ROCR Value Based Program Act

Transportation Assistance for Patients: Section 3(g) establishes a health equity achievement in radiation therapy add-on payment to help patients who report transportation insecurity access and complete their treatments. This provides direct financial support to help patients get rides to their necessary medical appointments.

Flexible Payment Plans for Coinsurance: Section 3(e) allows radiation therapy providers and suppliers to offer payment plans so patients can pay their 20 percent coinsurance in multiple installments. This can make managing the out-of-pocket costs of cancer treatment more manageable for individuals and families.

Exemption from Budget Neutrality Cuts: Section 5 ensures that reduced spending from this program will not trigger budget neutrality cuts in other areas of the Medicare physician fee schedule or hospital outpatient prospective payment system. This protects the broader Medicare system from unintended negative adjustments elsewhere due to this specific cancer care program.

Mandatory Program Participation: Section 3(f) requires all participating Medicare radiation therapy providers and suppliers to take part in the ROCR Program unless they qualify for a specific hardship exemption. This removes choice for providers and could cause operational burdens for local cancer treatment centers that prefer traditional payment structures.

Potential Payment Reductions for Non-Compliance: Section 3(h) reduces the per episode payment by 2.5 percent for providers or suppliers who do not meet specific accreditation and electronic health record requirements after two years. If local facilities face these financial penalties, it could strain their resources and indirectly affect patient care operations.