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CHA Issues Summary of Proposed Rule on Mandatory Specialty Care Payment Models

For CFOs, CMOs, Government Relations Staff, Strategic Planning/Development Staff

CHA has issued a summary — prepared by Health Policy Alternatives — of the proposed rule issued by the Centers for Medicare & Medicaid Services (CMS) that would establish two new mandatory payment models: the Radiation Oncology Model (RO model) and the End-Stage Renal Disease Treatment Choices Model.

The proposed RO model would provide participants with prospective, site-neutral, episode-based payment amounts for radiation therapy services furnished during a 90-day episode of care for 17 types of cancer. Participation would be required of hospital outpatient departments, physician group practices, and freestanding radiation therapy centers in randomly-selected core based statistical areas (CBSAs). The participating CBSAs will be announced when the final rule is published.

CHA is currently reviewing the proposed rule and seeks member input on the impact of the proposal. Comments are due to CMS by 2 p.m. (PT) on Sept. 16.