Radiation oncologists hold briefing on Capitol Hill, highlighting payment challenges

Radiation oncologists held a congressional briefing on Capitol Hill Tuesday, highlighting reimbursement challenges that are hindering the specialty. 

The American Society for Radiation Oncology (ASTRO) convened the conversation with the House Cancer Caucus, voicing mounting concerns over coding changes that took effect Jan. 1. 

As reported in April, most radiation therapy is now classified into three different levels ranging from “simple” to “complex.” Federal officials had claimed these updates would only reduce radiation oncology payments by 1%. But recent a recent ASTRO survey said many are experiencing declines of 10% or more, with some RO specialists saying reductions have reached 30%. 

Radiation oncologists met with members of the U.S. House on July 14 to sound the alarm about these challenges and their continuing push for reform. 

“Unstable payment policies can create barriers that stand between patients and lifesaving care,” ASTRO CEO Vivek S. Kavadi, MD, MBA, said in a statement shared Tuesday. “Congress has an opportunity to support bipartisan reforms that keep high-quality cancer care accessible to their constituents while saving money for Medicare.”

The society is urging for passage of the Radiation Oncology Case Rate (ROCR) Act, hoping to prevent further practice closures. Proposed in March 2025, the bipartisan bill seeks to realign the RO specialty so that Medicare pays for the quality of care, rather than the number of times patients visit cancer clinics. ASTRO noted that the legislation now has 42 cosponsors across the House and Senate and is supported by nearly 140 organizations.

Experts project that ROCR could save Medicare approximately $200 million over the next 10 years. At the hearing, ASTRO also highlighted recent research, estimating that over 50 million Americans now live in counties without a radiation oncology clinic. Rural and freestanding community clinics have faced higher odds of closure, the research found. 

“Cancer is the second leading cause of death in the United States, and nearly every family has been touched by cancer in some way,” Rep. Debbie Dingell, D-Mich., co-chair of the House Cancer Caucus, said in the announcement from ASTRO. “Many of these patients will receive radiation therapy, but continued reimbursement cuts threaten patient access in underserved areas. That's why legislation like the ROCR Act is so important and I'm proud to be a cosponsor.”

The briefing, which was not recorded nor attended by Radiology Business, was titled “Policies to Support Advances in Radiation Therapy for Patients. Speakers focused on ramifications from the Jan. 1 coding changes and how federal policies such as the ROCR Act could help to bolster access to radiation therapy. 

“With many clinics already under strain, speakers will note the latest reimbursement changes could accelerate the loss of local cancer care access,” ASTRO said in its announcement ahead of the D.C. hearing.