ROCR Value Based Program Act
Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.
Summary
This bill overhauls how Medicare pays for radiation therapy by replacing the current per-service fee schedule with bundled per-episode payments. The new ROCR Program would pay radiation therapy providers a single case rate per cancer treatment episode, split into professional and technical components. Payment rates are based on 2021 CMS national base rates, updated annually with inflation floors. The bill includes a health equity add-on payment starting at per episode for transportation-insecure patients, with mandatory participation for most providers and quality incentives tied to practice accreditation. It also creates a statutory exception to the anti-kickback statute to allow providers to offer free or discounted transportation to radiation therapy patients.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers.
At a Glance
What This Bill Does
Creates a new Medicare Radiation Oncology Case Rate Value Based Payment Program (ROCR Program) that replaces current fee-for-service payments for radiation therapy with per-episode bundled payments, includes health equity transportation add-on payments, practice accreditation quality incentives, and a statutory exception allowing free patient transportation to radiation therapy.
Who Benefits
- Radiation oncology providers and suppliers
- Cancer patients (especially transportation-insecure)
- Medicare program (cost containment)
Who Bears Costs
- Non-accredited radiation therapy facilities (2.5% payment cut)
- CMS (implementation complexity)
Key Policy Areas
{'domain': 'Healthcare', 'evidence': 'Amends Title XVIII of the Social Security Act to create radiation oncology payment program'}, {'domain': 'Medicare', 'evidence': 'Section 3 establishes ROCR Program under Medicare with mandatory participation for radiation therapy providers'}
Primary Purpose
Creates a new Medicare Radiation Oncology Case Rate Value Based Payment Program (ROCR Program) that replaces current fee-for-service payments for radiation therapy with per-episode bundled payments, includes health equity transportation add-on payments, practice accreditation quality incentives, and a statutory exception allowing free patient transportation to radiation therapy.
Policy Domains
Legislative Strategy
"Shifting Medicare radiation oncology from volume-based to value-based payments while protecting provider revenues with payment floors and inflation adjustments"
Sponsors
Legislative Progress
In CommitteeMr. Tillis (for himself and Mr. Peters) introduced the following …
Read twice and referred to the Committee on Finance.
Introduced in Senate
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Non-accredited radiation facilities, Other Medicare OPPS providers, Radiation oncology providers
Positive-direction: Other Medicare OPPS providers, Radiation oncology providers, Radiation oncology providers and suppliers, Radiation therapy providers
Negative-direction: Non-accredited radiation facilities
Cancer patients, Cancer patients needing transportation, Transportation-insecure cancer patients
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "cms"
- → Centers for Medicare and Medicaid Services
- "the_secretary"
- → Secretary of Health and Human Services
- "radiation_therapy_provider"
- → Hospital-based radiation oncology department
- "radiation_therapy_supplier"
- → Freestanding radiation therapy practice
Key Definitions
Terms defined in this bill
Cancer types designated by the Secretary for bundled payment
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology