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B-332578 1 (2020-10-13)

handle is hein.gao/gaobaebwx0001 and id is 1 raw text is: G A O U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 B-332578 October 13, 2020 The Honorable Chuck Grassley Chairman The Honorable Ron Wyden Ranking Member Committee on Finance United States Senate The Honorable Frank Pallone, Jr. Chairman The Honorable Greg Walden Ranking Member Committee on Energy and Commerce House of Representatives The Honorable Richard Neal Chairman The Honorable Kevin Brady Ranking Member Committee on Ways and Means House of Representatives Subject: Department of Health and Human Services, Centers for Medicare & Medicaid Services: Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures Pursuant to section 801(a)(2)(A) of title 5, United States Code, this is our report on a major rule promulgated by the Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) entitled Medicare Program; Specialty Care Models to Improve Quality of Care and Reduce Expenditures (RIN: 0938-AT89). We received the rule on September 21, 2020. It was published in the Federal Register as a final rule on September 29, 2020. 85 Fed. Reg. 61114. The effective date of the rule is November 30, 2020. According to CMS, this final rule implements two new mandatory Medicare payment models under section 1115A of the Social Security Act-the Radiation Oncology Model (RO Model) and the End-Stage Renal Disease (ESRD) Treatment Choices Model (ETC Model). Social Security Act, ch. 531, 49 Stat. 620 (Aug 14, 1935), 42 U.S.C. § 1315a. CMS stated that the RO Model will promote quality and financial accountability for providers and suppliers of radiotherapy (RT). CMS stated further that the RO Model will be a mandatory payment model and will test whether making prospective episode payments to hospital outpatient departments and freestanding radiation therapy centers for RT episodes of care preserves or enhances the quality of care furnished to Medicare beneficiaries while reducing Medicare program spending through enhanced financial accountability for RO Model participants. According to CMS, the ETC Model

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