The declines in reimbursement for radiation therapy services for people with cancer under the Medicare physician fee schedule are disappointing

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July 11, 2024 — The American Society for Radiation Oncology (ASTRO) issued the following statement from Jeff M. Michalski, MD, MBA, FASTRO, Chair of the ASTRO Board of Directors, in response to the proposed 2025 Medicare Physician Fee Schedule (MPFS) released by the Centers for Medicare and Medicaid Services (CMS):

“The declines in reimbursement for radiation therapy services for people with cancer under the Medicare physician fee schedule are disappointing. We are concerned that CMS continues to undervalue the impact of cost-effective radiation treatments for cancer and urge Congress to act on bipartisan radiation oncology payment reform legislation this year.

Since 2013, CMS has cut radiation oncology reimbursement through the MPFS by more than 20%, more than nearly any other medical specialty. This year’s proposal includes the final year of phased-in reductions stemming from updates to the MPFS clinical labor pricing, which disproportionately impacts radiation therapy services and other capital-intensive specialties.

Ongoing cuts undermine the ability of patients to receive vital, high-value cancer care close to home, and elucidate the need for legislative action to create long-term, comprehensive Medicare payment reform. ASTRO calls on Congress to usher in a sustainable solution to ensure that people with cancer can access their treatments without unnecessary financial or geographic barriers.

The bipartisan Radiation Oncology Case Rate (ROCR) Value-Based Payment Program Act (S.4330/H.R.8404), introduced in both chambers in May, provides an evidence-based policy solution that would stabilize Medicare reimbursement for radiation oncology by shifting from an outdated per-treatment system to a more patient-centered approach. By simplifying the payment model and linking reimbursement to overall patient episodes, the ROCR Act will incentivize high-value care, increase access, reduce disparities and ensure financial stability for radiation oncology practices.

The ROCR Act is not just about reform; it is about securing the future of cancer care. We applaud Senators Thom Tillis (R-N.C.) and Gary Peters (D-Mich.), and Representatives Brian Fitzpatrick (R-Pa.), Jimmy Panetta (D-Calif.), John Joyce, MD, (R-Pa.) and Paul Tonko (D-N.Y.) for leading this critical legislation, and we urge all members of Congress to support the ROCR Act to protect patient access to high quality of cancer care across the nation.”

For more information: www.astro.org


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