A bipartisan group of lawmakers has reintroduced legislation aimed at overhauling Medicare’s payment structure for radiation therapy.

The Radiation Oncology Case Rate (ROCR) Value-Based Payment Program Act of 2025 seeks to replace the current per-treatment reimbursement model with a patient-focused, episode-based system designed to improve care quality while reducing costs.

The bill, sponsored by Sens. Thom Tillis (R-N.C.) and Gary Peters (D-Mich.), along with Reps. Brian Fitzpatrick (R-Pa.), Jimmy Panetta (D-Calif.), Dr. John Joyce (R-Pa.), and Paul Tonko (D-N.Y.), is intended to stabilize access to radiation therapy and curb financial pressures on providers. Supporters argue that shifting to bundled payments will align financial incentives with evidence-based care, helping patients receive appropriate treatment without unnecessary visits.
“The ROCR Act represents a balanced, evidence-based policy solution to safeguard access to high-value cancer treatment for Americans,” said Dr. Howard M. Sandler, chair of the American Society for Radiation Oncology (ASTRO) board of directors. “It is the only viable policy solution designed to provide payment stability for the field of radiation oncology in 2026 and beyond.”

Over 80 organizations, including patient advocacy groups, hospital systems, independent clinics, and medical technology companies, have voiced support for the legislation. The proposal follows a decade of declining Medicare reimbursement for radiation therapy, with payments reduced by more than 25% since 2013. Rising practice costs and increasing demand for cancer treatment have also led to practice consolidation, with a 51% rise in large radiation oncology groups and a 27% decrease in solo practices between 2015 and 2023.

Key provisions of the ROCR Act include:

Establishing patient-specific, episode-based payments to encourage guideline-driven care

Supporting the use of shorter, evidence-based treatment courses when clinically appropriate

Incentivizing accreditation and new technology adoption to enhance quality and safety

Addressing transportation barriers that prevent patients from completing treatment

Standardizing technical payments across different care settings

Reducing overall Medicare costs while maintaining access to radiation therapy for over a million patients annually

Lawmakers say the bill builds on lessons from the Medicare Radiation Oncology Alternative Payment Model (RO Model), which was delayed indefinitely due to stakeholder concerns. The ROCR Act retains the model’s focus on episode-based payments but removes mandated cuts and reduces administrative burdens.

“Current reimbursement policies reward quantity over quality, making it harder for physicians to provide the tailored, high-quality care cancer patients deserve,” Tillis said. “This bipartisan bill fixes this by shifting to a fair, bundled payment model that removes incentives for longer treatments, supports innovation, and ensures continued access to world-class care.”

With broad support from industry stakeholders, ASTRO is urging Congress to pass the ROCR Act, positioning it as a critical step toward a more sustainable and patient-focused approach to radiation therapy reimbursement.

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