protocols that are evidence based and peer re-
viewed with a mechanism for monitoring com-
pliance on a routine basis; 
(F) to meet such clinical quality and out-
come measures as the Secretary shall require; 
(G) to measure and report data regarding 
variations in the utilization and allocation of 
services, where such data can be used to reduce 
scientific uncertainty in the delivery of care; 
(H) to establish and maintain a method of 
data collection that can track compliance to 
pathways and report compliance electronically 
for such beneficiaries or an alternative method 
approved by the Secretary; and 
(I) to meet such other service provision re-
quirements as the Secretary may specify. 
(3) VOLUNTARINESS.—Participation of pro-
viders of services and suppliers, and of individuals 
with cancer diagnoses, in a demonstration project 
shall be voluntary. 
(e) PAYMENT METHODOLOGY.—— 
(1) IN
GENERAL.—Under a demonstration 
project the Secretary shall pay, from the projected 
5 percent savings described in subsection (b)(2)(A), 
a per beneficiary amount to each participating oncol-
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ogy care group that meets or exceeds specific per-
formance standards established by the Secretary 
with respect to the clinical quality and outcome 
measures reported under subsection (d)(1)(A). Such 
per beneficiary amount shall be composed of— 
(A) a reporting fee described in paragraph 
(2), equal to half of such 5 percent savings; and 
(B) a performance fee described in para-
graph (3), equal to half of such 5 percent sav-
ings. 
(2) REPORTING
FEE.—The reporting fee de-
scribed in this paragraph shall be paid to partici-
pating oncology care groups intermittently, for costs 
associated with electronic health record maintenance, 
protocol adherence, and reporting of quality metrics. 
Such fee shall be fully refunded after annual cost 
reconciliation by participating oncology care groups 
that fail to meet the 5 percent savings target. 
(3) PERFORMANCE
FEE.—A performance fee 
described in this paragraph shall be paid after an-
nual cost reconciliation to participating oncology 
care groups that meet the spending targets estab-
lished by the Secretary. 
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(f) DEMONSTRATION PROJECT SITES.—The dem-
onstration projects shall be open to participation by self- 
identified oncology care groups employing— 
(1) formal, evidence-based treatment protocols 
applicable to patients with the selected diagnoses; 
and 
(2)(A) full electronic health record (EHR) tech-
nology; or 
(B) other data collection processes or databases 
approved by the Secretary. 
(g) DURATION.—The Secretary shall conduct dem-
onstration projects for the 3-year period beginning on the 
date that is 90 days after the date of the enactment of 
this Act. 
(h) EVALUATION AND REPORT.— 
(1) EVALUATIONS.—The Secretary shall con-
duct an evaluation of the demonstration projects— 
(A) to assess patient outcomes for the indi-
viduals with cancer diagnoses participating in 
the projects as compared to such outcomes to 
other individuals for the same health conditions; 
(B) to analyze the cost effectiveness of the 
projects, including an evaluation of the cost 
savings (if any) to the Medicare program attrib-
utable to reductions in physicians’ services, hos-
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pital stays, supplemental care drug costs, and 
part D drug costs; 
(C) to determine the satisfaction of pa-
tients 
participating 
in 
the 
demonstration 
projects; and 
(D) to evaluate other such matters as the 
Secretary determines is appropriate. 
(2) REPORTS.—Not later than 90 days after 
the completion of 1 year following the commence-
ment of the demonstration projects, and biannually 
thereafter, the Secretary shall submit to Congress a 
report on the evaluation conducted under paragraph 
(1) together which such recommendations for legisla-
tion or administrative action, regarding the exten-
sion, expansion, or termination of the demonstration 
projects, as the Secretary determines is appropriate. 
(i) WAIVER AUTHORITY.—The Secretary shall waive 
compliance with the requirements of title XVIII of the So-
cial Security Act (42 U.S.C. 1395 et seq.) to such extent 
and for such period as the Secretary determines is nec-
essary to conduct demonstration projects. 
(j) FUNDING.— 
(1) DEMONSTRATION PROJECTS.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B) and paragraph (2), the Secretary 
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shall provide for the transfer, from the Federal 
Hospital Insurance Trust Fund under section 
1817 of the Social Security Act (42 U.S.C. 
1395i) and from the Federal Supplementary In-
surance Trust Fund under section 1841 of such 
Act (42 U.S.C. 1395t), in such proportion as 
the Secretary determines appropriate, of such 
funds as are necessary for the costs of carrying 
out demonstration projects. 
(B) BUDGET NEUTRALITY.—In conducting 
demonstration projects under this section, the 
Secretary shall ensure that the aggregate pay-
ments made by the Secretary under the Medi-
care program do not exceed the amount which 
the Secretary would have paid under the Medi-
care program for the provision of cancer treat-
ment services if the demonstration projects 
were not implemented. 
(2) EVALUATION AND REPORT.—There are au-
thorized to be appropriated such sums as are nec-
essary for the purpose of conducting the evaluation 
and submitting reports to Congress under subsection 
(h). 
Æ 
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