervical cancer 
        incidence, morbidity, and mortality, including in populations 
        with higher than average rates;
            ``(8) to improve access to breast and cervical cancer 
        screening and diagnostic services and reduce related barriers, 
        including factors that relate to negative health outcomes; 
        and''; and
                            (vii) in paragraph (9), as so redesignated, 
                        by striking ``through (5)'' and inserting 
                        ``through (8)''; and
                    (B) by striking subsection (d);
            (2) in section 1503 (42 U.S.C. 300m)--
                    (A) in subsection (a)--
                            (i) in paragraph (1), by striking ``that, 
                        initially'' and all that follows through the 
                        semicolon and inserting ``that appropriate 
                        breast and cervical cancer screening and 
                        diagnostic services are provided consistent 
                        with relevant evidence-based recommendations; 
                        and'';
                            (ii) by striking paragraphs (2) and (4);
                            (iii) by redesignating paragraph (3) as 
                        paragraph (2); and
                            (iv) in paragraph (2), as so redesignated, 
                        by striking ``; and'' and inserting a period; 
                        and
                    (B) by striking subsection (d);
            (3) in section 1508(b) (42 U.S.C. 300n-4(b))--
                    (A) by striking ``1 year after the date of the 
                enactment of the National Breast and Cervical Cancer 
                Early Detection Program Reauthorization of 2007, and 
                annually thereafter,'' and inserting ``2 years after 
                the date of enactment of the Screening for Communities 
                to Receive Early and Equitable Needed Services for 
                Cancer Act of 2023, and every 5 years thereafter,'';
                    (B) by striking ``Labor and Human Resources'' and 
                inserting ``Health, Education, Labor, and Pensions''; 
                and
                    (C) by striking ``preceding fiscal year'' and 
                inserting ``preceding 2 fiscal years in the case of the 
                first report after the date of enactment of the 
                Screening for Communities to Receive Early and 
                Equitable Needed Services for Cancer Act of 2023 and 
                preceding 5 fiscal years for each report thereafter''; 
                and
            (4) in section 1510(a) (42 U.S.C. 300n-5(a))--
                    (A) by striking ``2011, and'' and inserting 
                ``2011,''; and
                    (B) by inserting ``, and $275,000,000 for each of 
                fiscal years 2024 through 2028'' before the period at 
                the end.

SEC. 3. GAO STUDY.

    Not later than September 30, 2027, the Comptroller General of the 
United States shall report to the Committee on Health, Education, 
Labor, and Pensions of the Senate and the Committee on Energy and 
Commerce of the House of Representatives on the work of the National 
Breast and Cervical Cancer Early Detection Program, including--
            (1) an estimate of the number of individuals eligible for 
        services provided under such program;
            (2) a summary of trends in the number of individuals served 
        through such program; and
            (3) an assessment of any factors that may be driving the 
        trends identified under paragraph (2), including any barriers 
        to accessing breast and cervical cancer screenings provided by 
        such program.
                                                       Calendar No. 317

118th CONGRESS

  2d Session

                                S. 1840

_______________________________________________________________________

                                 A BILL

 To amend the Public Health Service Act to reauthorize and improve the 
National Breast and Cervical Cancer Early Detection Program for fiscal 
            years 2024 through 2028, and for other purposes.

_______________________________________________________________________

                            February 1, 2024

                       Reported with an amendment