S. 1031: ROCR Value Based Program Act
Sponsor
Thomas Tillis
Republican · NC
Bill Progress
Latest Action · Mar 13, 2025
Read twice and Referred to Finance. for review
Medicare is about to change how it pays for radiation — oncologists aren't ready
Why it matters
If enacted, radiation oncology practices would get a more predictable episode-based payment stream, including 80% of the episode payment up front within 30 days of the first treatment, while patients with transportation insecurity could trigger a $500 year-one add-on and legally receive free rides under tightly defined rules. The winners are radiation providers, especially freestanding and community-based practices that want stable reimbursement and less fear around transportation assistance; the losers are budget hawks and potentially other Medicare sectors, because the bill explicitly says HHS cannot use ROCR savings to make budget-neutrality adjustments elsewhere.
S1031 Legislative Journey
Committee Action
Mar 13, 2025
Read twice and referred to the Committee on Finance.
About the Sponsor
Thomas Tillis
Republican, NC · 11 years in Congress
Committees: Commission on Security and Cooperation in Europe, Banking, Housing, and Urban Affairs, Veterans' Affairs
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Cosponsors (3)
This bill has 3 cosponsors: 2 Democrats, 1 Republican, reflecting bipartisan support. Cosponsors represent 3 states: Delaware, Kansas, Michigan.
Committee Sponsors
13 Republicans across this committee haven't cosponsored yet. Mobilize their constituents
What laws does S. 1031 change?
1 changes
Sections Amended
Section 1833(t) of Social Security Act (42 U.S.C. 1395l(t))
adding at the end the following new paragraph: ``(23) Non budget neutral application of reduced expenditures resulting from the radiation oncology case rate value based payment program
S. 1031 Quick Facts
- Committee
- Finance
- Chamber
- Senate
- Policy
- Health
- Introduced
- Mar 13, 2025
Read twice and Referred to Finance. for review
Mar 13, 2025
S. 1031 Common Questions
How much is the health equity add-on for transportation insecurity in the ROCR bill?
Under the Radiation Oncology Case Rate Value Based Program Act, the add-on is $500 per patient episode in year one for patients coded with ICD-10 Z59.82, rising by $10 each year after that (Section 3).
Can radiation oncology providers give free rides to patients under the ROCR bill?
Yes. Under the ROCR Value Based Program Act, free or discounted transportation is exempt from civil monetary penalties if strict conditions are met, including a uniform policy and no referral-based marketing (Section 4).
Does the ROCR bill require mandatory participation for Medicare radiation oncology providers?
Yes. According to S1031 Section 3, participation is mandatory for Medicare-participating radiation oncology providers and suppliers, except for state-based CMMI model participants and hardship cases such as natural disasters.
How much of a radiation oncology episode payment is paid upfront under the ROCR bill?
Under the ROCR Value Based Program Act, 80% of the per-episode payment is paid prospectively no later than 30 days after the first covered treatment is delivered (Section 3).
When is the second ROCR payment made for bone or brain metastases treatment?
According to S1031 Section 3, the second half of payment for bone or brain metastases is due on the earlier of treatment completion or the 30th day of the episode.
Can ROCR rebasing cut radiation oncology rates by more than 1% every 5 years?
No. Under the Radiation Oncology Case Rate Value Based Program Act, rebasing happens every 5 years and cannot reduce rates by more than 1% in each 5-year rebasing period (Section 3).
Does the ROCR bill keep new radiation technology out of base rates for 12 years?
Yes. Under S1031 Section 3, new technology is excluded from the national base rates for 12 years after it is identified.
Are radiation oncology providers in the ROCR model excluded from MIPS?
Yes. According to the ROCR Value Based Program Act, providers and suppliers participating in the program are excluded from the Merit-Based Incentive Payment System, or MIPS (Section 3).
Which patients qualify for transportation help under the ROCR bill's CMP exception?
Under S1031 Section 4, patients qualify if they live within 75 miles of the entity or live in a rural area, as long as the transportation program meets the bill's anti-marketing and no-cost-shifting rules.
What are the comment period requirements before the ROCR payment rules take effect?
Under the Radiation Oncology Case Rate Value Based Program Act, HHS must issue both an ANPRM and an NPRM, and each must include at least a 60-day public comment period (Section 3).
Based on S. 1031 bill text
S. 1031 Bill Text
“To amend Title XVIII of the Social Security Act to create a Radiation Oncology Case Rate Value Based Payment Program exempt from budget neutrality adjustment requirements, and to amend section 1128A of title XI of the Social Security Act to create a new statutory exception for the provision of free or discounted transportation for radiation oncology patients to receive radiation therapy services.”
Source: U.S. Government Publishing Office
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