---
kind: "section"
citation: "42 C.F.R. § 512.220"
title: "42"
number: "512.220"
heading: "RO participant compliance with RO Model requirements."
url: "https://uscodex.org/cfr/42/512.220"
---

# §512.220. RO participant compliance with RO Model requirements.

- (a) **RO participant-specific requirements.**
  - (1) An RO participant must satisfy the requirements of this section to be included in Track One under the RO Model in a particular PY. An RO participant that meets all of these RO Model requirements in a particular PY, excluding use of CEHRT, will be in Track Two for such PY. An RO participant that does not meet one or more of the RO Model requirements in [paragraph (a)](#a) of this section in a particular PY will be in Track Three for such PY.
  - (2) Each Professional participant and Dual participant must ensure its individual practitioners:
    - (i) Starting in PY1, discuss goals of care with each RO beneficiary before initiating treatment and communicate to the RO beneficiary whether the treatment intent is curative or palliative;
    - (ii) Starting in PY1, adhere to nationally recognized, evidence-based clinical treatment guidelines when appropriate in treating RO beneficiaries or, alternatively, document in the medical record the extent of and rationale for any departure from these guidelines;
    - (iii) Starting in PY1, assess each RO beneficiary's tumor, node, and metastasis cancer stage for the CMS-specified cancer diagnoses;
    - (iv) Starting in PY1, assess the RO beneficiary's performance status as a quantitative measure determined by the physician;
    - (v) Starting in PY1, send a treatment summary to each RO beneficiary's referring physician within 3 months of the end of treatment to coordinate care;
    - (vi) Starting in PY1, discuss with each RO beneficiary prior to treatment delivery his or her inclusion in, and cost-sharing responsibilities under, the RO Model; and
    - (vii) Starting in PY1, perform and document Peer Review (audit and feedback on treatment plans) before 25 percent of the total prescribed dose has been delivered and within 2 weeks of the start of treatment for:
      - (A) 50 percent of new patients in PY1,
      - (B) 55 percent of new patients in PY2,
      - (C) 60 percent of new patients in PY3,
      - (D) 65 percent of new patients in PY4,
      - (E) 70 percent of new patients in PY5.
  - (3) Starting in PY1, at such times and in the form and manner specified by CMS, each Technical participant and Dual participant must annually attest to whether it actively participates with a AHRQ-listed patient safety organization (PSO). Examples include maintaining a contractual or similar relationship with a PSO for the receipt and review of patient safety work product.
- (b) **CEHRT.**
  - (1) RO participants must use CEHRT, and ensure that their individual practitioners use CEHRT, in a manner sufficient to meet the applicable requirements of the Advanced APM criteria as specified at [§ 414.1415(a)(1)(i)](/cfr/42/414.1415.md?p=a-1-i) of this chapter.
  - (2) Within 30 days of the start of PY1 and each subsequent PY, the RO participant must certify its use of CEHRT throughout such PY in a manner sufficient to meet the requirements set forth in [§ 414.1415(a)(1)(i)](/cfr/42/414.1415.md?p=a-1-i) of this chapter.
  - (3) An RO participant that joins the RO Model at any time during an ongoing PY must certify their use of CEHRT by the last QP determination date as specified at [§ 414.1325](/cfr/42/414.1325.md) of this chapter.

## Notes

### Amendments

[85 FR 61362, Sept. 29, 2020, as amended at 85 FR 86304, Dec. 29, 2020; 86 FR 63995, Nov. 16, 2021]

### Authority

Authority: 42 U.S.C. 1302, 1315a, and 1395hh.

### Source

Source: 85 FR 61362, Sept. 29, 2020, unless otherwise noted.

### Amendments

[85 FR 61362, Sept. 29, 2020, as amended at 85 FR 86304, Dec. 29, 2020; 86 FR 63995, Nov. 16, 2021]