On May 20, ASTRO submitted testimony to the House Energy and Commerce Health Subcommittee for its hearing examining the Medicare Physician Fee Schedule (MPFS) and opportunities for reforms. Republican committee members focused their comments on the impact of fee schedule cuts on practice consolidation and the ability for providers to invest in high-cost equipment. Democratic members made similar comments but placed greater emphasis on reimbursement cuts related to primary care. ASTRO champion John Joyce, MD, (R-PA), submitted ASTRO's testimony into the official hearing record.

In the House Ways and Means Committee, the ASTRO-supported Provider Reimbursement Stability Act (H.R.8163) received a markup and was voted favorably out of the committee on a unanimous and bipartisan vote. The next step in the process will be for H.R.8163 to receive a vote by the full House of Representatives, or more likely, be attached to a larger legislative package. H.R.8163 would increase the budget neutrality threshold from $20 million to $54.3 million and index the threshold to inflation. Direct costs used to calculate practice expense RVUs would need to be updated every five years and the conversion factor's year-to-year variance would be limited to 2.5%. Such reforms will help address several flaws that have negatively impacted radiation oncology reimbursement over the last decade.

Finally, more than 135 organizations from across the radiation oncology community urged members of the GOP Doctors Caucus and Congressional Doctors Caucus to include the ROCR Act in their bipartisan draft legislation to reform Medicare payments for physicians. Organized and led by ASTRO, the letter said, "Among the package's proposed reforms, we support efforts to align physician reimbursement updates with medical inflation, modernize budget neutrality rules, and address flawed quality reporting programs, and we believe ROCR would enhance the legislative package." The legislation is expected to be be introduced in the coming weeks and ROCR is being considered to help offset the cost of some elements of the package.