The Radiation Oncology Case Rate Program (ROCR) Act continues to face an uphill battle on the legislative stage, but proponents say they have momentum on their side.
The ROCR Act, which aims to shift radiation reimbursement from fee-for-service to bundled payments, was reintroduced in Congress on March 14.
“We’re enthusiastic about it,” said Chris Corso, MD, PhD, government relations committee vice chair at the American Society for Radiation Oncology (ASTRO). “We think it’s good for medicine and think it’s good for patients. It’s also going to save Medicare money.”
Corso has served in several roles for ASTRO. Along with the government relations committee, this includes membership roles on the ASTRO PAC Board, the Mega Issue Working Group, and the ASTRO Rural Task Force. Outside of that, he is a radiation oncologist at the Levine Cancer Institute within the Atrium Health system in Charlotte, North Carolina.
ASTRO and other bill proponents say that ROCR is an opportunity for comprehensive payment reform in healthcare. It aims to incorporate parts of the Radiation Oncology Alternative Payment Model proposed by Medicare to change radiation oncology payment from per fraction to per patient.
ASTRO has said that this will make way for long-term rate stability while practitioners can continue to deliver care to patients, including to those who are underserved. Furthermore, the bill aims to align financial incentives with clinical guidelines and unify payment across care delivery settings.
Currently, the payment system for radiation oncology services is volume-based. The more patients that are treated, the higher the reimbursement will be. However, recent medical advances like hypofractionation, where the total dose of radiation is divided into large doses and treatments are given once a day or less often, have affected total patient volume.
“The current system sort of penalizes those who are practicing the best medicine from a reimbursement standpoint,” Corso said.
ROCR would switch this to a case-rate system, where for any individual case, the reimbursement will be paid at a fixed rate, stabilizing payments over the next five years until additional evaluation. Corso added that the bill promotes quality care through an added bonus payment for centers that are accredited by medical bodies such as ASTRO, the American College of Radiology, and the American College of Radiation Oncology. The bill also aims to increase patient access to radiation oncology services via transportation services through the Health Equity Achievement in Radiation Therapy (HEART) initiative.
Chris Corso, MD, PhD, discusses how the ROCR Act would help stabilize reimbursement payments for radiation oncologists and ultimately increase patient access to services.
The bipartisan bill was first introduced to Congress in May 2024 by Sen. Thom Tillis (R-NC) and Reps. Brian Fitzpatrick (R-PA), Jimmy Panetta (D-CA), John Joyce, MD (R-PA), and Paul Tonko (D-NY). Tillis led the reintroduction of the bill on March 14 just before the continuing resolution (CR) was voted on.
However, the Full-Year Continuing Appropriations and Extensions Act of 2025 did not address any “doc fix” measures, meaning a 2.83% pay cut is still in effect for doctors under the Centers for Medicare and Medicaid Services’ (CMS) Medicare physician fees schedule (MPFS).
However, Corso said he believes the ROCR Act has momentum going for it through its reintroduction in Congress.
“We really have excellent champions both in the Senate and the House,” Corso said. “We’re seeing a lot of bipartisan support for this bill. There are over 80 organizations representing the entire radiation oncology community, including academic centers, private practices, governing bodies, and industry partners. We think that all of those organizations being aligned is important for the momentum.”
He added that he believes the number of co-sponsors for the bill will increase as the year progresses, which ASTRO will work toward.
“We think it’s a win-win for everyone,” Corso said.