# Summary
The Radiation Oncology Case Rate Value Based Program Act creates a new Medicare payment model for radiation therapy services, effective within one year of enactment. Under this program, radiation therapy providers and suppliers will receive bundled per-episode payments covering all professional and technical services for treating specific cancer types, replacing the current fee-for-service system. The law aims to stabilize radiation therapy payments, reduce geographic disparities in access, improve quality of care through practice accreditation standards, and contain Medicare costs while ensuring patient-centered treatment.
The payment structure provides 80 percent of the episode payment upfront within 30 days of treatment initiation, with the remaining 20 percent paid either when treatment concludes or at 90 days (30 days for bone and brain metastases), whichever is earlier. Participation is mandatory for providers treating Medicare beneficiaries, though exemptions may be granted for significant hardship. The law includes a health equity add-on payment of $500 per patient (increased by $10 annually) to support transportation services for patients facing transportation insecurity. Providers can earn quality bonuses of up to 0.5 percent for maintaining accreditation from major radiation oncology organizations, or face reductions after three years for non-compliance. The law explicitly exempts the program from budget neutrality adjustments that typically offset Medicare savings elsewhere, protecting radiation therapy payment rates from reductions tied to broader federal healthcare spending cuts.
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