Radiation oncologists are pressing federal lawmakers to address what they describe as mounting financial pressure on community cancer centers, citing recent Medicare reimbursement changes and administrative hurdles that could limit patient access to care.

Physicians affiliated with the American Society for Radiation Oncology (ASTRO) met with members of Congress this week to advocate for policy changes, including passage of the Radiation Oncology Case Rate (ROCR) Act. The legislation would shift Medicare reimbursement toward a case-rate model based on individual treatment plans rather than the number of services delivered.

Data from a recent ASTRO survey suggest many practices are already experiencing strain. More than two-thirds of respondents reported double-digit declines in reimbursement early in 2026 following updates to radiation treatment delivery codes. Some indicated the reductions could jeopardize their financial stability. “If these new cuts are sustained for longer than 1-2 months, we will be at a very real risk of needing to declare bankruptcy,” one physician said.
The concerns build on longer-term trends. Medicare reimbursement for radiation therapy has declined 27% since 2013, according to ASTRO, while operating costs have increased. A separate study found a 13% drop in organizations employing radiation oncologists over the past decade, suggesting continued consolidation across the field.

Physicians also pointed to prior authorization requirements under Medicare Advantage as an additional barrier. ASTRO survey data indicate delays in treatment approvals and increased administrative workload, with some clinicians reporting longer processing times and adverse patient outcomes tied to authorization delays.

Lawmakers are also being asked to support the Improving Seniors’ Timely Access to Care Act, which would set timelines for authorization decisions and require greater transparency from insurers.

In addition to payment and administrative reforms, ASTRO is calling for increased federal investment in cancer research, including proposed funding levels for the National Institutes of Health, National Cancer Institute and ARPA-H.

“The data in our new survey signal a serious threat to cancer care access,” said Sameer Keole, M.D., FASTRO, chair of ASTRO’s board of directors. “Congress has the tools to fix these problems, and we're asking them to act now before people with cancer lose access to the care that can save their lives.”

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