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New Radiation Oncology Payment Model gets delayed by the CMS

  • CMS proposed a new rule to delay indefinitely the implementation of this radiation oncology bundled payments model.
  • The Radiation Oncology (RO) model is intended to reimburse oncology practices and hospital outpatient sites for total episodes of care.
  • CMS will accept comments on the proposal for 60 days since its published date. 

A new Radiation Oncology model has been delayed again, this time by CMS. Back in December 2021, the U.S. Congress passed a bill to also delay the implementation of this model.

On April 6th, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule. This rule delayed the implementation of this radiation oncology bundled payments model, that had been planned with no clear relaunch date.

What is this RO model about?

According to the CMS rule, this RO Model aims to improve the quality of care for cancer patients receiving radiotherapy (RT) and move toward a simplified and predictable payment system.

The RO model is a mandatory model that tests whether changing the way RT services are currently paid – via fee-for-service payments – to prospective, site neutral, modality agnostic, episode-based payments incentivizing physicians to deliver higher-value RT care.

This model is intended to reimburse oncology practices and hospital outpatient sites for total episodes of care and will make site-neutral payments for certain radiation therapies.

RO Model has generated major pushback from the oncology industry

The oncology industry alleges this rule will hurt their practices already under strain from the pandemic.

Leaders of  the American Society for Radiation Oncology (ASTRO) released a statement applauding the delay of this rule. ASTRO considers that the model in its current form is too punitive for clinics. Coupled with this, the association hopes CMS will make the adjustments recommended by Congress and the broad stakeholders coalition within the radiation oncology community.

CMS proposed to delay the current start date of the model indefinitely to be determined through future rulemaking. If the proposed rule is finalized, the model would be on hold for an indeterminate period of time. 

The delay is intended to help model participants which have invested funding to prepare for the model. CMS will accept comments on the proposal for 60 days since its published date. 

Stay tuned for this and more industry news through our April 2022 newsletter. Subscribe to our monthly newsletter and our Health Prime Blog for ongoing leading industry medical practice articles and policy updates.

Resources

CMS proposes indefinite delay for Radiation Oncology model already postponed by Congress

CMS Delays Implementation of New Radiation Oncology Payment Model

Radiation Oncology Model | CMS Innovation Center

CMS proposes to delay Radiation Oncology Model start date

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