H.R.2120 - Radiation Oncology Case Rate Value Based Program Act of 2025; ROCR Value Based Program Act (119th Congress)
Summary
H.R.2120, the Radiation Oncology Case Rate Value Based Program Act of 2025, aims to reform Medicare payments for radiation oncology services. It establishes a new payment program that moves away from fee-for-service towards a case rate, value-based system. This program seeks to create stable, unified payments, reduce disparities in care, enhance quality, encourage technology utilization, and protect Medicare resources.
Expected Effects
The bill will likely lead to changes in how radiation therapy providers and suppliers are reimbursed by Medicare. The shift to a value-based payment model could incentivize more efficient and patient-centered care. It also includes provisions for transportation assistance to improve access for patients with transportation insecurity.
Potential Benefits
- Stable and unified payments for radiation therapy services under Medicare.
- Reduced disparities in radiation therapy care by increasing access to services closer to beneficiaries' homes.
- Enhanced quality of care through practice accreditation and shorter treatment courses when appropriate.
- Encouraged utilization of state-of-the-art technology to improve care and outcomes.
- Potential Medicare savings through reasonable spending reductions for radiation therapy services.
Potential Disadvantages
- Potential for significant payment reductions that could jeopardize access to high-quality radiation therapy services, as seen in previous models.
- Onerous reporting requirements for participating providers, adding administrative burden.
- Mandatory participation for radiation therapy providers and suppliers, limiting autonomy.
- Possible negative impact on cancer hospitals exempt from the hospital outpatient prospective payment system.
- The savings adjustment could disproportionately affect certain providers or geographic areas.
Constitutional Alignment
The bill appears to align with the Constitution's general welfare clause (Preamble). Congress has the power to tax and spend for the general welfare, and this bill aims to improve healthcare delivery and access. The bill does not appear to infringe on any specific constitutional rights or limitations.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).