Congressional briefing highlights urgent threats to radiation therapy access and bipartisan solutions

With recent Medicare payment changes raising new concerns about access to radiation therapy, physician leaders from the American Society for Radiation Oncology (ASTRO) will join House Cancer Caucus leaders today to urge action to keep essential cancer care available close to home for patients nationwide.

The briefing, “Policies to Support Advances in Radiation Therapy for Patients,” will focus on how federal policy, including the Radiation Oncology Case Rate Act, or ROCR Act, can support timely access to affordable radiation therapy.

Speakers will address an emerging payment crisis tied to Medicare billing code changes that took effect January 1. CMS acknowledged the unique challenges of appropriately reimbursing the capital-intensive equipment used in radiation therapy and estimated the overall impact of this year’s changes at about -1%. Yet many respondents to a national ASTRO survey in March reported substantially larger reductions and sudden, unprecedented financial strain. More than two-thirds of physicians surveyed said their clinics were actually experiencing double-digit reimbursement declines.

The discussion comes as new research underscores how vulnerable the nation’s radiation oncology infrastructure was even before the 2026 changes took effect. A national analysis published last week found that in 2025, more than 50 million Americans lived in counties without a radiation oncology clinic. Rural clinics had 44% higher odds of disappearing than urban sites, while freestanding community-based clinics had 56% higher odds of closing than hospital-affiliated sites. With many clinics already under strain, speakers will note the latest reimbursement changes could accelerate the loss of local cancer care access.

Rep. Brian Fitzpatrick (R-Pa.), co-chair of the House Cancer Caucus, said: “Cancer care should be driven by the best science, the best outcomes and the needs of the patient — not by an outdated payment system. I introduced the ROCR Act to modernize Medicare’s reimbursement model for radiation therapy by aligning incentives with high-quality, evidence-based care, protecting access for seniors and underserved communities, and giving providers the stability they need to deliver cutting-edge treatment. As Co-chair of the House Cancer Caucus, I believe our responsibility is clear: to ensure that every American battling cancer can access the right care, at the right time, close to home, with the dignity, urgency and hope they deserve.”

“Cancer is the second leading cause of death in the United States, and nearly every family has been touched by cancer in some way. 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,” said House Cancer Caucus Co-chair Rep. Debbie Dingell (D-Mich.).

Radiation therapy is a core pillar of cancer treatment, contributing to 40% or more of cancer cures. More than half of people diagnosed with cancer will be prescribed radiation therapy, including more than one million Americans each year. Recent advances have made treatments more precise while expanding the ways radiation can be used to help patients, but speakers will emphasize that scientific progress means little without policies that keep care within patients’ reach.

“Radiation therapy is one of the most effective tools we have to treat cancer, but patients only benefit from these advances if treatment is available when and where they need it,” said ASTRO CEO Vivek S. Kavadi, MD, MBA, FASTRO. “Unstable payment policies can create barriers that stand between patients and lifesaving care. Congress has an opportunity to support bipartisan reforms that keep high-quality cancer care accessible to their constituents while saving money for Medicare.”

“Modern radiation therapy has changed dramatically, but the policies that support cancer care have not kept pace,” said Sameer R. Keole, MD, FASTRO, Chair of the ASTRO Board of Directors. “We do not use the word crisis lightly. What makes this moment different from past cuts is the speed and severity of the impact. Clinics are facing difficult decisions about layoffs and closures that could limit patient access, and Congress can help resolve this emergency with a patient-centered payment system that keeps the best treatment available close to where patients live.”

The 2026 disruptions come after more than a decade of Medicare payment reductions, even as the cost of delivering care continues to rise. Physician survey respondents reported clinic closures, physician and staff layoffs, canceled expansion plans and increased pressure to consolidate.

The cuts are falling hardest on independent and community-based clinics, which often serve as the primary access point for cancer care in rural areas. Radiation therapy typically requires repeated visits over days or weeks, and losing a nearby clinic can force patients to travel much farther for treatment or leave them with no realistic local option. In the recent national analysis, rural counties that lost a site were much more likely than urban counties to be left with little or no local treatment capacity. Research consistently shows that greater distance from a radiation therapy facility is associated with higher cancer mortality.

“For patients in rural communities, losing one clinic can mean losing realistic access to radiation therapy entirely,” said Casey Chollet-Lipscomb, MD, FASTRO, Chair of ASTRO’s Government Relations Council. “The ROCR Act offers a long-term path to a more stable reimbursement system that safeguards access and prioritizes the right care for each patient.”

“Patients and survivors need a cancer care system that supports timely treatment, coordinated care and quality of life. Payment and access policies should be judged by whether they help people get the whole-person care they need without unnecessary delays or added burden,” said Cancer Nation CEO Shelley Fuld Nasso, MPP, who will speak to the patient perspective on cancer policy at the briefing.

The briefing will highlight the bipartisan ROCR Act as a long-term solution. ROCR would move Medicare toward a more stable reimbursement model based on each patient’s episode of care, rather than the number of treatments delivered. The legislation is designed to support clinically appropriate treatment while giving practices a more stable foundation to keep high-quality radiation therapy available close to patients’ homes.

ROCR was introduced in the House by Representatives Brian Fitzpatrick, Jimmy Panetta, John Joyce and Paul Tonko, and in the Senate by Senators Thom Tillis and Gary Peters. The legislation currently has 42 cosponsors across both chambers and is supported by nearly 140 organizations across the oncology community. It is projected to save Medicare $200 million over 10 years.

ABOUT ASTRO
The American Society for Radiation Oncology (ASTRO) is the world’s largest professional society dedicated to advancing radiation medicine, with 10,000 members including physicians, nurses, physicists, radiation therapists, dosimetrists and other professionals who work to improve patient outcomes through clinical care, research, education and advocacy. Radiation therapy is integral to 40% of cancer cures worldwide, and more than one million Americans receive radiation treatments for their cancer each year. For information on radiation therapy, visit Speed of Light – The ASTRO Foundation. To learn more about ASTRO, visit our website and press room and connect with us on social media.