Medicare proposed to implement an update to the PFS that cuts reimbursement to providers because of flaws in the way that the clinical labor data is incorporated into the PFS. CMS proposed to also burden cancer facilities by imposing the draconian RO Model onto cancer providers.
The RO Model encompasses 30% of Medicare RO episodes among mandated providers creating bundled prospective payments for a 90-day episode across 15 disease types. The RO Model should be revised to establish appropriate and stable payments for cancer providers to bring the highest quality of healthcare to the patient.
Implementing these rules would drastically reduce Medicare reimbursement for cancer care and place administrative burden on cancer practices around the country, particularly in rural and disadvantaged populations. In the midst of a public health emergency, Medicare must not cut payments for cancer care.