The American Society for Radiation Oncology (ASTRO) today applauded the reintroduction of bipartisan federal legislation to reform prior authorization processes under Medicare Advantage. The Improving Seniors’ Timely Access to Care Act of 2025 (S.1816, H.R.3514), introduced by Senators Roger Marshall, MD (R-KS), and Mark Warner (D-VA) and Representatives Mike Kelly (R-PA), Suzan DelBene (D-WA), Ami Bera, MD (D-CA), and John Joyce, MD (R-PA), with 47 Senate and 73 House members co-sponsoring, addresses critical and pervasive barriers that impact timely access to lifesaving cancer treatments.

“Prior authorization is a persistent and problematic thorn in the side of American health care. Patients and physicians — not insurance companies — should be at the center of treatment decisions,” said Howard M. Sandler, MD, FASTRO, Chair of the ASTRO Board of Directors.

“Recent survey data from ASTRO confirms that prior authorization leads to dangerous delays in cancer care that can result in abandoned treatments and other patient harm. Nine in 10 physicians reported treatment delays due to prior authorization, affecting more than a third of their patients on average. Nearly seven in 10 doctors say their patients face delays of a week or longer, and a third say prior authorization has caused adverse events such as emergency room visits or hospitalization.

“This bill proposes critical improvements to prior authorization under Medicare Advantage, including transparency and additional oversight of the program. We commend the bill sponsors for continuing their leadership to protect patients and reform this broken system.

"ASTRO also advocates for moving away from fee-for-service payment models, which inherently incentivize insurers to micromanage individual treatments through prior authorization, and moving to a bundled payment model such as the Radiation Oncology Case Rate (ROCR) program introduced in Congress earlier this year. Under an episodic payment system, clinicians have greater flexibility and autonomy to deliver clinically appropriate care, eliminating the need for insurers to authorize each separate component of treatment and minimizing the harmful delays these administrative inefficiencies can cause."

Radiation oncologists encounter more prior authorization obstacles than any other clinical specialty, and delays in the start of radiation therapy are associated with worse outcomes, including increased risk of death. Yet Medicare Advantage’s prior authorization requirements for radiation therapy are failing to produce savings; a recent study in JAMA Network Open found that, compared to traditional Medicare, MA plans are associated with higher overall costs, casting further doubt on the value of prior authorization.

ASTRO urges Congress to swiftly pass the new bill, providing much-needed reform and supporting more efficient cancer care for Medicare Advantage beneficiaries nationwide.

ABOUT ASTRO
The American Society for Radiation Oncology (ASTRO) is the largest radiation oncology society in the world, with more than 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies. Radiation therapy contributes to 40% of global cancer cures, and more than a million Americans receive radiation treatments for cancer each year. For information on radiation therapy, visit RTAnswers.org. To learn more about ASTRO, visit our website and media center and follow us on social media.