Overview: ASTRO Takes the Fight to Capitol Hill
On April 27, members of the American Society for Radiation Oncology (ASTRO) descended on Capitol Hill. Their mission was direct: warn lawmakers that Medicare reimbursement cuts now threaten the survival of community cancer clinics across the country. Physicians arrived with data, urgency, and two specific legislative asks. Therefore, their visit marked a critical escalation in the fight to protect patient access to radiation therapy.
The Scale of Medicare Reimbursement Decline
What the Survey Revealed
ASTRO conducted a national physician survey ahead of the Capitol Hill visit. The results were alarming. More than two-thirds of respondents reported sudden double-digit drops in reimbursement. These drops followed Medicare’s recent changes to radiation treatment delivery codes. Moreover, many physicians cited a real risk of insolvency. In other words, community cancer centers face closure — not in theory, but in practice.
A Decade of Falling Payments
The cuts did not begin overnight. Instead, Medicare reimbursement for radiation therapy has declined by 27% since 2013. That figure represents cumulative erosion over more than a decade. Meanwhile, the cost of delivering high-quality cancer care has continued to rise. As a result, the gap between what clinics earn and what they spend grows wider each year. This financial pressure hits community-based clinics hardest. Consequently, patients in rural and underserved areas face the greatest risk of losing local care.
Key Legislation Radiation Oncologists Are Backing
The ROCR Act Explained
ASTRO members are urging lawmakers to co-sponsor and pass the bipartisan Radiation Oncology Case Rate (ROCR) Act. The Senate version carries the number S.1031, while the House version is H.R.2120. Crucially, this bill changes how Medicare pays for radiation therapy. Under current rules, reimbursement ties directly to the number of treatments a patient receives. The ROCR Act proposes a better model. Specifically, it would link payment to individualized patient treatment plans instead. This shift encourages clinicians to focus on patient outcomes rather than treatment volume. Additionally, the bill already has nearly 30 congressional co-sponsors. Furthermore, nearly 140 organizations have expressed support for its passage.
Prior Authorization Reform
Beyond payment reform, radiation oncologists are pushing for prior-authorization changes. ASTRO research shows that authorization requirements for radiation therapy do not generate savings. Worse, these bureaucratic hurdles may lead to adverse patient events. Delays in care are not harmless — they carry real clinical consequences. To address this, ASTRO is backing the Improving Seniors’ Timely Access to Care Act. The Senate bill is S.1816, and the companion House bill is H.R.3514. This legislation aims to streamline the approval process so patients get timely access to treatment.
Why This Matters for Cancer Patients
At its core, this is a patient access issue. When community clinics close or scale back services, patients lose local care options. Many cancer patients cannot travel long distances for radiation therapy. Treatment requires multiple sessions over weeks. Therefore, proximity to a radiation oncology center matters enormously. Cuts that appear abstract on paper translate directly into disrupted care at the bedside.
What Comes Next
ASTRO’s Capitol Hill visit signals growing urgency within the radiation oncology community. The bipartisan support for the ROCR Act offers cautious optimism. However, physicians stress that congressional action must come quickly. Each month of delay means more clinics operating under financial strain. Advocates will continue lobbying for both the ROCR Act and prior-authorization reform through 2026.
