Members of Congress introduce bill to reform radiation oncology reimbursement
Members of Congress on Friday introduced bipartisan legislation to stabilize radiation oncology reimbursement in the Medicare program.
Lawmakers in both chambers are proposing the Radiation Oncology Case Rate (ROCR) Value Based Payment Program Act of 2025. The bill seeks to realign the RO specialty, so Medicare pays for the quality of care, rather than the number of times patients visit cancer clinics.
ROCR would serve as a substitute for the long-delayed Medicare Radiation Oncology Alternative Payment Model that has faced criticism from the American College of Radiology and other imaging stakeholders.
“Current reimbursement policies reward quantity over quality, making it harder for physicians to provide the tailored, high-quality care cancer patients deserve,” bill co-sponsor and Sen. Thom Tillis, R-N.C., said in a statement. “This bipartisan bill fixes this by shifting to a fair, bundled payment model that removes incentives for longer treatments, supports innovation and ensures continued access to world-class care.”
Sen. Gary Peters, D-Mich., also is sponsoring the Senate bill, while Reps. Brian Fitzpatrick, R-Pa., Jimmy Panetta, D-Calif., John Joyce, MD, R-Pa., and Paul Tonko, D-N.Y., are sponsoring a companion bill in the U.S. House.
Medicare reimbursement for radiation therapy has declined about 23% over the past decade, experts note. The companion bills seek to end this trend and build off strengths from the shelved Radiation Oncology Alternative Payment Model. ROCR would maintain the previous proposal’s episode-based payments while eliminating “outsized” cuts and “burdensome” quality requirements, advocates note.
“The ROCR Act represents a balanced, evidence-based policy solution to safeguard access to high value cancer treatment for Americans, and it is the only viable policy solution designed to provide payment stability for the field of radiation oncology in 2026 and beyond,” Howard M. Sandler, MD, chair of the American Society for Radiation Oncology (ASTRO), said in a statement.
Over 80 organizations support the Radiation Oncology Case Rate Value Based Payment Program Act. They include ASTRO, the American College of Radiology, American Society of Radiologic Technologists and the Birmingham Radiological Group. Patient advocates, small and large hospital systems, independent clinics and technology companies also have endorsed the legislation.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.