MGMA Washington Connection 06/30/2022

06/30/2022 10:43 AM | Rebekah Francis (Administrator)

CMS announces new oncology payment model

On June 27, the Centers for Medicare and Medicaid Services (CMS) Innovation Center announced the Enhancing Oncology Model (EOM), a new oncology payment model. Building off of lessons learned in previous oncology models, the EOM will be a nation-wide, episode-based payment model focused on patient-centered care delivery. Expected to launch in July 2023, the EOM request for applications is now open through September 30, 2022.

This episode-based payment model will include seven cancer types: breast cancer, chronic leukemia, small intestine/colorectal cancer, lung cancer, lymphoma, multiple myeloma, and prostate cancer. Group practices that participate will be accountable for total spending during six-month episodes of care, and will be required to provide certain patient care enhancement benefits, including care planning and access to 24/7 care. More information is available on the EOM model website.

Updated resource highlights language access requirements

MGMA recently updated a key member resource outlining language access requirements for group practices. This resource reflects updates made in a 2020 final rule making changes to patient protections against discrimination in health programs and activities under Section 1557 of the Affordable Care Act. Please note, no changes to the language access requirements have been made since the 2020 final rule.

These updates include the four factor analysis the Office of Civil Rights (OCR) will use to determine if “meaningful access” is provided to limited English proficiency patients. In the 2020 final rule, OCR eliminated tagline requirements for all documentation, and instead, OCR will apply the four-factor standard to ensure taglines are provided to achieve “meaningful access.”

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