Indefinite Delay for CMS Radiation Oncology Model

April 11, 2022

On April 6, the Centers for Medicare & Medicaid Services (CMS) proposed to delay the start of the Radiation Oncology (RO) Model to a date that future rulemaking will determine. The CMS Innovation Center’s RO Model is mandatory for physician group practices and hospital outpatient departments (HOPDs) located in certain geographic areas. The RO Model is designed to test whether episode-based payments to physician group practices and HOPDs for radiotherapy episodes of care reduce Medicare expenditures while preserving or enhancing the quality of care. A small subset of GNYHA member hospitals are required to participate in the model.

The RO Model was initially scheduled to begin on January 1, 2021, but has been delayed several times due to the COVID-19 public health emergency and Congressional action. Under current law, the model is scheduled to begin no earlier than January 1, 2023, but CMS proposes to delay the start date indefinitely to account for the continued legislative delays, the significant resources required by both CMS and providers to prepare for and participate in the model, and the continued opposition to certain elements of the model design by some stakeholders. CMS plans to propose a new start date at least six months prior to implementation.