US SB1031

Establishes the Radiation Oncology Case Rate Value Based Payment Program (ROCR Program) under Medicare, providing per-episode bundled payments to radiation therapy providers for 15 cancer types including breast, lung, prostate, and colorectal cancers

Requires mandatory participation for radiation therapy providers enrolled in Medicare Part B, with exemptions for those in state-based innovation models or experiencing significant hardship such as natural disasters

Creates a $500 per-patient "health equity achievement" add-on payment (increasing $10 annually) for providers treating patients with documented transportation insecurity, and establishes a legal exception allowing free or discounted transportation services for radiation oncology patients

Implements quality incentives including a 1% payment increase for accredited providers meeting electronic health record requirements, and a 2.5% payment reduction after two years for non-accredited providers (with exemptions for limited-resource providers serving rural or underserved areas)

Exempts the ROCR Program from Medicare budget neutrality requirements, freezes current radiation therapy payment rates until the new program takes effect, and requires GAO reports on program implementation and access to radiation therapy in rural and underserved areas