A bill to amend title XVIII of the Social Security Act to establish a national Oncology Medical Home Demonstration Project under the Medicare program for the purpose of changing the Medicare payment for cancer care in order to enhance the quality of care and to improve cost efficiency, and for other purposes.
Cancer Care Payment Reform Act of 2016
This bill amends title XVIII (Medicare) of the Social Security Act to establish the Oncology Medical Home Demonstration Project, through which the Centers for Medicare & Medicaid Services (CMS) shall make special payments to participating oncology practices that coordinate patient care and meet other specified requirements.
During the first two years of the project, CMS shall pay a care coordination management fee to each such practice. After the third, fourth, and fifth years of the project, CMS shall pay a performance incentive payment to each participating practice that meets or exceeds performance standards developed by CMS.
CMS shall assess the performance of each participating oncology practice annually. Performance standards shall address: (1) specified measures related to patient care, resource utilization, survivorship, and end-of-life care; and (2) the patient experience of care, as reflected in surveys submitted by each practice. CMS shall also assess the extent to which a practice has used breakthrough or other best-in-class therapies.
To the extent practicable, CMS shall select practices of varying sizes and geographic areas for participation.
Referred to the Subcommittee on Health.
Introduced in Senate
Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S5163-5165)
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